Intermittent hemodialysis treatment in cefepime-induced neurotoxicity: Case report, pharmacokinetic modeling, and review of the literature.

Cefepime is a broad-spectrum cephalosporin indicated for in-hospital treatment of severe infections. Acute neurotoxicity, an increasingly recognized adverse effect of this drug in an overdose, predominantly affects patients with reduced renal function. Although dialytic approaches have been advocated to treat this condition, their role in this indication remains unclear. We report the case of an 88-year-old female patient with impaired renal function who developed life-threatening neurologic symptoms during cefepime therapy. She was treated with two intermittent 3-hour high-flux, high-efficiency hemodialysis sessions. Serial pre-, post-, and peridialytic (pre- and postfilter) serum cefepime concentrations were measured. Pharmacokinetic modeling showed that this dialytic strategy allowed for serum cefepime concentrations to return to the estimated nontoxic range 15 hours earlier than would have been the case without an intervention. The patient made a full clinical recovery over the next 48 hours. We conclude that at least 1 session of intermittent hemodialysis may shorten the time to return to the nontoxic range in severe clinically patent intoxication. It should be considered early in its clinical course pending chemical confirmation, even in frail elderly patients. Careful dosage adjustment and a high index of suspicion are essential in this population.

Thermal modeling and management in ultrathin chip stack technology

This paper presents a thermal modeling for power management of a new three-dimensional (3-D) thinned dies stacking process. Besides the high concentration of power dissipating sources, which is the direct consequence of the very interesting integration efficiency increase, this new ultra-compact packaging technology can suffer of the poor thermal conductivity (about 700 times smaller than silicon one) of the benzocyclobutene (BCB) used as both adhesive and planarization layers in each level of the stack. Thermal simulation was conducted using three-dimensional (3-D) FEM tool to analyze the specific behaviors in such stacked structure and to optimize the design rules. This study first describes the heat transfer limitation through the vertical path by examining particularly the case of the high dissipating sources under small area. First results of characterization in transient regime by means of dedicated test device mounted in single level structure are presented. For the design optimization, the thermal draining capabilities of a copper grid or full copper plate embedded in the intermediate layer of stacked structure are evaluated as a function of the technological parameters and the physical properties. It is shown an interest for the transverse heat extraction under the buffer devices dissipating most the power and generally localized in the peripheral zone, and for the temperature uniformization, by heat spreading mechanism, in the localized regions where the attachment of the thin die is altered. Finally, all conclusions of this analysis are used for the quantitative projections of the thermal performance of a first demonstrator based on a three-levels stacking structure for space application.

Integration of ground-penetrating radar and microgravimetric methods to map shallow caves

Ground-penetrating radar (GPR) and microgravimetric surveys have been conducted in the southern Jura mountains of western Switzerland in order to map subsurface karstic features. The study site, La Grande Rolaz cave, is an extensive system in which many portions have been mapped. By using small station spacing and careful processing for the geophysical data, and by modeling these data with topographic information from within the cave, accurate interpretations have been achieved. The constraints on the interpreted geologic models are better when combining the geophysical methods than when using only one of the methods, despite the general limitations of two-dimensional (2D) profiling. For example, microgravimetry can complement GPR methods for accurately delineating a shallow cave section approximately 10 X 10 mt in size. Conversely, GPR methods can be complementary in determining cavity depths and in verifying the presence of off-line features and numerous areas of small cavities and fractures, which may be difficult to resolve in microgravimetric data.

Multi-level modeling of aspects associated with poor mental health in a sample of prehospital emergency professionals.

