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.     

Geometric probing of dense range data

A new method is presented for the efficient and reliable pose determination of 3D objects in dense range image data. The method is based upon a minimalistic Geometric Probing strategy that hypothesizes the intersection of the object with some selected image point, and searches for additional surface data at locations relative to that point. The strategy is implemented in the discrete domain as a binary decision tree classifier. The tree leaf nodes represent individual voxel templates of the model, with one template per distinct model pose. The internal nodes represent the union of the templates of their descendant leaf nodes. The union of all leaf node templates is the complete template set of the model over its discrete pose space. Each internal node also encodes a single voxel which is the most common element of its child node templates. Traversing the free is equivalent to efficiently matching the large set of templates at a selected image seed location. The method was implemented and extensive experiments were conducted for a variety of combinations of tree designs and traversals under isolated, cluttered, and occluded scene conditions. The results demonstrated a tradeoff between efficiency and reliability. It was concluded that there exist combinations of tree design and traversal which are both highly efficient and reliable     

Unsupervised image-set clustering using an information theoretic framework.

In this paper, we combine discrete and continuous image models with information-theoretic-based criteria for unsupervised hierarchical image-set clustering. The continuous image modeling is based on mixture of Gaussian densities. The unsupervised image-set clustering is based on a generalized version of a recently introduced information-theoretic principle, the information bottleneck principle. Images are clustered such that the mutual information between the clusters and the image content is maximally preserved. Experimental results demonstrate the performance of the proposed framework for image clustering on a large image set. Information theoretic tools are used to evaluate cluster quality. Particular emphasis is placed on the application of the clustering for efficient image search and retrieval.     

Epoxy fatty acid ester plasticizers. Preparation and properties

Summary The preparation of epoxy fatty acid ester plasticizers has been reviewed. These plasticizers can be prepared by epoxidation reactions, utilizing a preformed peracid or anin-situ technique. A newin-situ epoxidation process, utilizing hydrogen peroxide and acetic acid in the presence of strong acid catalyst, has been described. Excellent conversions to epoxide have been achieved with a series of monounsaturated and polyunsaturated esters. Epoxy fatty acid esters are excellent plasticizers for vinyl resins. Their performance in a series of additional epoxy plasticizers of vegetable and marine origin is described. Novel epoxy plasticizers based upon mixed acetylated mono- and di-glyceride have been prepared and are found to have excellent plasticizer performance. Presented at the 28th fall meeting, American Oil Chemists’ Society, October 1954, Minneapolis, Minn.     

Model-based tracking by classification in a tiny discrete pose space

A method is presented for tracking 3D objects as they transform rigidly in space within a sparse range image sequence. The method operates in discrete space and exploits the coherence across image frames that results from the relationship between known bounds on the object's velocity and the sensor frame rate. These motion bounds allow the interframe transformation space to be reduced to a reasonable and indeed tiny size, comprising only tens or hundreds of possible states. The tracking problem is in this way cast into a classification framework, effectively trading off localization precision for runtime efficiency and robustness. The method has been implemented and tested extensively on a variety of freeform objects within a sparse range data stream comprising only a few hundred points per image. It has been shown to compare favorably against continuous domain iterative closest point (ICP) tracking methods, performing both more efficiently and more robustly. A hybrid method has also been implemented that executes a small number of ICP iterations following the initial discrete classification phase. This hybrid method is both more efficient than the ICP alone and more robust than either the discrete classification method or the ICP separately     

Mixture model for face-color modeling and segmentation

In this paper, we propose a general methodology for face-color modeling and segmentation. One of the major difficulties in face detection and retrieval is partial face extraction due to highlights, shadows and lighting variations. We show that a mixture-of-Gaussians modeling of the color space, provides a robust representation that can accommodate large color variations, as well as highlights and shadows. Our method enables to segment within-face regions, and associate semantic meaning to them, and provides statistical analysis and evaluation of the dominant variability within a given archive.     

Efficacy of psychotherapy. Asking the right questions

Economic pressures and "value" judgments both compel and contaminate the current debate on the efficacy of psychotherapy. Too often, complex clinical trial outcome studies ignore the clinical or treatment process, as well as personality or contextual variables. Thus, they fail to build the foundations of a clinical science that makes possible the development of individually tailored treatment approaches and outcome predictions for specific patients with unique personalities, symptoms, and life circumstances. The real challenge, therefore, is for each psychotherapeutic approach to delineate its "process steps" and relate these steps to different outcomes. The "process" is the "final common pathway" for a number of patient, therapist, technique, and contextual variables. The capacity to predict the relationship between process and outcome at each stage in a therapeutic procedure is the relevant clinical test of "efficacy."     

