The structural, electronic, optical, thermoelectric, and magnetic properties of the Perovskite PrFeO3: DFT and Monte Carlo simulations.

CONTEXT: Nowadays, Perovskite materials with diverse compositions and structures have garnered significant attention for their potential applications across various industrial and technological fields. Here, we investigated the structural, electronic, optical, thermodynamic, thermoelectric, and magnetic properties of perovskite PrFeO3 using density functional theory and Monte Carlo simulations. The optimization results demonstrate that the ferromagnetic phase is more stable than the antiferromagnetic phase. Under the GGA + SOC + U and GGA + mBJ approaches, the electronic results of the PrFeO3 compound expose the half-metallic and magnetic behavior. It was also demonstrated that introducing dilatation strain can effectively enhance both the mechanical and thermal stability of PrFeO3. Additionally, the optical properties show that this material has potential uses for solar cells because of its capacity to absorb light in the ultraviolet (UV) spectrum. The maximum values of the Seebeck coefficient reach 90 µV/K at 1000 K, indicating the potential of PrFeO3 as an efficient thermoelectric material. The magnetic properties exhibit a first transition of spin reorientation (TSR) at 171.44 K, followed by a second-order transition at 707.15 K. This investigation provides valuable insights into the unstudied aspect of Perovskite PrFeO3. METHODS: To carry out this investigation, we employed the density functional theory (DFT) implemented in the Wien2k package. To determine the exchange-correlation potential, we utilized the GGA-PBE (Perdew, Burke, and Ernzerhof) approach. The SOC was included based on the second-variational method using scalar relativistic wavefunctions, and electron-electron Coulomb interactions for Fe and Pr are considered in the rotationally invariant way GGA + SOC + U. In this paper, the effective parameter Ueff = U - J was adopted, where U and J stand for the Coulomb and exchange parameters, respectively. Also, we opted for the modified Becke-Johnson potential (mBJ) for comparison. The thermodynamic properties are obtained using the quasi-harmonic Debye model via Gibbs2 software programs. For the calculation of thermoelectric coefficients, a combination of first-principles band structure calculations and the Boltzmann transport theory within the rigid band approximation (RBA) and the constant scattering time approximation (CSTA) was employed, utilizing the BoltzTrap code. Subsequently, we delve into the magneto-caloric and magnetic properties by employing Monte Carlo simulations.

The effect of ventilation rate on outcome in adults receiving cardiopulmonary resuscitation.

AIM: To investigate whether a ventilation rate ≤10 breaths min-1 in adult cardiac arrest patients treated with tracheal intubation and chest compressions in a prehospital setting is associated with improved Return of Spontaneous Circulation (ROSC), survival to hospital discharge and one-year survival with favourable neurological outcome, compared to a ventilation rate >10 breaths min-1. METHODS: In this retrospective study, prospectively acquired data were analysed. Ventilation rates were measured with end-tidal CO2 and ventilation pressures. Analyses were corrected for age, sex, compression rate, compression depth, initial heart rhythm and cause of cardiac arrest. RESULTS: 337 of 652 patients met the inclusion criteria. Hyperventilation was common, with 85% of the patients ventilated >10 breaths min-1. The mean ventilation rate was 15.3 breaths min-1. The corrected odds ratio (OR) of ventilating >10 breaths min-1 for achieving ROSC was 0.91 (95% CI: 0.49 - 1.71, p = 0.78), the uncorrected OR of ventilating >10 breaths min-1 for survival to hospital discharge was 0.91 (95% CI: 0.30 - 2.77, p = 0.78), and the uncorrected OR of ventilating >10 breaths min1 for one-year survival with a favourable neurological outcome was 0.59 (95% CI: 0.19 - 1.87, p = 0.32). A logistic regression with continuous ventilation rate showed no significant relation with ROSC, and a ROC curve for ROSC showed a poor predictive performance (AUC: 0.52, 95% CI: 0.46 - 0.58), suggesting no other adequate cut-off value for ventilation rate. CONCLUSION: A ventilation rate ≤10 breaths min-1 was not associated with significantly improved outcomes compared to a ventilation rate >10 breaths min-1. No other adequate cut-off value could be proposed.

Interpretation Difficulties of Serum Immunofixation Test in Immunoglobulin D Multiple Myeloma with Hidden Lambda Light Chains.

