To evaluate the effects of early combination therapy with intravenous vitamin C and thiamine on recovery from organ failure in patients with septic shock. Methods: The ascorbic acid and thiamine effect in septic shock (ATESS) trial was a multi-centre, double-blind, randomized, controlled trial conducted in four academic emergency departments, enrolling adult patients with septic shock from December 2018 through January 2020. Patients were randomly assigned in a 1:1 ratio to either the treatment group [intravenous vitamin C (50 mg/kg, maximum single dose 3 g) and thiamine (200 mg) administration every 12 h for a total of 48 h] or the placebo group (identical volume of 0.9% saline with the same protocol). The primary outcome was Δ Sequential Organ Failure Assessment (SOFA) score (SOFA score at enrolment-SOFA score after 72 h). Eighteen secondary outcomes were predefined, including shock reversal and 28-day mortality. Results: A total of 111 patients were enrolled, of which 53 were assigned to the treatment group and 58 were assigned to the placebo group. There was no significant difference in ΔSOFA scores between the treatment group and the placebo group [3, interquartile range (IQR) − 1 to 5 vs. 3, IQR 0-4, respectively, p = 0.96]. Predefined secondary outcomes were also not significantly different between the groups. Conclusion: In this study, vitamin C and thiamine administration in the early phase of septic shock did not improve organ function compared with placebo, despite improvements in vitamin C and thiamine levels.
[1] We find invariant high stress drops and radiated energies for a sequence of intraplate earthquakes. We estimate source parameters of the Au Sable Forks, NY, earthquake (M5, 2002) and aftershocks. This intraplate earthquake was the largest to occur in Eastern North America since 1988 and the largest to be recorded by regional broadband networks. We use the empirical Green's function (EGF) method and define a set of qualitative and quantitative rules for the selection of EGF earthquake pairs and for the quality verification of the obtained EGF spectral ratio. We use a multitaper code that performs the complex spectral division with minimum frequency leakage and allows transformation back to the time domain to check the validity of the EGF event. We estimate source parameters for 22 earthquakes (M1-M5) in the sequence. The median stress drop of 104 MPa (using Madariaga source model, and 19 MPa for a Brune model) is significantly larger than estimates for interplate earthquakes. The lower crustal strain rates, and longer fault healing times in intraplate environments, may be responsible for this high average value. We find constant stress drop between M2 and M5, up to the bandwidth resolution limit (80 Hz) of the study, and no evidence of stress drop breakdown for M2 to M1 earthquakes. We find consistently high radiated seismic energy and apparent stress, and a median radiated energy to seismic moment ratio of 9 × 10 −5 . This is significantly larger than estimates for interplate earthquakes (∼2 × 10 −5 ) and consistent with higher stress drops and stronger faults.
This study explores attitudinal and behavioral patterns when using Cyworld by adopting an expanded Technology Acceptance Model (TAM). A model for Cyworld acceptance is used to examine how various factors modified from the TAM influence acceptance and its antecedents. This model is examined through an empirical study involving Cyworld users using structural equation modeling techniques. The model shows reasonably good measurement properties and the constructs are validated. The results not only confirm the model but also reveal general factors applicable to Web2.0. A set of constructs in the model can be the Web2.0-specific factors, playing as enhancing factor to attitudes and intention.
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