660 research outputs found
Dear Mary
No full textIn Dear Mary poet and painter Rupert Loydell writes about art and life and how they intersect. Fascinated by both renaissance and contemporary painting, he re-invents moments of annunciation in today's world, and revels in the colours and sunshine of Italy. This is a world of wonder and surprise, where aliens abduct the Virgin Mary, 20th century rock singers find themselves collaged together and singing about her, infinite greys (and grays) blur together between other greys, Francis Bacon paints angels, and even the weather forecast predicts the future.
Above all else, this is a book which celebrates language and art, and explores how we navigate the world around us, seen and unseen; how we might wonder, explain, and begin to understand
Use of hemodynamic algorithm after gastrointestinal surgery - reply
No full textIn Reply Drs Saugel and Reuter challenge the description of the OPTIMISE trial as a pragmatic trial. As applied to clinical trials, the term pragmatic has a particular meaning. Pragmatic trials are designed to evaluate the clinical effectiveness of a treatment in the context of routine clinical practice.1 This distinguishes them from explanatory trials, which are designed to evaluate the efficacy of a treatment under ideal conditions
Perioperative haemodynamic optimisation
No full textThe use of fluid and inotropic therapies to optimise global haemodynamic variables, in particular oxygen delivery, in critically ill patients has been a controversial area of research for more than 25 years. The aim of this review is to describe the current evidence base for this treatment and how concepts of haemodynamic optimisation have evolved in recent years. The inconsistent findings of a large number of small phase II trials continue to stimulate the debate about the value of this treatment approach. However, important recent developments include the use of optimisation only during periods of resuscitation, more cautious doses of fluid and/or inotropic therapy, confirmation that pulmonary artery catheter use does not result in excess mortality and an improved understanding of the mechanistic effects of haemodynamic optimisation. These advances in our understanding have now informed the design of large randomised trials in various patient groups. The true value of haemodynamic optimisation is likely to be confirmed or refuted within the next 5 years
Managing perioperative risk in patients undergoing elective non-cardiac surgery
No full textNon-cardiac surgery has a low overall mortality but is associated with a large number of deaths because so many procedures are performed.Most deaths occur in a group of patients who are at high risk because of advanced age, comorbid disease, or major surgery (hospital mortality rate 12%).More effective systems can improve quality of perioperative care and may improve survival while reducing healthcare costs.Further research is needed to identify the most effective approaches to perioperative medicine for high risk patients.Routine audit of outcomes after all non-cardiac surgery is urgently needed
Supplemental material for The association between ICU admission and emergency hospital readmission following emergency general surgery
No full textSupplemental Material for The association between ICU admission and emergency hospital readmission following emergency general surgery by Michael A Gillies, Sadia Ghaffar, Ewen Harrison, Catriona Haddow, Lorraine Smyth, Timothy S Walsh, Rupert M Pearse and Nazir I Lone in Journal of the Intensive Care Society</p
Time resolution of TileCal and searches for heavy metastable particles
No full textTitle: Time resolution of TileCal and searches for heavy metastable parti- cles Author: Martina Pagáčová Department: Institute of Particle and Nuclear Physics Supervisor: Doc. RNDr. Rupert Leitner, DrSc. Supervisor's e-mail address: [email protected] Abstract: In the present work, the timing of the ATLAS TileCal is stud- ied using the single hadron collision data. The time resolution and also the mean time response depend on the energy deposited in a given cell. The results are compared to the previous analysis with jets and muons. Precise time-of-flight measurement using TileCal can be used to identify the heavy long-lived particles predicted by the models of physics beyond the standard model. Their mass can be reconstructed by combining with the momentum measurement in the ATLAS inner detector. Finally, the mass resolution of an exotic particle with mass M = 600 GeV is estimated. Keywords: ATLAS experiment, TileCal, time resolution, stable massive particle
Dystopia, Memory and Travel in Rupert Thomson's Divided Kingdom
No full textThe present thesis is an analysis of contemporary British author Rupert Thomson’s 2005 novel entitled Divided Kingdom. In the novel the authorities create new borders, forming a dystopian dismembered kingdom from the United Kingdom. Besides briefly looking at the dystopic features of the divided kingdom’s society, in this thesis I focus on the protagonist’s subjective world, the importance of memory and nostalgia which are the his driving force to set out on a journey. The protagonist goes through a psychological development the main stages of which are his threshold and border-crossings and his wanderings with the White People.N.E.AnglisztikaMSc/M
Časové rozlišení TileCalu a hledání těžkých dlouhožijících částic
