Arcos (United States)

Maintaining balanced blood product ratios during damage control resuscitation (DCR) is independently associated with improved survival. We hypothesized that real-time performance improvement (RT-PI) would increase adherence to DCR best practice. From December 2020-August 2021, we prospectively used a bedside RT-PI tool to guide DCR in severely injured patients surviving at least 30 min. RT-PI study patients were compared to contemporary control patients at our institution and historic PROMMTT study patients. A subset of patients transfused ≥6 U red blood cells (RBC) in 6 h (MT+) was also identified. The primary endpoint was percentage time in a high ratio range (≥3:4) of plasma (PLAS):RBC and platelet (PLT):RBC over 6 h. Secondary endpoints included time to massive transfusion protocol activation, time to calcium and tranexamic acid (TXA) dosing, and cumulative 6-h ratios. Included patients (n = 772) were 35 (24-51) years old with an Injury Severity Score of 27 (17-38) and 42% had penetrating injuries. RT-PI (n = 10) patients spent 96% of the 6-h resuscitation in a high PLAS:RBC range, no different versus CONTROL (n = 87) (96%) but more than PROMMTT (n = 675) (25%, p < .001). In the MT+ subgroup, optimal PLAS:RBC and PLT:RBC were maintained for the entire 6 h in RT-PI (n = 4) versus PROMMTT (n = 391) patients for both PLAS (p < .001) and PLT ratios (p < .001). Time to TXA also improved significantly in RT-PI versus CONTROL patients (27 min [22-31] vs. 51 min [29-98], p = .035). In this prospective study, RT-PI was associated with optimized DCR. Multicenter validation of this novel approach to optimizing DCR implementation is warranted.

O objetivo principal deste estudo é compreender o que designa o Izakaya Hyotan, bar tradicional japonês localizado na cidade de Curitiba, como um espaço japonês. Que materialidades e configurações são elementos fundamentais para que percebamos a espacialidade como figurativa de uma estética japonesa. Nosso percurso narrativo foi construído por meio de três imagens que conduzem nossa análise espacial do macro para o micro, ou seja, do ambiente visto de um modo geral, pelos seus contornos e tipo de luz, até chegar em alguns detalhes e objetos. Para tanto, foi preciso acessarmos conceitos estéticos e filosóficos, metáforas poéticas budistas e xintoístas traduzidas no espaço por materialidades que expressam sentimentos de contenção, simplicidade e rusticidade, do mesmo modo, compreender artefatos que manifestam práticas supersticiosas, religiosas e culturais.

-

Abstract Despite the wide sample by sample variation, the electrical conduction mechanism of van der Waals flake thin film is characterized by the variable range hopping over wide range of temperature and subsequent transition into an Arrhenius type conduction at higher temperature. Using the reduced activation energy analysis and a multi-channel conduction model, we discuss how to characterize the nature of the Arrhenius type conduction at high temperature between the nearest neighbor hopping and the band conduction. Also, we examine how those conduction mechanisms are related to the microscopic structure in the electronic density of states of the sample. For the graphene flake thin film sample we synthesized, Mott VRH and band conduction are identified.

Coated gold nanorods (GNRs) are attractive as chemical sensors because their plasmon resonance energy is strongly dependent on the value of the dielectric constant in the local environment. For thin coatings (&lt;≈20 nm), the plasmon resonance is sensitive to both the coating and the surrounding medium, while for thicker coatings the plasmons are effectively screened from their surroundings. We use finite element modeling to develop a semi-empirical effective medium approximation for the dielectric constant surrounding GNRs 30-50 nm in length with coating thicknesses of 0.5-200 nm. We demonstrate that this approximation can be used to correctly interpret shifts in plasmon resonance energy when the dielectric constant of the surroundings changes with temperature. We compare plasmon resonances of gold nanorods embedded in an epoxy matrix when coated with polyethylene glycol or silica of various thicknesses during thermal cycling. The derived expression for the effective medium dielectric of a coated rod will help device engineers optimize the sensitivity and robustness of coated GNR plasmonic sensors.

A new Pselaphinae rove beetle species belonging to the genus Geopselaphus Jeannel, 1956, G. bullonorumsp. nov., from a cave in south Spain is described and diagnosed. Important morphological features of the new species are listed and photographed. The new species shows a significant troglomorphy, such as the reduction of the eyes (only three unpigmented ommatidia) and an extraordinary general elongation of the body (especially the head) and appendages (antennae, maxillary palps and legs). Being the first troglomorphic Pselaphini known worldwide.

