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V poslednich letech přitahuje terapeutický přistup s využitim mimotělnich hemadsorpcnich metod u kriticky nemocných stale větsi zajem. Snaha o casný zasah do patofyziologických procesů, ktere doprovazeji řadu inzultů u pacientů v intenzivni peci, představuje nepochybně atraktivni koncept, v soucasnosti pronikajici do klinicke praxe navzdory absenci evidence. Niže uvedený text představuje kritický pohled autorů na soucasný stav problematiky hemadsorpcnich metod a jejich využiti u kriticky nemocných, zejmena septických pacientů.

This corrects the article DOI: 10.1103/PhysRevLett.116.071802.

Single neutral pion production via muon antineutrino charged-current interactions in plastic scintillator (CH) is studied using the MINERvA detector exposed to the NuMI low-energy, wideband antineutrino beam at Fermilab. Measurement of this process constrains models of neutral pion production in nuclei, which is important because the neutral-current analog is a background for ν ¯ e appearance oscillation experiments. The differential cross sections for π 0 momentum and production angle, for events with a single observed π 0 and no charged pions, are presented and compared to model predictions. These results comprise the first measurement of the π 0 kinematics for this process.

MINER ν A (Main INjector ExpeRiment ν - A ) is a new few-GeV neutrino cross-section experiment that began taking data in the FNAL NuMI (Fermi National Accelerator Laboratory Neutrinos at the Main Injector) beam-line in March of 2010. MINER ν A employs a fine-grained scintillator detector capable of complete kinematic characterization of neutrino interactions. This paper describes the MINER ν A data acquisition system (DAQ) including the readout electronics, software, and computing architecture.

Production of K+ mesons in charged-current νμ interactions on plastic scintillator (CH) is measured using MINERvA exposed to the low-energy NuMI beam at Fermilab. Timing information is used to isolate a sample of 885 charged-current events containing a stopping K+ which decays at rest. The differential cross section in K+ kinetic energy, dσ/dTK, is observed to be relatively flat between 0 and 500 MeV. As a result, its shape is in good agreement with the prediction by the genie neutrino event generator when final-state interactions are included, however the data rate is lower than the prediction by 15%.

Muon-neutrino elastic scattering on electrons is an observable neutrino process whose cross section is precisely known. Consequently a measurement of this process in an accelerator-based $\nu_\mu$ beam can improve the knowledge of the absolute neutrino flux impinging upon the detector; typically this knowledge is limited to $\sim$ 10% due to uncertainties in hadron production and focusing. We have isolated a sample of 135 $\pm$ 17 neutrino-electron elastic scattering candidates in the segmented scintillator detector of MINERvA, after subtracting backgrounds and correcting for efficiency. We show how this sample can be used to reduce the total uncertainty on the NuMI $\nu_\mu$ flux from 9% to 6%. Our measurement provides a flux constraint that is useful to other experiments using the NuMI beam, and this technique is applicable to future neutrino beams operating at multi-GeV energies., Comment: 11 pages, 11 figures

Here, the MINERvA Collaboration reports a novel study of neutrino-nucleus charged-current deep inelastic scattering (DIS) using the same neutrino beam incident on targets of polystyrene, graphite, iron, and lead. Results are presented as ratios of C, Fe, and Pb to CH. The ratios of total DIS cross sections as a function of neutrino energy and flux-integrated differential cross sections as a function of the Bjorken scaling variable x are presented in the neutrino-energy range of 5–50 GeV. Based on the predictions of charged-lepton scattering ratios, good agreement is found between the data and prediction at medium x and low neutrino energy. However, the ratios appear to be below predictions in the vicinity of the nuclear shadowing region, x < 0.1. This apparent deficit, reflected in the DIS cross-section ratio at high Eν, is consistent with previous MINERvA observations [B. Tice (MINERvA Collaboration), Phys. Rev. Lett. 112, 231801 (2014).] and with the predicted onset of nuclear shadowing with the axial-vector current in neutrino scattering.

