ROLE OF VENTILATION IN CASES OF ACUTE RESPIRATORY DISTRESS SYNDROME /ACUTE LUNG INJURY

Introduction: Acute lung injury (ALI) and Acute Respiratory Distress Syndrome (ARDS) are characterized by re- fractory hypoxemia that develops secondary to high-permeability pulmonary edema. These syndromes are gaining more attention as a means of better comprehending the pathophysiology of ARDS and possiblyfor modifying venti- latory management. In this context a study was done to compare role of invasive and non-invasive ventilation in cases of ARDS/ALI. Methods: in this study patients of ARDS admitted in intensive care ward due to Pulmonary and Extra Pulmonary Sepsis (Lung Injury) during May 2008 to April 2011were included in the study. All the patients were clinically ex- amined and investigated after taking informed consent. Traumatic patients with ARDS were excluded from study. Results: In this study of 100 cases of ARDS/ALI admitted in ICU, all 44 cases on non‐invasive ventilation were improved. Whereas, out of 44 cases on invasive ventilation only 5 improved and 39 were expired. Rest 12 required no ventilator support. Conclusion: Early application of Non-invasive ventilation in patients of ARDS/ALI, in form of high PEEP and low Tidal Volume, which helps in clearance of secretion and prevents collapse of alveoli and thereby decreases need of invasive ventilation as well as decreases the mortality due to ARDS/ALI;and thereby 100% chances of improve- ment. In invasive ventilation, outcome of the patients is not favorable.

The Simons Observatory Large Aperture Telescope Receiver

The Simons Observatory (SO) Large Aperture Telescope Receiver (LATR) will be coupled to the Large Aperture Telescope located at an elevation of 5,200 m on Cerro Toco in Chile. The resulting instrument will produce arcminute-resolution millimeter-wave maps of half the sky with unprecedented precision. The LATR is the largest cryogenic millimeter-wave camera built to date with a diameter of 2.4 m and a length of 2.6 m. It cools 1200 kg of material to 4 K and 200 kg to 100 mk, the operating temperature of the bolometric detectors with bands centered around 27, 39, 93, 145, 225, and 280 GHz. Ultimately, the LATR will accommodate 13 40 cm diameter optics tubes, each with three detector wafers and a total of 62,000 detectors. The LATR design must simultaneously maintain the optical alignment of the system, control stray light, provide cryogenic isolation, limit thermal gradients, and minimize the time to cool the system from room temperature to 100 mK. The interplay between these competing factors poses unique challenges. We discuss the trade studies involved with the design, the final optimization, the construction, and ultimate performance of the system

Acknowledgement to reviewers of journal of functional biomaterials in 2019

The editorial team greatly appreciates the reviewers who have dedicated their considerable time and expertise to the journal’s rigorous editorial process over the past 12 months, regardless of whether the papers are finally published or not. In 2019, a total of 56 papers were published in the journal, with a median time to first decision of 18 days and a median time from submission to publication of 44 days. The editors would like to express their sincere gratitude to the following reviewers for their generous contribution in 201

The Simons Observatory: science goals and forecasts for the enhanced Large Aperture Telescope

We describe updated scientific goals for the wide-field, millimeter-wave survey that will be produced by the Simons Observatory (SO). Significant upgrades to the 6-meter SO Large Aperture Telescope (LAT) are expected to be complete by 2028, and will include a doubled mapping speed with 30,000 new detectors and an automated data reduction pipeline. In addition, a new photovoltaic array will supply most of the observatory's power. The LAT survey will cover about 60% of the sky at a regular observing cadence, with five times the angular resolution and ten times the map depth of the Planck satellite. The science goals are to: (1) determine the physical conditions in the early universe and constrain the existence of new light particles; (2) measure the integrated distribution of mass, electron pressure, and electron momentum in the late-time universe, and, in combination with optical surveys, determine the neutrino mass and the effects of dark energy via tomographic measurements of the growth of structure at redshifts z ≲ 3; (3) measure the distribution of electron density and pressure around galaxy groups and clusters, and calibrate the effects of energy input from galaxy formation on the surrounding environment; (4) produce a sample of more than 30,000 galaxy clusters, and more than 100,000 extragalactic millimeter sources, including regularly sampled AGN light-curves, to study these sources and their emission physics; (5) measure the polarized emission from magnetically aligned dust grains in our Galaxy, to study the properties of dust and the role of magnetic fields in star formation; (6) constrain asteroid regoliths, search for Trans-Neptunian Objects, and either detect or eliminate large portions of the phase space in the search for Planet 9; and (7) provide a powerful new window into the transient universe on time scales of minutes to years, concurrent with observations from the Vera C. Rubin Observatory of overlapping sky

