An objective categorization of respiratory infections based on outcomes is an unmet clinical need. Ventilator-associated pneumonia and tracheobronchitis remain used in clinical practice, whereas ...ventilator-associated events (VAE) are limited to surveillance purposes.
This was a secondary analysis from a multicentre observational prospective cohort study. VAE were defined as a sustained increase in minimum Oxygen inspired fraction (FiO2) and/or Positive end-expiratory pressures (PEEP) of ≥ 0.2/2 cm H2O respectively, or an increase of 0.15 FiO2 + 1 cm H20 positive end-expiratory pressures for ≥ 1 calendar-day.
15 Paediatric Intensive Care Units.
Mechanical ventilation duration, intensive care and hospital length of stay; (LOS) and mortality.
A cohort of 391 ventilated children with an age (median, Interquartile Ranges) of 1 year0.2–5.3 and 7 days5–10 of mechanical ventilation were included. Intensive care and hospital stays were 11 7–19 and 21 14–39 days, respectively. Mortality was 5.9 %. Fifty-eight ventilator-associated respiratory infections were documented among 57 patients: Seventeen (29.3 %) qualified as ventilator-associated pneumonia (VAP) and 41 (70.7 %) as ventilator-associated tracheobronchitis (VAT). Eight pneumonias and 16 tracheobronchitis (47 % vs 39 %,P = 0.571) required positive end-expiratory pressure or oxygen increases consistent with ventilator-associated criteria. Pneumonias did not significantly impact on outcomes when compared to tracheobronchitis. In contrast, infections (pneumonia or tracheobronchitis) following VAEs criteria were associated with > 6, 8 and 15 extra-days of ventilation (16 vs 9.5, P = 0.001), intensive care stay (23.5 vs 15; P = 0.004) and hospital stay (39 vs 24; P = 0.015), respectively.
When assessing ventilated children with respiratory infections, VAE apparently is associated with higher ventilator-dependency and LOS compared with pneumonia or tracheobronchitis.
Incorporating the modification of ventilatory settings for further categorization of the respiratory infections may facilitate therapeutic management among ventilated patients.
KRE(WO4)2 (RE = Gd and Yb) nanocrystalline powder was obtained by the modified sol-gel Pechini method. The precursor powder was calcined between 923 and 1023 K for a maximum of 6 h at air atmosphere. ...DTA-TG of the precursor powder shows that the temperature for total calcination is around 800–850 K. Molar ratio between the complexing agent and the metal ions in the first step of the method and molar ratio between the complexing agent and the ethylene glycol in the second step of the method were studied to optimize the preparation process. X-ray diffraction and IR spectroscopy were used to study the transformation from precursor powder into a crystalline monoclinic phase. Raman spectroscopy was used to study the vibrational structure of the nanoparticles. The Scherrer formula was used to confirm the grain sizes visualized by SEM and TEM techniques. Small nanoparticles in the range of 20–50 nm of monoclinic KREW have been successfully obtained by this methodology.
This paper presents the crystal growth and optical characterization of thulium-doped KLu(WO4)2 (KLuW). Thulium-doped KLuW macrodefect-free monoclinic single crystals (a*XbXc Delta #~10X7X15 mm3) were ...grown by the top seeded solution growth slow cooling method with dopant concentrations of 0.5%, 1%, 3% and 5% atomic in solution. The evolution of unit cell parameters in relation with thulium doping was studied by X-ray powder patterns. Thulium energy levels in the KLuW host were determined by 6 K polarized optical absorption. The Judd--Ofelt parameters determined were Delta *W2=9.01X10-20 cm2, Delta *W4=1.36X10-20 cm2 and Delta *W6=1.43X10-20 cm2. The maximum emission cross section for the 1.9 Delta *mm emission, calculated by Fuchtbauer--Ladenburg method, is 1.75X10-20 cm2, at 1845 nm with E//Nm. The intensity decay time from the emitting levels 1 G 4 and 3 H 4 levels in relation to the concentration were studied. For the lowest thulium concentration, the measured decay times from 1 G 4 and 3 H 4 emitting levels are 140 Delta *ms and 230 Delta *ms, respectively.
Prediction of the response to a biological treatment in psoriasis patients would allow efficient treatment allocation.
To identify polymorphisms associated with secukinumab response in psoriasis ...patients in a daily practice setting.
We studied 180 SNPs in patients with moderate-to-severe plaque psoriasis recruited from 15 Spanish hospitals. Treatment effectiveness was evaluated by absolute PASI ≤3 and ≤1 at 6 and 12 months. Individuals were genotyped using a custom Taqman array. Multiple logistic regression models were generated. Sensitivity, specificity and area under the curve (AUC) were analysed.