Plutonium recycling in hydride fueled PWR cores

The classic approach to the recycling of Pu in PWR is to use mixed U-oxide Pu-oxide (MOX) fuel. The mono-recycling of plutonium in PWR transmutes less than 30% of the loaded plutonium, providing only a limited reduction in the long-term radiotoxicity and in the inventory of TRU to be stored in the repository. The primary objective of this study is to assess the feasibility of plutonium recycling in PWR in the form of plutonium hydride, PuH₂, mixed with uranium and zirconium hydride, ZrH_1.6, referred to as PUZH, that is loaded uniformly in each fuel rod. The assessment is performed by comparing the performance of the PUZH fueled core to that of the MOX fueled core. Performance characteristics examined are transmutation effectiveness, proliferation resistance of the discharged fuel and fuel cycle economics. The PUZH loaded core is found superior to the MOX fueled core in terms of the transmutation effectiveness and proliferation resistance. For the reference cycle duration and reference fuel rod diameter and pitch, the percentage of the plutonium loaded that is transmuted in one recycle is 53% for PUZH versus 29% for MOX fuel. That is, the net amount of plutonium transmuted in the first recycle is 55% higher in cores using PUZH than in cores using MOX fuel. Relative to the discharged MOX, the discharged PUZH fuel has smaller fissile plutonium fraction - 45% versus 60%, 15% smaller minor actinides (MA) inventory and more than double spontaneous fission neutron source intensity and decay heat per gram of discharged TRU. Relative to the MOX fuel assembly, the radioactivity of the PUZH fuel assembly is 26% smaller and the decay heat and the neutron yield are only 3% larger. The net effect is that the handling of the discharged PUZH fuel assembly will be comparable in difficulty to that of the discharged MOX assembly while the proliferation resistance of the TRU of the discharged PUZH fuel is enhanced.     

Uranium-zirconium hydride fuel properties

Properties of the two-phase hydride U_0.3ZrH_1.6 pertinent to performance as a nuclear fuel for LWRs are reviewed. Much of the available data come from the Space Nuclear Auxiliary Power (SNAP) program of 4 decades ago and from the more restricted data base prepared for the TRIGA research reactors some 3 decades back. Transport, mechanical, thermal and chemical properties are summarized. A principal difference between oxide and hydride fuels is the high thermal conductivity of the latter. This feature greatly decreases the temperature drop over the fuel during operation, thereby reducing the release of fission gases to the fraction due only to recoil. However, very unusual early swelling due to void formation around the uranium particles has been observed in hydride fuels. Avoidance of this source of swelling limits the maximum fuel temperature to ∼650 °C (the design limit recommended by the fuel developer is 750 °C). To satisfy this temperature limitation, the fuel-cladding gap needs to be bonded with a liquid metal instead of helium. Because the former has a thermal conductivity ∼100 times larger than the latter, there is no restriction on gap thickness as there is in helium-bonded fuel rods. This opens the possibility of initial gap sizes large enough to significantly delay the onset of pellet-cladding mechanical interaction (PCMI). The large fission-product swelling rate of hydride fuel (3× that of oxide fuel) requires an initial radial fuel-cladding gap of ∼300 m if PCMI is to be avoided. The liquid-metal bond permits operation of the fuel at current LWR linear-heat-generation rates without exceeding any design constraint. The behavior of hydrogen in the fuel is the source of phenomena during operation that are absent in oxide fuels. Because of the large heat of transport (thermal diffusivity) of H in ZrH_x, redistribution of hydrogen in the temperature gradient in the fuel pellet changes the initial H/Zr ratio of 1.6 to ∼1.45 at the center and ∼1.70 at the periphery. Because the density of the hydride decreases with increasing H/Zr ratio, the result of H redistribution is to subject the interior of the pellet to a tensile stress while the outside of the pellet is placed in compression. The resulting stress at the pellet periphery is sufficient to overcome the tensile stress due to thermal expansion in the temperature gradient and to prevent radial cracking that is a characteristic of oxide fuel. Several mechanisms for reduction of the H/Zr ratio during irradiation are identified. The first is transfer of impurity oxygen in the fuel from Zr to rare-earth oxide fission products. The second is the formation of metal hydrides by these same fission products. The third is by loss to the plenum as H₂.The review of the fabrication method for the hydride fuel suggests that its production, even on a large scale, may be significantly higher than the cost of oxide fuel fabrication.     

