Lactate clearance and survival following injury

Previous reports cite optimization of O2 delivery (DO2) to 660 mL/min/m2, O2 consumption (VO2) to 170 mL/min/m2, and cardiac index (CI) of 4.5 L/min as predicting survival. We prospectively evaluated 76 consecutive patients with multiple trauma admitted directly to the ICU from the operating room or emergency department. Patients had serum lactate levels and oxygen transport measured on ICU admission and at 8, 16, 24, 36, and 48 hours. Patients were analyzed with respect to survival (S) versus nonsurvival (NS), lactate clearance to normal (< or = 2 mmol/L) by 24 and 48 hours, hemodynamic optimization as defined above, as well as Injury Severity Score (ISS), ICU stay (LOS), and admission blood pressure. All patients achieved non-flow-dependent VO2. There was no difference in CI, DO2, VO2, or ISS when S was compared with NS. All 27 patients whose lactate level normalized in 24 hours survived. If lactate levels cleared to normal between 24 and 48 hours, the survival rate was 75%. Only 3 of the 22 patients who did not clear their lactate level to normal by 48 hours survived. Ten of the 25 nonsurvivors (40%) achieved the above arbitrary optimization criteria. Fifteen of the survivors never achieved any of these criteria. Optimization alone does not predict survival. However, the time needed to normalize serum lactate levels is an important prognostic factor for survival in severely injured patients.     

The future of behavior therapy.

Predicts the future of behavior therapy, focusing on theoretical development, therapeutic techniques, and empirical research. The importance of cognitive and affective processes in behavior change will attract increasing attention. Already one of the most widely adopted approaches, behavior therapy will be used to treat an expanded range of psychiatric disorders and health problems. Research will focus on comparative outcome studies and provide probes for investigating the nature of specific disorders and the mechanisms of therapeutic change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Analysis of characteristic odors from human male axillae

A number of studies concerning the analysis of axillary odors have assumed that the characteristic odor produced in the axillae is due to volatile steroids and isovaleric acid. Organoleptic evaluation of Chromatographic eluants from axillary extracts was employed to isolate the region in the chromatogram where the characteristic odor eluted. The odor of the dissolved eluant was eliminated when it was treated with base, suggesting that acids make up the characteristic axillary odor. Subsequent extraction of the pH-adjusted axillary extract in conjunction with organoleptic evaluation of the Chromatographic eluant, preparative gas chromatography, and analysis by GC-MS as well as GC-FTIR showed the presence of a number of C₆ to C₁₁ straight-chain, branched, and unsaturated acids as important contributors to the axillary odor. The major odor component is (E)-3-methyl-2-hexenoic acid. Three homologous series of minor components are also important odor contributors; these consist of the terminally unsaturated acids, the 2-methyl-C₆ to -C₁₀ acids and the 4-ethyl-C₅ to -C₁₁ acids. These types of acids have not been reported previously as components of the human axillary secretions and have not been proposed previously as part of the principal odor components in this area.     

Selbstgesteuertes Identitätsmanagement

Von eBay bis Xbox Live — wer im Internet unterwegs ist, nutzt viele (Teil-) Identit?ten. Um Waren zu verkaufen oder Dienste anzubieten, tritt man anders auf, als wenn man einfach nur online spielen m?chte. Pseudonyme helfen die Privatsph?re zu wahren. Doch nicht immer ist die Modifikation von Identit?tsmerkmalen zul?ssig.     

Adaptive 2D finite element simulation of metal forming processes

The development and integration of available current methods and the development of new methods for an adaptive finite element analysis of metal forming processes are presented. The analysis includes large-strain, elastic–plastic, and thermal effects. Many numerical methods such as mesh generation, simulation of the contact between the workpiece and tool and die, and optimization of the finite element mesh are integrated and incorporated. In addition, an algorithm is developed which can detect certain severely distorted elements where the area of integration is approaching zero. The advantage of correcting these regions of locally distorted elements is demonstrated. These numerical methods are implemented in a finite element program developed for simulating metal forming processes, with the emphasis on automating the analysis. Examples include an axisymmetric stress simulation of a coldheading process, a plane strain simulation of an extrusion process and a plane strain simulation of orthogonal metal cutting, all with noticeable thermal effects. The orthogonal cutting forces and feed forces calculated are compared with two sets of experimental data, with good agreement.     

Internalization of interpersonal process in time-limited dynamic psychotherapy.

[Correction Notice: An erratum for this article was reported in Vol 31(3) of Psychotherapy: Theory, Research, Practice, Training (see record 2009-17141-002). This article contained, as Figure 1, an SASB model. The authorship and copyrights for the model were not acknowledged. The following acknowledgement should have been included: "Adapted from Benjamin (1984). Principles of Prediction using Structural Analysis of Social Behavior (SASB). In R. A. Zucker, J. Aronoff, and A. J. Rabin (Eds.), Personality and the Prediction of Behavior (pp. 121- 174). New York: Academic." An apology is offered to the author, Dr. Lorna Smith Benjamin. The particular version used in the article was developed in collaboration with Clinton W. McLemore.] Investigated the internalization of positive aspects of therapist–patient (TP) interactions among 70 patients and their 16 therapists who participated in a 5-yr study (H. H. Strupp et al, unpublished) of time-limited dynamic psychotherapy. Patients sought help for anxiety, depression, or other problems with a clear interpersonal component and qualified for an Axis I or Axis II diagnosis on the Diagnostic and Statistical Manual of Mental Disorders-III (DSM-III). Instruments included the Structural Analysis of Social Behavior and outcome measures of depression, anxiety, and psychological functioning. Patients' intrapsychic functioning became more similar to interpersonal activity in the TP relationship over the course of psychotherapy. Intrapsychic movement toward interpersonal activity in the TP relationship was associated with positive outcome on measures of depression, anxiety, and on independent clinician ratings of patient psychological functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Piaget and plasticine: Who's right about conservation?

Comments on the article by J. Macnamara and G. Austin (see record 1994-05070-001) suggesting that Piaget seriously misinterpreted the significance of children's documented difficulties in correctly responding to tasks involving conservation of quantity. It is shown that Macnamara and Austin make some basic errors in their analysis of the Piagetian position and that their alternative theory of how children learn to conserve is both inconsistent with empirical evidence and epistemologically untenable. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Resonant couplers acting as add-drop filters made withsilica-on-silicon waveguide technology

Add-drop filters are demonstrated using silica-on-silicon optical waveguide technology. This device consists of a full directional coupler subdivided by Mach-Zehnder sections. Tapering of the coupling coefficients is experimentally shown to dramatically reduce the filters' sidelobes. Only one photolithographic step is required using the silica planar waveguide technology, yielding accurate wavelength control of the filters. Excellent agreement between measurement and design was achieved     

Cognitive treatments for eating disorders.

Cognitive-behavioral therapy (CBT) is applicable to all eating disorders but has been most intensively studied in the treatment of bulimia nervosa (BN). CBT is designed to alter abnormal attitudes about body shape and weight, replace dysfunctional dieting with normal eating habits, and develop coping skills for resisting binge eating and purging. CBT is effective in reducing all core features of BN and shows good maintenance of therapeutic improvement. Although superior to therapy with antidepressant drugs, CBT has not been shown to be consistently superior to alternative psychological treatments. Different hypotheses about CBT's mechanisms of action are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)