Anàlisi territorial de la preinscripció al sistema universitari públic de Catalunya. L’efecte distància–temps des del domicili habitual en l’elecció de centre i estudi.

[cat] La mobilitat obligada per raó d'estudi analitza els desplaçaments dels alumnes entre el seu lloc de residencia i el lloc d'estudi en qualsevol de les etapes educatives, des dels ensenyaments primaris obligatoris fins als superiors. En aquest sentit, doncs, el fenomen de la mobilitat es consubstancial a la mateixa universitat ja des dels seus inicis esdevenint avui un fenomen complex fent-se necessari, per entendre'I en tota la seva magnitud, identificar-ne tant els diferents actors que hi intervenen com les diferents escales geogràfiques que abasta, el mare formal en el que es desenvolupa i la seva direccionalitat. En aquest context, l'objectiu principal que persegueix aquesta recerca es el d'esbrinar els criteris i patrons que determinen l'elecció de centre i estudi per part dels estudiants residents a Catalunya que accedeixen per primer cop a l'oferta de titulacions de les universitats catalanes que participen del procés de preinscripció (UB, UAB, UPC, UPF, Udl, UdG, URV i UVic) tot confeccionant un mapa de fluxos de la mobilitat d'aquest col·lectiu al llarg del per1ode que abasta del curs 2000-01 al 2013-14 per a, tal vegada, obtenir orientacions sobre el seu comportament futur. D'aquesta manera, emprant com a font principal de dades els fitxers del sistema UNEIX sobre els estudiants matriculats de nou accés en cadascuna d'aquestes universitats per a cada any acadèmic analitzat i a partir de la comarca d'origen d'aquest estudiantat (aquella on tenen establert el seu domicili habitual, generalment el familiar) s'han determinat en primer lloc l'àrea d'influència i de captació d'aquestes institucions per tal d'esbrinar quina es la seva presencia i pes específic en el territori i, en segon terme, s'han identificat tres dinàmiques de comportament dels estudiant a l'hora d'escollir centre i estudi segons sigui la distancia que separa aquest domicili de la ubicació de l'oferta universitària. Tot plegat, pretén resoldre el problema que planteja el desconeixement existent en l'actualitat de les relacions complexes que s'estableixen entre la selecció d'estudis universitaris i centre amb les xarxes de transport i la mobilitat induïda dels estudiants del sistema universitari de Catalunya.[eng] Mobility forced by study reasons analyses the students' travels between their place of residence and the study location in any of the formative stages: from mandatory elementary studies to higher education. In this sense, the mobility phenomenon is consubstantial to university itself from the very start, currently growing up to be a complex phenomenon. In order to be able to understand it to its fullest, it is then necessary to identify the various actors participating in it, the different geographical scales reached, as well as the formal framework in which it is carried out, and its directionality.In this contex the main objective of this research is to find out the criteria and patterns that prompt the choice of centre and studies by the students residing in Catalonia accessing for the very first time the degree's offer from the Catalan universities taking part of the pre­ registration process (UB, UAB, UPC, UPF, Udl , UdG, URV and UVic), by composing a flow map of this collective's mobility within the period covering the academic years 2000/01 to 2013/ 14, so as to perhaps obtain orientations on their future behaviour.In this way, and by using as a primary source the data from the UNEIX system files on freshman students, sorted by each of the aforementioned universities and academic year, and based on the county of origin of this student body (the one where their permanent address is estabilshed, generally this being the home address), the following has been determined: first, these institutions' influence and acquisition area in order to find out their actual presence and specific weight within the territory; and, second, three students' behaviour dynamics regarding their centre and studies choice, depending on the distance separating their place of residence and the location of the university offer.All of that hopes to solve the problem resulting from the currently existing ignorance on the complex relations established vis a vis the university studies and centre selection, and the transport network and induced mobility of the Catalan university system's students

Comments on morelli et al.. extracorporeal carbon dioxide removal (ECCO2R) in patients with acute respiratory failure

Comment on Extracorporeal carbon dioxide removal (ECCO2R) in patients with acute respiratory failure. [Intensive Care Med. 2017

Interest of a simple on-line screening registry for measuring ICU burden related to an Influenza pandemic.

