Fluid resuscitation practice patterns in intensive care units of the USA: a cross-sectional survey of critical care physicians.

BACKGROUND: Fluid resuscitation is a cornerstone of intensive care treatment, yet there is a lack of agreement on how various types of fluids should be used in critically ill patients with different disease states. Therefore, our goal was to investigate the practice patterns of fluid utilization for resuscitation of adult patients in intensive care units (ICUs) within the USA. METHODS: We conducted a cross-sectional online survey of 502 physicians practicing in medical and surgical ICUs. Survey questions were designed to assess clinical decision-making processes for 3 types of patients who need volume expansion: (1) not bleeding and not septic, (2) bleeding but not septic, (3) requiring resuscitation for sepsis. First-choice fluid used in fluid boluses for these 3 patient types was requested from the respondents. Descriptive statistics were performed using a Kruskal-Wallis test to evaluate differences among the physician groups. Follow-up tests, including t tests, were conducted to evaluate differences between ICU types, hospital settings, and bolus volume. RESULTS: Fluid resuscitation varied with respect to preferences for the factors to determine volume status and preferences for fluid types. The 3 most frequently preferred volume indicators were blood pressure, urine output, and central venous pressure. Regardless of the patient type, the most preferred fluid type was crystalloid, followed by 5 % albumin and then 6 % hydroxyethyl starches (HES) 450/0.70 and 6 % HES 600/0.75. Surprisingly, up to 10 % of physicians still chose HES as the first choice of fluid for resuscitation in sepsis. The clinical specialty and the practice setting of the treating physicians also influenced fluid choices. CONCLUSIONS: Practice patterns of fluid resuscitation varied in the USA, depending on patient characteristics, clinical specialties, and practice settings of the treating physicians.

Sediment budget and geomorphic process units of the Swedish Kärkevagge, link to ArcInfo E00 files

Geomorphic process units have been derived in order to allow quantification via GIS techniques at a catchment scale. Mass movement rates based on existing field measurements are employed in the budget calculations. In the Kärkevagge catchment, Northern Sweden, 80% of the area can be identified either as a source area for sediments or as a zone where sediments are deposited. The overall budget for the slopes beneath the rockwalls in the Kärkevagge is approximately 680 t/a whilst about 150 t a-1 are transported into the fluvial system.

Comprehensive Characterization of Measurement Data Gathered by the Pressure Tube to Calandria Tube Gap Probe

Multi-frequency eddy current measurements are employed in estimating pressure tube (PT) to calandria tube (CT) gap in CANDU fuel channels, a critical inspection activity required to ensure fitness for service of fuel channels. In this thesis, a comprehensive characterization of eddy current gap data is laid out, in order to extract further information on fuel channel condition, and to identify generalized applications for multi-frequency eddy current data. A surface profiling technique, generalizable to multiple probe and conductive material configurations has been developed. This technique has allowed for identification of various pressure tube artefacts, has been independently validated (using ultrasonic measurements), and has been deployed and commissioned at Ontario Power Generation. Dodd and Deeds solutions to the electromagnetic boundary value problem associated with the PT to CT gap probe configuration were experimentally validated for amplitude response to changes in gap. Using the validated Dodd and Deeds solutions, principal components analysis (PCA) has been employed to identify independence and redundancies in multi-frequency eddy current data. This has allowed for an enhanced visualization of factors affecting gap measurement. Results of the PCA of simulation data are consistent with the skin depth equation, and are validated against PCA of physical experiments. Finally, compressed data acquisition has been realized, allowing faster data acquisition for multi-frequency eddy current systems with hardware limitations, and is generalizable to other applications where real time acquisition of large data sets is prohibitive.

Development of measurement and modeling techniques to quantify atmospheric deposition of persistent, bioaccumulative and toxic chemicals in the Great Lakes

Measurement and modeling techniques were developed to improve over-water gaseous air-water exchange measurements for persistent bioaccumulative and toxic chemicals (PBTs). Analytical methods were applied to atmospheric measurements of hexachlorobenzene (HCB), polychlorinated biphenyls (PCBs), and polybrominated diphenyl ethers (PBDEs). Additionally, the sampling and analytical methods are well suited to study semivolatile organic compounds (SOCs) in air with applications related to secondary organic aerosol formation, urban, and indoor air quality. A novel gas-phase cleanup method is described for use with thermal desorption methods for analysis of atmospheric SOCs using multicapillary denuders. The cleanup selectively removed hydrogen-bonding chemicals from samples, including much of the background matrix of oxidized organic compounds in ambient air, and thereby improved precision and method detection limits for nonpolar analytes. A model is presented that predicts gas collection efficiency and particle collection artifact for SOCs in multicapillary denuders using polydimethylsiloxane (PDMS) sorbent. An approach is presented to estimate the equilibrium PDMS-gas partition coefficient (Kpdms) from an Abraham solvation parameter model for any SOC. A high flow rate (300 L min-1) multicapillary denuder was designed for measurement of trace atmospheric SOCs. Overall method precision and detection limits were determined using field duplicates and compared to the conventional high-volume sampler method. The high-flow denuder is an alternative to high-volume or passive samplers when separation of gas and particle-associated SOCs upstream of a filter and short sample collection time are advantageous. A Lagrangian internal boundary layer transport exchange (IBLTE) Model is described. The model predicts the near-surface variation in several quantities with fetch in coastal, offshore flow: 1) modification in potential temperature and gas mixing ratio, 2) surface fluxes of sensible heat, water vapor, and trace gases using the NOAA COARE Bulk Algorithm and Gas Transfer Model, 3) vertical gradients in potential temperature and mixing ratio. The model was applied to interpret micrometeorological measurements of air-water exchange flux of HCB and several PCB congeners in Lake Superior. The IBLTE Model can be applied to any scalar, including water vapor, carbon dioxide, dimethyl sulfide, and other scalar quantities of interest with respect to hydrology, climate, and ecosystem science.

