Assessing pain in critically ill patients, particularly in nonverbal patients, is a great challenge. In this study, we validated a behavioral pain scale (BPS) in critically ill, sedated, and mechanically ventilated patients. The BPS score was the sum of 3 subscales that have a range score of 1-4: facial expression, upper limb movements, and compliance with mechanical ventilation. Two assessors observed and scored pain simultaneously with the BPS at rest and during painful procedures. The psychometric properties of the BPS that were studied were reliability, validity, and responsiveness. We achieved 360 observations in 30 patients. The BPS was internally reliable (Cronbach alpha = 0.72). The intraclass correlation coefficient to evaluate inter-rater reliability was high (0.95). Validity was demonstrated by the change in BPS scores, which were significantly higher during painful procedures, with averages of 3.9 +/- 1.1 at rest and 6.8 +/- 1.9 during procedures (P < 0.001), and by the principal components factor analysis, which revealed a large first-factor accounting for 65% of the variance in pain expression. The BPS exhibited excellent responsiveness, with an effect size ranging from 2.2 to 3.4. This study demonstrated that the BPS can be valid and reliable for measuring pain in noncommunicative intensive care unit patients.

Introduction Eosinopenia is a cheap and forgotten marker of acute infection that has not been evaluated previously in intensive care units (ICUs). The aim of the present study was to test the value of eosinopenia in the diagnosis of sepsis in patients admitted to ICUs.

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Abstract-A new discrete-time integral sliding mode control (DISMC) scheme is proposed for sampled-data systems. The new control scheme is characterized by a discrete-time integral switching surface which inherits the desired properties of the continuous-time integral switching surface, such as full order sliding manifold with eigenvalue assignment, and elimination of the reaching phase. In particular, comparing with existing discrete-time sliding mode control, the new scheme is able to achieve more precise tracking performance. It will be shown in this work that, the new control scheme achieves O(T 2 ) steadystate error for state regulation with the widely adopted delaybased disturbance estimation. Another desirable feature is, the proposed DISMC prevents the generation of overlarge control actions, which are usually inevitable due to the deadbeat poles of a reduced order sliding manifold designed for sampled-data systems. Both the theoretical analysis and illustrative example demonstrate the validity of the proposed scheme.

A new discrete-time integral sliding mode control (DISMC) scheme is proposed for sampled-data systems. The new control scheme is characterized by a discrete-time integral switching surface which inherits the desired properties of the continuous-time integral switching surface, such as full order sliding manifold with eigenvalue assignment, and elimination of the reaching phase. In particular, comparing with existing discrete-time sliding mode control, the new scheme is able to achieve more precise tracking performance. It will be shown in this work that, the new control scheme achieves O(T 2 ) steadystate error for state regulation with the widely adopted delaybased disturbance estimation. Another desirable feature is, the proposed DISMC prevents the generation of overlarge control actions, which are usually inevitable due to the deadbeat poles of a reduced order sliding manifold designed for sampled-data systems. Both the theoretical analysis and illustrative example demonstrate the validity of the proposed scheme.

This study suggests the possibility to use eosinophil cell count at admission and during the first 7 days as a prognosis marker of mortality in medical ICU.

The Arabic version of the SF-36 appears to be a robust tool in ICU. Background variables are the only significant determinants of HRQL 3 months after medical ICU discharge.