No full textNázev práce: Časové rozlíšenie TileCalu a hl'adanie t'ažkých metastabilných častíc Autor: Martina Pagáčová Ústav: Ústav částicové a jaderné fyziky Vedoucí diplomové práce: doc. RNDr. Rupert Leitner, DrSc. E-mail vedoucího: [email protected] Abstrakt: Predložená práca sa zaoberá štúdiom časovania kalorimetru Tile- Cal experimentu ATLAS prostredníctvom dát single hadrónov. Časové rozlíšenie rovnako ako odozva stredného času závisia na deponovanej energii v danej cele. Výsledky sú porovnané s predchádzajúcimi analýzami s jetmi a miónami. Presné meranie doby letu pomocou TileCalu môže identifikovat' t'ažké dlhožijúce častice, ktoré sú predpovedané modelmi za štandardným modelom. Ich hmotu je možné zrekonštruovat' skombinovaním tohto merania s meraním hybnosti vo vnútornom detektore experimentu ATLAS. Nakoniec je vypočítaná chyba určenia hmoty exotickej častice o hmotnosti M = 600 GeV. Klíčová slova: ATLAS experiment, TileCal kalorimeter, časové rozlíšenie, stabilné t'ažké časticeTitle: Time resolution of TileCal and searches for heavy metastable parti- cles Author: Martina Pagáčová Department: Institute of Particle and Nuclear Physics Supervisor: Doc. RNDr. Rupert Leitner, DrSc. Supervisor's e-mail address: [email protected] Abstract: In the present work, the timing of the ATLAS TileCal is stud- ied using the single hadron collision data. The time resolution and also the mean time response depend on the energy deposited in a given cell. The results are compared to the previous analysis with jets and muons. Precise time-of-flight measurement using TileCal can be used to identify the heavy long-lived particles predicted by the models of physics beyond the standard model. Their mass can be reconstructed by combining with the momentum measurement in the ATLAS inner detector. Finally, the mass resolution of an exotic particle with mass M = 600 GeV is estimated. Keywords: ATLAS experiment, TileCal, time resolution, stable massive particlesÚstav částicové a jaderné fyzikyInstitute of Particle and Nuclear PhysicsMatematicko-fyzikální fakultaFaculty of Mathematics and Physic
The whole truth and nothing but the truth: the need for full reporting of randomised trials.
No full textThe use of cardiac output monitoring to guide fluid and inotropic therapy in surgical patients has remained a controversial topic for more than 40 years. The reasons for this are numerous and complex, but key amongst them is the interplay between poor research methodology and the likely selective reporting of randomised trials. In this issue of Perioperative Medicine, we find a very unusual report, one which describes a randomised trial stopped for futility after the recruitment of only a small proportion of the target patient sample (Jammer et al. Periop Med). The authors offer no statistical analysis of their findings but simply an explanation of what went wrong. On the face of it, this exercise would seem to offer little of value to the general reader. How can publication of the findings of an unsuccessful trial contribute to the evidence base on this topic? To understand this, we must delve a little deeper into the evidence and see how these trials were designed
Chronotropic incompetence and myocardial injury after noncardiac surgery: planned secondary analysis of a prospective observational international cohort study
No full text
Background: Physiological measures of heart failure are common in surgical patients, despite the absence of a diagnosis. Heart rate (HR) increases during exercise are frequently blunted in heart failure (termed chronotropic incompetence), which primarily reflects beta-adrenoreceptor dysfunction. We examined whether chronotropic incompetence was associated with myocardial injury after noncardiac surgery. Methods: This was a predefined analysis of an international cohort study where participants aged ≥40 yr underwent symptom-limited cardiopulmonary exercise testing before noncardiac surgery. Chronotropic incompetence was defined as the ratio of increase in HR during exercise to age-predicted maximal increase in HR <0.6. The primary outcome was myocardial injury within 3 days after surgery, defined by high-sensitivity troponin assays >99th centile. Explanatory variables were biomarkers for heart failure (ventilatory efficiency slope [minute ventilation/carbon dioxide production] ≥34; peak oxygen consumption ≤14 ml kg
−1
min
−1
; HR recovery ≤6 beats min
−1
decrease 1 min post-exercise; preoperative N-terminal pro-B-type natriuretic peptide [NT pro-BNP] >300 pg ml
−1
). Myocardial injury was compared in the presence or absence of sympathetic (i.e. chronotropic incompetence) or parasympathetic (i.e. impaired HR recovery after exercise) thresholds indicative of dysfunction. Data are presented as odds ratios (ORs) (95% confidence intervals). Results: Chronotropic incompetence occurred in 396/1325 (29.9%) participants; only 16/1325 (1.2%) had a heart failure diagnosis. Myocardial injury was sustained by 162/1325 (12.2%) patients. Raised preoperative NT pro-BNP was more common when chronotropic incompetence was <0.6 (OR: 1.57 [1.11–2.23]; P=0.011). Chronotropic incompetence was not significantly associated with myocardial injury (OR: 1.05 [0.74–1.50]; P=0.78), independent of rate-limiting therapy. HR recovery <12 beats min
−1
decrease after exercise was associated with myocardial injury in the presence (OR: 1.62 [1.05–2.51]; P=0.03) or absence (OR: 1.60 [1.06–2.39]; P=0.02) of chronotropic incompetence. Conclusions: Chronotropic incompetence is common in surgical patients. In contrast to parasympathetic dysfunction which was associated with myocardial injury, preoperative chronotropic incompetence (suggestive of sympathetic dysfunction) was not associated with postoperative myocardial injury.
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