BACKGROUND: The goal of this paper is to investigate the respective influence of work characteristics, the effort-reward ratio, and overcommitment on the poor mental health of out-of-hospital care providers. METHODS: 333 out-of-hospital care providers answered a questionnaire that included queries on mental health (GHQ-12), demographics, health-related information and work characteristics, questions from the Effort-Reward Imbalance Questionnaire, and items about overcommitment. A two-level multiple regression was performed between mental health (the dependent variable) and the effort-reward ratio, the overcommitment score, weekly number of interventions, percentage of non-prehospital transport of patients out of total missions, gender, and age. Participants were first-level units, and ambulance services were second-level units. We also shadowed ambulance personnel for a total of 416 hr. RESULTS: With cutoff points of 2/3 and 3/4 positive answers on the GHQ-12, the percentages of potential cases with poor mental health were 20% and 15%, respectively. The effort-reward ratio was associated with poor mental health (P < 0.001), irrespective of age or gender. Overcommitment was associated with poor mental health; this association was stronger in women (β = 0.054) than in men (β = 0.020). The percentage of prehospital missions out of total missions was only associated with poor mental health at the individual level. CONCLUSIONS: Emergency medical services should pay attention to the way employees perceive their efforts and the rewarding aspects of their work: an imbalance of those aspects is associated with poor mental health. Low perceived esteem appeared particularly associated with poor mental health. This suggests that supervisors of emergency medical services should enhance the value of their employees' work. Employees with overcommitment should also receive appropriate consideration. Preventive measures should target individual perceptions of effort and reward in order to improve mental health in prehospital care providers.

Front and domain growth in the presence of gravity

Front and domain growth of a binary mixture in the presence of a gravitational field is studied. The interplay of bulk- and surface-diffusion mechanisms is analyzed. An equation for the evolution of interfaces is derived from a time-dependent Ginzburg-Landau equation with a concentration-dependent diffusion coefficient. Scaling arguments on this equation give the exponents of a power-law growth. Numerical integrations of the Ginzburg-Landau equation corroborate the theoretical analysis.

Groundwater Availability Modeling of the Lower Dakota Aquifer in Northwest Iowa, October 2008

The 2007 Iowa General Assembly, recognizing the increased demand for water to support the growth of industries and municipalities, approved funding for the first year of a multi-year evaluation and modeling of Iowa’s major aquifers by the Iowa Department of Natural Resources. The task of conducting this evaluation and modeling was assigned to the Iowa Geological and Water Survey (IGWS). The first aquifer to be studied was the Lower Dakota aquifer in a sixteen county area of northwest Iowa.

Numerical modeling of the effect of variation of boundary conditions on vadose zone hydraulic properties

An accurate estimation of hydraulic fluxes in the vadose zone is essential for the prediction of water, nutrient and contaminant transport in natural systems. The objective of this study was to simulate the effect of variation of boundary conditions on the estimation of hydraulic properties (i.e. water content, effective unsaturated hydraulic conductivity and hydraulic flux) in a one-dimensional unsaturated flow model domain. Unsaturated one-dimensional vertical water flow was simulated in a pure phase clay loam profile and in clay loam interlayered with silt loam distributed according to the third iteration of the Cantor Bar fractal object Simulations were performed using the numerical model Hydrus 1D. The upper and lower pressure heads were varied around average values of -55 cm for the near-saturation range. This resulted in combinations for the upper and lower constant head boundary conditions, respectively, of -50 and -60 cm, -40 and -70 cm, -30 and -80 cm, -20 and -90 cm, and -10 and -100 cm. For the drier range the average head between the upper and lower boundary conditions was set to -550 cm, resulting in the combinations -500 and -600 cm, -400 and -700 cm, -300 and -800 cm, -200 and -900 cm, and -100 and -1,000 cm, for upper and lower boundary conditions, respectively. There was an increase in water contents, fluxes and hydraulic conductivities with the increase in head difference between boundary conditions. Variation in boundary conditions in the pure phase and interlayered one-dimensional profiles caused significant deviations in fluxes, water contents and hydraulic conductivities compared to the simplest case (a head difference between the upper and lower constant head boundaries of 10 cm in the wetter range and 100 cm in the drier range).

Modeling premartensitic effects in Ni2MnGa: A mean-field and Monte Carlo simulation study

ic first-order transition line ending in a critical point. This critical point is responsible for the existence of large premartensitic fluctuations which manifest as broad peaks in the specific heat, not always associated with a true phase transition. The main conclusion is that premartensitic effects result from the interplay between the softness of the anomalous phonon driving the modulation and the magnetoelastic coupling. In particular, the premartensitic transition occurs when such coupling is strong enough to freeze the involved mode phonon. The implication of the results in relation to the available experimental data is discussed.

