1,008 research outputs found
Enumeration of Hypermaps of a Given Genus
Full text linkThis paper addresses the enumeration of rooted and unrooted hypermaps of a
given genus. For rooted hypermaps the enumeration method consists of
considering the more general family of multirooted hypermaps, in which darts
other than the root dart are distinguished. We give functional equations for
the generating series counting multirooted hypermaps of a given genus by number
of darts, vertices, edges, faces and the degrees of the vertices containing the
distinguished darts. We solve these equations to get parametric expressions of
the generating functions of rooted hypermaps of low genus. We also count
unrooted hypermaps of given genus by number of darts, vertices, hyperedges and
faces.Comment: 42 page
Red cell transfusion triggers in critically ill patients: time for some new TRICCs?
Get PDFCurrent evidence suggests that critically ill patients tolerate anaemia well and that blood transfusions may increase the risk of adverse outcomes. Dr Sakr and colleagues present a contradictory analysis of a surgical ICU cohort, finding an association between blood transfusions and lower hospital mortality after adjustment for a range of potential confounders. Analyses of this kind are interesting and provocative, but are limited by residual confounding and bias by indication. The data emphasise the need for additional high quality trials of transfusion practice in critical care
SOUTHERNMOST OCCURRENCE OF THE SUWANNEE COOTER, PSEUDEMYS CONCINNA SUWANNIENSIS (TESTUDINES: EMYDIDAE)
Get PDFThe Suwannee Cooter, Pseudemys concinna suwanniensis, the largest member of the speciose turtle family Emydidae, inhabits a small number of rivers that drain into the northeastern Gulf of Mexico along the northwest coast of Florida from just west of Tallahassee to just south of Tampa. The status of this state-protected subspecies in the southernmost of these rivers, the Alafia, is unknown and hence of conservation concern. We provide recent evidence confirming that a reproducing population still exists in this river, and review available specimens and both published and unpublished records documenting the southern limit of distribution. At least within the eastern United States, our observations also extend confirmed knowledge of the geographic occurrence of hatchling turtles overwintering in the nest southward by 285 km
Prolonged mechanical ventilation in critically ill patients: epidemiology, outcomes and modelling the potential cost consequences of establishing a regional weaning unit
Get PDFA novel computerized test for detecting and monitoring visual attentional deficits and delirium in the ICU
Get PDFObjectives: Delirium in the ICU is associated with poor outcomes
but is under-detected. Here we evaluated performance of a novel,
graded test for objectively detecting inattention in delirium, implemented
on a custom-built computerized device (Edinburgh Delirium
Test Box–ICU).
Design: A pilot study was conducted, followed by a prospective
case-control study.
Setting: Royal Infirmary of Edinburgh General ICU.
Patients: A pilot study was conducted in an opportunistic sample
of 20 patients. This was followed by a validation study in
30 selected patients with and without delirium (median age,
63 yr; range, 23–84) who were assessed with the Edinburgh
Delirium Test Box–ICU on up to 5 separate days. Presence
of delirium was assessed using the Confusion Assessment
Method for the ICU.
Measurements and Main Results: The Edinburgh Delirium Test
Box–ICU involves a behavioral assessment and a computerized
test of attention, requiring patients to count slowly presented
lights. Thirty patients were assessed a total of 79 times (n = 31, 23,
15, 8, and 2 for subsequent assessments; 38% delirious). Edinburgh
Delirium Test Box–ICU scores (range, 0–11) were lower
for patients with delirium than those without at the first (median, 0
vs 9.5), second (median, 3.5 vs 9), and third (median, 0 vs 10.5)
assessments (all p < 0.001). An Edinburgh Delirium Test Box–ICU
score less than or equal to 5 was 100% sensitive and 92% specific
to delirium across assessments. Longitudinally, participants’
Edinburgh Delirium Test Box–ICU performance was associated
with delirium status.
Conclusions: These findings suggest that the Edinburgh Delirium
Test Box–ICU has diagnostic utility in detecting ICU delirium
in patients with Richmond Agitation and Sedation Scale Score
greater than –3. The Edinburgh Delirium Test Box–ICU has potential
additional value in longitudinally tracking attentional deficits
because it provides a range of scores and is sensitive to change
Resuscitation of the trauma patient: tell me a trigger for early haemostatic resuscitation please!
Get PDFThe management of trauma-related coagulopathy and haemorrhage is changing from a reactive strategy to a proactive early intervention with blood products and haemostatic agents. Although major haemorrhage and massive transfusion are associated with higher mortality, the pattern of this association with modern trauma care is poorly described. In addition, early predictors of massive transfusion, which might trigger a proactive haemostatic resuscitation strategy, are not currently available. We review recent literature relating to predictors of massive transfusions and the relationship between transfusion and mortality
Development and feasibility of a smartphone-based test for the objective detection and monitoring of attention impairments in delirium in the ICU
Get PDFHyperinflammation and mediators of immune suppression in critical illness
Get PDFCritical illness, constituting an acute illness or injury resulting in organ dysfunction and failure, is associated with a profound, systemic activation of the immune system and inflammation-mediated organ damage [1]. However, critically ill patients also suffer a high rate of nosocomial infection with secondary sepsis being a common cause of death [2]. This high prevalence of secondary infections argues for the influence of an immune suppression that may, at first glance, appear paradoxical in light of the pro-inflammatory nature of many critical illnesses. Although immune cell hypo-function has been noted in clinical and experimental critical illnesses, the mediators of these effects remain poorly defined. This review will present the recent evidence accumulating for the role of pro-inflammatory mediators in driving immune dysfunction, and how this insight may, in part, explain the apparent paradox of immune suppression occurring in a patient with manifestations of hyperinflammation [3]
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