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The effect of an early resuscitation protocol on sepsis outcomes in developing countries remains unknown.OBJECTIVE To determine whether an early resuscitation protocol with administration of intravenous fluids, vasopressors, and blood transfusion decreases mortality among Zambian adults with sepsis and hypotension compared with usual care. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial of 212 adults with sepsis (suspected infection plus Ն2 systemic inflammatory response syndrome criteria) and hypotension (systolic blood pressure Յ90 mm Hg or mean arterial pressure Յ65 mm Hg) presenting to the emergency department at a 1500-bed referral hospital in Zambia between

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We consider compact submanifolds of dimension n ≥ 2 in R n+k , with nonzero mean curvature vector everywhere, and such that the full norm of the second fundamental form is bounded by a fixed multiple (depending on n) of the length of the mean curvature vector at every point. We prove that the mean curvature flow deforms such a submanifold to a point in finite time, and that the solution is asymptotic to a shrinking sphere in some (n + 1)dimensional affine subspace of R n+k .

The aim of the present study was to explore the relationship between crisis support and psychiatric symptomatology among adult survivors in the year following the Jupiter cruise ship disaster. Evidence is presented that support decreases over the following year, and that higher levels of crisis support are strongly related to better psychological outcome. Crisis support is shown to retain its association with symptomatology even when satisfaction with support is partialled out. These data are discussed with reference to the debate over the relative importance of received vs. perceived support.