Blood transfusion in cardiac surgery is a risk factor for increased hospital length of stay in adult patients

Abstract Background Allogeneic red blood cell (RBC) transfusion has been proposed as a negative indicator of quality in cardiac surgery. Hospital length of stay (LOS) may be a surrogate of poor outcome in transfused patients. Methods Data from 502 patients included in Transfusion Requirements After Cardiac Surgery (TRACS) study were analyzed to assess the relationship between RBC transfusion and hospital LOS in patients undergoing cardiac surgery and enrolled in the TRACS study. Results According to the status of RBC transfusion, patients were categorized into the following three groups: 1) 199 patients (40%) who did not receive RBC, 2) 241 patients (48%) who received 3 RBC units or fewer (low transfusion requirement group), and 3) 62 patients (12%) who received more than 3 RBC units (high transfusion requirement group). In a multivariable Cox proportional hazards model, the following factors were predictive of a prolonged hospital length of stay: age higher than 65 years, EuroSCORE, valvular surgery, combined procedure, LVEF lower than 40% and RBC transfusion of > 3 units. Conclusion RBC transfusion is an independent risk factor for increased LOS in patients undergoing cardiac surgery. This finding highlights the adequacy of a restrictive transfusion therapy in patients undergoing cardiac surgery. Trial registration Clinicaltrials.gov identifier: http://NCT01021631.

Length scales of dynamic heterogeneities of low and high molecular weight glass formers from multidimensional NMR

Das Ziel der vorliegenden Arbeit ist die Untersuchung der räumlichen und zeitlichen Aspekte der heterogenen Dynamik in Modellglasbildnern. Dabei wird vor allem die langsame alpha-Relaxationsdynamik oberhalb des Glasüberganges Tg untersucht. Die nukleare Magnetresonanz zeigt ihre einmalige Vielseitigkeit bei der Untersuchung molekularer Dynamik, wenn die angewandten Techniken und Experimente durch Simulationen unterstützt werden. Die räumliche Aspekt dynamischer Heterogenitäten wird untersucht durch ein reduziertes vierdimensionales Spindiffusionsexperiment (4D3CP), ein Experiment, das Reorientierungsraten örtlich korreliert. Eine Simulation dieses Experimentes an einem System harter Kugeln liefert wertvolle Informationen über die Auswertemethode des 4D3CP Experiments. Glycerol und o-terphenyl werden durch das 4D3CP Experiment untersucht. Die erhaltenen Resultate werden mit bereits publizierten Daten des polymeren Glasbildners PVAc verglichen. Während PVAc und o-terphenyl eine Längenskale von 3.7 nm bzw. 2.9 nm aufweisen, ist die Längenskale von Glycerol signifikant kleiner bei 1.1 nm. Ein neues Experiment, welches sensitiv auf Translationsbewegung reagiert, wird vorgestellt. Durch Verwendung eines pi-Impulszuges kann eine separate Evolution unter dem Hamiltonian der dipolaren Kopplung und der chemischen Verschiebungsanisotropie erreicht werden.

Measurement of the K + - pi + pi - e + - (-) v e form factors and of the pi pi scattering length a 0 0

