Objectives
Compared to other countires internationally, South Africa has the largest number of people living with HIV. There are limited data in developing countries on the outcomes of HIV‐infected ...patients in the intensive care unit (ICU). The objectives of this study were to describe the pattern of presentation of these patients and to determine factors that may influence survival to ICU discharge.
Methods
The medical charts of 204 consecutive HIV‐infected individuals who were admitted to the Charlotte Maxeke Johannesburg Academic Hospital adult general ICU during the calendar year 2017 were retrospectively reviewed. Relevant data were subjected to univariate and multivariate analysis.
Results
Two‐hundred and four (22.6%) out of a total of 903 patients who were admitted to the ICU were HIV positive. Sepsis‐related illnesses were the most common reason for ICU admission (n = 95; 46.6%), followed by post‐operative care (n = 69; 33.8%) and non‐sepsis‐related illnesses (n = 40; 19.6%). The median length of stay in the ICU was 5 (interquartile range 2–9) days. ICU mortality was 33.3% (n = 68). On univariate analysis, age (P = 0.039), length of stay in the ICU (P = 0.040), primary diagnostic category (P < 0.05), sepsis acquired during the ICU stay (P = 0.012), inotrope/vasopressor administration (P < 0.001), mechanical ventilation (P < 0.001), haemodialysis (P = 0.001), CD4 cell count (P = 0.011), Acute Physiology and Chronic Health Assessment (APACHE) II score (P < 0.001) and Sequential Organ Failure Assessment (SOFA) score (P < 0.001) were significantly associated with mortality.
Conclusions
Age, diagnostic category, sepsis acquired during the ICU stay, inotrope/vasopressor administration, mechanical ventilation, haemodialysis, CD4 cell count, APACHE II score, SOFA score and length of ICU stay were associated with ICU mortality in HIV‐infected patients.
The SAMI Galaxy Survey: Early Data Release Allen, J. T.; Croom, S. M.; Konstantopoulos, I. S. ...
Monthly Notices of the Royal Astronomical Society,
01/2015, Letnik:
446, Številka:
2
Journal Article
Recenzirano
Odprti dostop
We present the Early Data Release of the Sydney-AAO Multi-object Integral field spectrograph (SAMI) Galaxy Survey. The SAMI Galaxy Survey is an ongoing integral field spectroscopic survey of ~3400 ...low-redshift (z < 0.12) galaxies, covering galaxies in the field and in groups within the Galaxy And Mass Assembly (GAMA) survey regions, and a sample of galaxies in clusters. In the Early Data Release, we publicly release the fully calibrated data cubes for a representative selection of 107 galaxies drawn from the GAMA regions, along with information about these galaxies from the GAMA catalogues. All data cubes for the Early Data Release galaxies can be downloaded individually or as a set from the SAMI Galaxy Survey website. In this paper we also assess the quality of the pipeline used to reduce the SAMI data, giving metrics that quantify its performance at all stages in processing the raw data into calibrated data cubes. The pipeline gives excellent results throughout, with typical sky subtraction residuals in the continuum of 0.9-1.2 per cent, a relative flux calibration uncertainty of 4.1 per cent (systematic) plus 4.3 per cent (statistical), and atmospheric dispersion removed with an accuracy of 0.09 arcsec, less than a fifth of a spaxel.
There is currently no objective practical guide to intensity of drug treatment for individuals with heart failure. We hypothesised that pharmacotherapy guided by plasma concentrations of the cardiac ...peptide aminoterminal brain natriuretic peptide (N-BNP) would produce a superior outcome to empirical trial-based therapy dictated by clinical acumen.
69 patients with impaired systolic function (left-ventricular ejection fraction <40%) and symptomatic heart failure (New York Heart Association class II–IV) were randomised to receive treatment guided by either plasma N-BNP concentration (BNP group) or standardised clinical assessment (clinical group).
During follow-up (minimum 6-months, median 9–5 months), there were fewer total cardiovascular events (death, hospital admission, or heart failure decompensation) in the BNP group than in the clinical group (19
vs 54, p=0·02). At 6 months, 27% of patients in the BNP group and 53% in the clinical group had experienced a first cardiovascular event (p=0·034). Changes in left-ventricular function, quality of life, renal function, and adverse events were similar in both groups.
N-BNP-guided treatment of heart failure reduced total cardiovascular events, and delayed time to first event compared with intensive clinically guided treatment.