Here, the MINERvA experiment observes an excess of events containing electromagnetic showers relative to the expectation from Monte Carlo simulations in neutral-current neutrino interactions with mean beam energy of 4.5 GeV on a hydrocarbon target. The excess is characterized and found to be consistent with neutral-current π0 production with a broad energy distribution peaking at 7 GeV and a total cross section of 0.26 $$\pm$$ 0.02 (stat) $$\pm$$ 0.08 (sys) x $$10^{-39} cm^{2}$$. The angular distribution, electromagnetic shower energy, and spatial distribution of the energy depositions of the excess are consistent with expectations from neutrino neutral-current diffractive neutral pion production from hydrogen in the hydrocarbon target. These data comprise the first direct experimental observation and constraint for a reaction that poses an important background process in neutrino oscillation experiments searching for $$\nu_{\mu}$$to $$\nu_e$$ oscillations.

Neutrino interaction events in the MINER ν A detector are visually represented with a web-based tool called Arachne. Data are retrieved from a central server via AJAX, and client-side JavaScript draws images into the user's browser window using the draft HTML 5 standard. These technologies allow neutrino interactions to be viewed by anyone with a web browser, allowing for easy hand-scanning of particle interactions. Arachne has been used in MINER ν A to evaluate neutrino data in a prototype detector, to tune reconstruction algorithms, and for public outreach and education.

Neuropeptide Y (NPY), a potent vasoconstrictor released from the sympathetic nerves, has been suggested to counterbalance sepsis-induced vasodilation. Thus, the changes in plasma and tissue NPY concentrations in relation to hemodynamic variables and inflammatory markers in a porcine model of moderate septic shock were investigated. Susceptibility of NPY to be removed by continuous hemofiltration in two settings has been also studied. Thirty-four domestic pigs were divided into five groups: (i) control group; (ii) control group with conventional hemofiltration; (iii) septic group; (iv) septic group with conventional hemofiltration; and (v) septic group with high-volume hemofiltration. Sepsis induced by fecal peritonitis continued for 22 h. Hemofiltration was applied for the last 10 h. Hemodynamic and inflammatory parameters (heart rate, mean arterial pressure, cardiac output, systemic vascular resistance, plasma concentrations of tumor necrosis factor-α, interleukin-6, and NPY) were measured before and at 12 and 22 h of peritonitis. NPY tissue levels were determined in the left ventricle and mesenteric and coronary arteries. Sepsis induced long-lasting increases in the systemic NPY levels without affecting its tissue concentrations. Continuous hemofiltration at any dose did not reduce sepsis-induced elevations in NPY plasma concentrations, nor did it affect the peptide tissue levels. The increases in NPY systemic levels were significantly correlated with changes in the systemic vascular resistance. The results support the hypothesis of NPY implication in the regulation of the vascular resistance under septic conditions and indicate that NPY clearance rate during hemofiltration does not exceed the capacity of perivascular nerves to release it.

Syndrom multiorganove dysfunkce (MODS) je hlavni přicinou umrti na jednotkach intenzivni pece. K rozvoji MODS obvykle dochazi u kriticky nemocných v průběhu těžkých infekci, u sokových stavů, polytraumat, masivni hemoragie ci kombinaci těchto stavů. Přesna patofyziologie MODS zůstava neobjasněna. Zahrnuje řadu molekularnich, buněcných a systemových poruch, v jejichž důsledku dochazi k deregulovane zanětlive a imunitni odpovědi, aktivaci koagulace a neuroendokrinnich a metabolických procesů. Zakladnim preventivnim opatřenim je vcasna a agresivni lecba vyvolavajiciho onemocněni, zatimco vlastni lecba MODS je převažně podpůrna. Tento clanek shrnuje epidemiologii MODS, strucně popisuje soucasnou patofyziologii a pojednava o zakladnich preventivnich a lecebných principech.

Charged pion production via charged-current ${\ensuremath{\nu}}_{\ensuremath{\mu}}$ interactions on plastic scintillator (CH) is studied using the MINERvA detector exposed to the NuMI wideband neutrino beam at Fermilab. Events with hadronic invariant mass $Wl1.4\text{ }\text{ }\mathrm{GeV}$ and $Wl1.8\text{ }\text{ }\mathrm{GeV}$ are selected in separate analyses: the lower $W$ cut isolates single pion production, which is expected to occur primarily through the $\mathrm{\ensuremath{\Delta}}(1232)$ resonance, while results from the higher cut include the effects of higher resonances. Cross sections as functions of pion angle and kinetic energy are compared to predictions from theoretical calculations and generator-based models for neutrinos ranging in energy from 1.5--10 GeV. The data are best described by calculations which include significant contributions from pion intranuclear rescattering. These measurements constrain the primary interaction rate and the role of final state interactions in pion production, both of which need to be well understood by neutrino oscillation experiments.