The quark condensate is a fundamental free parameter of Chiral Perturbation Theory ($chi PT$), since it determines the relative size of the mass and momentum terms in the power expansion. In order to confirm or contradict the assumption of a large quark condensate, on which $chi PT$ is based, experimental tests are needed. In particular, the $S$-wave $pipi$ scattering lengths $a_0^0$ and $a_0^2$ can be predicted precisely within $chi PT$ as a function of this parameter and can be measured very cleanly in the decay $K^{pm} to pi^{+} pi^{-} e^{pm} stackrel{mbox{tiny(---)}}{nu_e}$ ($K_{e4}$). About one third of the data collected in 2003 and 2004 by the NA48/2 experiment were analysed and 342,859 $K_{e4}$ candidates were selected. The background contamination in the sample could be reduced down to 0.3% and it could be estimated directly from the data, by selecting events with the same signature as $K_{e4}$, but requiring for the electron the opposite charge with respect to the kaon, the so-called ``wrong sign'' events. This is a clean background sample, since the kaon decay with $Delta S=-Delta Q$, that would be the only source of signal, can only take place through two weak decays and is therefore strongly suppressed. The Cabibbo-Maksymowicz variables, used to describe the kinematics of the decay, were computed under the assumption of a fixed kaon momentum of 60 GeV/$c$ along the $z$ axis, so that the neutrino momentum could be obtained without ambiguity. The measurement of the form factors and of the $pipi$ scattering length $a_0^0$ was performed in a single step by comparing the five-dimensional distributions of data and MC in the kinematic variables. The MC distributions were corrected in order to properly take into account the trigger and selection efficiencies of the data and the background contamination. The following parameter values were obtained from a binned maximum likelihood fit, where $a_0^2$ was expressed as a function of $a_0^0$ according to the prediction of chiral perturbation theory: f'_s/f_s = 0.133+- 0.013(stat)+- 0.026(syst) f''_s/f_s = -0.041+- 0.013(stat)+- 0.020(syst) f_e/f_s = 0.221+- 0.051(stat)+- 0.105(syst) f'_e/f_s = -0.459+- 0.170(stat)+- 0.316(syst) tilde{f_p}/f_s = -0.112+- 0.013(stat)+- 0.023(syst) g_p/f_s = 0.892+- 0.012(stat)+- 0.025(syst) g'_p/f_s = 0.114+- 0.015(stat)+- 0.022(syst) h_p/f_s = -0.380+- 0.028(stat)+- 0.050(syst) a_0^0 = 0.246+- 0.009(stat)+- 0.012(syst)}+- 0.002(theor), where the statistical uncertainty only includes the effect of the data statistics and the theoretical uncertainty is due to the width of the allowed band for $a_0^2$.

Polymer surfaces on small length- and short time-scales

The behaviour of a polymer depends strongly on the length- and time scale as well as on the temperature rnat which it is probed. In this work, I describe investigations of polymer surfaces using scanning probe rnmicroscopy with heatable probes. With these probes, surfaces can be heated within seconds down to rnmicroseconds. I introduce experiments for the local and fast determination of glass transition and melting rntemperatures. I developed a method which allows the determination of glass transition and melting rntemperatures on films with thicknesses below 100 nm: A background measurement on the substrate was rnperformed. The resulting curve was subtracted from the measurement on the polymer film. The rndifferential measurement on polystyrene films with thicknesses between 35 nm and 160 nm showed rncharacteristic signals at 95 ± 1 °C, in accordance with the glass transition of polystyrene. Pressing heated rnprobes into polymer films causes plastic deformation. Nanometer sized deformations are currently rninvestigated in novel concepts for high density data storage. A suitable medium for such a storage system rnhas to be easily indentable on one hand, but on the other hand it also has to be very stable towards rnsurface induced wear. For developing such a medium I investigated a new approach: A comparably soft rnmaterial, namely polystyrene, was protected with a thin but very hard layer made of plasma polymerized rnnorbornene. The resulting bilayered media were tested for surface stability and deformability. I showed rnthat the bilayered material combines the deformability of polystyrene with the surface stability of the rnplasma polymer, and that the material therefore is a very good storage medium. In addition we rninvestigated the glass transition temperature of polystyrene at timescales of 10 µs and found it to be rnapprox. 220 °C. The increase of this characteristic temperature of the polymer results from the short time rnat which the polymer was probed and reflects the well-known time-temperature superposition principle. rnHeatable probes were also used for the characterization of silverazide filled nanocapsules. The use of rnheatable probes allowed determining the decomposition temperature of the capsules from few rnnanograms of material. The measured decomposition temperatures ranged from 180 °C to 225 °C, in rnaccordance with literature values. The investigation of small amounts of sample was necessary due to the rnlimited availability of the material. Furthermore, investigating larger amounts of the capsules using rnconventional thermal gravimetric analysis could lead to contamination or even damage of the instrument. rnBesides the analysis of material parameters I used the heatable probes for the local thermal rndecomposition of pentacene precursor material in order to form nanoscale conductive structures. Here, rnthe thickness of the precursor layer was important for complete thermal decomposition. rnAnother aspect of my work was the investigation of redox active polymers - Poly-10-(4-vinylbenzyl)-10H-rnphenothiazine (PVBPT)- for data storage. Data is stored by changing the local conductivity of the material rnby applying a voltage between tip and surface. The generated structures were stable for more than 16 h. It rnwas shown that the presence of water is essential for succesfull patterning.