Economic analysis of grid and wire wrap supported hydride and oxide fueled pressurized water reactors

An economic analysis is performed to calculate the levelized unit cost of electricity (COE) for a pressurized water reactor (PWR) retrofitted with a range of potential U (45 wt.%)-ZrH_1.6 hydride and UO₂ oxide fueled geometries (i.e., combinations of rod diameter and pitch) supported by traditional grid spacers (square array) and wire wrap spacers (hexagonal array). The time frame considered in computing the COE is the remaining plant life, beginning at the time of retrofit. The goals of the analysis are twofold: (1) comparing the economic performance of UO₂ and U-ZrH_1.6 fuels for a range of retrofitted geometries supported by grid and wire wrap spacers; and (2) investigating the potential economic benefits for nuclear utilities considering retrofitting new fuels and/or geometries into existing PWR pressure vessels. Fuel cycle, operations and maintenance (O & M), and capital costs are considered.The economic performance of U-ZrH_1.6 and UO₂ fuels is found to be similar, with UO₂ fueled designs providing a slight advantage when supported by grid spacers, and U-ZrH_1.6 providing a slight advantage when supported by wire wrap spacers. These small differences in cost, however, are within the bounds of uncertainty of this study and are not believed to provide a strong economic argument for the use of one fuel type over the other.To demonstrate the potential economic benefits of retrofitted designs to nuclear utilities, two different comparisons are made. The first compares the COE for retrofitted designs with the COE for a reference PWR, assumed to have operated long enough to recuperate its initial capital investment. The costs for this reference PWR reflect the “do-nothing” case for current plant owners whose primary expenditures are fuel cycle and O & M costs. The second comparison introduces a different reference PWR that includes the costs to operate an existing unit and the cost to purchase power from a newly constructed PWR, for comparison with retrofitted designs which offer increased power relative to existing commercial PWRs.For the first comparison, no grid supported designs and only one wire wrap supported design (i.e., U-ZrH_1.6 Stretch Case) provide a lower levelized unit cost of electricity than the reference “do-nothing” PWR. The primary cause of this conclusion is the capital costs incurred by retrofitted designs to change the core geometry and, for many designs, to upgrade primary and secondary loop components for operation at higher power than the reference PWR. The reference “do-nothing” PWR cost in this first comparison includes only operations and maintenance as well as fuel cycle costs but does not include a capital component. For the second comparison, significant cost savings are demonstrated for both grid (15-19% savings) and wire wrap (30-40% savings) supported designs using U-ZrH_1.6 and UO₂ fuels. These cost savings are enabled by enhancing the pumping capacity of the primary system and, for wire wrap supported designs, by taking advantage of enhanced critical heat flux performance. The optimal geometry for retrofitted UO₂ and U-ZrH_1.6 fueled PWR cores supported by grid spacers is D_rod = 6.5 mm and P/D = 1.39. The cost savings over the second case reference PWR are ∼19 and 15%, respectively. The cost savings for retrofitted PWRs that incorporate wire wrap spacing are even larger because of operation at even higher power. Cost savings over the reference PWR range between 30 and 40% for the U-ZrH_1.6 and UO₂ Achievable and Stretch Cases. The optimal geometries for the U-ZrH_1.6 Achievable and Stretch Cases are D_rod = 8.08 mm, P/D = 1.41 and D_rod = 8.71 mm, P/D = 1.39, respectively. The optimal geometries for the UO₂ Achievable and Stretch Cases are D_rod = 7.13 mm, P/D = 1.42 and D_rod = 9.34 mm, P/D = 1.27, respectively. Utilities seeking to meet rising demand by expanding capacity may therefore strongly benefit from retrofitting existing PWRs with either U-ZrH_1.6 or UO₂ fueled designs. These new designs have different geometries than are currently used by commercial plants. A conclusion on which fuel type to use, however, could not be reached in this analysis as both offer similar economic performance.