Impaired endothelium-dependent vasodilatation is a novel predictor of mortality in intensive care

Objective: Endothelial function may be impaired in critical illness. We hypothesized that impaired endothelium-dependent vasodilatation is a predictor of mortality in critically ill patients.
Design: Prospective observational cohort study.
Setting: Seventeen-bed adult intensive care unit in a tertiary referral university teaching hospital. Patients: Patients were recruited within 24 hrs of admission to the intensive care unit.
Interventions: The SphygmoCor Mx system was used to derive the aortic augmentation index from radial artery pulse pressure waveforms. Endothelium-dependent vasodilatation was calculated as the change in augmentation index in response to an endothelium-dependent vasodilator (salbutamol).
Measurements and Main Results: Demographics, severity of illness scores, and physiological parameters were collected. Statistically significant predictors of mortality identified using single regressor analysis were entered into a multiple logistic regression model. Receiver operator characteristic curves were generated. Ninety-four patients completed the study. There were 80 survivors and 14 nonsurvivors. The Simplified Acute Physiology Score II, the Sequential Organ Failure Assessment score, leukocyte count, and endothelium-dependent vasodilatation conferred an increased risk of mortality. In logistic regression analysis, endothelium-dependent vasodilatation was the only predictor of mortality with an adjusted odds ratio of 26.1 (95% confidence interval [CI], 4.3-159.5). An endothelium-dependent vasodilatation value of 0.5% or less predicted intensive care unit mortality with a sensitivity of 79% (CI, 59-88%) and specificity of 98% (CI, 94-99%).
Conclusions: In vivo bedside assessment of endothelium-dependent vasodilatation is an independent predictor of mortality in the critically ill. We have shown it to be superior to other validated severity of illness scores with high sensitivity and specificity.

Performance analysis of a metro WDM ring networks with variable-length packets under symmetric and asymmetric traffic

In this paper, we discuss and evaluate two proposed metro wavelength division multiplexing (WDM) ring network architectures for variable-length packet traffic in storage area networks (SANs) settings. The paper begins with a brief review of the relevant architectures and protocols in the literature. Subsequently, the network architectures along with their medium access control (MAC) protocols are described. Performance of the two network architectures is studied by means of computer simulation in terms of their queuing delay, node throughput and proportion of packets dropped. The network performance is evaluated under symmetric and asymmetric traffic scenarios with Poisson and self-similar traffic. (C) 2011 Elsevier Inc. All rights reserved.

Experimental investigation of negative pressure intrusion techniques of acetabular cementation in total hip arthroplasty

The main mode of failure of the acetabular component in total hip arthroplasty is aseptic loosening. Successive generations of cementation techniques have evolved to alleviate this problem.

Tracing Inspiration in Proverbial Material: From 'The Royal Dictionary' (1699 & 1729) of Abel Boyer to 'The English-Irish Dictionary' (1732) of Begley-McCurtin.

This metalexicographic study examines the relationship between the proverbial material in The English-Irish Dictionary (1732) of Begley and McCurtin, Abel Boyer’s The Royal Dictionary (First edition 1699, second edition 1729), and Nathaniel Bailey’s An Universal Etymological English Dictionary (1721). It will show, for the first time, that both the English macrostructure and microstructure of the proverbial entries in Begley and McCurtin (1732) were reproduced directly from Boyer’s dictionary and, in spite of claims to the contrary, the impact of Bailey’s (1721) dictionary was negligible. Furthermore, empirical data gleaned from a comparative linguistic analysis of the various editions of The Royal Dictionary prior to 1732, will prove that it was the second official edition (1729) that was used as the framework for The English-Irish Dictionary. A quantitative and qualitative analysis of the nature of the proverbial entries will also outline the various translation strategies that were used to compose the Irish material— particularly literal translation—and show that there are extremely high-levels of borrowings from Boyer (1729), both in terms of the English entries under the lemma, and the French entries in the comment.

The Blason Populaire: Slurs and Stereotypes in Irish Proverbial Material

This paper examines the concept of the blason populaire in a corpus of Irish-language proverbial material covering the period 1858-1952. It will demonstrate that the focus of these blasons populaires is primarily regional, as opposed to national or ethnic, and, furthermore, that such proverbs are usually jocular, descriptive, and benign, rarely exhibiting ethnic or racial slurs. The study identifies and analyses the most salient stereotypical characterizations, and the proverbial forms in which they appear.

Using smart people to form future mobile wireless networks

The concept of a body-to-body network, where smart communicating devices carried or worn by a person are used to form a wireless network with devices situated on other nearby persons. New innovations in this area will see the form factor of smart devices being modified, so that they may be worn on the human body or integrated into clothing, in the process creating a new generation of smart people. Applications of body-to-body networking will extend well beyond the support of cellular and Wi-Fi networks. They will also be used in short-range covert military applications, first responder applications, team sports and used to interconnect body area networks (BAN). Security will be a major issue as routing between multiple nodes will increase the risk of unauthorized access and compromise sensitive data. This will add complexity to the medium access layer (MAC) and network management. Antennas designed to operate in body centric communications systems may be broadly categorized as on- or off-body radiators, according to their radiation pattern characteristics when mounted on the human body.

Improving the ultra-low-power performance of IEEE 802.15.6 by adaptive synchronisation

In ultra-low data rate wireless sensor networks (WSNs) waking up just to listen to a beacon every superframe can be a major waste of energy. This study introduces MedMAC, a medium access protocol for ultra-low data rate WSNs that achieves significant energy efficiency through a novel synchronisation mechanism. The new draft IEEE 802.15.6 standard for body area networks includes a sub-class of applications such as medical implantable devices and long-term micro miniature sensors with ultra-low power requirements. It will be desirable for these devices to have 10 years or more of operation between battery changes, or to have average current requirements matched to energy harvesting technology. Simulation results are presented to show that the MedMAC allows nodes to maintain synchronisation to the network while sleeping through many beacons with a significant increase in energy efficiency during periods of particularly low data transfer. Results from a comparative analysis of MedMAC and IEEE 802.15.6 MAC show that MedMAC has superior efficiency with energy savings of between 25 and 87 for the presented scenarios. © 2011 The Institution of Engineering and Technology.

Transient pumping of a Ni-like Ag x-ray laser with a subpicosecond pump pulse in a traveling-wave irradiation geometry

We report what is to our knowledge the first demonstration of a transient x-ray laser pumped by a 350-fs pulse in a traveling-wave irradiation geometry. For a 500-fs pump pulse the traveling-wave irradiation was found to have a strong effect on enhancing the Ni-like silver 4d-4p lasing emission at 13.9 nm. The signal enhancement was significantly less when the pulse duration was lengthened to 1.7 ps. The experimental observations are well reproduced by a simple model when the duration of gain is taken of the order of 15-20 ps. For the 500-fs pulse a gain coefficient of 14.5 cm(-1) was measured for plasma lengths up to 7 mm. Refraction of the amplified photons is believed to be the main cause of the limitation of the effective amplification length. (C) 2000 Optical Society of America.