q-Hook length formulas for colored labeled forests

The major index has been deeply studied from the early 1900s and recently has been generalized in different directions, such as the case of labeled forests and colored permutations. In this thesis we define new types of labelings for forests in which the labels are colored integers. We extend the definition of the flag-major index for these labelings and we present an analogue of well known major index hook length formulas. Finally, this study (which has just apparently a simple combinatoric nature) allows us to show a notion of duality for two particular families of groups obtained from the product G(r,n)×G(r,m).

Single-shot electron bunch length measurements using a spatial electro-optical autocorrelation interferometer

A spatial, electro-optical autocorrelation (EOA) interferometer using the vertically polarized lobes of coherent transition radiation (CTR) has been developed as a single-shot electron bunch length monitor at an optical beam port downstream the 100 MeV preinjector LINAC of the Swiss Light Source. This EOA monitor combines the advantages of step-scan interferometers (high temporal resolution) [D. Mihalcea et al., Phys. Rev. ST Accel. Beams 9, 082801 (2006) and T. Takahashi and K. Takami, Infrared Phys. Technol. 51, 363 (2008)] and terahertz-gating technologies [U. Schmidhammer et al., Appl. Phys. B: Lasers Opt. 94, 95 (2009) and B. Steffen et al., Phys. Rev. ST Accel. Beams 12, 032802 (2009)] (fast response), providing the possibility to tune the accelerator with an online bunch length diagnostics. While a proof of principle of the spatial interferometer was achieved by step-scan measurements with far-infrared detectors, the single-shot capability of the monitor has been demonstrated by electro-optical correlation of the spatial CTR interference pattern with fairly long (500 ps) neodymium-doped yttrium aluminum garnet (Nd:YAG) laser pulses in a ZnTe crystal. In single-shot operation, variations of the bunch length between 1.5 and 4 ps due to different phase settings of the LINAC bunching cavities have been measured with subpicosecond time resolution.

Gunshot energy transfer profile in ballistic gelatine, determined with computed tomography using the total crack length method

By measuring the total crack lengths (TCL) along a gunshot wound channel simulated in ordnance gelatine, one can calculate the energy transferred by a projectile to the surrounding tissue along its course. Visual quantitative TCL analysis of cut slices in ordnance gelatine blocks is unreliable due to the poor visibility of cracks and the likely introduction of secondary cracks resulting from slicing. Furthermore, gelatine TCL patterns are difficult to preserve because of the deterioration of the internal structures of gelatine with age and the tendency of gelatine to decompose. By contrast, using computed tomography (CT) software for TCL analysis in gelatine, cracks on 1-cm thick slices can be easily detected, measured and preserved. In this, experiment CT TCL analyses were applied to gunshots fired into gelatine blocks by three different ammunition types (9-mm Luger full metal jacket, .44 Remington Magnum semi-jacketed hollow point and 7.62 × 51 RWS Cone-Point). The resulting TCL curves reflected the three projectiles' capacity to transfer energy to the surrounding tissue very accurately and showed clearly the typical energy transfer differences. We believe that CT is a useful tool in evaluating gunshot wound profiles using the TCL method and is indeed superior to conventional methods applying physical slicing of the gelatine.

Precision of endodontic working length measurements: a pilot investigation comparing cone-beam computed tomography scanning with standard measurement techniques

The objective of this pilot investigation was to evaluate the utility and precision of already existing limited cone-beam computed tomography (CBCT) scans in measuring the endodontic working length, and to compare it with standard clinical procedures.