The first direct measurement of electron neutrino quasielastic and quasielasticlike scattering on hydrocarbon in the few-GeV region of incident neutrino energy has been carried out using the MINERvA detector in the NuMI beam at Fermilab. The flux-integrated differential cross sections in the electron production angle, electron energy, and Q^{2} are presented. The ratio of the quasielastic, flux-integrated differential cross section in Q^{2} for ν_{e} with that of similarly selected ν_{μ}-induced events from the same exposure is used to probe assumptions that underpin conventional treatments of charged-current ν_{e} interactions used by long-baseline neutrino oscillation experiments. The data are found to be consistent with lepton universality and are well described by the predictions of the neutrino event generator GENIE.

A study of charged-current muon neutrino scattering on hydrocarbon in which the final state includes a muon, at least one proton, and no pions is presented. Although this signature has the topology of neutrino quasielastic scattering from neutrons, the event sample contains contributions from quasielastic and inelastic processes where pions are absorbed in the nucleus. The analysis accepts events with muon production angles up to 70° and proton kinetic energies greater than 110 MeV. The cross section, when based completely on hadronic kinematics, is well described by a relativistic Fermi gas nuclear model including the neutrino event generator modeling for inelastic processes and particle transportation through the nucleus. This is in contrast to the quasielastic cross section based on muon kinematics, which is best described by an extended model that incorporates multinucleon correlations. As a result, this measurement guides the formulation of a complete description of neutrino-nucleus interactions that encompasses the hadronic as well as the leptonic aspects of this process.

Two different nuclear-medium effects are isolated using a low three-momentum transfer subsample of neutrino-carbon scattering data from the MINERvA neutrino experiment. The observed hadronic energy in charged-current $\nu_\mu$ interactions is combined with muon kinematics to permit separation of the quasielastic and $\Delta$(1232) resonance processes. First, we observe a small cross section at very low energy transfer that matches the expected screening effect of long-range nucleon correlations. Second, additions to the event rate in the kinematic region between the quasielastic and $\Delta$ resonance processes are needed to describe the data. The data in this kinematic region also has an enhanced population of multi-proton final states. Contributions predicted for scattering from a nucleon pair have both properties; the model tested in this analysis is a significant improvement but does not fully describe the data. We present the results as a double-differential cross section to enable further investigation of nuclear models. Improved description of the effects of the nuclear environment are required by current and future neutrino oscillation experiments., Comment: 7 pages, 3 figures, supplemental material. v2 includes updates from the review process. v3 includes ancillary files. v4 fixes incorrect exponent in Fig. 2 and supplemental files, synchronized with the erratum in the journal version

Neutrino-induced coherent charged pion production on nuclei ν(–)μA → μ±π∓A is a rare, inelastic interaction in which a small squared four-momentum |t| is transferred to the recoil nucleus, leaving it intact in the reaction. In the scintillator tracker of MINERvA, we remove events with evidence of particles from nuclear breakup and reconstruct |t| from the final-state pion and muon. In addition, we select low |t| events to isolate a sample rich in coherent candidates. By selecting low |t| events, we produce a model-independent measurement of the differential cross section for coherent scattering of neutrinos and antineutrinos on carbon. We find poor agreement with the predicted kinematics in neutrino generators used by current oscillation experiments.

The MINERνA experiment at Fermilab will use a fully-active scintillator based fine grained neutrino detector and the high rate NuMI neutrino beam. MINERνA will measure low energy neutrino interaction properties and cross sections to a new level of precision. These measurements will be critical input to present and future accelerator-based neutrino oscillation experiments in this energy range.