An investigation of sepsis surveillance and emergency treatment on patient mortality outcomes: An observational cohort study

Abstract Objective To determine the prevalence of initiating the sepsis 3-h bundle of care and estimate effects of bundle completion on risk-adjusted mortality among emergency department (ED) patients screened-in by electronic surveillance. Materials and Methods This was a multiple center observational cohort study conducted in 2016. The study population was comprised of patients screened-in by St. John Sepsis Surveillance Agent within 4 h of ED arrival, had a sepsis bundle initiated, and admitted to hospital. We built multivariable logistic regression models to estimate impact of a 3-h bundle completed within 3 h of arrival on mortality outcomes. Results Approximately 3% ED patients were screened-in by electronic surveillance within 4 h of arrival and admitted to hospital. Nearly 7 in 10 (69%) patients had a bundle initiated, with most bundles completed within 3 h of arrival. The fully-adjusted risk model achieved good discrimination on mortality outcomes [area under the receiver operating characteristic 0.82, 95% confidence interval (CI) 0.79–0.85] and estimated 34% reduced mortality risk among patients with a bundle completed within 3 h of arrival compared to non-completers. Discussion The sepsis bundle is an effective intervention for many vulnerable patients, and likely to be completed within 3 h after arrival when electronic surveillance with reliable alert notifications are integrated into clinical workflow. Beginning at triage, the platform and sepsis program enables identification and management of patients with greater precision, and increases the odds of good outcomes. Conclusion Sepsis surveillance and clinical decision support accelerate accurate recognition and stratification of patients, and facilitate timely delivery of health care. </jats:sec

Data from: An investigation of sepsis surveillance and emergency treatment on patient mortality outcomes: an observational cohort study

Objective. To determine the prevalence of initiating the sepsis 3-hour bundle of care and estimate effects of bundle completion on risk-adjusted mortality among ED patients screened-in by electronic surveillance. Materials and Methods. This was a multiple center observational cohort study conducted in 2016. The study population was comprised of patients screened-in by St. John Sepsis Surveillance Agent within four hours of ED arrival, had a sepsis bundle initiated, and admitted to hospital. We built multivariable logistic regression models to estimate impact of a 3-hour bundle completed within three hours of arrival on mortality outcomes. Results. Approximately 3% ED patients were screened-in by electronic surveillance within four hours of arrival and admitted to hospital. Nearly 7 in 10 (69%) patients had a bundle initiated, with most bundles completed within three hours of arrival. The fully-adjusted risk model achieved good discrimination on mortality outcomes (AUROC = .82, 95% CI = .79 to .85) and estimated 34% reduced mortality risk among patients with a bundle completed within three hours of arrival compared to non-completers. Discussion. The sepsis bundle is an effective intervention for many vulnerable patients, and likely to be completed within three hours after arrival when electronic surveillance with reliable alert notifications are integrated into clinical workflow. Beginning at triage, the platform and sepsis program enables identification and management of patients with greater precision, and increases the odds of good outcomes. Conclusion. Sepsis surveillance and clinical decision support accelerate accurate recognition and stratification of patients, and facilitate timely delivery of healthcare

Afobazole nanoparticles formulation for enhanced therapeutics

A novel nanoparticle drug composition and method of use thereof is presented herein. The nanoparticle drug composition is comprised of at least one nanoparticle carrier, formed from the conjugation of PLGA and PEG, which encapsulates a drug such as afobazole and its derivatives, in a pharmaceutically acceptable carrier. The nanoparticle drug composition may be used to treat various diseases of the central nervous system involving excessive neuronal activity and inflammation such as stroke, Alzheimer\u27s disease and anxiety