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OBJECTIVE: Describe recent developments in the pharmacological management of sepsis and septic shock, focusing on fluid resuscitation, vasopressors, and corticosteroids. DATA SOURCES: A literature search limited to randomized controlled trials written in the English language reporting mortality and other clinically relevant outcomes that were published from July 1, 2016, to August 31, 2018, in patients aged ≥ 18 years. Titles and abstracts were reviewed for relevance...

Reduced-lead electrocardiographic systems are currently a widely accepted medical technology used in a number of applications. They provide increased patient comfort and superior performance in arrhythmia and ST monitoring. These systems have unique and compelling advantages over the traditional multichannel monitoring lead systems. However, the design and development of reduced-lead systems create numerous technical challenges. This article summarizes the major technical challenges commonly encountered in lead reconstruction for reduced-lead systems...

PURPOSE: We examined the extent to which the substituted judgments made by spouses of patients with end-stage renal disease actually reflect patient preferences. DESIGN AND METHODS: We used data from 291 couples to compare dialysis patients' preferences for continuing hemodialysis under a variety of hypothetical situations with both substituted judgment data from spouses and information about spouses' own preferences. RESULTS: Substituted judgments were more highly related to spouses' preferences than to patients' preferences...

The flowering plants--angiosperms--appeared during the Early Cretaceous period and within 10-30 Myr dominated the species composition of many floras worldwide. Emerging insights into the phylogenetics of development and discoveries of early angiosperm fossils are shedding increased light on the patterns and processes of early angiosperm evolution. However, we also need to integrate ecology, in particular how early angiosperms established a roothold in pre-existing Mesozoic plant communities. These events were critical in guiding subsequent waves of angiosperm diversification during the Aptian-Albian...