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Signal reversal in Kelvin-probe force microscopy. 开尔文探针力显微镜中的信号反转。
ICU director Pub Date : 2019-11-01 DOI: 10.1063/1.5118357
P Mesquida, D Kohl, G Schitter
{"title":"Signal reversal in Kelvin-probe force microscopy.","authors":"P Mesquida, D Kohl, G Schitter","doi":"10.1063/1.5118357","DOIUrl":"10.1063/1.5118357","url":null,"abstract":"<p><p>Kelvin-probe force microscopy is a measurement mode of atomic force microscopy, which is used to quantitatively map the electrical surface potential of a sample. Inadequate hardware and electronic design can lead to signal cross talk and, in consequence, false results. Here, we show that certain cross talk artifacts not only do manifest themselves in additional noise, reduced resolution, or an offset of the measured surface potential but can also lead to an inverted signal scale and, crucially, cannot be diagnosed with a known reference signal. We show experimental data on an electrically homogeneous sample, describe a method to detect the artifact, and propose simple remedies, which should be well within the reach of most research and industrial laboratories.</p>","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"1 1","pages":"113703"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87982124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Temporal Reduction in Chronotropic Index Predicts Risk of Cardiovascular Death Among Healthy Middle-Aged Men: a 28-Year Follow-Up Study. 变时指数的时间降低预测健康中年男性心血管死亡风险:一项28年随访研究
ICU director Pub Date : 2016-11-23 DOI: 10.1161/JAHA.116.004555
Kristian Engeseth, Christian Hodnesdal, Irene Grundvold, Knut Liestøl, Knut Gjesdal, Sverre E Kjeldsen, Jan E Erikssen, Johan Bodegard, Per Torger Skretteberg
{"title":"Temporal Reduction in Chronotropic Index Predicts Risk of Cardiovascular Death Among Healthy Middle-Aged Men: a 28-Year Follow-Up Study.","authors":"Kristian Engeseth, Christian Hodnesdal, Irene Grundvold, Knut Liestøl, Knut Gjesdal, Sverre E Kjeldsen, Jan E Erikssen, Johan Bodegard, Per Torger Skretteberg","doi":"10.1161/JAHA.116.004555","DOIUrl":"10.1161/JAHA.116.004555","url":null,"abstract":"<p><strong>Background: </strong>Chronotropic index is a standardized measure of heart rate (HR) increment during exercise that reflects the combined effects of age, resting HR, and physical fitness. Low chronotropic index has been reported to predict disease and death. We tested whether temporal change in chronotropic index over 7 years influenced risk of cardiovascular death through up to 28 years.</p><p><strong>Methods and results: </strong>Chronotropic index was calculated ([achieved maximal HR-resting HR]/[age-predicted maximal HR-resting HR]) after a symptom-limited bicycle ECG exercise test in 1420 healthy men at 2 examinations 7 years apart, in 1972 and 1979. Events of cardiovascular death were registered by manual scrutiny of all participants' hospital charts and the Norwegian Cause of Death Registry. The participants were divided into quartiles of temporal change in chronotropic index, with quartile one having the most negative value. Cox proportional hazard regression models were used to estimate risks and adjusted for classical cardiovascular risk factors. Incidence of cardiovascular death was 310 (22%) during median of 21 years of follow-up. After multivariable adjustment, and comparison with quartile four (mean +0.11), quartiles one (-0.16), two (-0.04), and three (+0.02) were associated with hazard ratios 1.50 (95% CI 1.10-2.05), 1.10 (0.79-1.53), and 1.04 (0.74-1.45) for cardiovascular death. Results remained robust also after exclusion of 31 participants with exercise ECG-induced signs of coronary ischemia.</p><p><strong>Conclusions: </strong>Temporal reduction in chronotropic index was associated with increased long-term risk of cardiovascular death and might be a clinically important predictor when assessing risk in healthy individuals over a longer time.</p>","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1161/JAHA.116.004555","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87980648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 15
Central Line-Associated Bloodstream Infections and Ventilator-Associated Events in the Intensive Care Unit 重症监护病房中心静脉相关血流感染和呼吸机相关事件
ICU director Pub Date : 2013-11-11 DOI: 10.1177/1944451613509672
B. Cohn, Lee-lynn Chen
{"title":"Central Line-Associated Bloodstream Infections and Ventilator-Associated Events in the Intensive Care Unit","authors":"B. Cohn, Lee-lynn Chen","doi":"10.1177/1944451613509672","DOIUrl":"https://doi.org/10.1177/1944451613509672","url":null,"abstract":"Central line–associated bloodstream infections (CLABSIs) and ventilator-associated events (VAEs) are among the most prevalent and morbid health care–associated infections (HAIs) encountered in the ...","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"4 1","pages":"310-316"},"PeriodicalIF":0.0,"publicationDate":"2013-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451613509672","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65899208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Teaching in the ICU A Comprehensive Review ICU教学A综合综述
