A new type of terrestrial line spectra has been detected by the Arase satellite. These spectra are called hectometric line spectra. They consist primarily of constant frequency narrowband components at frequencies between 525 and 1,700 kHz, which originate and are sometimes amplified from AM broadcasting waves and other generated emissions. These line spectra can be amplified or generated by the odd‐harmonic electrostatic cyclotron instability while in the Z mode. Hectometric line spectra need to be mode‐converted to the L‐O mode to be received at higher altitudes because the Z mode can only exist when its frequency is lower than the local upper hybrid resonance frequency. Wave penetration into the ionosphere and mode conversion are enabled by low‐density regions and steep density gradients in ionospheric irregularities. Note that the broadcasting waves passed through the ionosphere with frequencies lower than the maximum plasma frequency along their paths.
BackgroundDelirium has been shown to prolong the length of intensive care unit stay, hospitalization, and duration of ventilatory control, in addition to increasing the use of sedatives and increasing the medical costs. Although there have been a number of reports referring to risk factors for the development of delirium, no model has been developed to predict delirium in trauma patients at the time of admission. This study aimed to create a scoring system that predicts delirium in trauma patients.MethodsIn this single-center, retrospective, observational study, trauma patients aged 18 years and older requiring hospitalization more than 48 hours were included and divided into the development and validation cohorts. Univariate analysis was performed in the development cohort to identify factors significantly associated with prediction of delirium. The final scoring system for predicting delirium was developed using multivariate analysis and internal validation was performed.ResultsOf the 308 patients in the development cohort, 91 developed delirium. Clinical Frailty Score, fibrin/fibrinogen degradation products, low body mass index, lactate level, and Glasgow Coma Scale score were independently associated with the development of delirium. We developed a scoring system using these factors and calculated the delirium predictive score, which had an area under the curve of 0.85. In the validation cohort, 46 of 206 patients developed delirium. The area under the curve for the validation cohort was 0.86, and the calibration plot analysis revealed the scoring system was well calibrated in the validation cohort.DiscussionThis scoring system for predicting delirium in trauma patients consists of only five risk factors. Delirium prediction at the time of admission may be useful in clinical practice.Level of evidencePrognostic and epidemiological, level III.
OBJECTIVES: Neuromuscular electrical stimulation (NMES) is used in the rehabilitation of patients with critical illness. However, it is unclear whether NMES prevents ICU-acquired weakness (ICU-AW). For this purpose, we conducted an updated systematic review and meta-analysis. DATA SOURCES: We searched the MEDLINE, Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi databases from April 2019 to November 2022 to identify new randomized controlled trials to the previous meta-analysis. STUDY SELECTION: We systematically searched the literature for all randomized controlled trials on the effect of NMES in patients with critical illness. DATA EXTRACTION: Two authors independently selected the studies and extracted data. They calculated the pooled effect estimates associated with the occurrence of ICU-AW and adverse events as primary outcomes and muscle mass change, muscle strength, length of ICU stay, mortality, and quality of life as secondary outcomes. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. DATA SYNTHESIS: Overall, eight studies were added to the previous 10 studies. Evidence suggests that the use of NMES reduces the occurrence of ICU-AW (six trials; risk ratio [RR], 0.48; 95% CI, 0.32–0.72); however, NMES may have little to no effect on pricking sensation in patients (eight trials; RR, 6.87; 95% CI, 0.84–56.50). NMES is likely to reduce the change in muscle mass (four trials; mean difference, –10.01; 95% CI, –15.54 to –4.48) and may increase muscle strength (six trials; standardized mean difference, 0.43; 95% CI, 0.19–0.68). Further, NMES may result in little to no difference in the length of ICU stay, and the evidence is uncertain about the effect on mortality and quality of life. CONCLUSIONS: This updated meta-analysis revealed that the use of NMES may result in a lower occurrence of ICU-AW in patients with critical illness, but its use may have little to no effect on pricking sensation in patients.
Background The severe acute respiratory syndrome coronavirus 2 Omicron variant has a low rate of serious illness, is highly contagious, and has spread rapidly since January 2022. The number of severe cases and deaths remains problematic. Here, we aimed to elucidate the coagulation pathology of Omicron‐infected patients using rotational thromboelastometry. Methods Patients with coronavirus disease 2019, hospitalized and treated from January 2021 to April 2022, were included. The Alpha–Delta and Omicron groups were defined during admission. Blood tests, clinical course, and rotational thromboelastometry measurements were compared using a propensity score‐matched cohort. Results Both groups had 21 patients each. Lactate dehydrogenase (Alpha–Delta group [interquartile range] vs. Omicron group [interquartile range]; 449 [368–518] U/L vs. 241 [196–398] U/L, p = 0.01) and ferritin (1428 [1145–3061] ng/dl vs. 481 [188–881] ng/dl, p = 0.0002) levels were significantly lower in the Omicron group. In rotational thromboelastometry, the thrombus hardness indexes FIBTEM A5 (29 [23–34] mm vs. 23 [18–28] mm, p = 0.034) and maximum clot firmness (34 [27–40] mm vs. 26 [21–33] mm, p = 0.021) were significantly lower in the Omicron group, whereas the fibrinolysis index FIBTEM LI60 (98 [92–100] % vs. 100 [100–100] %, p = 0.0082) was higher. Conclusion Severe coagulation abnormalities may be less likely in Omicron‐infected patients than in those infected with the previous Alpha and Delta variants.
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