RESUMEN
Early neurological deterioration (END) is progressive neurological deterioration with an increase in NIHSS score of 2 points or more in the first 72 hours from the onset of acute ischemic stroke. END increases the risk of poor clinical outcomes at day 90 of ischemic stroke. We will study the frequency, predictors, and outcomes of patients with END in a case-control study at a comprehensive stroke centre in Vietnam. of the design is a descriptive observational study, longitudinal follow-up of patients with minor stroke hospitalized at the Stroke Center of Bach Mai Hospital from December 1, 2023, to December 1, 2024. Minor stroke patients characterized by NIHSS score ≤ 5 hospitalized within 24 hours of symptom onset will be recruited. The estimated END rate is about 30%, relative accuracy ε = 0.11, 95% reliability, expected 5% of patients lost data or follow-up, and an estimated sample size of 779 patients. This study will help determine the END rate in patients with minor stroke and related factors, thereby building a prognostic model for END. Our study determined the END rate in patients with minor stroke in Vietnam and also proposed risk factors for minor stroke management and treatment.
Asunto(s)
Accidente Cerebrovascular , Humanos , Vietnam/epidemiología , Accidente Cerebrovascular/epidemiología , Estudios de Casos y Controles , Masculino , Femenino , Pronóstico , Factores de Riesgo , Persona de Mediana Edad , Anciano , Estudios Longitudinales , Estudios de Seguimiento , Índice de Severidad de la EnfermedadRESUMEN
BACKGROUND: Cardiac output (QË) monitoring can support the management of high-risk surgical patients, but the pulmonary artery catheterisation required by the current 'gold standard'-bolus thermodilution (QËT)-has the potential to cause life-threatening complications. We present a novel noninvasive and fully automated method that uses the inspired sinewave technique to continuously monitor cardiac output (QËIST). METHODS: Over successive breaths the inspired nitrous oxide (N2O) concentration was forced to oscillate sinusoidally with a fixed mean (4%), amplitude (3%), and period (60 s). QËIST was determined in a single-compartment tidal ventilation lung model that used the resulting amplitude/phase of the expired N2O sinewave. The agreement and trending ability of QËIST were compared with QËT during pharmacologically induced haemodynamic changes, before and after repeated lung lavages, in eight anaesthetised pigs. RESULTS: Before lung lavage, changes in QËIST and QËT from baseline had a mean bias of -0.52 L min-1 (95% confidence interval [CI], -0.41 to -0.63). The concordance between QËIST and QËT was 92.5% as assessed by four-quadrant analysis, and polar plot analysis revealed a mean angular bias of 5.98° (95% CI, -24.4°-36.3°). After lung lavage, concordance was slightly reduced (89.4%), and the mean angular bias widened to 21.8° (-4.2°, 47.6°). Impaired trending ability correlated with shunt fraction (r=0.79, P<0.05). CONCLUSIONS: The inspired sinewave technique provides continuous and noninvasive monitoring of cardiac output, with a 'marginal-good' trending ability compared with cardiac output based on thermodilution. However, the trending ability can be reduced with increasing shunt fraction, such as in acute lung injury.
Asunto(s)
Gasto Cardíaco , Monitoreo Fisiológico/métodos , Animales , Modelos Animales , Óxido Nitroso , Porcinos , Termodilución/métodosRESUMEN
Lieb and Robinson provided bounds on how fast bipartite connected correlations can arise in systems with only short-range interactions. We generalize Lieb-Robinson bounds on bipartite connected correlators to multipartite connected correlators. The bounds imply that an n-partite connected correlator can reach unit value in constant time. Remarkably, the bounds also allow for an n-partite connected correlator to reach a value that is exponentially large with system size in constant time, a feature which stands in contrast to bipartite connected correlations. We provide explicit examples of such systems.
RESUMEN
Nonclassical correlations between measurement results make entanglement the essence of quantum physics and the main resource for quantum information applications. Surprisingly, there are n-particle states which do not exhibit n-partite correlations at all but still are genuinely n-partite entangled. We introduce a general construction principle for such states, implement them in a multiphoton experiment and analyze their properties in detail. Remarkably, even without multipartite correlations, these states do violate Bell inequalities showing that there is no classical, i.e., local realistic model describing their properties.