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that impairs the control of attention and behavioral inhibition in affected individuals. Recent genome-wide ...association findings have revealed an association between glutamate and GABA gene sets and ADHD symptoms. Consistently, people with ADHD show altered glutamate and GABA content in the brain circuitry that is important for attention control function. Yet, it remains unknown how glutamate and GABA content in the attention control circuitry change when people are controlling their attention, and whether these changes can predict impaired attention control in people with ADHD. To study these questions, we recruited 18 adults with ADHD (31-51 years) and 16 adults without ADHD (28-54 years). We studied glutamate + glutamine (Glx) and GABA content in the fronto-striatal circuitry while participants performed attention control tasks. We found that Glx and GABA concentrations at rest did not differ between participants with ADHD or without ADHD. However, while participants were performing the attention control tasks, participants with ADHD showed smaller Glx and GABA increases than participants without ADHD. Notably, smaller GABA increases in participants with ADHD significantly predicted their poor task performance. Together, these findings provide the first demonstration showing that attention control deficits in people with ADHD may be related to insufficient responses of the GABAergic system in the fronto-striatal circuitry.
We use data from the Sydney-AAO Multi-Object Integral Field Spectrograph Galaxy Survey and the Galaxy And Mass Assembly (GAMA) survey to investigate the spatially resolved signatures of the ...environmental quenching of star formation in galaxies. Using dust-corrected measurements of the distribution of H... emission, we measure the radial profiles of star formation in a sample of 201 star-forming galaxies covering three orders of magnitude in stellar mass (M*; 10 super( 8.1)-10 super( 10.95) M...) and in fifth nearest neighbour local environment density (...; 10 super( -1.3)-10 super( 2.1) Mpc super( -2)). We show that star formation rate gradients in galaxies are steeper in dense (log sub( 10)(.../Mpc super( 2)) > 0.5) environments by 0.58 plus or minus 0.29dexr sub( e) super( -1) in galaxies with stellar masses in the range 10 super( 10)<M*/M...<10 super( 11) and that this steepening is accompanied by a reduction in the integrated star formation rate. However, for any given stellar mass or environment density, the star formation morphology of galaxies shows large scatter. We also measure the degree to which the star formation is centrally concentrated using the unitless scale-radius ratio (r sub( 50,H...)/r sub( 50,cont)), which compares the extent of ongoing star formation to previous star formation. With this metric, we find that the fraction of galaxies with centrally concentrated star formation increases with environment density, from ~5 plus or minus 4 per cent in low-density environments (log sub( 10)(.../Mpc super( 2)) < 0.0) to 30 plus or minus 15 per cent in the highest density environments (log sub( 10)(.../Mpc super( 2)) > 1.0). These lines of evidence strongly suggest that with increasing local environment density, the star formation in galaxies is suppressed, and that this starts in their outskirts such that quenching occurs in an outside-in fashion in dense environments and is not instantaneous. (ProQuest: ... denotes formulae/symbols omitted.)
The galactose-α-1,3-galactose (α-gal) mammalian meat allergy, α-gal syndrome, often includes diarrhea, abdominal pain, and other gastrointestinal (GI) symptoms. Pancreatic exocrine insufficiency ...causes similar symptoms. The pancreatic replacement enzymes, referred to here as pancreatic enzymes, used to treat pancreatic insufficiency are porcine products and contain α-gal. Patients with pancreatic insufficiency who also have α-gal syndrome may be intolerant of mammalian products in their diet and of α-gal in pancreatic enzymes. In this article, we describe 40 patients from one GI clinic in central Virginia with suspected pancreatic insufficiency and increased α-gal immunoglobulin E (IgE) levels. Over 50% of these patients had some clinical improvement when mammalian products were removed from the diet. Most patients could tolerate pancreatic enzymes; 10% could not tolerate them due to suspected allergy symptoms, but none developed anaphylaxis. Understanding that α-gal syndrome can be superimposed on pancreatic exocrine insufficiency and exacerbate symptoms, and that treatment with pancreatic enzymes may increase GI and/or allergy symptoms in this group, will lead to improved medical management of this complex patient population.
ABSTRACT
The Vera C. Rubin Observatory Legacy Survey of Space and Time (LSST) will observe several Deep Drilling Fields (DDFs) to a greater depth and with a more rapid cadence than the main survey. ...In this paper, we describe the ‘DeepDrill’ survey, which used the Spitzer Space Telescope Infrared Array Camera (IRAC) to observe three of the four currently defined DDFs in two bands, centred on 3.6 and 4.5 μm. These observations expand the area that was covered by an earlier set of observations in these three fields by the Spitzer Extragalactic Representative Volume Survey (SERVS). The combined DeepDrill and SERVS data cover the footprints of the LSST DDFs in the Extended Chandra Deep Field–South (ECDFS) field, the ELAIS-S1 field (ES1), and the XMM-Large-Scale Structure Survey field (XMM-LSS). The observations reach an approximate 5σ point-source depth of 2 μJy (corresponding to an AB magnitude of 23.1; sufficient to detect a 10$^{11} \, \mathrm{M}_{\odot}$ galaxy out to z ≈ 5) in each of the two bands over a total area of $\approx 29\,$ deg2. The dual-band catalogues contain a total of 2.35 million sources. In this paper, we describe the observations and data products from the survey, and an overview of the properties of galaxies in the survey. We compare the source counts to predictions from the Shark semi-analytic model of galaxy formation. We also identify a population of sources with extremely red (3.6−4.5 >1.2) colours which we show mostly consists of highly obscured active galactic nuclei.
