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Validation of a pediatric bedside tool to predict time to death after withdrawal of life support

World Journal of Clinical Pediatrics 2016年第1期5卷 89-94页

作者： Ashima Das Ingrid M Anderson David G speicher richard h speicher Steven L Shein Alexandre T Rotta Division of Pediatric Critical Care Medicine Rainbow Babies and Children’s Hospital Case Western Reserve University School of Medicine

AIM: To evaluate the accuracy of a tool developed to predict timing of death following withdrawal of life support in children. METhODS: Pertinent variables for all pediatric deaths(age ≤ 21 years) from 1/2009 to 6/2014 in our pediatric intensive care unit(PICU) were extracted through a detailed review of the medical records. As originally described, a recently developed tool that predicts timing of death in children following withdrawal of life support(dallas predictor tool [DPT]) was used to calculate individual scores for each patient. Individual scores were calculated for prediction of death within 30 min(DPT30) and within 60 min(DPT60). For various resulting DPT30 and DPT60 scores, sensitivity, specificity and area under the receiver operating characteristic curve were ***: There were 8829 PICU admissions resulting in 132(1.5%) deaths. Death followed withdrawal of life support in 70 patients(53%). After excluding subjects with insufficient data to calculate DPT scores, 62 subjects were analyzed. Average age of patients was 5.3 years(SD: 6.9), median time to death after withdrawal oflife support was 25 min(range; 7 min to 16 h 54 min). Respiratory failure, shock and sepsis were the most common diagnoses. Thirty-seven patients(59.6%) died within 30 min of withdrawal of life support and 52(83.8%) died within 60 min. DPT30 scores ranged from-17 to 16. A DPT30 score ≥-3 was most predictive of death within that time period, with sensitivity = 0.76, specificity = 0.52, AUC = 0.69 and an overall classification accuracy = 66.1%. DPT60 scores ranged from-21 to 28. A DPT60 score ≥-9 was most predictive of death within that time period, with sensitivity = 0.75, specificity = 0.80, AUC = 0.85 and an overall classification accuracy = 75.8%.CONCLUSION: In this external cohort, the DPT is clinically relevant in predicting time from withdrawal of life support to death. In our patients, the DPT is more useful in predicting death within 60 min of withdrawal of life

关键词： Death Organ donation Children Donation after circulatory death

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Target fabrication for laser-ion acceleration research at the Technological Laboratory of the LMU Munich

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Matter and Radiation at Extremes 2019年第3期4卷 25-31页

作者： J.Szerypo W.Ma G.Bothmann D.hahner M.haug P.hilz Ch.Kreuzer R.Lange S.Seuferling M.speicher F.Stehr S.Stork P.G.Thirolf J.Schreiber h.-F.Wirth Fakultat fur Physik Ludwig-Maximilians-Universitat MunchenD-85748 GarchingGermany State Key Laboratory of Nuclear Physics and Technology School of PhysicsPeking UniversityBeijing 100871China helmholtz-Institut Jena Frobelstieg 307743 JenaGermany

The Technological Laboratory of LMU Munich supplies various types of solid-state target for laser plasma experiments at the Centre for Advanced Laser Applications in *** main focus here is on the production of free-standing,thin foil targets,such as diamond-likecarbon foils,carbon nanotube foams(CNFs),plastic,and gold *** presented methods comprise cathodic arc deposition for DLC targets,chemical vapor deposition for CNFs,a droplet and spin-coating process for plastic foil production,as well as physical vapor deposition that has been optimized to provide ultrathin gold foils and tailored sacrifice *** paper reviews our current capabilities,which are a result of a close collaboration between target production processes and experiment,using high-power chirped pulse amplification laser systems over the past eight years.

关键词： acceleration laser coating

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An automated, 0.5 hz nano-foil target positioning system for intense laser plasma experiments

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high Power Laser Science and Engineering 2017年第2期5卷 52-56页

作者： Ying Gao Jianhui Bin Daniel haffa Christian Kreuzer Jens hartmann Martin speicher Florian h.Lindner Tobias M.Ostermayr Peter hilz Thomas F.Rsch Sebastian Lehrack Franz Englbrecht Sebastian Seuferling Max Gilljohann hao Ding Wenjun Ma Katia Parodi Jorg Schreiber Lehrstuhl fur Medizinphysik Fakultat fUr PhysikLudwig-Maximilians-Universitat MiinchenAm Coulombwall 1D-85748GarchingGermany Max-Planck-lnstitut fur Quantenoptik D-85748 GarchingGermany peking University Beijing 100871PR China

We report on a target system supporting automated positioning of nano-targets with a precision resolution of 4 μm in three dimensions. It relies on a confocal distance sensor and a microscope. The system has been commissioned to position nanometer targets with 1 hz repetition rate. Integrating our prototype into the table-top ATLAS 300 TW-laser system at the Laboratory for Extreme Photonics in Garching, we demonstrate the operation of a 0.5 hz laser-driven proton source with a shot-to-shot variation of the maximum energy about 27% for a level of confidence of 0.95. The reason of laser shooting experiments operated at 0.5 hz rather than 1 hz is because the synchronization between the nano-foil target positioning system and the laser trigger needs to improve.

关键词： high intense laser nm thick target positioning system repetition rated laser-driven ion source

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