We consider arbitrary orderings of the edges entering each vertex of the (downward directed) Pascal graph. Each ordering determines an adic (Bratteli-Vershik) system, with a transformation that is defined on most of the space of infinite paths that begin at the root. We prove that for every ordering the coding of orbits according to the partition of the path space determined by the first three edges is essentially faithful, meaning that it is one-to-one on a set of paths that has full measure for every fully supported invariant probability measure. We also show that for every $k$ the subshift that arises from coding orbits according to the first $k$ edges is topologically weakly mixing. We give a necessary and sufficient condition for any adic system to be topologically conjugate to an odometer and use this condition to determine the probability that a random order on a fixed diagram, or a diagram constructed at random in some way, is topologically conjugate to an odometer. We also show that the closure of the union over all orderings of the subshifts arising from codings of the Pascal adic by the first edge has superpolynomial complexity, is not topologically transitive, and has no periodic points besides the two fixed points, while the intersection over all orderings consists of just four orbits

Study Design Retrospective analysis. Objectives Sepsis, one of the most frequent and life-threatening complications on intensive care units (ICUs), is associated with a need for mechanical ventilation (MV) as well as adverse respiratory outcomes in hospitalized individuals. However, it has poorly been investigated in patients with spinal cord injury (SCI); a population at high risk for pulmonary and infectious complications. Setting Spinal Cord Injury Center, Heidelberg University Hospital. Methods Over a 5-year period, 182 individuals with SCI requiring MV during their ICU stay were analyzed. Data assessment included demographics, medical characteristics, focus and causative pathogen of sepsis, length of stay, weaning outcomes, and mortality. Results Sepsis was recorded in 28 patients (15%), containing a subgroup of individuals suffering from infectious SCI and co-occurring primary sepsis with Staphylococcus aureus as the predominant microorganism. In most individuals, sepsis was found as secondary complication, which was associated with pulmonary foci, Gram-negative bacteria, and high mortality. More than 80% of individuals with secondary sepsis required induction of MV due to respiratory failure. Furthermore, respiratory failure was found to be independent of sepsis focus, spectrum of causative pathogens, SCI etiology, or severity of injury. Subsequent weaning from the respirator was prolonged in more than 90% with a high proportion of weaning failure. Conclusions Sepsis predominantly occurs as a secondary complication after SCI and is associated with detrimental outcomes. Although the lung is frequently affected as a failing organ, not all sepsis foci are pulmonary. Awareness of both actual sepsis focus and causative pathogen is central to initiate an adequate sepsis treatment.

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