BACKGROUND: We report a case of immunoglobulin (Ig) D myeloma with hidden lambda light chains in a patient whose immunofixation test was very difficult to interpret: the IgD reacts with the anti-δ heavy chain antiserum but does not react with anti-lambda antiserum. The band in the D heavy chain lane is unmatched in light chain lanes and the band in lambda light chain lane migrates higher. METHODS: To distinguish between heavy chain disease and immunoglobulin with "hidden" light chains, the sample was exposed to a very high concentration of anti-lambda and anti-kappa antisera for 48 hours. RESULTS: The serum immunofixation test of the sample treated with anti-lambda showed a decrease in the intensity of the band corresponding to D heavy chain lane as well as the modification of its mobility confirming the presence of IgD with the hidden lambda light chains. CONCLUSIONS: The IgD myeloma with hidden light chains remains a rare entity, hence the interest of sensitizing health professionals to be vigilant and ensure a good diagnosis. The proposed technique is useful, simple, reliable, and less laborious than those previous reported in the literature. Medical laboratories using Sebia-Hydrasys® system should be aware of the described phenomenon in order to avoid identifying an IgD myeloma as a delta heavy chain disease.

Complex intubation, cricothyrotomy and tracheotomy.

Complex intubation, cricothyrotomy and tracheotomy. Successful management of a difficult airway begins with recognizing the potential problem. When the patient cannot breathe spontaneously, oxygenation and ventilation should start first with bag-valve ventilation, with or without an airway adjunct such as a Mayo cannula, followed by an orotrache4l intubation attempt, performed by an experienced emergency doctor. If orotracheal intubation fails, a quick decision must be made regarding surgical options. In a "cannot intubate, cannot ventilate" situation, a surgical cricothyrotomy should be considered. When orotracheal intubation is impossible, but bag-valve or laryngeal mask ventilation is possible, an urgent surgical tracheostomy should be performed. In the long run, patients in need of longterm artificial ventilation will need a percutaneous or open tracheostomy. This review provides an update of all aspects of immediate and long-term airway management.

Emergency care in Belgium.

Emergency care in Belgium. Problems and objectives: Europe encompasses not only fifty or more different languages and cultures, but also a similar number of different systems of healthcare and medical practice. Each country has different medical traditions, different systems of professional registration and differing lists of medical specialties. METHODOLOGY: Literature, Report of The European Observatory on Health Systems, as well as World Health Organization health statistics analysis Results and conclusions: In this chapter, the Belgian healthcare system will be discussed, as well as the area of emergency medicine, which is currently recognized as an independent specialty. The different stakeholders in emergency medicine will also be discussed in this chapter, and their qualifications and responsibilities will be presented.

First-line attitudes in acute medicine.

First-line attitudes in acute medicine. The often complex problems of the trauma and/or severely ill patient present many challenges to front-line emergency staff. Multiple injuries and/or systems of the body involved require careful and timely prioritization and intervention. Optimum evaluation and resuscitation involves repetitive, systematic ipproaches that are known as the "primary", "secondary" and "tertiary" surveys. The primary survey focuses in general on the ABCDE approach of "Airway, Breathing, Circulation, Disability, Expoure", and is designed to recognize and to treat immediate life-threatening conditions within the initial minutes. This primary resuscitation of non-trauma patients does not differ from the ABCDE approach used to evaluate severely traumatized patients. This approach is applicable in all clinical emergencies, whether the patient is located in the street, at home, in the emergency room, and even in the intensive care or the general wards of the hospital. This approach is widely accepted by experts, and is likely to improve outcomes by helping healthcare professionals to focus on the most life-threatening clinical problems. In an acute setting, high-quality ABCDE skills among all treating team members can save valuable time and improve team performance. The secondary and the tertiary surveys are intended to diagnose all injuries before formulating definitive management strategies. This chapter briefly describes how to perform the ABCDE approach in general, and how to conduct the secondary and the tertiary surveys. A more detailed use of this approach within a specific medical condition will be described in later chapters of this report.

Facing coagulation disorders after acute trauma.