The MINERvA 6 experiment is designed to perform precision studies of neutrino-nucleus scattering using ν μ and ν ¯ μ neutrinos incident at 1–20 GeV in the NuMI beam at Fermilab. This article presents a detailed description of the MINERvA detector and describes the ex situ and in situ techniques employed to characterize the detector and monitor its performance. The detector is composed of a finely segmented scintillator-based inner tracking region surrounded by electromagnetic and hadronic sampling calorimetry. The upstream portion of the detector includes planes of graphite, iron and lead interleaved between tracking planes to facilitate the study of nuclear effects in neutrino interactions. Observations concerning the detector response over sustained periods of running are reported. The detector design and methods of operation have relevance to future neutrino experiments in which segmented scintillator tracking is utilized.

We have isolated muon anti-neutrino charged-current quasi-elastic interactions occurring in the segmented scintillator tracking region of the MINERvA detector running in the NuMI neutrino beam at Fermilab. We measure the flux-averaged differential cross-section, d{\sigma}/dQ^2, and compare to several theoretical models of quasi-elastic scattering. Good agreement is obtained with a model where the nucleon axial mass, M_A, is set to 0.99 GeV/c^2 but the nucleon vector form factors are modified to account for the observed enhancement, relative to the free nucleon case, of the cross-section for the exchange of transversely polarized photons in electron-nucleus scattering. Our data at higher Q^2 favor this interpretation over an alternative in which the axial mass is increased., Comment: 8 pages, 5 figures. Added correlation between neutrino and anti-neutrino results in ancillary text files (CSV)

Beams of neutrinos have been proposed as a vehicle for communications under unusual circumstances, such as direct point-to-point global communication, communication with submarines, secure communications and interstellar communication. We report on the performance of a low-rate communications link established using the NuMI beam line and the MINERvA detector at Fermilab. The link achieved a decoded data rate of 0.1 bits/sec with a bit error rate of 1% over a distance of 1.035 km, including 240 m of earth., 10 pages, 7 figures, updated with final figures used in Modern Physics Letters A publication

The kidney is a common “victim organ” of various insults in critically ill patients. Sepsis and septic shock are the dominant causes of acute kidney injury, accounting for nearly 50 % of episodes of acute renal failure. Despite our substantial progress in the understanding of mechanisms involved in septic acute kidney injury there is still a huge pool of questions preclusive of the development of effective therapeutic strategies. This review briefly summarizes our current knowledge of pathophysiological mechanisms of septic acute kidney injury focusing on hemodynamic alterations, peritubular dysfunction, role of inflammatory mediators and nitric oxide, mitochondrial dysfunction and structural changes. Role of proteomics, new promising laboratory method, is mentioned.

A 24-year-old man presented with cough, sore throat, fever, maculopapulous exanthema, pericardial and pleural effusion. Despite extensive evaluation neither infectious, autoimmune, hematological nor oncological disorders were revealed. Broad spectrum antibiotic and subsequently corticosteroid treatment failed to resolve the symptoms. Multiorgan failure with rapid progress of acute respiratory distress syndrome and circulatory failure developed and patient died. Adult onset Still's disease (AOSD), a diagnosis considered in this patient, is a rare disease with unknown prevalence, pathogenesis and etiology. Clinically it is characterized by spiking fever, arthritis, rash, and impairment of multiple organs. There is no single diagnostic test for AOSD. Rather, the diagnosis is based on the clinical criteria and requires the exclusion of infectious, neoplastic, and other autoimmune diseases. Rarely the course of the disease can be rapidly progressive to death. Treatment includes the use of non-steroid antirheumatic drugs and corticosteroids. Limited data suggest that biological agents (e.g. anti-TNF-alpha, anti-IL-1), rituximab or intravenous immunoglobulins might be promising for the treatment of severe cases.

