Intraoperative end-tidal carbon dioxide values and derived calculations correlated with outcome: prognosis and capnography

OBJECTIVE: To determine how much information concerning resuscitation and outcome is provided by the end-tidal CO2 and derived variables obtained during surgery. DESIGN: Retrospective chart review. SETTING: Emergency hospital operating room. PATIENTS: One hundred critically ill or injured patients requiring major surgery and having a mortality rate of 41%. INTERVENTIONS: Standard intraoperative monitoring, including continuous capnography, plus arterial blood gas analyses every 1 to 1.5 hrs during surgery. MEASUREMENTS AND MAIN RESULTS: There was only a fair correlation between the PaCO2 and end-tidal CO2 (r2 = .14). The mortality rates in these patients were highest in those patients who had the lowest end-tidal CO2 values, the highest arterial to end-tidal CO2 differences, and the highest estimated alveolar deadspace fraction. A persistent end-tidal CO2 of < or = 28 torr (< or = 3.8 kPa) was associated with a mortality rate of 55% (vs. 17% in those patients with a higher end-tidal CO2). The mortality rate was also increased in patients with a persistent arterial to end-tidal CO2 difference of > or = 8 torr (> or = 1.1 kPa) (58% vs. 23%). CONCLUSIONS: End-tidal CO2 and derived values should be monitored closely in critically ill or injured patients. Efforts should be made--by increasing cardiac output and core temperature and by adjusting ventilation as needed--to maintain the end-tidal CO2 at > or = 29 torr (> or = 3.9 kPa) and the arterial to end-tidal CO2 difference at < or = 7 torr (< or = 1.0 kPa).     

Quantitative pulsed CEST-MRI at a clinical 3T MRI system

Objectives

The goal of this study was to quantify CEST related parameters such as chemical exchange rate and fractional concentration of exchanging protons at a clinical 3T scanner. For this purpose, two CEST quantification approaches—the AREX metric (for ‘apparent exchange dependent relaxation’), and the AREX-based Ω-plot method were used. In addition, two different pulsed RF irradiation schemes, using Gaussian-shaped and spin-lock pulses, were compared.

Materials and methods

Numerical simulations as well as MRI measurements in phantoms were performed. For simulations, the Bloch–McConnell equations were solved using a two-pool exchange model. MR experiments were performed on a clinical 3T MRI scanner using a cylindrical phantom filled with creatine solution at different pH values and different concentrations.

Results

The validity of the Ω-plot method and the AREX approach using spin-lock preparation for determination of the quantitative CEST parameters was demonstrated. Especially promising results were achieved for the Ω-plot method when the spin-lock preparation was employed.

Conclusion

Pulsed CEST at 3T could be used to quantify parameters such as exchange rate constants and concentrations of protons exchanging with free water. In the future this technique might be used to estimate the exchange rates and concentrations of biochemical substances in human tissues in vivo.

     

Dynamic tax depreciation strategies

The tax depreciation decision potentially has significant impact on the profitability of firms and projects. Indeed, the depreciation method chosen for tax purposes affects the timing of tax payments, and, as a consequence, it also affects the after-tax net present value of investment projects. Previous research focusses on the optimal choice of depreciation method under the assumption that the depreciation method has to be set ex ante and cannot be changed during the useful life of the asset. However, several countries allow changes of depreciation method under certain circumstances. This paper develops a dynamic programming approach to determine the firm??s optimal choice with regard to the initial depreciation method, and whether changes of method are proposed in later periods.     

Reduction of Campylobacter jejuni by natural antimicrobials in chicken meat-related conditions

Nowadays it is essential to test new preservation and decontamination procedures using naturally occurring chemicals against important pathogenic bacteria in meat. We tested the antimicrobial effect of rosemary extracts and the bacteriocin nisin against Campylobacter jejuni at a low storage temperature (8 °C) with or without short-term pre-freezing. The antimicrobial effect of rosemary extract was four times greater in laboratory media than in chicken meat juice. Furthermore, low temperature storage conditions prolonged the survival of C. jejuni in chicken meat juice. Nisin, with an approximately 1.0 log reduction was neither effective alone nor in combination with the extract. Pre-freezing with plant extract addition proved to be effective treatment by more than 3.0 log reduction in 48 h. The results in chicken meat food model again showed the synergistic effect of freezing and plant extract antimicrobial activity. As the combination of pre-freezing and plant extract treatment reduced the cell number by more than 2.0 log reduction, studies should be conducted to further evaluate this promising treatment for Campylobacter reduction in the poultry meat supply.     

Short communication: A comparison between purebred Holstein and Brown Swiss × Holstein cows for milk production, somatic cell score, milking speed, and udder measurements in the first 3 lactations

Brown Swiss × Holstein (BS × HO) crossbred cows (n = 55) and purebred Holstein (HO) cows (n = 50) were compared for milk yield, fat and protein production, somatic cell score, milking speed, and udder measurements for the first 3 lactations. Cows from a designed experiment were housed in a freestall barn at the experimental station of the federal state of Saxony-Anhalt, Germany, and calved from July 2005 to August 2008. Best prediction was used to determine actual production for 305-d lactations from test-day observations. For the first 3 lactations, BS × HO cows and HO cows were not significantly different for milk yield, fat and protein production, or SCS. Average milking time was significantly longer for BS × HO cows than for HO cows for first, second, and third lactations by 35, 51, and 30 s, respectively. Average milking speed expressed as average yield per minute was significantly lower for BS × HO cows than for HO cows for the first 3 lactations by 0.19, 0.35, and 0.19 kg/min, respectively. Front and rear teats were significantly longer for BS × HO cows than for HO cows. Furthermore, front and rear udder clearance was significantly lower for BS × HO cows compared with HO cows in first and second lactations.     

Folgen des Globalen Wandels für das Grundwasser in Süddeutschland – Teil 2: Sozioökonomische Aspekte

In order to account for complex interactions between humans climate and the water cycle, the research consortium GLOWA-Danube (www.glowa-danube.de) has developed the simulation system DANUBIA which consists of 17 coupled models. DANUBIA was applied to investigate various impacts of global-change between 2011 and 2060 in the Upper Danube Catchment. This article describes part 2 of an article series with investigations of socio-economic aspects, while part 1 (Barthel et al. in Grundwasser 16(4), doi:10.1007/s007-011-01794, 2011) deals with natural-spatial aspects. The principles of socio-economic actor-modeling and interactions between socio-economic and natural science model components are described here. We present selected simulations that show impacts on groundwater from changes in agriculture, tourism, economy, domestic water users and water supply. Despite decreases in water consumption, the scenario simulations show significant decreases in groundwater quantity. On the other hand, groundwater quality will likely be influenced more severely by land use changes compared to direct climatic causes. However, overall changes will not be dramatic.