Facing coagulation disorders after acute trauma. PROBLEMS/OBJECTIVES: Trauma is the leading cause of mortality for persons between one and 44 years of age, essentially due to bleeding complications. METHODOLOGY: We screened the PubMed, Scopus and Cochrane Library databases, using specific keywords. Only publications in English were considered. MAIN RESULTS: The pathophysiology of trauma-induced coagulopathy (TIC) is complex and includes the classic "lethal triad" (i.e., haemodilution, acidosis, hypothermia) but may also include activation of protein C, endothelial and platelet dysfunction, and fibrinogen depletion. The time between trauma and treatment of the resultant massive bleeding should be as short as possible using techniques for rapid control of bleeding and avoiding aggravating factors (hypothermia, metabolic acidosis and hypocalcaemia). If given within three hours of injury, tranexamic acid (TXA) reduces all causes of mortality in trauma patients and reduces transfusion requirements. In a bleeding patient, crystalloids are preferred to colloids and the ratio of fresh frozen plasma to packed red blood cells should be at least 1:2. Damage control surgery (DCS) should be considered for patients who present with, or are at risk for developing, the "lethal triad", multiple life-threatening injuries or shock, and in mass casualty situations. DCS can also aid in the evaluation of the extent of tissue injuries and the control of haemorrhage and infection. Finally, there is currently no evidence of the added value of laboratory assays in the management of TIC. CONCLUSIONS: TIC appears quickly after trauma and should be anticipated and detected as soon as possible. TXA plays a central role in the management of such patients. Each institution should establish a local algorithm for the management of bleeding patients.

Pre-hospital interventions: introduction to life support systems.

Pre-hospital interventions: introduction to life support systems. Crucial decisions in pre-hospital emergency care are often made; therefore, a tactical emergency medical support team (TEMS) should maintain the capacity to capture the situation instantaneously and in all circumstances. However, low exposure to severe trauma cases can be a weakness for emergency specialists, which makes pre-hospital assessment more difficult. Pre-hospital interventions (PHI) are usually classified in Western countries into BLS (basic life support) and ALS (ad- vanced life support) levels, according to the methods used. This review introduces tactical combat casualty care for medical personnel (TCCC) guidelines, designed for basic care management under fire or in a hostile environment. The phases of TCCC are: (1) care under fire (or in an unstable environment); (2) tactical field care; and (3) tactical evacuation care, and are mainly dependent on the different hazard zones (hot, warm or cold). In a mass casualty situation due to disaster or cataclysm, standardized protocol and triage are unquestionably required for identifying the environmental risks, for categorizing the casualties in accordance with medical care priorities, and for the initial management of casualty care. When considering conflict situations, or chemical, biological, radiological, or nuclear (CBRN) events, processes always start at the local level. Even before the detection and analysis of agents can be undertaken, zoning, triage, decontamination, and treatment should be initiated promptly. Otorhinolaryngologists should be aware of PHI procedures for completing preliminary assessment and management together with emergency specialists or TEMS.

At risk populations: from children to the elderly.

At risk populations:from children to the elderly. PROBLEMS/OBJECTIVES: When considering emergencies in children and elderly people, the risks and consequences are considerably different. For example, the anatomical differences of children have direct consequences on intubation and airway physiology influences breathing, circulation and neurological outcomes.Pharmacotherapy should be adapted for children according to their differences (maturational changes) where drug metabolism and disposition is concerned and for the elderly, to geriatric pharmacokinetics, pharmacodynamics, the existence of poly-medications and the risk of adverse drug reactions. METHODOLOGY: Literature review Results: Children respond better to rapid medical care than adults. Hypoxia is dangerous for the child and is responsible for bradycardia and cardiac arrest. Hypoxia can be deleterious for elderly patients because of their fragility, e.g., less metabolic reserves, poor muscular compensation and higher risk of heart failure. CONCLUSIONS: It is widely accepted that children require paediatric-specific assessment/treatment equipment and pharmacotherapy. When compared to adults, there is no difference in the Royal College of Physician guidelines for elderly people's reanimation, however, other criteria such as polypathology, co-morbidity, polypharmacy, fragility, risk of delirium, adverse drug reaction, poor outcome and quality of life should be considered.

Basilar skull fractures: the petrous bone.

