Plasma adrenomedullin is associated with short-term mortality and vasopressor requirement in patients admitted with sepsis

Introduction: The incidence of death among patients admitted for severe sepsis or septic shock is high. Adrenomedullin (ADM) plays a central role in initiating the hyperdynamic response during the early stages of sepsis. Pilot studies indicate an association of plasma ADM with the severity of the disease. In the present study we utilized a novel sandwich immunoassay of bioactive plasma ADM in patients hospitalized with sepsis in order to assess the clinical utility.Methods: We enrolled 101 consecutive patients admitted to the emergency department with suspected sepsis in this study. Sepsis was defined by fulfillment of at least two systemic inflammatory response syndrome (SIRS) criteria plus clinical suspicion of infection. Plasma samples for ADM measurement were obtained on admission and for the next four days. The 28-day mortality rate was recorded.Results: ADM at admission was associated with severity of disease (correlation with Acute Physiology and Chronic Health Evaluation II (APACHE II) score: r = 0.46; P <0.0001). ADM was also associated with 28-day mortality (ADM median (IQR): survivors: 50 (31 to 77) pg/mL; non-survivors: 84 (48 to 232) pg/mL; P <0.001) and was independent from and additive to APACHE II (P = 0.02). Cox regression analysis revealed an additive value of serial measurement of ADM over baseline assessment for prediction of 28-day mortality (P < 0.01). ADM was negatively correlated with mean arterial pressure (r = -0.39; P <0.0001), and it strongly discriminated those patients requiring vasopressor therapy from the others (ADM median (IQR): no vasopressors 48 (32 to 75) pg/mL; with vasopressors 129 (83 to 264) pg/mL, P <0.0001).Conclusions: In patients admitted with sepsis, severe sepsis or septic shock plasma ADM is strongly associated with severity of disease, vasopressor requirement and 28-day mortality

Vanishing conductivity of quantum solitons in polyacetylene

Quantum solitons or polarons are supposed to play a crucial role in the electric conductivity of polyacetylene, in the intermediate doping regime. We present an exact fully quantized calculation of the quantum soliton conductivity in polyacetylene and show that it vanishes exactly. This is obtained by applying a general method of soliton quantization, based on order-disorder duality, to a Z(2)-symmetric complex extension of the TLM dimerization effective field theory. We show that, in this theory, polyacetylene solitons are sine-Gordon solitons in the phase of the complex field.Comment: To appear in J. Phys. A: Math. Theor., 15 page

Sulle orme del consumatore affinity analysis e knowledge visualization per il processo decisionale

L\u2019articolo analizza i reali comportamenti di acquisto dell\u2019acquirente all\u2019interno del punto vendita e individua i pattern latenti pi\uf9 significativi attraverso un\u2019analisi di affinit\ue0 di 128.364 scontrini estratti da un dataset di 715.662 transazioni effettuate in un anno. Lo studio individua le strutture associative pi\uf9 ricorrenti relativamente alla singola merceologia. Attraverso la tecnica della Market Basket Analysis \ue8 stato possibile individuare le categorie merceologiche che creano \u201cpoli d\u2019attrazione\u201d sul punto vendita stimolando acquisti di altre categorie. In particolar modo, applicando le regole associative sul punto vendita \ue8 stato possibile identificare le \u201caree calde\u201d e le \u201caree fredde\u201d. L\u2019articolo evidenzia quindi alcune riflessioni sulle strategie che possono adottare gli store manager

Evidence of a non-conservative mass transfer for XTE J0929-314

Context. In 1998 the first accreting millisecond pulsar, SAX J1808.4-3658, was discovered and to date 18 systems showing coherent, high frequency (> 100 Hz) pulsations in low mass X-ray binaries are known. Since their discovery, this class of sources has shown interesting and sometimes puzzling behaviours. In particular, apart from a few exceptions, they are all transient with very long X-ray quiescent periods implying a quite low averaged mass accretion rate onto the neutron star. Among these sources, XTE J0929-314 has been detected in outburst just once in about 15 years of continuous monitoring of the X-ray sky. Aims. We aim to demonstrate that a conservative mass transfer in this system will result in an X-ray luminosity that is higher than the observed, long-term averaged X-ray luminosity. Methods. Under the hypothesis of a conservative mass transfer driven by gravitational radiation, as expected for this system given the short orbital period of about 43.6 min and the low mass of the companion implied by the mass function derived from timing techniques, we calculate the expected mass transfer rate in this system and predict the long-term averaged X-ray luminosity. This is compared with the averaged, over 15 years, X-ray flux observed from the system, and a lower limit of the distance to the source is inferred. Results. This distance is shown to be > 7.4 kpc in the direction of the Galactic anticentre, implying a large height, > 1.8 kpc, of the source with respect to the Galactic plane, placing the source in an empty region of the Galaxy. We suggest that the inferred value of the distance is unlikely. (abridged)Comment: 6 pages, 2 figures, accepted for publication in Astronomy & Astrophysics (A&A

Multiple stellar populations in Magellanic Cloud clusters. V. The split main sequence of the young cluster NGC1866

