Beriberi: A Reversible Cause of Acute Severe Pulmonary Hypertension.

Thiamine, also known as vitamin B1, plays a fundamental role in energy metabolism. The organs most sensitive to thiamine deficiency are the cardiovascular and nervous systems. The usual presentations include Wernicke's encephalopathy, polyneuropathy (known as "dry beriberi"), and the cardiovascular form (known as "wet beriberi"). Wet beriberi-induced acute severe pulmonary hypertension has rarely been previously described. Here we present a case of wet beriberi with severe right heart failure due to acute pulmonary hypertension. The underlying physiologic derangements dramatically improved after thiamine treatment. No other possible causes of pulmonary hypertension could be identified, with the exception of thiamine deficiency. This case illustrates the importance of considering wet beriberi as a possible cause of acute pulmonary hypertension with right heart failure.

A confocal microscope position sensor for micron-scale target alignment in ultra-intense laser-matter experiments.

A diagnostic tool for precise alignment of targets in laser-matter interactions based on confocal microscopy is presented. This device permits precision alignment of targets within the Rayleigh range of tight focusing geometries for a wide variety of target surface morphologies. This confocal high-intensity positioner achieves micron-scale target alignment by selectively accepting light reflected from a narrow range of target focal planes. Additionally, the design of the device is such that its footprint and sensitivity can be tuned for the desired chamber and experiment. The device has been demonstrated to position targets repeatably within the Rayleigh range of the Scarlet laser system at The Ohio State University, where use of the device has provided a marked increase in ion yield and maximum energy.

Demonstrating a correlation between the maturity of road safety practices and road safety incidents.

OBJECTIVE: The objective of this study is to demonstrate a correlation between the maturity of a country's road safety practices and road safety incidents. METHODS: Firstly, data on a number of road injuries and fatalities for 129 countries were extracted from the United Nations Global Status on Road Safety database. These data were subdivided according to road safety incident and accident causation factors and normalized based on vehicular fleet (per 1000 vehicles) and road network (per meter of paved road). Secondly, a road safety maturity model was developed based on an adaptation of the concept of process maturity modeling. The maturity of countries with respect to 10 road safety practices was determined through the identification of indicators recorded in the United Nations Global Status of Road Safety Database. Plots of normalized road safety performance of the 129 countries against their maturity scores for each road safety practice as well as an aggregation of the road safety practices were developed. An analysis of variance was done to determine the extent of the correlation between the road safety maturity of the countries and their performance. In addition, a full Bayesian analysis was done to confirm the correlation of each of the road safety practices with injuries and fatalities. RESULTS: Regression analysis for fatalities, injuries, and combined accidents identified maturity with respect to road safety practices associated with speed limits and use of alternative modes as being the most significant predictors of traffic fatalities. A full Bayesian regression confirms that there is a correlation between the maturity of road safety practices and road safety incidents. CONCLUSION: Road safety practices associated with enforcement of speed limits and promotion of alternative modes are the most significant road safety practices toward which mature countries have concentrated their efforts, resulting in a lower frequency of fatalities, injury rates, and property damage accidents. The authors argue that the use of gross domestic product (GDP) as a predictor of road safety incidents suffers from the presumptive assumption that the only criterion that matters is national income, therefore erroneously predicting that richer countries all perform approximately the same in fatalities and that developing nations are at various stages, with high variability and uncertainty in prediction. It is proposed that an aggregation of individual maturity scores from road safety practices will lead to a better indicator for policy because it connects externalities (fatalities/injuries) with intrinsic factors for which policies can be oriented.