Basilar skullfractures: the petrous bone. OBJECTIVES: to provide suggestions for the management of three of the most dangerous or important lesions (internal carotid artery lesions, cerebrospinal fluid leaks and facial nerve paralysis) associated with the petrous part of basilar skull fractures, thereby trying to assess categories of evidence and determine strengths of recommendation. METHODOLOGY: A PubMed-based literature review was carried out, as well as a consultation of online sources as encountered in the literature review. Also, a non-systematic search of chapters of well-known books dealing with the subject of temporal bone traumata was conducted. RESULTS: Specific levels of evidence and/or strength of recommendation can be retrieved from the literature, but only with respect to the prophylactic use of antibiotics, the prescription of antithrombotic medications and the indications for angiography. CONCLUSION: The ample amount of available literature allows for sound management decisions, with reference made to algorithms when available in the literature. Nevertheless, for most of the management/search questions, categories of evidence and strength of recommendation are low or lacking.

[Association between bone turnover markers, bone mineral density and vitamin D in Moroccan postmenopausal women]. / Association entre les marqueurs du remodelage osseux, la densité minérale osseuse et le statut vitaminique D chez des femmes ménopausées d'origine marocaine.

UNLABELLED: The aim of the study is to find the correlation between bone turnover markers and bone mineral density in a cohort of Moroccan postmenopausal women. PATIENTS AND METHODS: A cross-sectional study, conducted over a period of 12 months from October 2008 to November 2009. Five hundred Moroccan postmenopausal women volunteers participated in this study and we included only 185. RESULTS: In this cohort of 185 women, average age 60 years, the percentage of osteoporotic women was 35.7%, they were older 62.09 (9.13) years and they had an average of the body mass index (BMI), the lowest 29.58 (4.45). The values of the bone mineral density (BMD) measured at the lumbar spine correlated positively and significantly with BMI (P<0.001), serum calcium (P=0.026), negatively with age (P<0.001) and osteocalcin (OC) (P=0.0033). As for the results of BMD measured at the femoral neck, they show a negative and highly significant correlation with age (P<0.001) and osteocalcin. Looking for an association between the biochemical markers of bone remodeling, a weak positive correlation was found between the calcium (Ca) and alkaline phosphatase (PAL) on the one hand and Ca and intact parathyroid hormone (PTHi) in the other hand. And a significant positive correlation was found between PTHi and PAL, and between PTHi and OC. Finally, a significant positive correlation was found between the cross-laps (ß-CTX) and Ca and between PAL and OC. CONCLUSION: Our results are in agree to some international studies and disagree to others.

Complement factor H functional assay may help to monitor atypical haemolytic uraemic syndrome: a pilot study.

BACKGROUND: Atypical haemolytic uraemic syndrome (aHUS) results from uncontrolled complement system activation. Complement factor H gene mutations are common causes of aHUS. Plasmatherapy, including plasma infusions and/or plasma exchanges, has been tried in this setting with various successes. At present, we lack a specific marker to monitor functional factor H deficiency-related aHUS. METHODS: We report the use of factor H functional assay in three patients with atypical haemolytic uraemic syndrome. This assay is based on the requirement of soluble complement regulators that bind sheep red cells to prevent haemolysis. As factor H is highly abundant in the plasma, its defect results in haemolysis. Factor H activity was also measured among plasma donors. RESULTS: One patient suffered from a plasma-dependent form of atypical haemolytic uraemic syndrome. Plasma exchanges restored higher factor H activity and were associated with a 15-months disease-free period. In the two other patients, one with a failing renal graft and the other on chronic dialysis, a bout of thrombotic microangiopathy was preceded by a drop of haemolytic activity below normal values. Plasma from healthy donors (N=65) showed only minimal variations of Factor H activity (mean activity: 98.3%, SD=4.0). CONCLUSION: These preliminary data suggest that factor H activity could be of interest in both the diagnosis and the treatment by plasmatherapy of factor H-related aHUS.

Paediatric community-acquired septic shock: results from the REPEM network study.

