SwissScoring--a nationwide survey of SAPS II assessing practices and its accuracy.

OBJECTIVE The first description of the simplified acute physiology score (SAPS) II dates back to 1993, but little is known about its accuracy in daily practice. Our purpose was to evaluate the accuracy of scoring and the factors that affect it in a nationwide survey. METHODS Twenty clinical scenarios, covering a broad range of illness severities, were randomly assigned to a convenience sample of physicians or nurses in Swiss adult intensive care units (ICUs), who were asked to assess the SAPS II score for a single scenario. These data were compared to a reference that was defined by five experienced researchers. The results were cross-matched with demographic characteristics and data on the training and quality control for the scoring, structural and organisational properties of each participating ICU. RESULTS A total of 345 caregivers from 53 adult ICU providers completed the SAPS II evaluation of one clinical scenario. The mean SAPS II scoring was 42.6 ± 23.4, with a bias of +5.74 (95%CI 2.0-9.5) compared to the reference score. There was no evidence of bias variation according to the case severity, ICU size, linguistic area, profession (physician vs. nurse), experience, initial SAPS II training, or presence of a quality control system. CONCLUSION This nationwide survey revealed substantial variability in the SAPS II scoring results. On average, SAPS II scoring was overestimated by more than 13%, irrespective of the profession or experience of the scorer or of the structural characteristics of the ICUs.

Fatty acids and intact polar lipids of laminated microbial sediments from St. Peter Ording, German Wadden Sea

Hidden for the untrained eye through a thin layer of sand, laminated microbial sediments occur in supratidal beaches along the North Sea coast. The inhabiting microbial communities organize themselves in response to vertical gradients of light, oxygen or sulfur compounds. We performed a fine-scale investigation on the vertical zonation of the microbial communities using a lipid biomarker approach, and assessed the biogeochemical processes using a combination of microsensor measurements and a 13C-labeling experiment. Lipid biomarker fingerprinting showed the overarching importance of cyanobacteria and diatoms in these systems, and heterocyst glycolipids revealed the presence of diazotrophic cyanobacteria even in 9 to 20 mm depth. High abundance of ornithine lipids (OL) throughout the system may derive from sulfate reducing bacteria, while a characteristic OL profile between 5 and 8 mm may indicate presence of purple non-sulfur bacteria. The fate of 13C-labeled bicarbonate was followed by experimentally investigating the uptake into microbial lipids, revealing an overarching importance of cyanobacteria for carbon fixation. However, in deeper layers, uptake into purple sulfur bacteria was evident, and a close microbial coupling could be shown by uptake of label into lipids of sulfate reducing bacteria in the deepest layer. Microsensor measurements in sediment cores collected at a later time point revealed the same general pattern as the biomarker analysis and the labeling experiments. Oxygen and pH-microsensor profiles showed active photosynthesis in the top layer. The sulfide that diffuses from deeper down and decreases just below the layer of active oxygenic photosynthesis indicates the presence of sulfur bacteria, like anoxygenic phototrophs that use sulfide instead of water for photosynthesis.

A reconstruction of atmospheric carbon dioxide and its stable carbon isotopic composition from the penultimate glacial maximum to the glacial inception

The reconstruction of the stable carbon isotope evolution in atmospheric CO2 (d13Catm ), as archived in Antarctic ice cores, bears the potential to disentangle the contributions of the different carbon cycle fluxes causing past CO2 variations. Here we present a new record of d13Catm before, during and after the Marine Isotope Stage 5.5 (155 000 to 105 000 years BP). The record was derived with a well established sublimation method using ice from the EPICA Dome C (EDC) and the Talos Dome ice cores in East Antarctica. We find a 0.4 permil shift to heavier values between the mean d13Catm level in the Penultimate (~ 140 000 years BP) and Last Glacial Maximum (~ 22 000 years BP), which can be explained by either (i) changes in the isotopic composition or (ii) intensity of the carbon input fluxes to the combined ocean/atmosphere carbon reservoir or (iii) by long-term peat buildup. Our isotopic data suggest that the carbon cycle evolution along Termination II and the subsequent interglacial was controlled by essentially the same processes as during the last 24 000 years, but with different phasing and magnitudes. Furthermore, a 5000 years lag in the CO2 decline relative to EDC temperatures is confirmed during the glacial inception at the end of MIS 5.5 (120 000 years BP). Based on our isotopic data this lag can be explained by terrestrial carbon release and carbonate compensation.

Concentration of hydrogen in hot brines of the Atlantis II Deep

An analysis of earlier measurements and author's data serves as a basis for a discussion of origin of deep-sea hydrogen. High hydrogen concentrations (0.001 ml/l or higher) in geothermal brines of the Atlantis II Deep depression are of abiogenic origin.