A total of 173 patients were studied at 6 months, (67% achieved absolute PASI ≤ 3 and 65% PASI ≤ 1) and 162 at 12 months (75% achieved absolute PASI ≤ 3 and 64% PASI ≤ 1). Multivariable analysis showed the association of different sets of SNPs with the response to secukinumab. The model of absolute PASI≤3 at 6 months showed best values of sensitivity and specificity. Four SNPs were associated with the capability of achieving absolute PASI ≤ 3 at 6 months. rs1801274 (FCGR2A), rs2431697 (miR-146a) and rs10484554 (HLCw6) were identified as risk factors for failure to achieve absolute PASI≤3, while rs1051738 (PDE4A) was protective. AUC including these genotypes, weight of patients and history of biological therapy was 0.88 (95% CI 0.83-0.94), with a sensitivity of 48.6% and specificity of 95.7% to discriminate between both phenotypes.
We have identified a series of polymorphisms associated with the response to secukinumab capable of predicting the potential response/non-response to this drug in patients with plaque psoriasis.
KGd(WO sub(4)) sub(2) has been studied by high-pressure Raman spectroscopy at room temperature up to 32.2 GPa. Evidences of two pressure-driven phase transitions have been detected. The low-pressure ...monoclinic phase undergoes a phase transition at 7.2(+ or-0.9) GPa. The second transition is found at 14.2(+ or-1.6) GPa. Both transitions are reversible. No evidence of pressure-induced amorphization is found up to 32 GPa. The pressure dependence of the Raman active modes of the low-and high-pressure phases is reported. A Raman mode is detected to exhibit a weak softening in the low-pressure phase. Three Raman modes are also observed to have a similar behavior in the second high-pressure phase. The reported results are discussed comparing with the studies available in related tungstates. Emphasis is placed on the physical implications of the results.
As many countries seek to slow the spread of COVID-19 without reimposing national restrictions, it has become important to track the disease at a local level to identify areas in need of targeted ...intervention.
In this prospective, observational study, we did modelling using longitudinal, self-reported data from users of the COVID Symptom Study app in England between March 24, and Sept 29, 2020. Beginning on April 28, in England, the Department of Health and Social Care allocated RT-PCR tests for COVID-19 to app users who logged themselves as healthy at least once in 9 days and then reported any symptom. We calculated incidence of COVID-19 using the invited swab (RT-PCR) tests reported in the app, and we estimated prevalence using a symptom-based method (using logistic regression) and a method based on both symptoms and swab test results. We used incidence rates to estimate the effective reproduction number, R(t), modelling the system as a Poisson process and using Markov Chain Monte-Carlo. We used three datasets to validate our models: the Office for National Statistics (ONS) Community Infection Survey, the Real-time Assessment of Community Transmission (REACT-1) study, and UK Government testing data. We used geographically granular estimates to highlight regions with rapidly increasing case numbers, or hotspots.
From March 24 to Sept 29, 2020, a total of 2 873 726 users living in England signed up to use the app, of whom 2 842 732 (98·9%) provided valid age information and daily assessments. These users provided a total of 120 192 306 daily reports of their symptoms, and recorded the results of 169 682 invited swab tests. On a national level, our estimates of incidence and prevalence showed a similar sensitivity to changes to those reported in the ONS and REACT-1 studies. On Sept 28, 2020, we estimated an incidence of 15 841 (95% CI 14 023–17 885) daily cases, a prevalence of 0·53% (0·45–0·60), and R(t) of 1·17 (1·15–1·19) in England. On a geographically granular level, on Sept 28, 2020, we detected 15 (75%) of the 20 regions with highest incidence according to government test data.
Our method could help to detect rapid case increases in regions where government testing provision is lower. Self-reported data from mobile applications can provide an agile resource to inform policy makers during a quickly moving pandemic, serving as a complementary resource to more traditional instruments for disease surveillance.
Zoe Global, UK Government Department of Health and Social Care, Wellcome Trust, UK Engineering and Physical Sciences Research Council, UK National Institute for Health Research, UK Medical Research Council and British Heart Foundation, Alzheimer's Society, Chronic Disease Research Foundation.
Europium doping in KLu(WO4)2 Pujol, M.C.; Carvajal, J.J.; Mateos, X. ...
Journal of luminescence,
06/2013, Letnik:
138
Journal Article
Recenzirano
Europium single doped potassium lutetium tungstate Eu3+:KLu(WO4)2 single crystals have been grown with an active ion doping concentration from 0.5 to 5at% using the top seeded solution growth slow ...cooling method. The experimental parameters for growing these single crystals have been optimized. Optical absorption and emission cross section were subjected to a detailed spectroscopic study. 58 sublevels were determined. Red visible emission was observed and attributed to the pure electronic transition under UV laser pumping. The CIE coordinates were (0.59,0.35) with 604nm as the dominant wavelength and 84% of purity.
► Successful crystal growth of new lanthanide monoclinic doped double tungstate. ► Full determination of the energy sublevels of Europium in KLu(WO4)2. ► Observation of no band transfer from the double tungstate host to Europium. ► Determination of the complete set of spectroscopic parameters of Eu3+ in KLu(WO4)2.
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