The incidence and outcome of severe sepsis in Finland : The Finnsepsis Study

Severe sepsis is associated with common occurrence, high costs of care and significant mortality. The incidence of severe sepsis has been reported to vary between 0.5/1000 and 3/1000 in different studies. The worldwide Severe Sepsis Campaign, guidelines and treatment protocols aim at decreasing severe sepsis associated high morbidity and mortality. Various mediators of inflammation, such as high mobility group box-1 protein (HMGB1) and vascular endothelial growth factor (VEGF), have been tested for severity of illness and outcome in severe sepsis. Long-term survival with quality of life (QOL) assessment is important outcome after severe sepsis. The objective of this study was to evaluate the incidence, severity of organ dysfunction and outcome of severe sepsis in intensive care treated patients in Finland (study I)). HMGB1 and VEGF were studied in predicting severity of illness, development and type of organ dysfunction and hospital mortality (studies II and III). The long-term outcome and quality of life were assessed and quality-adjusted life years and cost per one QALY were estimated (study IV). A total of 470 patients with severe sepsis were included in the Finnsepsis Study. Patients were treated in 24 Finnish intensive care units in a 4-month period from 1 November 2004 to 28 February 2005. The incidence of severe sepsis was 0.38 /1,000 in the adult population (95% confidence interval 0.34-0.41). Septic shock (77%), severe oxygenation impairment (71.4%) and acute renal failure (23.2%) were the most common organ failures. The ICU, hospital, one-year and two-year mortalities were 15.5%, 28.3%, 40.9% and 44.9% respectively. HMGB1 and VEGF were elevated in patients with severe sepsis. VEGF concentrations were lower in non-survivors than in survivors, but HMGB1 levels did not differ between patients. Neither HMGB1 nor VEGF were predictive of hospital mortality. The QOL was measured median 17 months after severe sepsis and QOL was lower than in reference population. The mean QALY was 15.2 years for a surviving patient and the cost for one QALY was 2,139 . The study showed that the incidence of severe sepsis is lower in Finland than in other countries. The short-term outcome is comparable with that in other countries, but long-term outcome is poor. HMGB1 and VEGF are not useful in predicting mortality in severe sepsis. The mean QALY for a surviving patient is 15.2 and as the cost for one QALY is reasonably low, the intensive care is cost-effective in patients with severe sepsis.

Stretching single polymer chains of donor-acceptor foldamers: toward the quantitative study on the extent of folding

Single-molecule force spectroscopy has proven to be an efficient tool for the quantitative characterization of flexible foldamers on the single-molecule level in this study. The extent of folding has been estimated quantitatively for the first time to the best of our knowledge, which is crucial for a better understanding of the ``folding-process'' on single-molecule level. Therefore, this study may provide a guidance to regulate folding for realizing rational control over the functions of bulk materials.

激光诱导放电打孔实验研究=The Experimental Study of Laser Guiding Discharge Boring Hole

研究在空气中使用1.06#mu#m YAG激光诱导放电打孔的方法。在不同的放电脉宽下进行激光诱导放电打孔的实验,比较了激光打孔和激光诱导放电打孔两种方法,指出了激光诱导放电打孔的优点。

The Experimental Study of Injection and Mixing of the Model Ejector Rocket

专门设计了可用于研究箭基组合循环发动机(RBCC)在起动阶段(Ma=0)所使用的引射火箭性能的实验装置.作为初步试验,研究了不同工况的引射热喷流(一次流)和被引射空气(二次流)之间混合的演变、发展过程,找出不同来流条件下影响引射性能的主要参数,为最终探明引射火箭的最佳工作条件打下基础,同时根据试验结果提出了促进一、二次流混合的可行方案,便于下一步深入研究.

MILU-CG method and the numerical study on the flow around a rotating circular cylinder

A hybrid finite difference method and vortex method (HDV), which is based on domain decomposition and proposed by the authors (1992), is improved by using a modified incomplete LU decomposition conjugate gradient method (MILU-CG), and a high order implicit difference algorithm. The flow around a rotating circular cylinder at Reynolds number R-e = 1000, 200 and the angular to rectilinear speed ratio alpha is an element of (0.5, 3.25) is studied numerically. The long-time full developed features about the variations of the vortex patterns in the wake, and drag, lift forces on the cylinder are given. The calculated streamline contours agreed well with the experimental visualized flow pictures. The existence of critical states and the vortex patterns at the states are given for the first time. The maximum lift to drag force ratio can be obtained nearby the critical states.

Fishing effort validation and substitution possibilities among components: the case study of the VIII division European anchovy fishery

Command and control regulation programs, particularly input constraints, typically fail to achieve stated objectives, because fishermen may substitute unregulated for regulated inputs. It is, thus, essential to have an understanding of the internal structure of production technology. A primal formulation is used to estimate a translog production function at the vessels level that includes fishing effort and fisherman’s skill. The flexibility of the selected functional permits the analysis of the substitution possibilities among inputs by estimating the elasticity of substitution with no prior constraints. Particular attention is paid to the empirical validation of fishing effort as an aggregate input, which implies either, the acceptation of the joint hypothesis that inputs making up effort are weakly separable from the inputs out of the subgroup or considering that effort is an intermediate input produced by a non-separable two stage technology. Cross sectional data from the Spanish purse seine fleet operating in the VIII Division European anchovy fishery provide evidence of limited input substitution possibilities among the inputs making up the empirically validated fishing effort translog micro-production function.

Tax-Based Fisheries Management: The Case Study Of The Cantabrian Anchovy Fishery

A dynamic optimisation framework is adopted to show how tax-based management systems theoretically correct the inefficient allocation of fishing resources derived from the stock externality. Optimal Pigouvian taxes on output (τ) and on inputs (γ) are calculated, compared and considered as potential alternatives to the current regulation of VIII division Cantabrian anchovy fishery. The sensibility analysis of optimal taxes illustrates an asymmetry between (τ) and (γ) when cost price ratio varies. The distributional effects also differ. Special attention will be paid to the real implementation of the tax-based systems in fisheries.

Proceedings of the workshop on conclusions and lessons learnt from the livelihood study. Phnom Penh, Cambodia, 26-27 September 2002

This workshop is to follow-up the study on livelihoods of farmers and fishers in Kandal, Kampong Chhnang and Kratie provinces in Cambodia. It was the fourth workshop, part of an ongoing series of activities that will inform the Community Fisheries Development (CFD) Office of the Department of Fisheries (DOF), of the development of and changes in the fisheries law as it affects poor users of aquatic resources.(41 p.)

A shock tube method in the kinetic study of nonequilibrium ionization-recombination by rarefaction wave cooling

A shock tube method is introduced to study the ionization–recombination kinetics of high temperature gas, in which a test gas is heated and ionized by a reflected shock wave and subsequently quenched by a strong rarefaction wave reflected on the end wall of the driver section as the main cooling wave associated with a rarefaction wave incident back into region 5 when the reflected shock wave interacts with the contact surface. As the quenching rate of the strong rarefaction wave reaches 106 K/s, a nonequilibrium ionization-recombination process occurs, during which the ion recombination with electrons dominates.

A brief history of the scientific study of tropical African inland waters

An account is given of a study of African tropical waters, drawing on the personal experiences of the author. Reviewing developments since 1900, the author examines the way in which research has developed and the influence the changes in the policitcal map of Africa, in particular the change from colonial rule, has had on research.

Analytical method development for the uptake study of different organic pollutants by crops cultivated in compost-amended soils

256 p.