Introducción: Los accidentes de tránsito son un problema de salud pública, su atención y forma de presentación desde la atención prehospitalaria hasta las unidades complejas como hospitales son eventos graves en el Ecuador y han hecho que se considere uno de los países con mayores índices de mortalidad por accidentes de tránsito. Objetivo: determinar el número de pacientes evaluados por atención prehospitalaria por accidentes de tránsito que necesitan cirugías de emergencia. Metodología: Investigación no experimental, descriptiva y transversal, con una muestra censal constituido por 75 pacientes atendidos por atención prehospitalaria en accidentes de tránsito y derivados al Hospital General Docente Ambato de la Provincia de Tungurahua, en el período enero­-marzo del 2019, se utilizaron dos escalas un instrumento de atención prehospitalaria y el score de trauma revisado, el análisis estadístico se realizó por el software estadístico (SPSS Estatistics 20.0 para Windows), por medio del cálculo de la distribución numérica y porcentual. Resultados: De los pacientes con atención pre-hospitalaria en accidentes de tránsito predominaron los adolescentes de 12 a 18 años en 40%, pero los pacientes graves evaluados por la escala de trauma revisado la mayor frecuencia fueron los adultos de 27-59 años, el servicio de traumatología tuvo un 53.3% de los pacientes quirúrgicos y las complicaciones postquirúrgicas gastrointestinales representaron un 44.44%. Conclusiones: Los accidentes de tránsito, en su mayoría necesitan cirugías de emergencia, predominando las patologías traumatológicas, la escala de trauma revisado es una herramienta que permiten establecer pautas de atención para reducir la morbimortalidad&#x0D; Palabras Clave: prehospitalaria, emergencia, cirugía , trauma.&#x0D; ABSTRACT&#x0D; Introduction: Traffic accidents are a public health problem, their attention and form of presentation from prehospital care to complex units such as hospitals are serious events in Ecuador and have made it consider one of the countries with the highest mortality rates for traffic accidents. Objective: to determine the number of patients evaluated for pre-hospital care for traffic accidents who need emergency surgeries. Methodology: Non-experimental, descriptive and cross-sectional research, with a census sample made up of 75 patients treated for prehospital care in traffic accidents and referred to the Ambato General Teaching Hospital of the Province of Tungurahua, in the period January-March 2019, Two scales were used, a pre-hospital care instrument and the revised trauma score. Statistical analysis was performed by statistical software (SPSS Statistics 20.0 for Windows), by calculating the numerical and percentage distribution. Results: Of the patients with pre-hospital care in traffic accidents, adolescents aged 12 to 18 years predominated in 40%, but the seriously ill patients evaluated by the revised trauma scale, the highest frequency were adults aged 27-59 years. The trauma department had 53.3% of surgical patients and gastrointestinal post-surgical complications accounted for 44.44%. Conclusions: Traffic accidents mostly require emergency surgeries, predominantly trauma pathologies, the revised trauma scale is a tool that allows establishing care guidelines to reduce morbidity and mortality&#x0D; Key Words: Prehospital, emergency, surgery, trauma.

Dissatisfaction with current methods of burn resuscitation exclusively using Lactated Ringer’s and physician-directed adjustments in hourly fluid infusions are based on a record of excessive total fluid volume infused and complications of fluid overload. Alternative approaches to current standard of care include early use of albumin, supplements of high dose vitamin C and nurse-driven, protocolized care. However, electronic urinary output monitors and computerized decision support technologies are emerging. The efficacy of these approaches of different fluids and computerized solutions remains to be proven with current multicenter trials.

A 1st-principles-inspired physiological model was developed that can predict the redistribution of fluid and albumin in the patient after thermal injury. The key components of the model include volume kinetics, renal function, and burn-induced perturbations in circulatory physiology. The model was developed in such a way that it can be fully characterized by the patient weight, height, and total burn surface area (TBSA) as well as a small set of model parameters to be individualized to predict the patient's response to thermal injury and resuscitation. Based on the underlying physics and constraints of organs, new mathematical functions were developed to describe the renal function and lymph return. A novel approach was employed to implement the effect of burn on the pertinent physiology of patients' body. The model was identified and tested using two groups of sheep undergoing burn injury and resuscitation. The results suggested that the model can boast acceptable accuracy in reproducing experimentally observed plasma volume and urinary output despite its simplicity. Such a model, after meeting the requirements on accuracy and physiological credibility, may facilitate the validation and testing of burn resuscitation protocols and closed-loop decision support systems.

Arctos (https://arctosdb.org), an online collection management information system, was developed in 1999 to manage museum specimen data and to make those data publicly available. The portal (arctos.database.museum) now serves data on over 3.5 million cataloged specimens from more than 130 collections throughout North America in an instance at the Texas Advanced Computing Center. Arctos also is a community of museum professionals that collaborates on museum best practices and works together to improve Arctos data richness and functionality for on-line museum data streaming. In 2017, three large Arctos genomics collections at the Museum of Southwestern Biology (MSB), Museum of Vertebrate Zoology, Berkeley (MVZ), and University of Alaska Museum of the North (UAM), received support from GGBN to create a pipeline for publishing data from Arctos to the GGBN portal. Modifications to Arctos included standardization of controlled vocabulary for tissues; changes to the data structure and code tables with regard to permit information, container history, part attributes, and sample quality; implementation of interfaces and protocols for parent-child relationships between tissues, tissue subsamples, and DNA extracts; and coordination with the DWC community to ensure that all GGBN data standards and formatting are included in the standard DWC export in order to finalize the pipeline to GGBN. The addition of these three primary Arctos biorepositories to the GGBN network will add over 750,000 tissue and DNA records representing over 11,000 species and 667 families. These voucher-based archives represent primarily vertebrate taxa, with growing collections of arthropods, endoparasites, and incipient collections of microbiome and environmental samples associated with online media and linked to GenBank and other external databases. The high-quality data in Arctos complement and significantly extend existing GGBN holdings, and the establishment of an Arctos-GGBN pipeline also will facilitate future collaboration between more Arctos collections and GGBN.