Projected 21st century decrease in marine productivity: a multi-model analysis

Changes in marine net primary productivity (PP) and export of particulate organic carbon (EP) are projected over the 21st century with four global coupled carbon cycle-climate models. These include representations of marine ecosystems and the carbon cycle of different structure and complexity. All four models show a decrease in global mean PP and EP between 2 and 20% by 2100 relative to preindustrial conditions, for the SRES A2 emission scenario. Two different regimes for productivity changes are consistently identified in all models. The first chain of mechanisms is dominant in the low- and mid-latitude ocean and in the North Atlantic: reduced input of macro-nutrients into the euphotic zone related to enhanced stratification, reduced mixed layer depth, and slowed circulation causes a decrease in macro-nutrient concentrations and in PP and EP. The second regime is projected for parts of the Southern Ocean: an alleviation of light and/or temperature limitation leads to an increase in PP and EP as productivity is fueled by a sustained nutrient input. A region of disagreement among the models is the Arctic, where three models project an increase in PP while one model projects a decrease. Projected changes in seasonal and interannual variability are modest in most regions. Regional model skill metrics are proposed to generate multi-model mean fields that show an improved skill in representing observation-based estimates compared to a simple multi-model average. Model results are compared to recent productivity projections with three different algorithms, usually applied to infer net primary production from satellite observations.

Embryonic exposure to corticosterone modifies the juvenile stress response, oxidative stress, and telomere length.

Early embryonic exposure to maternal glucocorticoids can broadly impact physiology and behaviour across phylogenetically diverse taxa. The transfer of maternal glucocorticoids to offspring may be an inevitable cost associated with poor environmental conditions, or serve as a maternal effect that alters offspring phenotype in preparation for a stressful environment. Regardless, maternal glucocorticoids are likely to have both costs and benefits that are paid and collected over different developmental time periods. We manipulated yolk corticosterone (cort) in domestic chickens (Gallus domesticus) to examine the potential impacts of embryonic exposure to maternal stress on the juvenile stress response and cellular ageing. Here, we report that juveniles exposed to experimentally increased cort in ovo had a protracted decline in cort during the recovery phase of the stress response. All birds, regardless of treatment group, shifted to oxidative stress during an acute stress response. In addition, embryonic exposure to cort resulted in higher levels of reactive oxygen metabolites and an over-representation of short telomeres compared with the control birds. In many species, individuals with higher levels of oxidative stress and shorter telomeres have the poorest survival prospects. Given this, long-term costs of glucocorticoid-induced phenotypes may include accelerated ageing and increased mortality.

Equations for the Drag Force and Aerodynamic Roughness Length of Urban Areas with Random Building Heights

We use a conceptual model to investigate how randomly varying building heights within a city affect the atmospheric drag forces and the aerodynamic roughness length of the city. The model is based on the assumptions regarding wake spreading and mutual sheltering effects proposed by Raupach (Boundary-Layer Meteorol 60:375-395, 1992). It is applied both to canopies having uniform building heights and to those having the same building density and mean height, but with variability about the mean. For each simulated urban area, a correction is determined, due to height variability, to the shear stress predicted for the uniform building height case. It is found that u (*)/u (*R) , where u (*) is the friction velocity and u (*R) is the friction velocity from the uniform building height case, is expressed well as an algebraic function of lambda and sigma (h) /h (m) , where lambda is the frontal area index, sigma (h) is the standard deviation of the building height, and h (m) is the mean building height. The simulations also resulted in a simple algebraic relation for z (0)/z (0R) as a function of lambda and sigma (h) /h (m) , where z (0) is the aerodynamic roughness length and z (0R) is z (0) found from the original Raupach formulation for a uniform canopy. Model results are in keeping with those of several previous studies.

Suitability of real-time quantitative PCR to estimate the relative telomere length in European Hake (Merluccius merluccius Linnaeus, 1758)

Telomere length measurement has been proposed as a promising tool to estimate the age of individuals in natural populations. We used real-time quantitative PCR (qPCR) to measure relative telomere length in four tissues (brain, kidney, liver and muscle) of European hake (Merluccius merluccius) in different groups based upon body length an otolith age estimate. We observed a high level of inter-individual differences in the measurements of relative telomere length in hakes of similar age and body length groups. The results of qPCR analysis showed a great variability in all measures and a lack of repeatability and reproducibility with significant statistical differences in the results of the different assays. The paper discusses the technical reasons for the variability in qPCR obtained in this work and by other authors.