The risk of early mortality of polytrauma patients associated to ISS, NISS, APACHE II values and prothrombin time

BACKGROUND: The early hemodynamic normalization of polytrauma patients may lead to better survival outcomes. The aim of this study was to assess the diagnostic quality of trauma and physiological scores from widely used scoring systems in polytrauma patients. METHODS: In total, 770 patients with ISS > 16 who were admitted to a trauma center within the first 24 hours after injury were included in this retrospective study. The patients were subdivided into three groups: those who died on the day of admission, those who died within the first three days, and those who survived for longer than three days. ISS, NISS, APACHE II score, and prothrombin time were recorded at admission. RESULTS: The descriptive statistics for early death in polytrauma patients who died on the day of admission, 1--3 days after admission, and > 3 days after admission were: ISS of 41.0, 34.0, and 29.0, respectively; NISS of 50.0, 50.0, and 41.0, respectively; APACHE II score of 30.0, 25.0, and 15.0, respectively; and prothrombin time of 37.0%, 56.0%, and 84%, respectively. These data indicate that prothrombin time (AUC: 0.89) and APACHE II (AUC: 0.88) have the greatest prognostic utility for early death. CONCLUSION: The estimated densities of the scores may suggest a direction for resuscitative procedures in polytrauma patients.Trial registration: "Retrospektive Analysen in der Chirurgischen Intensivmedizin" StV01-2008.http://www.kek.zh.ch/internet/gesundheitsdirektion/kek/de/home.html.

Family-related values and future orientation in adolescence: A German-Russian comparison

This article compares family values and family future orientation between German and Russian adolescents. Based on different cultural values in Germany and Russia a higher family orientation of Russian as compared to German adolescents was assumed. Adolescents from both countries responded to a questionnaire of general and family-related values and family-related future orientation in the framework of the VOC-study. Results showed that for both German and Russian adolescents a future family of one's own is of high importance. The majority of adolescents from both countries (and both genders) reported wanting to get married in the future and to have (preferably two) children. Russian as compared to German adolescents reported a higher importance of traditional family values and child-related values (value of children), as well as a stronger desire to have children. Russian girls were most likely to abandon own career plans for the benefit of a future family. The results are discussed with regard to psychological models of cultural values' and the notion of a regaining strength of traditional family values in the course of social change in Germany and Russia.

Reference Values and Factors Associated With Renal Resistive Index in a Family-Based Population Study

Increased renal resistive index (RRI) has been recently associated with target organ damage and cardiovascular or renal outcomes in patients with hypertension and diabetes mellitus. However, reference values in the general population and information on familial aggregation are largely lacking. We determined the distribution of RRI, associated factors, and heritability in a population-based study. Families of European ancestry were randomly selected in 3 Swiss cities. Anthropometric parameters and cardiovascular risk factors were assessed. A renal Doppler ultrasound was performed, and RRI was measured in 3 segmental arteries of both kidneys. We used multilevel linear regression analysis to explore the factors associated with RRI, adjusting for center and family relationships. Sex-specific reference values for RRI were generated according to age. Heritability was estimated by variance components using the ASSOC program (SAGE software). Four hundred women (mean age±SD, 44.9±16.7 years) and 326 men (42.1±16.8 years) with normal renal ultrasound had mean RRI of 0.64±0.05 and 0.62±0.05, respectively (P<0.001). In multivariable analyses, RRI was positively associated with female sex, age, systolic blood pressure, and body mass index. We observed an inverse correlation with diastolic blood pressure and heart rate. Age had a nonlinear association with RRI. We found no independent association of RRI with diabetes mellitus, hypertension treatment, smoking, cholesterol levels, or estimated glomerular filtration rate. The adjusted heritability estimate was 42±8% (P<0.001). In a population-based sample with normal renal ultrasound, RRI normal values depend on sex, age, blood pressure, heart rate, and body mass index. The significant heritability of RRI suggests that genes influence this phenotype.

Swiss Shock: Minaret Rejection, European Values, and the Challenge of Tolerant neutrality

In 2009 Switzerland, for long an apparent beacon of European toleration and neutrality, voted to ban the erection of minarets. Internal religious matters are normally dealt with at the regional or local level – not at the level of the Swiss national parliament, although the state does seek to ensure good order and peaceful relations between different faith communities. Indeed, the freedom of these communities to believe and function publicly is enshrined in law. However, as a matter of national policy, now constitutionally embedded, one religious group, the Muslim group, is not permitted to build their distinctive religious edifice, the minaret. Switzerland may have joined the rest of Europe with respect to engaging the challenge of Islamic presence to European identity and values, but the rejection of a symbol of the presence of one faith – in this case, Islamic – by a society that is otherwise predominantly secular, pluralist, and of Christian heritage, poses significant concerns. How and why did this happen? What are the implications? This paper will discuss some of the issues involved, concluding the ban is by no means irreversible. Tolerant neutrality may yet again be a leitmotif of Swiss culture and not just of foreign policy.

