Toward optimal display of physiologic status in critical care: I. Recreating bedside displays from archived physiologic data

BACKGROUND: Physiologic data display is essential to decision making in critical care. Current displays echo first-generation hemodynamic monitors dating to the 1970s and have not kept pace with new insights into physiology or the needs of clinicians who must make progressively more complex decisions about their patients. The effectiveness of any redesign must be tested before deployment. Tools that compare current displays with novel presentations of processed physiologic data are required. Regenerating conventional physiologic displays from archived physiologic data is an essential first step. OBJECTIVES: The purposes of the study were to (1) describe the SSSI (single sensor single indicator) paradigm that is currently used for physiologic signal displays, (2) identify and discuss possible extensions and enhancements of the SSSI paradigm, and (3) develop a general approach and a software prototype to construct such "extended SSSI displays" from raw data. RESULTS: We present Multi Wave Animator (MWA) framework-a set of open source MATLAB (MathWorks, Inc., Natick, MA, USA) scripts aimed to create dynamic visualizations (eg, video files in AVI format) of patient vital signs recorded from bedside (intensive care unit or operating room) monitors. Multi Wave Animator creates animations in which vital signs are displayed to mimic their appearance on current bedside monitors. The source code of MWA is freely available online together with a detailed tutorial and sample data sets.

Miocene basin development and volcanism along a strike-slip to flat-slab subduction transition: Stratigraphy, geochemistry, and geochronology of the central Wrangell volcanic belt, Yakutat-North America collision zone

New geochronologic, geochemical, sedimentologic, and compositional data from the central Wrangell volcanic belt (WVB) document basin development and volcanism linked to subduction of overthickened oceanic crust to the northern Pacific plate margin. The Frederika Formation and overlying Wrangell Lavas comprise >3 km of sedimentary and volcanic strata exposed in the Wrangell Mountains of south-central Alaska (United States). Measured stratigraphic sections and lithofacies analyses document lithofacies associations that reflect deposition in alluvial-fluvial-lacustrine environments routinely influenced by volcanic eruptions. Expansion of intrabasinal volcanic centers prompted progradation of vent-proximal volcanic aprons across basinal environments. Coal deposits, lacustrine strata, and vertical juxtaposition of basinal to proximal lithofacies indicate active basin subsidence that is attributable to heat flow associated with intrabasinal volcanic centers and extension along intrabasinal normal faults. The orientation of intrabasinal normal faults is consistent with transtensional deformation along the Totschunda-Fairweather fault system. Paleocurrents, compositional provenance, and detrital geochronologic ages link sediment accumulation to erosion of active intrabasinal volcanoes and to a lesser extent Mesozoic igneous sources. Geochemical compositions of interbedded lavas are dominantly calc-alkaline, range from basaltic andesite to rhyolite in composition, and share geochemical characteristics with Pliocene-Quaternary phases of the western WVB linked to subduction-related magmatism. The U/Pb ages of tuffs and Ar-40/Ar-39 ages of lavas indicate that basin development and volcanism commenced by 12.5-11.0 Ma and persisted until at least ca. 5.3 Ma. Eastern sections yield older ages (12.5-9.3 Ma) than western sections (9.6-8.3 Ma). Samples from two western sections yield even younger ages of 5.3 Ma. Integration of new and published stratigraphic, geochronologic, and geochemical data from the entire WVB permits a comprehensive interpretation of basin development and volcanism within a regional tectonic context. We propose a model in which diachronous volcanism and transtensional basin development reflect progressive insertion of a thickened oceanic crustal slab of the Yakutat microplate into the arcuate continental margin of southern Alaska coeval with reported changes in plate motions. Oblique northwestward subduction of a thickened oceanic crustal slab during Oligocene to Middle Miocene time produced transtensional basins and volcanism along the eastern edge of the slab along the Duke River fault in Canada and subduction-related volcanism along the northern edge of the slab near the Yukon-Alaska border. Volcanism and basin development migrated progressively northwestward into eastern Alaska during Middle Miocene through Holocene time, concomitant with a northwestward shift in plate convergence direction and subduction collision of progressively thicker crust against the syntaxial plate margin.