Spectral analysis-based risk score enables early prediction of mortality and cerebral performance in patients undergoing therapeutic hypothermia for ventricular fibrillation and comatose status

Background: Early prognosis in comatose survivors after cardiac arrest due to ventricular fibrillation (VF) is unreliable, especially in patients undergoing mild hypothermia. We aimed at developing a reliable risk-score to enable early prediction of cerebral performance and survival. Methods: Sixty-one out of 239 consecutive patients undergoing mild hypothermia after cardiac arrest, with eventual return of spontaneous circulation (ROSC), and comatose status on admission fulfilled the inclusion criteria. Background clinical variables, VF time and frequency domain fundamental variables were considered. The primary and secondary outcomes were a favorable neurological performance (FNP) during hospitalization and survival to hospital discharge, respectively. The predictive model was developed in a retrospective cohort (n = 32; September 2006 September 2011, 48.5 ± 10.5 months of follow-up) and further validated in a prospective cohort (n = 29; October 2011 July 2013, 5 ± 1.8 months of follow-up). Results: FNP was present in 16 (50.0%) and 21 patients (72.4%) in the retrospective and prospective cohorts, respectively. Seventeen (53.1%) and 21 patients (72.4%), respectively, survived to hospital discharge. Both outcomes were significantly associated (p < 0.001). Retrospective multivariate analysis provided a prediction model (sensitivity = 0.94, specificity = 1) that included spectral dominant frequency, derived power density and peak ratios between high and low frequency bands, and the number of shocks delivered before ROSC. Validation on the prospective cohort showed sensitivity = 0.88 and specificity = 0.91. A model-derived risk-score properly predicted 93% of FNP. Testing the model on follow-up showed a c-statistic ≥ 0.89. Conclusions: A spectral analysis-based model reliably correlates time-dependent VF spectral changes with acute cerebral injury in comatose survivors undergoing mild hypothermia after cardiac arrest.the CNIC is supported by the Spanish Ministry of Economy and Competitiveness and the Pro-CNIC Foundation.Filgueiras-Rama, D.; Calvo Saiz, CJ.; Salvador-Montañés, Ó.; Cádenas, R.; Ruiz-Cantador, J.; Armada, E.; Rey, JR.... (2015). Spectral analysis-based risk score enables early prediction of mortality and cerebral performance in patients undergoing therapeutic hypothermia for ventricular fibrillation and comatose status. International Journal of Cardiology. 186:250-258. doi:10.1016/j.ijcard.2015.03.074S25025818

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Not AvailableThe increasing demand for crop production, given worldwide increases in the human population, puts pressure on moving natural resources towards sus-tainable development. This creates a big challenge for the upcoming generation. If improvement is not successful, there exists the unfortunate consequence that global food production may soon become insufficient to feed all of the world’s people. It is therefore essential that agricultural productivity be significantly increased in a more sustainable and environmentally friendly approach. Plant-beneficiary rhizo-bacteria (PBR) naturally activate microorganisms found in the soil. Because they are inexpensive, effective, and environmentally friendly, PBR are gaining impor-tance for use in crop production by restoring the soil’s natural fertility and protect-ing it against drought and soil diseases, thereby stimulating plant growth. PBR decrease the use of chemical fertilisers, pesticides, and artificial growth regulators; the intensive use of these inputs has led to severe health and environmental hazards, such as soil erosion, water contamination, pesticide poisoning, decreased ground-water table, water logging, surface crusting and depletion of biodiversity. The use of PBR has been proven to be an environmentally sound way of increasing crop yields by facilitating plant growth through either a direct or indirect mechanism with the aim of sustaining soil health over the long term. (7) (PDF) Towards Plant-Beneficiary Rhizobacteria and Agricultural Sustainability. Available from: https://www.researchgate.net/publication/325854138_Towards_Plant-Beneficiary_Rhizobacteria_and_Agricultural_Sustainability [accessed Nov 19 2018].Not Availabl