One of the most unexpected results in the field of stellar populations of the last few years, is the discovery that some Magellanic-Cloud globular clusters younger than ~400 Myr, exhibit bimodal main sequences (MSs) in their color-magnitude diagrams (CMDs). Moreover, these young clusters host an extended main sequence turn off (eMSTO) in close analogy with what is observed in most ~1-2 Gyr old clusters of both Magellanic Clouds. We use high-precision Hubble-Space-Telescope photometry to study the young star cluster NGC1866 in the Large Magellanic Cloud. We discover an eMSTO and a split MS. The analysis of the CMD reveals that (i) the blue MS is the less populous one, hosting about one-third of the total number of MS stars; (ii) red-MS stars are more centrally concentrated than blue-MS stars; (iii) the fraction of blue-MS stars with respect to the total number of MS stars drops by a factor of ~2 in the upper MS with F814W <~19.7. The comparison between the observed CMDs and stellar models reveals that the observations are consistent with ~200 Myr old highly-rotating stars on the red-MS, with rotation close to critical value, plus a non-rotating stellar population spanning an age interval between ~140 and 220 Myr, on the blue-MS. Noticeable, neither stellar populations with different ages only, nor coeval stellar models with different rotation rates, properly reproduce the observed split MS and eMSTO. We discuss these results in the context of the eMSTO and multiple MS phenomenon.Comment: 11 pages, 11 figures, accepted for publication in MNRA

Progress in understanding colour confinement

New results from lattice are presented,which demonstrate that monopoles condense in the vacuum of confined phase of QCD, which is thus a dual superconductor. Monopoles defined by different abelian projections appear to be physically equivalent.Comment: 5 pages,4 figures. Presented by A.Di Giacomo at QCD98 Montpellier July199

A matrix model for the topological string II: The spectral curve and mirror geometry

In a previous paper, we presented a matrix model reproducing the topological string partition function on an arbitrary given toric Calabi-Yau manifold. Here, we study the spectral curve of our matrix model and thus derive, upon imposing certain minimality assumptions on the spectral curve, the large volume limit of the BKMP "remodeling the B-model" conjecture, the claim that Gromov-Witten invariants of any toric Calabi-Yau 3-fold coincide with the spectral invariants of its mirror curve.Comment: 1+37 page

High resolution computed tomography quantitation of emphysema is correlated with selected lung function values in stable COPD.

BACKGROUND: The literature shows conflicting results when high-resolution computed tomography (HRCT) scores of emphysema were correlated with different indices of airflow obstruction. OBJECTIVES: We correlated HRCT scores of emphysema with different indices of airflow obstruction. METHODS: We performed HRCT of the chest in 59 patients, all smokers or ex-smokers, with stable chronic obstructive pulmonary disease of different severity [GOLD stages I-IV; mean age \ub1 SD 67.8 \ub1 7.3 years; pack/years 51.0 \ub1 34.6; percent predicted forced expiratory volume in 1 s (FEV(1)% predicted) 52.3 \ub1 17.6; post-bronchodilator FEV(1)% predicted 56.5 \ub1 19.1; FEV(1)/forced vital capacity (FVC) ratio 50.8 \ub1 10.2; post-bronchodilator FEV(1)/FVC ratio 51.6 \ub1 11.0; percent diffusion lung capacity for carbon monoxide (DLCO%) 59.2 \ub1 21.1; DLCO/percent alveolar volume (VA%) 54.5 \ub1 18.2; percent residual volume 163.0 \ub1 35.6; percent total lung capacity (TLC%) 113.2 \ub1 15; residual volume/TLC 1.44 \ub1 0.2]. All patients were in stable phase. RESULTS: The mean \ub1 SD visual emphysema score in all patients was 25.6 \ub1 25.4%. There was a weak but significant correlation between the percentage of pulmonary emphysema and numbers of pack/years (R = +0.31, p = 0.024). The percentage of emphysema was inversely correlated with the FEV(1)/FVC ratio before and after bronchodilator use (R = -0.44, p = 0.002, and R = -0.39, p = 0.005), DLCO% (R = -0.64, p = 0.0003) and DLCO/VA% (R = -0.68, p < 0.0001). A weak positive correlation was also found with TLC% (R = +0.28, p = 0.048). When patients with documented emphysema were considered separately, the best significant correlation observed was between DLCO/VA% and HRCT scan score (p = 0.007). CONCLUSIONS: These data suggest that in patients with stable chronic obstructive pulmonary disease of varying severity, the presence of pulmonary emphysema is best represented by the impaired gas exchange capability of the respiratory system

A Geometric Approach to Massive p-form Duality

Massive theories of abelian p-forms are quantized in a generalized path-representation that leads to a description of the phase space in terms of a pair of dual non-local operators analogous to the Wilson Loop and the 't Hooft disorder operators. Special atention is devoted to the study of the duality between the Topologically Massive and the Self-Dual models in 2+1 dimensions. It is shown that these models share a geometric representation in which just one non local operator suffices to describe the observables.Comment: 26 pages, LaTeX. The discussion about the equivalence between the Proca model and two seldual models, with opposite spins, was eliminated. Typos correcte