Data base on pelagic ciliates grazing and growth rate as a function of size, prey size and type compiled from the literature

Microzooplankton (the 20 to 200 µm size class of zooplankton) is recognised as an important part of marine pelagic ecosystems. In terms of biomass and abundance pelagic ciliates are one of the important groups of organism in microzooplankton. However, their rates - grazing and growth - , feeding behaviour and prey preferences are poorly known and understood. A set of data was assembled in order to derive a better understanding of pelagic ciliates rates, in response to parameters such as prey concentration, prey type (size and species), temperature and their own size. With these objectives, literature was searched for laboratory experiments with information on one or more of these parameters effect studied. The criteria for selection and inclusion in the database included: (i) controlled laboratory experiment with a known ciliates feeding on a known prey; (ii) presence of ancillary information about experimental conditions, used organisms - cell volume, cell dimensions, and carbon content. Rates and ancillary information were measured in units that meet the experimenter need, creating a need to harmonize the data units after collection. In addition different units can link to different mechanisms (carbon to nutritive quality of the prey, volume to size limits). As a result, grazing rates are thus available as pg C/(ciliate*h), µm**3/(ciliate*h) and prey cell/(ciliate*h); clearance rate was calculated if not given and growth rate is expressed as the growth rate per day.

Analysis and optimization of trajectories for Ballistic Missiles Interception

Intercontinental Ballistic Missiles are capable of placing a nuclear warhead at more than 5,000 km away from its launching base. With the lethal power of a nuclear warhead a whole city could be wiped out by a single weapon causing millions of deaths. This means that the threat posed to any country from a single ICBM captured by a terrorist group or launched by a 'rogue' state is huge. This threat is increasing as more countries are achieving nuclear and advanced launcher capabilities. In order to suppress or at least reduce this threat the United States created the National Missile Defense System which involved, among other systems, the development of long-range interceptors whose aim is to destroy incoming ballistic missiles in their midcourse phase. The Ballistic Missile Defense is a high-profile topic that has been the focus of political controversy lately when the U.S. decided to expand the Ballistic Missile system to Europe, with the opposition of Russia. However the technical characteristics of this system are mostly unknown by the general public. The Interception of an ICBM using a long range Interceptor Missile as intended within the Ground-Based Missile Defense System by the American National Missile Defense (NMD) implies a series of problems of incredible complexity: - The incoming missile has to be detected almost immediately after launch. - The incoming missile has to be tracked along its trajectory with a great accuracy. - The Interceptor Missile has to implement a fast and accurate guidance algorithm in order to reach the incoming missile as soon as possible. - The Kinetic Kill Vehicle deployed by the interceptor boost vehicle has to be able to detect the reentry vehicle once it has been deployed by ICBM, when it offers a very low infrared signature, in order to perform a final rendezvous manoeuvre. - The Kinetic Kill Vehicle has to be able to discriminate the reentry vehicle from the surrounding debris and decoys. - The Kinetic Kill Vehicle has to be able to implement an accurate guidance algorithm in order to perform a kinetic interception (direct collision) of the reentry vehicle, at relative speeds of more than 10 km/s. All these problems are being dealt simultaneously by the Ground-Based Missile Defense System that is developing very complex and expensive sensors, communications and control centers and long-range interceptors (Ground-Based Interceptor Missile) including a Kinetic Kill Vehicle. Among all the technical challenges involved in this interception scenario, this thesis focuses on the algorithms required for the guidance of the Interceptor Missile and the Kinetic Kill Vehicle in order to perform the direct collision with the ICBM. The involved guidance algorithms are deeply analysed in this thesis in part III where conventional guidance strategies are reviewed and optimal guidance algorithms are developed for this interception problem. The generation of a realistic simulation of the interception scenario between an ICBM and a Ground Based Interceptor designed to destroy it was considered as necessary in order to be able to compare different guidance strategies with meaningful results. As a consequence, a highly representative simulator for an ICBM and a Kill Vehicle has been implemented, as detailed in part II, and the generation of these simulators has also become one of the purposes of this thesis. In summary, the main purposes of this thesis are: - To develop a highly representative simulator of an interception scenario between an ICBM and a Kill Vehicle launched from a Ground Based Interceptor. -To analyse the main existing guidance algorithms both for the ascent phase and the terminal phase of the missiles. Novel conclusions of these analyses are obtained. - To develop original optimal guidance algorithms for the interception problem. - To compare the results obtained using the different guidance strategies, assess the behaviour of the optimal guidance algorithms, and analyse the feasibility of the Ballistic Missile Defense system in terms of guidance (part IV). As a secondary objective, a general overview of the state of the art in terms of ballistic missiles and anti-ballistic missile defence is provided (part I).

Specific T cell recognition of kinetic isomers in the binding of peptide to class II major histocompatibility complex

Helper T cells are triggered by molecular complexes of antigenic peptides and class II proteins of the major histocompatibility complex . The formation of stable complexes between class II major histocompatibility complex proteins and antigenic peptides is often accompanied by the formation of a short-lived complex. In this report, we describe T cell recognition of two distinct complexes, one short-lived and the other long-lived, formed during the binding of an altered myelin basic protein peptide to I-Ak. One myelin basic protein-specific T cell clone is triggered by only the short-lived complex, and another is triggered by only the stable complex. Thus, a single peptide bound to a particular class II molecule can activate different T cells depending on the conditions of the binding reaction.