70 research outputs found
Monitoring tissue oximetry during cardiopulmonary resuscitation
No full textIzhodišča: NIRS (angl. Near-infrared spectroscopy) je v klinični praksi relativno nova metoda ki v realnem času prikazuje vrednosti tkivne oksimetrije. Uporaba te merilne tehnike na čelu bolnika se imenuje možganska oksimetrija (ScO2). Številne raziskave so pokazale vrednost spremljanja možganske oksimetrije med operacijami, pravtako so bile objavljene raziskave o spremljanju ScO2 med srčnim zastojem, a nobena raziskava do sedaj ni spremljala vrednosti ScO2 med celotnim potekom srčnega zastoja v zunaj-bolnišničnem srčnem zastojuod prepoznave do post-reanimacijske oskrbe.
Hipoteze: V naši raziskavi smo želeli ovrednosti dinamiko gibanja vrednosti ScO2 med kardio-pulmonalnim oživljanjem (KPO) v zunaj-bolnišničnem okolju. Predvidevali smo, da so vrednosti ScO2 ob prihodu ekip nujne medicinske pomoči nevarno nizke in da se z KPO zvišujejo. Dinamika tega zviševanja pa je poglavitna spremenljivka ki vpliva na kasnejše preživetje. Dodatno smo spremljali vrednosti serumskega laktata pri istih pacientih in dinamiko gibanja the vrednosti primerjali z preživetjem.
Metode: V raziskavo smo vključili 53 bolnikov, ki so utrpeli zunaj-bolnišnični srčni zastoj. Vsi postopki oživljanja so bili opravljeni v skladu s takrat-veljavnimi smernicami za oživljanje, le pacientom, vključenim v raziskavo smo od prepoznave srčnega zastoja do zaključka oživljanja nenehno merili vrednosti možganske oksimetrije.
Rezultati: Vrednosti ScO2 ob pričetku oživljanja so pri vseh bolnikih bile kritično nizke. Vrednosti so se tekom KPO zlagoma zviševale, statistično bolj pri pacientih ki so kasneje preživeli. Preživelim bolnikom so se vrednosti ScO2 pričele pomembno zviševati že pred dosegom spontane cirkulacije (ROSC) in so se po ROSC normalizirale in ostale stabilne. Vzorec hitrega, jasnega in statistično pomembnega porasta ScO2 ki se normalizirajo, so tipične za bolnike ki so preživeli do sprejema v bolnišnico, za razliko od pacientov ki so umrli na terenu. Podobno so vrednosti serumskega laktata med KPO pomembno padale pri bolnikih ki so preživeli.
Zaključek: Vrednosti ScO2 pri bolnikih ki so v zunaj-bolnišničnem okolju oživljani, so do prihoda reševalnih ekip že kritično nizke in se tekom KPO zlagoma zvišujejo. Zvišanje je pri bolnikih ki kasneje preživijo. Za slednje je značilen vzorec hitrega, jasnega in statistično pomembnega dviga ScO2 tik pred dosegom ROSC ki se normalizirajo. Vrednosti serumskega laktata pri istih bolnikih tekom KPO pomembno padejo.Background: NIRS (angl. Near-infrared spectroscopy) is relatively novel diagnostic modality that measures levels of tissue oximetry in real time. Use of its detectors over skull is called cerebral oximetry (ScO2). Several studies have proven value of ScO2 monitoring during anesthesia. There were also studies describing use of ScO2 in different phases of cardiopulmnary resuscitation (CPR). But none of the studies have until ours been conducted to describe dynamics of ScO2 values during out-of-hospital cardiac arrest, from beginning of CPR well into post-resuscitation period in field.
Hypothesis: The aim of our study was to describe dynamics of ScO2 values during CPR in out-of-hospital setting. We hypothesised, that levels of ScO2 on arrival of Emergency medical services would be dangerously low, but would rise during CPR. Dynamics of this rise would be main determinant of later clinical outcome. In addition, we measured dynamics of serum lactate levels and compared it with outcomes.
Methods: Our study included 53 patients that suffered out-of-hospital cardiac arrest during study period. All patients were resuscitated as per current CPR guidelines and patients enrolled in the study had NIRS optodes applied and levels of ScO2 measured continuously.
Results: Levels of ScO2 in all patients were critically low at the beginning of CPR. Levels of ScO2 have risen during CPR, statistically higher in patients that later survived. These patients also exhibited rise of ScO2 minutes before achieving return of spontaneous circulation (ROSC) and have normalised after achieving ROSC. We have found, that pattern of clear, rapid, statistically significant and sustained rise of ScO2, is specific for patients that have achieved ROSC. This pattern is very different to occasional spikes in ScO2 levels that we observed in patients that died in field. Similarly, values of serum lactate have fallen significantly during CPR in patients that achieved ROSC.
