Background
The aim of the study was to evaluate the performance of “Acute Physiology and Chronic Health Evaluation II” (APACHE-II), “Simplified Acute Physiology Score 3” (SAPS-3), and “APACHE-II ...Score for Critically Ill Patients with a Solid Tumor” (APACHE-II
CCP
) models in cancer patients admitted to ICU.
Methods
Prospective cohort study of 414 patients with an active solid tumor. Discrimination was assessed by area under receiver operating characteristic (AROC) curves and calibration by Hosmer–Lemeshow goodness-of-fit
C
test (H–L).
Results
The hospital mortality rate was 32.6%. In the total cohort, discrimination for prognostic models were: APACHE-II
CCP
(AROC 0.98), APACHE-II (AROC 0.96), SAPS-3 for Central and South American countries (SAPS-3
CSA
) (AROC 0.95), and SAPS-3 (AROC 0.91). Calibration was good (
p
value of H–L test > 0.05) using APACHE-II
CCP
, APACHE-II and SAPS-3
CSA
models. Estimation of the probability of death was more precise with APACHE-II
CCP
(standardized mortality ratio, SMR = 1.03) and SAPS-3 (SMR = 1.08) models. Further analysis showed that discrimination was high with all prognostic model whether for patients with planned ICU admission (
AROC
APACHE-II
CCP
0.97, APACHE-II 0.96, SAPS-3 0.95, SAPS-3
CSA
0.95) or for patients with unplanned ICU admission (
AROC
APACHE-II
CCP
0.97, APACHE-II 0.94, SAPS-3 0.86, SAPS-3
CSA
0.95). Calibration was good for all predictive models in both subgroups (
p
value of H–L test > 0.05, except for APACHE-II model inpatients with planned ICU admission).
Conclusions
In this prospective study, general predictive models (e.g., APACHE-II, SAPS-3) and cancer-specific models (e.g., APACHE-II
CCP
) are accurate in predicting hospital mortality. Other studies confirming these results are required.
Intensive Care to facilitate Organ Donation (ICOD) consists of the initiation or continuation of intensive care measures in patients with a devastating brain injury (DBI) in whom curative treatment ...is deemed futile and death by neurological criteria (DNC) is foreseen, to incorporate organ donation into their end-of-life plans. In this study we evaluate the outcomes of patients subject to ICOD and identify radiological and clinical factors associated with progression to DNC. In this first prospective multicenter study we tested by multivariate regression the association of clinical and radiological severity features with progression to DNC. Of the 194 patients, 144 (74.2%) patients fulfilled DNC after a median of 25 h (95% IQR: 17-44) from ICOD onset. Two patients (1%) shifted from ICOD to curative treatment, both were alive at discharge. Factors associated with progression to DNC included: age below 70 years, clinical score consistent with severe brain injury, instability, intracranial hemorrhage, midline shift ≥5 mm and certain types of brain herniation. Overall 151 (77.8%) patients progressed to organ donation. Based on these results, we conclude that ICOD is a beneficial and efficient practice that can contribute to the pool of deceased donors.
Magnet Cycles and Stability Periods of the CMS Experiment are studied with the Alignment Link System data recorded along the 2008–2013 years of operation. The motions of the mechanical structures due ...to the magnetic field forces are studied and the mechanical stability of the detector during the physics data taking periods is verified.
The central feature of the CMS Link alignment system is a network of Amorphous Silicon Position Detectors distributed throughout the muon spectrometer that are connected by multiple laser lines. The ...data collected during the years from 2008 to 2015 is presented confirming an outstanding performance of the photo sensors during more than seven years of operation. Details of the photo sensor readout of the laser signals are presented. The mechanical motions of the CMS detector are monitored using these photosensors and good agreement with distance sensors is obtained.
This document presents an overview of the induced photocurrents in the Amorphous Silicon Position Detectors used in the network of diode lasers and photo sensors of the CMS Link alignment system ...recorded during its eleven years of operation. After a description of the sensors characteristics, the layout of the sensors network is discussed. The sensors are distributed throughout the muon spectrometer and connected by laser lines. The data used correspond to readout information obtained during some of the physics runs from 2008 to 2018.
The mesoporous silicon microparticles (MSMPs) are excellent vehicles for releasing molecules inside the cell. The aim of this work was to use MSMPs to deliver viral specific MHC class I restricted ...epitopes into human antigen presenting cells (monocyte derived dendritic cells, MDDCs) to facilitate their capture, processing, and presentation to CD8+ (cytotoxic) T lymphocytes. We show for the first time that MSMPs vehiculation of antigenic peptides enhances their MHC class I presentation by human MDDCs to CD8 T lymphocytes.
Skeletal muscle regeneration by muscle satellite cells is a physiological mechanism activated upon muscle damage and regulated by Notch signaling. In a family with autosomal recessive limb‐girdle ...muscular dystrophy, we identified a missense mutation in POGLUT1 (protein O‐glucosyltransferase 1), an enzyme involved in Notch posttranslational modification and function. In vitro and in vivo experiments demonstrated that the mutation reduces O‐glucosyltransferase activity on Notch and impairs muscle development. Muscles from patients revealed decreased Notch signaling, dramatic reduction in satellite cell pool and a muscle‐specific α‐dystroglycan hypoglycosylation not present in patients' fibroblasts. Primary myoblasts from patients showed slow proliferation, facilitated differentiation, and a decreased pool of quiescent PAX7+ cells. A robust rescue of the myogenesis was demonstrated by increasing Notch signaling. None of these alterations were found in muscles from secondary dystroglycanopathy patients. These data suggest that a key pathomechanism for this novel form of muscular dystrophy is Notch‐dependent loss of satellite cells.
Synopsis
A protein O‐glucosyltransferase 1 (POGLUT1) homozygous D233E mutation underlies a novel autosomal recessive muscular dystrophy, wherein altered Notch signaling affects muscle regeneration and, as a consequence, α‐dystroglycan glycosylation.
POGLUT1 D233E exhibits decreased enzymatic activity toward Notch EGF repeats.
POGLUT1 D233E leads to Notch activity downregulation, which affects muscle regeneration due to satellite cell (SC) loss of quiescence, depletion of PAX7+ cells, and premature and enhanced differentiation.
Reduced Notch signaling accelerates muscle differentiation and disrupts the progressive and coordinated process of α‐dystroglycan glycosylation during differentiation, and hence, mild α‐dystroglycan hypoglycosylation is observed in skeletal muscle from POGLUT1 D233E patients.
Defective regeneration, combined with α‐dystroglycan hypoglycosylation, likely results in skeletal muscle degeneration and finally gives rise to muscular dystrophy.
A protein O‐glucosyltransferase 1 (POGLUT1) homozygous D233E mutation underlies a novel autosomal recessive muscular dystrophy, wherein altered Notch signaling affects muscle regeneration and, as a consequence, α‐dystroglycan glycosylation.
A study of the photo-response behaviour of carbon-doped hydrogenated amorphous silicon photo-detectors over 2800h of continuous illumination with white light is presented. Both direct and inverse ...Staebler–Wronski effects are observed in the data.
This document presents an application of the new generation of amorphous silicon position detecting (ASPD) sensors to multipoint alignment. Twelve units are monitored along a 20
m long laser beam, ...where the light path is deflected by 90° using a pentaprism.
PDF