Personality complexes in adolescence: Traits, interests, work values, and self-evaluations

Following the recent trend in psychology towards a more integrative view of personality, the study attempted to establish the connections and underlying complexes of fundamental personality dispositions within two cohorts of Swiss adolescents in eighth and eleventh grade (N = 492, ages 13 to 19): Big-Five basic traits, big six vocational interests, work values, and generalized self-efficacy and externality of control beliefs. Five factors were identified which accounted for 60% of variance among the relations of the variables: (1) enterprisingconventional interests, (2) favorable personality dispositions, (3) social-artistic personality characteristics, (4) investigative-realistic interests, and (5) work value endorsement. Crosssectional findings indicate that particularly agreeableness and conscientiousness become closer related to interests and work values with increasing grade-level.

Association Between Baseline Impedance Values and Response Proton Pump Inhibitorsin Patients With Heartburn

BACKGROUND & AIMS: Esophageal impedance measurements have been proposed to indicate the status of the esophageal mucosa, and might be used to study the roles of the impaired mucosal integrity and increased acid sensitivity in patients with heartburn. We compared baseline impedance levels among patients with heartburn who did and did not respond to proton pump inhibitor (PPI) therapy, along with the pathophysiological characteristics of functional heartburn (FH). METHODS: In a case-control study, we collected data from January to December 203 on patients with heartburn and normal findings from endoscopy who were not receiving PPI therapy and underwent impedance pH testing at hospitals in Italy. Patients with negative test results were placed on an 8-week course of PPI therapy (84 patients received esomeprazole and 36 patients received pantoprazole). Patients with more than 50% symptom improvement were classified as FH/PPI responders and patients with less than 50% symptom improvement were classified as FH/PPI nonresponders. Patients with hypersensitive esophagus and healthy volunteers served as controls. In all patients and controls, we measured acid exposure time, number of refluxes, baseline impedance, and swallow-induced peristaltic wave indices. RESULTS: FH/PPI responders had higher acid exposure times, numbers of reflux events, and acid refluxes compared with FH/PPI nonresponders (P < .05). Patients with hypersensitive esophagus had mean acid exposure times and numbers of reflux events similar to those of FH/PPI responders. Baseline impedance levels were lower in FH/PPI responders and patients with hypersensitive esophagus, compared with FH/PPI nonresponders and healthy volunteers (P < .001). Swallow-induced peristaltic wave indices were similar between FH/PPI responders and patients with hypersensitive esophagus. CONCLUSIONS: Patients with FH who respond to PPI therapy have impedance pH features similar to those of patients with hypersensitive esophagus. Baseline impedance measurements might allow for identification of patients who respond to PPIs but would be classified as having FH based on conventional impedance-pH measurements.

Experimental growth characteristics, cell size, yessotoxin values and bioassay data of Protoceratium reticulatum (Dinophyceae)

Harmful algal blooms are mainly caused by marine dinoflagellates and are known to produce potent toxins that may affect the ecosystem, human activities and health. Such events have increased in frequency and intensity worldwide in the past decades. Numerous processes involved in Global Change are amplified in the Arctic, but little is known about species specific responses of arctic dinoflagellates. The aim of this work was to perform an exhaustive morphological, phylogenetical and toxinological characterization of Greenland Protoceratium reticulatum and, in addition, to test the effect of temperature on growth and production of bioactive secondary metabolites. Seven clonal isolates, the first isolates of P. reticulatum available from arctic waters, were phylogenetically characterized by analysis of the LSU rDNA. Six isolates were further characterized morphologically and were shown to produce both yessotoxins (YTX) and lytic compounds, representing the first report of allelochemical activity in P. reticulatum. As shown for one of the isolates, growth was strongly affected by temperature with a maximum growth rate at 15 °C, a significant but slow growth at 1 °C, and cell death at 25 °C, suggesting an adaptation of P. reticulatum to temperate waters. Temperature had no major effect on total YTX cell quota or lytic activity but both were affected by the growth phase with a significant increase at stationary phase. A comparison of six isolates at a fixed temperature of 10 °C showed high intraspecific variability for all three physiological parameters tested. Growth rate varied from 0.06 to 0.19 per day, and total YTX concentration ranged from 0.3 to 15.0 pg YTX/cell and from 0.5 to 31.0 pg YTX/cell at exponential and stationary phase, respectively. All six isolates performed lytic activity; however, for two isolates lytic activity was only detectable at higher cell densities in stationary phase.