Structural changes in latosols of the cerrado region: II - soil compressive behavior and modeling of additional compaction

Currently in Brazil, as in other parts of the world, the concern is great with the increase of degraded agricultural soil, which is mostly related to the occurrence of soil compaction. Although soil texture is recognized as a very important component in the soil compressive behaviors, there are few studies that quantify its influence on the structural changes of Latosols in the Brazilian Cerrado region. This study aimed to evaluate structural changes and the compressive behavior of Latosols in Rio Verde, Goiás, through the modeling of additional soil compaction. The study was carried out using five Latosols with very different textures, under different soil compaction levels. Water retention and soil compression curves, and bearing capacity models were determined from undisturbed samples collected on the B horizons. Results indicated that clayey and very clayey Latosols were more susceptible to compression than medium-textured soils. Soil compression curves at density values associate with edaphic functions were used to determine the beneficial pressure (σ b) , i.e., pressure with optimal water retention, and critical pressure (σcrMAC), i.e., pressure with macroporosity below critical levels. These pressure values were higher than the preconsolidation pressure (σp), and therefore characterized as additional compaction. Based on the compressive behavior of these Latosols, it can be concluded that the combined preconsolidation pressure, beneficial pressure and critical pressure allow a better understanding of compression processes of Latosols.

Modeling changes in organic carbon stocks for distinct soils in southeastern brazil after four eucalyptus rotations using the century model

Soil organic matter (SOM) plays an important role in carbon (C) cycle and soil quality. Considering the complexity of factors that control SOM cycling and the long time it usually takes to observe changes in SOM stocks, modeling constitutes a very important tool to understand SOM cycling in forest soils. The following hypotheses were tested: (i) soil organic carbon (SOC) stocks would be higher after several rotations of eucalyptus than in low-productivity pastures; (ii) SOC values simulated by the Century model would describe the data better than the mean of observations. So, the aims of the current study were: (i) to evaluate the SOM dynamics using the Century model to simulate the changes of C stocks for two eucalyptus chronosequences in the Rio Doce Valley, Minas Gerais State, Brazil; and (ii) to compare the C stocks simulated by Century with the C stocks measured in soils of different Orders and regions of the Rio Doce Valley growing eucalyptus. In Belo Oriente (BO), short-rotation eucalyptus plantations had been cultivated for 4.0; 13.0, 22.0, 32.0 and 34.0 years, at a lower elevation and in a warmer climate, while in Virginópolis (VG), these time periods were 8.0, 19.0 and 33.0 years, at a higher elevation and in a milder climate. Soil samples were collected from the 0-20 cm layer to estimate C stocks. Results indicate that the C stocks simulated by the Century model decreased after 37 years of poorly managed pastures in areas previously covered by native forest in the regions of BO and VG. The substitution of poorly managed pastures by eucalyptus in the early 1970´s led to an average increase of C of 0.28 and 0.42 t ha-1 year-1 in BO and VG, respectively. The measured C stocks under eucalyptus in distinct soil Orders and independent regions with variable edapho-climate conditions were not far from the values estimated by the Century model (root mean square error - RMSE = 20.9; model efficiency - EF = 0.29) despite the opposite result obtained with the statistical procedure to test the identity of analytical methods. Only for lower soil C stocks, the model over-estimated the C stock in the 0-20 cm layer. Thus, the Century model is highly promising to detect changes in C stocks in distinct soil orders under eucalyptus, as well as to indicate the impact of harvest residue management on SOM in future rotations.

Determination of hydraulic properties of a tropical soil of Hawaii using column experiments and inverse modeling

A method for determining soil hydraulic properties of a weathered tropical soil (Oxisol) using a medium-sized column with undisturbed soil is presented. The method was used to determine fitting parameters of the water retention curve and hydraulic conductivity functions of a soil column in support of a pesticide leaching study. The soil column was extracted from a continuously-used research plot in Central Oahu (Hawaii, USA) and its internal structure was examined by computed tomography. The experiment was based on tension infiltration into the soil column with free outflow at the lower end. Water flow through the soil core was mathematically modeled using a computer code that numerically solves the one-dimensional Richards equation. Measured soil hydraulic parameters were used for direct simulation, and the retention and soil hydraulic parameters were estimated by inverse modeling. The inverse modeling produced very good agreement between model outputs and measured flux and pressure head data for the relatively homogeneous column. The moisture content at a given pressure from the retention curve measured directly in small soil samples was lower than that obtained through parameter optimization based on experiments using a medium-sized undisturbed soil column.