Enteral nutrition (EN) represents a preferred type of nutritional support in critical care patients, in spite of the high incidence of intolerance. One of the methods which can speed up the delivery of adequate amounts of food is to switch from the gastric to post-pyloric feeding. A three-luminal tube (TLT) enables post-pyloric enteral feeding with accompanying gastric decompression. The aim of our study was to evaluate effectiveness and safety of the endoscopically introduced TLT along with the estimation of the adequate dose of enteral nutrition.Retrospective analysis of 111 critical care patients with 140 introduced TLT during 2003 to 2006 in two intensive care units (UIC) in the Teaching hospital in Plzen included patients of average age 54 years (+/- 15), APACHE II score 26 (+/- 10) and UIC mortality was 24%. Eight introductions were technically not successful (6%). Reintroduction of the tube was necessary in 21 patients (19%). The average time of tube introduction was 6 minutes (+/- 3). In direct relation to endoscopy no serious complication was observed. In our cohort, 34 ventilator-associated pneumonias developed (31%). Average time interval since the admission to the hospital till TLT introduction was 7 days (+/- 6). Evaluation of a subgroup of 77 patients from one UIC has shown that the adequate amount of EN was achieved in 82% of patients in 4 days (+/- 3) after the TLT introduction. In average, TLT was introduced for 11 days (+/- 7).Endoscopic TLT introduction represents a safe and reliable method which can ensure adequate amount of enteral nutrition in majority of critical care patients with gastrointestinal dysfunction. In our conditions, TLT is probably not sufficiently used.

We present a case report of a 59-year-old man with a history of arterial hypertension and excision of malignant melanoma. He was admitted to the hospital because of two months history of diarrhoea, weight loss and circulatory collapse. In addition, the patient suffered from marked vegetative instability with symptomatic hypotension, polyneuropathy and progression of renal insufficiency, without proteinuria. Complex examination did not reveal neoplasms, endocrine, autoimmune, infectious or neurodegenerative disorders. A serial biopsy of colon failed to provide a clue to the diagnosis. However, AA amyloidosis was found on the kidney biopsy. Neither chronic inflammation nor malignancy was revealed and, hence, no causal treatment could have been established. The patient died from multiple organ failure. The autopsy confirmed systemic AA amyloidosis. The triad consisting ofdiarrhoea, polyneuropathy and hypotension should rise the suspicion on amyloidosis.

Sepsis is the leading cause of mortality in non-coronary intensive care units. The uncontrolled and deregulated systemic inflammatory response to infection plays a central role in the pathophysiology of sepsis. This response is mediated by a broad spectrum of endogenous mediators leading to dysfunction in multiple organs remote from the primary infectious site. The failure of numerous clinical trials aimed at eliminating a single mediator stimulated the research to focus on non-selective removal of excessively produced mediators of sepsis. This "detoxification" forms the theoretical basis and biological rationale for the use of hemopurification therapies as an adjunctive treatment of sepsis. Our article reviews the current evidence of hemopurification methods in the supportive treatment of sepsis, briefly discusses new trends and summarizes the recommendations for clinical practice.

The aim is to specify contemporary diagnostic and therapeutic procedures of liver injuries.The authors present a trial group of 117 patients with various stages of liver injuries hospitalized at the Traumacentrum Surgical Department of the Faculty Hospital in Plzen from 1.1.2000 to 31.9.2005. 61 injured (52.1%) were treated conservatively, 56 (47.9%) surgically, who underwent 87 procedures, in total.10 polytrauma patients exited (8.5%) from a haemorrhagic shock (group Moore IV-VI). Six subjects (5.1%) had complications on hospitalization. Average hospitalization lasted 18 days (1-69 days).The basic diagnostic tools in liver injuries include "bed side" ultrasonography, spiral computer tomography, in more complicated traumas also MRI, angiography or endoscopic retrograde cholangiography. As a treatment strategy, conservative methods prevail in haemodynamically stable patients, regardless of the liver injury stage. The objective of the surgical management is to provide "damage control surgery", i.e. the first procedure is aimed at life-saving, no time-demanding surgical procedures (e.g. liver tamponade), management of hypothermia, haemocoagulation and metabolic acidosis.