International audienceABSTRACT: INTRODUCTION: The specific burden imposed on Intensive Care Units (ICUs) during the A/H1N1 influenza 2009 pandemic has been poorly explored. An on-line screening registry allowed a daily report of ICU beds occupancy rate by flu infected patients (Flu-OR) admitted in French ICUs. METHODS: A prospective inception cohort study with results of an on-line screening registry designed for daily assessment of ICU burden. RESULTS: Among the 108 centers participating to the French H1N1 research network on mechanical ventilation (REVA) - French Society of Intensive Care (SRLF) registry, 69 ICUs belonging to seven large geographical areas voluntarily participated to a website screening-registry. The aim was to daily assess the ICU beds occupancy rate by influenza-infected and non-infected patients for at least three weeks. 391 critically ill infected patients were enrolled in the cohort, representing a subset of 35% of the whole French 2009 pandemic cohort; 73% were mechanically ventilated, 13% required extra corporal membrane oxygenation (ECMO) and 22% died. The global Flu-OR in these ICUs was only 7.6%, but it exceeded a predefined 15% critical threshold in 32 ICUs for a total of 103 weeks. Flu-ORs were significantly higher in University than in non University hospitals. The peak ICU burden was poorly predicted by observations obtained at the level of large geographical areas. CONCLUSIONS: The peak Flu-OR during the pandemic significantly exceeded a 15% critical threshold in almost half of the ICUs, with an uneven distribution with time, geographical areas and between University and non University hospitals. An on-line assessment of Flu-OR via a simple dedicated registry may contribute to better match resources and needs

Range, mean, median and standard deviation according to assays (POC and Lab).

<p>Range, mean, median and standard deviation according to assays (POC and Lab).</p

Between-day imprecision of the Point-of-Care Siemens RAPIDPoint 500 blood gas system (POC).

<p>Between-day imprecision of the Point-of-Care Siemens RAPIDPoint 500 blood gas system (POC).</p

Between-day imprecision of central laboratory automated analyzers (Lab).

<p>Between-day imprecision of central laboratory automated analyzers (Lab).</p

Veno-Arterial Extracorporeal Membrane Oxygenation for Circulatory Failure in COVID-19 Patients: Insights from the ECMOSARS Registry

International audienceObjectives: The clinical profile and outcomes of patients with Covid-19 who require veno-arterial or veno-venous-arterial extracorporeal membrane oxygenation (VA-ECMO - VAV-ECMO) are poorly understood. We aimed to describe the characteristics and outcomes of these patients and to identify predictors of both favorable and unfavorable outcomes.Methods: ECMOSARS is a multicenter, prospective, nationwide French registry enrolling patients who require VV/VA-ECMO in the context of Covid-19 infection (652 patients at 41 centers). We focused on 47 patients supported with VA- or VAV-ECMO for refractory cardiogenic shock.Results: Median age was 49. 14% of patients had a prior diagnosis of heart failure. The most common etiologies of cardiogenic shock were acute pulmonary embolism (30%), myocarditis (28%), and acute coronary syndrome (4%). E-CPR (Extracorporeal Cardiopulmonary Resuscitation) occurred in 38%. In-hospital survival was 28% in the whole cohort, and 43% when E-CPR patients were excluded. ECMO cannulation was associated with significant improvements in pH and FiO2 on day one, but non-survivors showed significantly more severe acidosis and higher FiO2 than survivors at this point (p = 0.030 and p = 0.006). Other factors associated with death were greater age (p = 0.02), higher BMI (p = 0.03), E-CPR (p = 0.001), non-myocarditis etiology (p = 0.02), higher serum lactates (p = 0.004), epinephrine (but not noradrenaline) use before initiation of ECMO (p = 0.003), hemorrhagic complications (p = 0.001), greater transfusion requirements (p = 0.001), and more severe SAVE and SAFE scores (p = 0.01 and p = 0.03).Conclusions: We report the largest focused analysis of VA- and VAV-ECMO recipients in Covid-19. Although relatively rare, the need for temporary mechanical circulatory support in these patients is associated with poor prognosis. However, VA-ECMO remains a viable solution to rescue carefully selected patients. We identified factors associated with poor prognosis and suggest that E-CPR is not a reasonable indication for VA-ECMO in this population