Initial concentration profile influence on migration measurements from plastic packaging: A simulation study

Migration of components from plastic packaging into foodstuffs or into medicines is a very important issue, concerning public health. Using experimental techniques, like gas chromatography-mass spectrometry, these essays measure total migration and specific migration of components from plastic packaging. This work presents an explanation and applications of a numerical technique tool for this measurement, allowing the comprehension of the diffusion process and the estimate of component migration in difficult or impractical measurements. As an application example, the non-uniform influence of initial concentration profile on the migration is presented, demonstrating the necessity of this profile determination for high quality considerations on involved metrology.

Gestión del tratamiento dietético cuali-cuantitativo en el sobrepeso y la obesidad: metodología y una nueva perspectiva de asesoramiento individualizado

%WL: porcentaje de pérdida de peso; %FL: porcentaje de pérdida de grasa. Objetivo: describir la metodología en la gestión del tratamiento dietético cuali-cuantitativo en el sobrepeso y la obesidad. Método: se llevaron a cabo 4.625 consultas con 616 pacientes mayores de 25 años con sobrepeso y obesidad, en el sur-este de España, durante los años 2006-12. Se utilizó una dieta equilibrada, hipocalórica, cuali-cuantitativa con alimentos de la zona. Se describió la metodología del tratamiento dietético en la pérdida y el mantenimiento. Se trató qué unidades de medida son adecuadas para la expresión del éxito en la pérdida; una nueva visión del asesoramiento individualizado y el tratamiento multidisciplinar. Resultados: el 80% de los pacientes obtienen un %FL ≥ 5% (22,6 ± 11,8 - 11,2 ± 7,4), y asistieron a la consulta más de mes y medio. Conclusión: se presenta un esquema de la metodología del tratamiento dietético; se han recomendado las unidades de medidas a utilizar en consulta y en la publicación de ensayos clínicos, creando un precedente con grado de evidencia de cómo determinar la pérdida exitosa; se recomienda medir los perímetros de cadera y cintura, e incorporar el estudio de la imagen corporal; se presenta una nueva visión del asesoramiento individualizado y una atención multidisciplinar avanzada, independiente de la edad, el estado de gestación y las minusvalías físicas. La postura del sanitario debe de ser considerada como el gestor encargado de determinar qué técnicas podrían ser más efectivas en dicha pérdida.

Status report for radon in Illinois /

Cover title.

Tafeln zur Verwandlung des Längen- und Hohl-Masses ... = Tables pour la réduction des mesures de longueur et de capacité ... /

German and French.

Measurement of energy expenditure of daily tasks among mothers of young children

There is currently some debate about whether the energy expenditure of domestic tasks is sufficient to confer health benefits. The aim of this study was therefore to measure the energy cost of five activities commonly undertaken by mothers of young children. Seven women with at least one child younger than five years of age spent 15 minutes in each of the following activities: sitting quietly, vacuum cleaning, washing windows, walking at moderate pace (approx 5km/hour), walking with a stroller and grocery shopping in a super-market. Each of the six 'trials' was completed on the same day, in random order. A carefully calibrated portable gas analyser was used to measure oxygen uptake during each activity, and data were converted to units of energy expenditure (METS). Vacuum cleaning, washing windows and walking with and without a stroller were found to be 'moderate intensity activities' (3 to 6 METs), but supermarket shopping did not reach this criterion. The MET values for these activities were similar to those reported in the Compendium of Physical Activities (Ainsworth et al., 2000). However, the energy expenditures of walking, both with and without a stroller, were higher than those reported in the Compendium. The findings suggest that some of the tasks associated with domestic caring duties are conducted at an intensity which is sufficient to confer some health benefit. Such benefits will only accrue however if the daily duration of these activities is sufficient to meet current guidelines.

Measurement of the inelastic proton-proton cross section at root s=7 TeV

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Measurement of diffractive dissociation cross sections in pp collisions at root s=7 TeV

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Measurement of the top quark charge in pp collisions at sqrts = 7 TeV with the ATLAS detector

A measurement of the top quark electric charge is carried out in the ATLAS experiment at the Large Hadron Collider using 2.05 fb-1 of data at a centre-of-mass energy of 7 TeV. In units of the elementary electric charge, the top quark charge is determined to be 0.64 +- 0.02 (stat.) +- 0.08 (syst.) from the charges of the top quark decay products in single lepton ttbar candidate events. This excludes models that propose a heavy quark of electric charge --4/3, instead of the Standard Model top quark, with a significance of more than 8 sigma.