Conclusion: Levels of ScO2 during out-of-hospital cardiac arrest fall dangerously low by the time CPR is started. Levels of ScO2 rise during CPR, more so in group of surviving patients. In later group, we found specific pattern of clear, rapid, significant and sustained rise in ScO2 levels minutes before ROSC that normalize during post-arrest care. Levels of serume lactate fall during successful CPR
Quasilocal conservation laws in XXZ spin-1/2 chains: Open, periodic and twisted boundary conditions
No full textAbstractA continuous family of quasilocal exact conservation laws is constructed in the anisotropic Heisenberg (XXZ) spin-1/2 chain for periodic (or twisted) boundary conditions and for a set of commensurate anisotropies densely covering the entire easy plane interaction regime. All local conserved operators follow from the standard (Hermitian) transfer operator in fundamental representation (with auxiliary spin s=1/2), and are all even with respect to a spin flip operation. However, the quasilocal family is generated by differentiation of a non-Hermitian highest weight transfer operator with respect to a complex auxiliary spin representation parameter s and includes also operators of odd parity. For a finite chain with open boundaries the time derivatives of quasilocal operators are not strictly vanishing but result in operators localized near the boundaries of the chain. We show that a simple modification of the non-Hermitian transfer operator results in exactly conserved, but still quasilocal operators for periodic or generally twisted boundary conditions. As an application, we demonstrate that implementing the new exactly conserved operator family for estimating the high-temperature spin Drude weight results, in the thermodynamic limit, in exactly the same lower bound as for almost conserved family and open boundaries. Under the assumption that the bound is saturating (suggested by agreement with previous thermodynamic Bethe ansatz calculations) we propose a simple explicit construction of infinite time averages of local operators such as the spin current
Continuous capnography and focused echocardiographic evaluation during resuscitation—Additional criteria for cessation of treatment out-of-hospital-cardiac arrest
No full text
Faster than Lyapunov decays of classical Loschmidt echo
No full textこの論文は国立情報学研究所の電子図書館事業により電子化されました。We show that the composition of perturbed forward and unperturbed backward hamiltonian evolution can be treated as a time-dependent hamiltonian system. For strongly chaotic systems we derive a cascade of exponential decays for the classical Loschmidt echo, starting with the leading Lyapunov exponent, followed by a sum of two largest exponents, etc
Expression of basic emotions in primary students with Autism Spectrum Disorder
No full textEmotions play a significant role in everyday life. They guide our thinking, behaviour, motivation, and decisions. Since emotions are strongly present also in the school environment, it is crucial that professionals are aware of their importance, try to understand them and accept the students’ emotions. Children with autism spectrum disorder (hereinafter ASD) who have specific deficits in the socio-emotional aspects are also included in educational institutions, so it is important that professionals know their characteristics, accept them and help them overcome behavioural and emotional difficulties.
In the master’s thesis, the analysis was made of the basic emotions that appear in students with ASD in the first five grades of the adapted program with a lower educational standard (hereinafter AP with LES) in class and during breaks. The author tried to determine which situations trigger emotions and whether these situations are more frequently related to persons or objects. Further research questions were whether students with ASD are able to recognize basic emotions with the help of pictorial material, describe them and identify trigger situations related to these emotions, and whether they know which strategies help them manage intense, unpleasant emotions. For the purpose of this research, observations in the natural environment and semi-structured interviews were conducted. The observations were performed with the help of the observation scheme Students’ emotions in the classroom (Smrtnik Vitulić and Prosen, 2017) and they included several students in the first five classes of AP with LES in five different institutions in Slovenia. From the initial sample, students who were diagnosed with ASD or with ASD and other associated disorders were selected. An interview based on the research questions and scientific literature was carried out with four students with ASD.
The results of the research showed that students with ASD experience all the basic emotions in the school environment. Most often, they experience joy, followed by anger, fear and sadness. Joy was largely related to interesting learning material, aid, or method. Anger most often occurred because of an unfulfilled desire of a student with ASD, while fear usually appeared because of expectation of failure. Sadness was triggered in equal measure by the loss of an important object (e.g. toy), worse results than those of classmates, a teacher’s rebuke, and by an unfulfilled desire. Joy was more often caused by an object while anger occurred more often because of another person. Fear was more frequently experienced because of an object, and sadness appeared in equal amount because of a person or an object. Students with ASD were most successful in recognizing and naming joy on pictorial material and less successful in recognizing unpleasant emotions. The nonverbal cues by which they recognized the emotion were described very differently by the students and only one described the nonverbal cues for all the emotions. Three students with ASD described trigger situations for the emergence of all emotions on pictorial material, and one student described one situation. They were less successful in describing situations that trigger their own emotions, as only one student described situations for all basic emotions. Three students identified that when experiencing intense, uncomfortable emotions, a teacher or mother helps them or they calm down while playing. The obtained results offer a better insight into the emotions of students with ASD and their comprehension of these emotions. The master’s thesis provides special pedagogical profession in Slovenia with new knowledge about emotions of children with special needs and raises new questions for further research
Data analysis for the Epidemiology of Emergency Room visits in Maribor in 2023
No full text<div>This notebook contains the code used to compute the results presented in Epidemiology of Emergency Room visits in Maribor in 2023, that was presented at SZUM, Portorož 2023. The notebook was written by Luka Petravić and includes all of the results presented at the conference.</div>
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<div>Authors of the article are Luka Petravić, Domen Kulovec, Janez Žibert, Nicole Bohr, Gregor Prosen, Matej Strnad.</div>
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