UNLABELLED: INTRODUCTION AND PURPOSE OF THE STUDY: With this study we aimed to describe a "true world" picture of severe paediatric 'community-acquired' septic shock and establish the feasibility of a future prospective trial on early goal-directed therapy in children. During a 6-month to 1-year retrospective screening period in 16 emergency departments (ED) in 12 different countries, all children with severe sepsis and signs of decreased perfusion were included. RESULTS: A 270,461 paediatric ED consultations were screened, and 176 cases were identified. Significant comorbidity was present in 35.8 % of these cases. Intensive care admission was deemed necessary in 65.7 %, mechanical ventilation in 25.9 % and vasoactive medications in 42.9 %. The median amount of fluid given in the first 6 h was 30 ml/kg. The overall mortality in this sample was 4.5 %. Only 1.2 % of the survivors showed a substantial decrease in Paediatric Overall Performance Category (POPC). 'Severe' outcome (death or a decrease ≥2 in POPC) was significantly related (p < 0.01) to: any desaturation below 90 %, the amount of fluid given in the first 6 h, the need for and length of mechanical ventilation or vasoactive support, the use of dobutamine and a higher lactate or lower base excess but not to any variables of predisposition, infection or host response (as in the PIRO (Predisposition, Infection, Response, Organ dysfunction) concept). CONCLUSION: The outcome in our sample was very good. Many children received treatment early in their disease course, so avoiding subsequent intensive care. While certain variables predispose children to become septic and shocked, in our sample, only measures of organ dysfunction and concomitant treatment proved to be significantly related with outcome. We argue why future studies should rather be large multinational prospective observational trials and not necessarily randomised controlled trials.

Electronic medical file exchange between on-duty care providers and the attending paediatrician: a Belgian paediatric pilot project.

The authors propose the introduction of a pilot project: "paediatric core file exchange in emergencies" (PCF-EXEM) which enables the exchange of medical data between the attending paediatrician (AP), holder of the medical record, and on-duty medical units (i.e. general practitioners, paediatricians, surgeons, emergency physicians,...). This project is based on two pillars: a protected server (PCF-server) containing paediatric core files (PCF), with important clinical data that should be available for the physician in order to quickly get a clear insight into the relevant clinical medical history of the child, and secondly, the possibility to provide feedback to the attending physician about the findings recorded during the on-call duty. The permanent availability of health data on the PCF-server and the possibility to provide feedback represent together the PCF-EXEM-project. This project meets the demand of the care providers to have relevant medical information permanently available in order to guarantee high quality care in emergency situations. The frail balance between the right to informative privacy and professional confidentiality on the one hand and the right to quality health care on the other hand has been taken into account. The technical and practical feasibility of this project is described. The objectives and vision of the PCF-EXEM project are conform to Belgian legislation concerning the processing of medical data and are in line with the still under consideration European projects which are focusing on interoperability and the development of a common access control to databanks containing health data for care providers. PCF-EXEM could therefore be a model for other EU countries as well.

SVMT: a MATLAB toolbox for stereo-vision motion tracking of motor reactivity.

This article presents a Matlab-based stereo-vision motion tracking system (SVMT) for the detection of human motor reactivity elicited by sensory stimulation. It is a low-cost, non-intrusive system supported by Graphical User Interface (GUI) software, and has been successfully tested and integrated in a broad array of physiological recording devices at the Human Physiology Laboratory in the University of Granada. The SVMT GUI software handles data in Matlab and ASCII formats. Internal functions perform lens distortion correction, camera geometry definition, feature matching, as well as data clustering and filtering to extract 3D motion paths of specific body areas. System validation showed geo-rectification errors below 0.5 mm, while feature matching and motion paths extraction procedures were successfully validated with manual tracking and RMS errors were typically below 2% of the movement range. The application of the system in a psychophysiological experiment designed to elicit a startle motor response by the presentation of intense and unexpected acoustic stimuli, provided reliable data probing dynamical features of motor responses and habituation to repeated stimulus presentations. The stereo-geolocation and motion tracking performance of the SVMT system were successfully validated through comparisons with surface EMG measurements of eyeblink startle, which clearly demonstrate the ability of SVMT to track subtle body movement, such as those induced by the presentation of intense acoustic stimuli. Finally, SVMT provides an efficient solution for the assessment of motor reactivity not only in controlled laboratory settings, but also in more open, ecological environments.

[Contribution of CSF/serum immunofixation to the diagnosis of inflammatory diseases of the central nervous system]. / Intérêt de l'immunofixation du couple LCR/sérum dans le diagnostic des maladies inflammatoires du système nerveux central.