ICU director Pub Date : 2013-11-11 DOI: 10.1177/1944451613510317
M. Bhave, M. Brzezinski
{"title":"Teaching in the ICU A Comprehensive Review","authors":"M. Bhave, M. Brzezinski","doi":"10.1177/1944451613510317","DOIUrl":"https://doi.org/10.1177/1944451613510317","url":null,"abstract":"Teaching in the fast-paced, high-pressure environment of the ICU can be very demanding. Thus, the educator-intensivist must learn teaching strategies that are time-efficient, simple, and successful. In this article, we provide an overview of the current and relevant teaching theories and highlight potential obstacles and limitations to teaching in the ICU. In the second part, we discuss a sample of simple approaches to optimize the ICU-rotation curriculum as well as effective techniques to improve teaching, while not compromising quality of care.","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"4 1","pages":"270-278"},"PeriodicalIF":0.0,"publicationDate":"2013-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451613510317","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65899214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
A Fatal Gastrointestinal Hemorrhage From Colonic Mucormycosis After a Short Course of Steroids: Quality Implications 短期类固醇治疗后致死性结肠毛霉菌病胃肠道出血:质量影响
ICU director Pub Date : 2013-11-01 DOI: 10.1177/1944451613500811
L. Esolen, N. Z. Kubilay, Xiaohong Zhang, A. Layon
{"title":"A Fatal Gastrointestinal Hemorrhage From Colonic Mucormycosis After a Short Course of Steroids: Quality Implications","authors":"L. Esolen, N. Z. Kubilay, Xiaohong Zhang, A. Layon","doi":"10.1177/1944451613500811","DOIUrl":"https://doi.org/10.1177/1944451613500811","url":null,"abstract":"We discuss a fatal infection with colonic mucormycosis in a patient with short-term corticosteroid use and no other form of immunosuppression. The patient was a 75-year-old woman admitted with an acute respiratory decompensation and bilateral pulmonary infiltrates of unclear etiology. When infectious etiologies were ruled out she was started on high-dose corticosteroids. On hospital day 23, the patient developed lower gastrointestinal bleeding and on colonoscopy she was found to have developed colonic ulcerations. Biopsy of these ulcerations demonstrated fungal forms consistent with invasive gastrointestinal mucormycosis. The patient refused surgery and after 10 days of aggressive antifungal therapy, she expired.","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"4 1","pages":"332-334"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451613500811","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65897852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mechanical Ventilation Bringing the ICU Into the Operating Room 机械通气将重症监护病房带入手术室
ICU director Pub Date : 2013-11-01 DOI: 10.1177/1944451613501196
K. Thornton
{"title":"Mechanical Ventilation Bringing the ICU Into the Operating Room","authors":"K. Thornton","doi":"10.1177/1944451613501196","DOIUrl":"https://doi.org/10.1177/1944451613501196","url":null,"abstract":"Patients who become critically ill from sepsis, acute respiratory illness or other inflammatory processes often require intubation and mechanical ventilation to support respiratory function. The lungs are very susceptible to injury in these circumstances and may develop the syndromes of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Furthermore, patients in the operating room under anesthesia may also develop lung injury due to direct surgical trauma (pneumonectomy), aspiration, transfusion, shock, or allergic reaction. The approaches and techniques of mechanical ventilation continue to evolve with better understanding of the pathophysiology of ALI/ARDS. In this article, we will (a) review the definitions of ALI/ARDS, (b) define lung-protective ventilation and the etiologies of ventilator-associated lung injury, (c) discuss rescue therapies for hypoxemic respiratory failure, and (d) describe newer modes of mechanical ventilation in use both in the ICU and the operating room.","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"4 1","pages":"301-305"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451613501196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65898406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Primary spontaneous pneumothorax, an era of fresh air 原发性自发性气胸，一个空气清新的时代
ICU director Pub Date : 2013-11-01 DOI: 10.1177/1944451613500985
R. B. Chebl, C. Noujeim, Z. Ayoub, G. A. Dagher