Objectives
Despite better access to antiretroviral therapy (ART) over recent years, HIV remains a major global cause of mortality. The present study aimed to identify predictors of in‐hospital ...mortality among HIV‐positive patients presenting to an emergency department (ED).
Methods
In this cross‐sectional study, HIV‐positive patients presenting to the Charlotte Maxeke Johannesburg Academic Hospital adult ED between 07 July 2017 and 18 October 2018 were prospectively enrolled. Data were compared between participants who survived to hospital discharge and those who died. The data were further subjected to univariate and multivariate logistic regression analyses to determine variables that were associated with in‐hospital mortality.
Results
Of a total of 1224 participants, the in‐hospital mortality was 13.6% (n = 166). On multivariate analysis, respiratory rate > 20 breaths/min odds ratio (OR) = 1.90, P = 0.012, creatinine > 120 μmol/L (OR = 1.97, P = 0.006), oxygen saturation < 90% (OR = 2.09, P = 0.011), white cell count < 4.0 × 109/L (OR = 2.09, P = 0.008), ART non‐adherence or not yet on ART (OR = 2.39, P = 0.012), Glasgow Coma Scale < 15 (OR = 2.53, P = 0.000), albumin < 35 g/L (OR = 2.61, P = 0.002), lactate > 2 mmol/L (OR = 4.83, P = 0.000) and cryptococcal meningitis (OR = 6.78, P = 0.000) were significantly associated with in‐hospital mortality.
Conclusions
Routine clinical and laboratory parameters are useful predictors of in‐hospital mortality in HIV‐positive patients presenting to the ED with an acute illness. These parameters may be of value in guiding clinical decision‐making, directing the appropriate use of resources and influencing patient disposition, and may also be useful in developing an outcome prediction tool.
Summary
Context
In contrast to the cardiac hormones, atrial natriuretic peptide (ANP) and B‐type natriuretic peptide (BNP), variations in plasma concentrations of C‐type natriuretic peptide (CNP) in ...healthy adults are ill‐defined, limiting their clinical application.
Objective
Our objective was to define the effect of age, phenotype (gender, height, BMI), and cardiac and renal function on plasma CNPs in an adults population without renal or cardiovascular disease.
Design and setting
This was a prospective cross‐sectional observational study of adult volunteers, aged 21–80 years, randomly selected from the electoral roll.
Subjects and methods
Plasma CNP and its associated aminoterminal propeptide (NTproCNP) were measured in 258 subjects and related to age, gender, height and plasma creatinine. Subgroup analyses seeking associations with cardiac function (plasma BNP and NTproBNP) and bone turnover bone‐specific alkaline phosphatase (bALP) were also determined.
Results
Plasma concentrations of CNPs in men continued to decline from adolescent values to reach a nadir in the 5th decade after which values increased. Similar but less marked changes occurred in women. In both sexes, NTproCNP was inversely and independently correlated with height. In contrast to B‐type natriuretic peptides (BNPs), NTproCNP was higher in men, significantly related to creatinine and positively related to bALP.
Conclusions
Gender‐ and age‐specific changes affect CNPs in adults. Inverse associations of NTproCNP with adult height, positive correlation with creatinine – and in contrast to CNP – no association with BNP are further unique findings distinguishing NTproCNP, which need to be considered in future studies.
We present a methodology for the regularization and combination of sparse sampled and irregularly gridded observations from fibre-optic multiobject integral field spectroscopy. The approach minimizes ...interpolation and retains image resolution on combining subpixel dithered data. We discuss the methodology in the context of the Sydney-AAO multiobject integral field spectrograph (SAMI) Galaxy Survey underway at the Anglo-Australian Telescope. The SAMI instrument uses 13 fibre bundles to perform high-multiplex integral field spectroscopy across a 1° diameter field of view. The SAMI Galaxy Survey is targeting ~3000 galaxies drawn from the full range of galaxy environments. We demonstrate the subcritical sampling of the seeing and incomplete fill factor for the integral field bundles results in only a 10 per cent degradation in the final image resolution recovered. We also implement a new methodology for tracking covariance between elements of the resulting data cubes which retains 90 per cent of the covariance information while incurring only a modest increase in the survey data volume.
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