XRF data, magnetic susceptibility, greyscale values and revised depths of sediments from ODP Leg 154 sites

The distinctly cyclic sediments recovered during ODP Leg 154 played an important role in constructing the astronomical time scale and associated astro(bio)chronology for the Miocene, and in deciphering ocean-climate history. The accuracy of the timescale critically depends on the reliability of the shipboard splice used for the tuning and on the tuning itself. New high-resolution colour- and magnetic susceptibility core scanning data supplemented with limited XRF-data allow improvement of the stratigraphy. The revised composite record results in an improved astronomical age model for ODP Site 926 between 5 and 14.4 Ma. The new age model is confirmed by results of complex amplitude demodulation of the precession and obliquity related cycle patterns. Different values for tidal dissipation are applied to improve the fit between the sedimentary cycle patterns and the astronomical solution. Due to the improved stratigraphy and tuning, supported by the results of amplitude demodulation, the revised time scale yields more reliable age estimates for planktic foraminiferal and calcareous nannofossil events. The results of this study highlight the importance of stratigraphy for timescale construction.

Radiocarbon ages, d13C values and rare earth element content of sediment cores BP00-23/07 and BP00-07/06

Two bottom sediment cores (BP00-23/7 and BP00-7/6) recovered from the Yenisei transect in the southern Kara Sea are described. Data on their grain size composition, clay and heavy mineral assemblages, and distribution of a large group of chemical elements are presented. Radiocarbon dates based on AMS C-14 method suggest the Holocene age of sediments in the cores. Literature data on physical properties and foraminifers have also been analyzed. The facies affiliation of the lithostratigraphic subdivisions has been unraveled. History of the Yenisei River runoff in the Holocene has been reconstructed on the basis of different indicators.

Planktic foraminiferal sieve size specific d13C and d18O values and maximum test diameter from ODP sites 171-1051 and 120-748

Many genera of modern planktic foraminifera are adapted to nutrient-poor (oligotrophic) surface waters by hosting photosynthetic symbionts, but it is unknown how they will respond to future changes in ocean temperature and acidity. Here we show that ca. 40 Ma, some fossil photosymbiont-bearing planktic foraminifera were temporarily 'bleached' of their symbionts coincident with transient global warming during the Middle Eocene Climatic Optimum (MECO). At Ocean Drilling Program (ODP) Sites 748 and 1051 (Southern Ocean and mid-latitude North Atlantic, respectively), the typically positive relationship between the size of photosymbiont-bearing planktic foraminifer tests and their carbon isotope ratios (d13C) was temporarily reduced for ~100 k.y. during the peak of the MECO. At the same time, the typically photosymbiont-bearing planktic foraminifera Acarinina suffered transient reductions in test size and relative abundance, indicating ecological stress. The coincidence of minimum d18O values and reduction in test size-d13C gradients suggests a link between increased sea-surface temperatures and bleaching during the MECO, although changes in pH and nutrient availability may also have played a role. Our findings show that host-photosymbiont interactions are not constant through geological time, with implications for both the evolution of trophic strategies in marine plankton and the reliability of geochemical proxy records generated from symbiont-bearing planktic foraminifera.

Organic- and carbonate-carbon values and extract data for DSDP Holes 63-467 and 63-471

Quantity, type, and maturity of the organic matter of middle Miocene to Quaternary sediments from the eastern North Pacific (Deep Sea Drilling Project Leg 63) were determined. Hydrocarbons and fatty acids in lipid extracts were analyzed by capillary column gas chromatography and combined gas chromatography/mass spectrometry. Kerogens were investigated by Rock-Eval pyrolysis and microscopy, and vitrinite reflectance values were determined. At Site 467, in the San Miguel Gap of the outer California Continental Borderland, organic carbon contents range from 1.46% to 5.40%. Normalized to organic carbon, total extracts increase from about 10 to 36 mg/g Corg with depth. The organic matter is a mixture of both marine and terrestrial origin, with the marine organic matter representing a high proportion in some of the samples. Steroid hydrocarbons - sterenes and steradienes in the upper part of the section and steranes in the deepest sample - are the most abundant compounds in the nonaromatic hydrocarbon fractions. Perylene, alkylated thiophenes, and aromatic steroid hydrocarbons dominate in the aromatic hydrocarbon fractions of the shallower samples; increasing maturation is indicated by a more petroleumlike aromatic hydrocarbon distribution. Microscopy revealed a high amount of liptinitic organic matter and confirmed the maturation trend as observed from analysis of the extracts. The vitrinite reflectance may be extrapolated to a bottom-hole value of nearly 0.5% Ro. The liquid hydrocarbon potential of the sediments at higher maturity levels is rated to be good to excellent. At Site 471, off Baja California, organic carbon values are between 0.70% and 1.12%. Extract values increase with depth, as at Site 467. The investigation of the soluble and insoluble organic matter, despite some compositional similarities, consistently revealed a more terrigenous influx compared with Site 467. Thus the potential for liquid hydrocarbon generation is lower, the organic matter being more gas-prone. The deepest sample analyzed indicates the onset of hydrocarbon generation. At this site, frequent sand intercalations offer pathways for migration and possibly reservoir formation.