An argument for colloid resuscitation for shock

A focused review of the physiologic mechanisms of colloid and crystalloid fluid resuscitations for acute critical illness is presented. This review suggests that postresuscitation plasma volume, cardiac output, left ventricular mechanical performance, and global and microcirculatory O2 supplies are more favorable with colloid therapy. Conversely, crystalloid may adversely affect microcirculatory blood flow and resultant O2 supply and use by ischemic tissues in shock. Poor relief of global and regional hypoxia may persist in critically ill patients after resuscitation with crystalloid.     

Guidelines for Warranty Contracting for Highway Construction

This paper presents guidelines for implementing the construction warranty contracting method in the highway construction industry. A logical, step-by-step method for effectively applying the warranty contracting program for use in the highway construction industry is developed. Relevant issues that may present obstacles to the implementation are addressed, while the best practices, compiled from an evaluation of the current industry’s state-of-the-art practices, will assist an interested state highway agency in creating a warranty specification. In performing this research, the current use of warranty specifications among state highway agencies was examined, and an in-depth case study of the Wisconsin Department of Transportation’s warranty program was conducted.     

NEHRP Provisions for 1994 for Nonstructural Components

The recently published 1994 National Earthquake Hazards Reduction Program (NEHRP) provisions include new and substantially improved provisions for the seismic design of nonstructural components, including architectural, mechanical, and electrical components. The provisions are a significant departure from the 1991 NEHRP provisions and other seismic provisions, such as those offered by the 1994 Uniform Building Code (UBC). The design-force provisions are rationally derived and consider actual in-structure acceleration data recorded in recent significant California earthquakes. Also considered in the design-force equations are the dynamic properties of the components, the location of the component within the supporting structure, the safety and operational importance of the component, and the component's anchorage ductility and energy-absorption capability. The resulting force requirements of the new recommendations are compared with the 1991 NEHRP provisions and the 1994 UBC requirements. In addition, explicit design displacement provisions are introduced and discussed.     

Considerations for Design Criteria for Lunar Structures

The development of design criteria for lunar structures must begin soon in order to establish adequate criteria. Some of the items that need consideration in such criteria are discussed. The categorization of the structures will provide designers with information on the purpose and level of complexity of the structure. Various construction materials and structure types that will be critical for the design of lunar structures, are considered. The environment of the moon and its possible effects on structures are presented and lead to the development of a few load cases that need to be considered in design. A probabilistic format for the criteria and design lifetimes are also discussed.     

Evidence for a genetic predisposition for status epilepticus

The role of genetic factors in determining risk for status epilepticus (SE) was examined in twins identified using the population-based Virginia Twin Registry. Concordance rates for SE were 0.38 for monozygotic (MZ) and 0.00 for dizygotic (DZ) twins, with the rate in MZs being significantly increased over DZs. The prevalence of SE in MZ co-twins of affected individuals was as high as 0.55. Clinical presentation of SE was evaluated, and no association was found between occurrence of SE and age at onset or seizure etiology. Genetic factors contribute to risk for SE.     

Ketamine used for anaesthesia in children for pneumoencephalography

The average blood pressure measured in a representative sample of 8th grade juveniles (14-16 years) was 120/70 mm Hg. Mean systolic pressure was 5 mm Hg higher in boys. The 90th percentile was 135/80 mm Hg for both sexes. Systolic and diastolic pressure rose with increasing body weight. Correlation with height was less obvious. Difference in weight could not account for all the sex difference in blood pressure. Association of sexual maturation with higher blood pressure values was more pronounced in boys.