INTRODUCTION: Multiple sclerosis and other inflammatory diseases of the central nervous system produce various and nonspecific symptoms. The diagnosis of these diseases is ultimately a clinical decision, although examination of cerebrospinal fluid (CSF) and other complementary tests such magnetic resonance imaging (MRI) and evoked potentials can be contributive. One important aspect of these diseases is intrathecal synthesis of immunoglobulins. PATIENTS AND METHODS: In order to determine the contribution of CSF/serum immunofixation to the diagnosis of inflammatory diseases of the central nervous system, we conducted a retrospective study in the biochemistry laboratory of the military instruction hospital Mohammed V. 363 CSF/serum samples were collected over a period of four years. RESULTS: Immunofixation was less sensitive than MRI for the diagnosis of inflammatory neurological disease (44% vs 87%), but was much more specific than MRI (97% for immunofixation vs 38%). The positive predictive value was higher that for MRI (85% vs 40%). The negative predictive value (80%) was close to that of MRI (86%). The bivariate analysis showed that immunofixation results could be predicted from clinical findings and complementary test results such as the index of Link, syphilis serology in CSF, and MRI. CONCLUSIONS/DISCUSSION: Semi-automatic Hydrasys immunofixation of CSF IgG is a technique exhibiting excellent diagnostic and analytical performance for the diagnosis of inflammatory neurological diseases.

Intérêt des marqueurs tumoraux sériques dans les cancers digestifs

Les marqueurs tumoraux sont des composés produits par les cellules cancéreuses ou leur environnement se retrouvant en quantité suffisante dans le sang, les urines et les liquides d'effusion. Les marqueurs les plus utilisés en pathologie digestive sont l'antigène carcino-embryonnaire (ACE), l'alpha foetoproteine (_FP) et le CA19-19. Le but de notre travail est de discuter l'intérêt de ces trois marqueurs dans le dépistage, le suivi et le pronostic des cancers gastriques, pancréatiques, colorectaux et hépatiques.La faible sensibilité et l'existence de faux positifs rendent parfois ces marqueurs impropres à une stratégie de dépistage. Par contre, seul l'_FP a une valeur diagnostique dans les hépato carcinomes pour les populations à haut risque. L'ACE et le CA19-9 ont une bonne sensibilité et une spécificité relative qui leur permettent de suivre l'évolution des cancers digestifs en particulier les cancers colorectaux. Ils constituent les meilleurs marqueurs pour évaluer le pronostic, l'efficacité thérapeutique et pour dépister les récidives de façon précoce. Leur association est justifiée et permet d'atteindre 91% de spécificité et 76% de sensibilité.Devant la place occupée par la biologie dans le diagnostic, le pronostic et le suivi des cancers digestifs par le dosage des marqueurs tumoraux, nous nous devons que de reconnaître tant leurs performances que leurs limites

Safety and feasibility of nasopharyngeal evaporative cooling in the emergency department setting in survivors of cardiac arrest.

AIM: Mild therapeutic hypothermia improves survival and neurologic recovery in primary comatose survivors of cardiac arrest. Cooling effectivity, safety and feasibility of nasopharyngeal cooling with the RhinoChill device (BeneChill Inc., San Diego, USA) were determined for induction of therapeutic hypothermia. METHODS: Eleven emergency departments and intensive care units participated in this multi-centre, single-arm descriptive study. Eighty-four patients after successful resuscitation from cardiac arrest were cooled with nasopharyngeal delivery of an evaporative coolant for 1h. Subsequently, temperature was controlled with systemic cooling at 33 degrees C. Cooling rates, adverse events and neurologic outcome at hospital discharge using cerebral performance categories (CPC; CPC 1=normal to CPC 5=dead) were documented. Temperatures are presented as median and the range from the first to the third quartile. RESULTS: Nasopharyngeal cooling for 1h reduced tympanic temperature by median 2.3 (1.6; 3.0) degrees C, core temperature by 1.1 (0.7; 1.5) degrees C. Nasal discoloration occurred during the procedure in 10 (12%) patients, resolved in 9, and was persistent in 1 (1%). Epistaxis was observed in 2 (2%) patients. Periorbital gas emphysema occurred in 1 (1%) patient and resolved spontaneously. Thirty-four of 84 patients (40%) patients survived, 26/34 with favorable neurological outcome (CPC of 1-2) at discharge. CONCLUSIONS: Nasopharyngeal evaporative cooling used for 1h in primary cardiac arrest survivors is feasible and safe at flow rates of 40-50L/min in a hospital setting.