{"title":"Primary spontaneous pneumothorax, an era of fresh air","authors":"R. B. Chebl, C. Noujeim, Z. Ayoub, G. A. Dagher","doi":"10.1177/1944451613500985","DOIUrl":"https://doi.org/10.1177/1944451613500985","url":null,"abstract":"Background. There are no rigid guidelines for the management of primary spontaneous pneumothorax. Although there seems to be a consensus between several medical societies regarding the management of an asymptomatic small pneumothorax, the approach toward a moderate to large symptomatic primary spontaneous pneumothorax is unclear and is not substantiated by well-designed research studies. Objectives. Our aim is to shed some light on the role of observation alone in the setting of moderate to large primary spontaneous pneumothorax and to report the different medical societies’ views on the treatment of a primary spontaneous pneumothorax. Case report. We report a case of a 26-year-old man who presented to our emergency department with shortness of breath and was found to have a symptomatic moderate-size pneumothorax that was successfully treated with oxygen therapy and supportive care. Conclusion. We hope that this case will stimulate further research in the field of primary spontaneous pneumothorax manageme...","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"4 1","pages":"306-309"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451613500985","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65897895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Economic Benefit of a Novel Intensivist Coverage in a Surgical ICU 外科ICU新型重症监护医师覆盖的经济效益
ICU director Pub Date : 2013-11-01 DOI: 10.1177/1944451613507450
Michael H. Goldberg, Thomas Bily, Garry Ritter, R. Barrera
{"title":"Economic Benefit of a Novel Intensivist Coverage in a Surgical ICU","authors":"Michael H. Goldberg, Thomas Bily, Garry Ritter, R. Barrera","doi":"10.1177/1944451613507450","DOIUrl":"https://doi.org/10.1177/1944451613507450","url":null,"abstract":"Objective. To assess the cost implications of changing the ICU staffing model from a mandatory 24-hour in-house critical care specialist presence to a 16-hour coverage model with external supervision. Design. A pre–post comparison was undertaken among the prospectively assessed cohorts of patients admitted to our surgical ICU over a period of 3 years. Our data were stratified by case mixed index. Costs were modeled using a generalized linear model with log-link and gamma-distributed errors. Setting. Tertiary medical facility. Patients. All patients admitted to the adult surgical intensive care unit during the study period of June 2007 to April 2013. Intervention. Changing the ICU staffing model from a mandatory 24/7 in-house critical care specialist presence to a 16/7 model with robotic rounding in off hours. Results. A total cost model was calculated and evaluated. Total cost estimates of hospitalization were calculated for each patient. Length of stay and mortality were evaluated. Adjusted mean total co...","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"4 1","pages":"291-295"},"PeriodicalIF":0.0,"publicationDate":"2013-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451613507450","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65898529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
The Development and Implementation of a Bundled Quality Improvement Initiative to Reduce Inappropriate Stress Ulcer Prophylaxis 开发和实施捆绑质量改进倡议，以减少不适当的应激性溃疡预防
ICU director Pub Date : 2013-10-28 DOI: 10.1177/1944451613508185
Noelle de Leon, S. Sharpton, Cindy Burg, A. K. Gross, Fanny Li, Ashley Thompson, Robin Kobayashi, Sherilyn J Vanosdol, C. Tsourounis, Chelsea L Tasaka, C. Garwood, L. Bekeart, Stephanie Rennke
{"title":"The Development and Implementation of a Bundled Quality Improvement Initiative to Reduce Inappropriate Stress Ulcer Prophylaxis","authors":"Noelle de Leon, S. Sharpton, Cindy Burg, A. K. Gross, Fanny Li, Ashley Thompson, Robin Kobayashi, Sherilyn J Vanosdol, C. Tsourounis, Chelsea L Tasaka, C. Garwood, L. Bekeart, Stephanie Rennke","doi":"10.1177/1944451613508185","DOIUrl":"https://doi.org/10.1177/1944451613508185","url":null,"abstract":"Stress ulcer prophylaxis (SUP) with acid suppressive therapy is often inappropriately prescribed in the intensive care setting. Acid suppressive therapy, including proton pump inhibitors and histam...","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"4 1","pages":"322-325"},"PeriodicalIF":0.0,"publicationDate":"2013-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451613508185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65899196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Management of New Anticoagulants in the ICU 新型抗凝剂在ICU的管理
ICU director Pub Date : 2013-10-18 DOI: 10.1177/1944451613507451
E. McKay, Linda L. Liu
{"title":"Management of New Anticoagulants in the ICU","authors":"E. McKay, Linda L. Liu","doi":"10.1177/1944451613507451","DOIUrl":"https://doi.org/10.1177/1944451613507451","url":null,"abstract":"The development of novel anticoagulant drugs, namely factor Xa and factor IIa inhibitors, has proceeded at a remarkable pace over the past 15 years. Because of their ease of administration, predict...","PeriodicalId":89772,"journal":{"name":"ICU director","volume":"4 1","pages":"326-331"},"PeriodicalIF":0.0,"publicationDate":"2013-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1944451613507451","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65899114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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