We present measurements of $\nu_{\mu}$ charged-current cross section ratios on carbon, iron, and lead relative to a scintillator (CH) using the fine-grained MINERvA detector exposed to the NuMI neutrino beam at Fermilab. The measurements utilize events of energies $2=8~GeV$, which have a reconstructed $\mu^{-}$ scattering angle less than $17^\circ$ to extract ratios of inclusive total cross sections as a function of neutrino energy $E_{\nu}$ and flux-integrated differential cross sections with respect to the Bjorken scaling variable $x$. These results provide the first high-statistics direct measurements of nuclear effects in neutrino scattering using different targets in the same neutrino beam. Measured cross section ratios exhibit a relative depletion at low $x$ and enhancement at large $x$. Both become more pronounced as the nucleon number of the target nucleus increases. The data are not reproduced by GENIE, a conventional neutrino-nucleus scattering simulation, or by the alternative models for the nuclear dependence of inelastic scattering that are considered., Comment: 6 pages, 2 figures, 7 pages of supplemental material. Published in Physical Review Letters June 13, 2014

The author reviews information on the use of a pulsatile magnetic field with defined parameters in some child diseases of the CNS according to his experience assembled during the past five years. PMP was applied in 17 cases with spinal amyotrophy type M. Werdnig-Hoffman and in 16 cases with DMO. In both diseases treatment was previously only symptomatic. PMP frequencies of alpha EEG waves were used during application on the area of the head and a different frequency for whole body treatment focused on muscular dystonia. The author draws attention to the specificity of biotropic parameters of the applied magnetic field.

Phase reversal sound barriers, composed of periodic slotted waveguides, have shown promising results in low‐frequency noise control for plane waves normal to the obstacle, when compared with solid barriers. The phase reversal effect results in destructive interferences in the shadow zone of the barrier. In order to introduce this new phase‐controlling device in real conditions (obliquely incident ground reflections, variable source position, etc.), it was necessary to investigate its performance at any angle of incidence. This complementary experimental study, performed in an anechoic chamber, is a verification of the previous theoretical [Mongeau et al., J. Acoust. Soc. Am. 80, 665–671 (1986)] and experimental [Chvojka et al., J. Acoust. Can. 13 (1985)] studies. The results show that, in a measuring plane normal to the slots (waveguide entrances), the performance of this new type of barrier remains quite unchanged at any oblique angle of incidence within −60 ° to +60 °. On the other hand, the studies hav...

Using the fact that low‐frequency sound waves are diffracted by any kind of obstacle, a ‘‘sound velocity reducer’’ waveguide has been designed so as to create a 180° phase lag between the diffracted part of the incident noise and that transmitted through the duct of the guide. Further, this waveguide, being a low‐pass filter, insures that the acoustic pressure amplitudes diffracted and transmitted are of the same order of magnitude. For a low‐frequency band of noise, this results in the formation of coherent dipole line sources and, thus, of destructive interferences, at a distance from the acoustically transparent obstacle. The goal of this paper is to show how we can calculate this phase lag and the relative amplitudes of the components, and how they compare to the actual measurements. The results for the model investigated show good agreement between calculation and measurement, within the precision expected.

Single neutral pion production via muon antineutrino charged-current interactions in plastic scintillator (CH) is studied using the MINERvA detector exposed to the NuMI low-energy, wideband antineutrino beam at Fermilab. Measurement of this process constrains models of neutral pion production in nuclei, which is important because the neutral-current analog is a background for ν¯e appearance oscillation experiments. The differential cross sections for π0 momentum and production angle, for events with a single observed π0 and no charged pions, are presented and compared to model predictions. These results comprise the first measurement of the π0 kinematics for this process.

The MINERvA collaboration operated a scaled-down replica of thesolid scintillator tracking and sampling calorimeter regions of the MINERvA detector in a hadron test beam at the Fermilab Test Beam Facility. This paper reports measurements with samples of protons, pions, and electrons from 0.35 to 2.0 GeV/c momentum. The calorimetric response to protons, pions, and electrons is obtained from these data. A measurement of the parameter in Birks׳ law and an estimate of the tracking efficiency are extracted from the proton sample. Overall the data are well described by a Geant4-based Monte Carlo simulation of the detector and particle interactions with agreements better than 4% for the calorimetric response, though some features of the data are not precisely modeled. These measurements are used to tune the MINERvA detector simulation and evaluate systematic uncertainties in support of the MINERvA neutrino cross-section measurement program.

Pharmacoangiography has not yet become a routine method to differentiate inflammatory and tumorous processes of the lower extremities. Noradrenalin and Vasoxin was compared in its effect on the peripheral blood vessels in inflammatory and tumourous disease.