Discordant identification of pediatric severe sepsis by research and clinical definitions in the SPROUT international point prevalence study

Introduction: Consensus criteria for pediatric severe sepsis have standardized enrollment for research studies. However, the extent to which critically ill children identified by consensus criteria reflect physician diagnosis of severe sepsis, which underlies external validity for pediatric sepsis research, is not known. We sought to determine the agreement between physician diagnosis and consensus criteria to identify pediatric patients with severe sepsis across a network of international pediatric intensive care units (PICUs). Methods: We conducted a point prevalence study involving 128 PICUs in 26 countries across 6 continents. Over the course of 5 study days, 6925 PICU patients <18 years of age were screened, and 706 with severe sepsis defined either by physician diagnosis or on the basis of 2005 International Pediatric Sepsis Consensus Conference consensus criteria were enrolled. The primary endpoint was agreement of pediatric severe sepsis between physician diagnosis and consensus criteria as measured using Cohen's ?. Secondary endpoints included characteristics and clinical outcomes for patients identified using physician diagnosis versus consensus criteria. Results: Of the 706 patients, 301 (42.6 %) met both definitions. The inter-rater agreement (? ± SE) between physician diagnosis and consensus criteria was 0.57 ± 0.02. Of the 438 patients with a physician's diagnosis of severe sepsis, only 69 % (301 of 438) would have been eligible to participate in a clinical trial of pediatric severe sepsis that enrolled patients based on consensus criteria. Patients with physician-diagnosed severe sepsis who did not meet consensus criteria were younger and had lower severity of illness and lower PICU mortality than those meeting consensus criteria or both definitions. After controlling for age, severity of illness, number of comorbid conditions, and treatment in developed versus resource-limited regions, patients identified with severe sepsis by physician diagnosis alone or by consensus criteria alone did not have PICU mortality significantly different from that of patients identified by both physician diagnosis and consensus criteria. Conclusions: Physician diagnosis of pediatric severe sepsis achieved only moderate agreement with consensus criteria, with physicians diagnosing severe sepsis more broadly. Consequently, the results of a research study based on consensus criteria may have limited generalizability to nearly one-third of PICU patients diagnosed with severe sepsis

The global burden of adolescent and young adult cancer in 2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15–39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods: Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15–39 years to define adolescents and young adults. Findings: There were 1·19 million (95% UI 1·11–1·28) incident cancer cases and 396 000 (370 000–425 000) deaths due to cancer among people aged 15–39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59·6 [54·5–65·7] per 100 000 person-years) and high-middle SDI countries (53·2 [48·8–57·9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14·2 [12·9–15·6] per 100 000 person-years) and middle SDI (13·6 [12·6–14·8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23·5 million (21·9–25·2) DALYs to the global burden of disease, of which 2·7% (1·9–3·6) came from YLDs and 97·3% (96·4–98·1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation: Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Funding: Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities, St Baldrick's Foundation, and the National Cancer Institute

Unsupported Ni/Mo(W)S-2 Catalysts from Hexamethylenediammonium Thiometallates Precursors: In Situ Activation During the HDS of DBT

Lumbreras, J. A. Huirache-Acuna, R. Rivera-Munoz, E. M. Berhault, G. Alonso-Nunez, G.Unsupported Ni/MoS2 and Ni/WS2 HDS catalysts were prepared by in situ activation of hexamethylenediammonium thiometallates promoted with Ni. The method involved an aqueous solution reaction of ammonium thiomolybdate (ATM) or ammonium thiotungstate (ATT) with Ni(NO3)(2)center dot 6H(2)O and hexamethylenediamine. Ni-promoted precursors were then in situ activated during the hydrodesulfurization (HDS) of dibenzothiophene (DBT) producing Ni/MoS2 and Ni/WS2 catalysts. Solids were analyzed after the in situ activation by scanning electron microscopy, transmission electron microscopy, X-ray diffraction, and for textural properties by using the BET and BJH methods. Catalysts with relatively high surface area and type IV N-2 adsorption-desorption isotherms were obtained. The use of the hexamethylenediammonium precursor led to a significant nickel promotion of MoS2 and WS2 catalysts. For Ni/MoS2, the use of this carbon-containing precursor was found to be more beneficial for the final HDS catalytic activity than using the classical ammonium tetrathiomolybdate (ATM) without carbon. For Ni/WS2, compared to tetraalkylammonium thiosalts, the lower amount of carbon in excess formed during the decomposition of the hexamethylenediammonium precursor coupled with a lower crystallization rate of WS2 favors a correct nickel accommodation on the WS2 edges

Unsupported trimetallic CoMoW sulfide HDS catalysts prepared by in situ decomposition of sulfur-containing precursors

SSCI-VIDE+ECI2D+GBEInternational audienc

Methanol dehydrogenation and oxidation on Pt1-XNiX/CNTs at low temperature: Effect of Ni addition

SSCI-VIDE+ECI2D+JRD:GBE:GANInternational audienceThis study reports the effect on catalytic activity resulting from Ni incorporation in Pt nanoparticles supported on carbon nanotubes (CNTs) for electrochemical methanol oxidation at low temperature in acidic conditions. Chemical composition, morphology and structure of the Pt1-XNiX/CNTs (X = 0, 0.1, 0.2, 0.3, 0.4, 0.5) catalysts were studied by EDS, SEM, XRD, TEM and TGA. The catalytic activity of the prepared materials in methanol electro-oxidation reaction was investigated by cyclic voltammetry (CV) and chronoamperometry (CA). The results of catalytic activity of the nanostructured materials showed a volcano-type relationship between the Ni relative concentration current density. The enhancement of catalytic activity was attributed to changes in surface electronic structure of Pt nanoparticles that impacted in an increment of active sites for methanol dehydrogenation and oxidation processes. On the other hand, high concentration of Ni (concentration >= 30 at.%) in Pt nanoparticles caused a substantial decrease of the catalytic activity due to a depletion of active sites for the methanol dehydrogenation process. The highest catalytic activity was observed when the Ni relative concentration reaches 30 at.%. (C) 2016 Elsevier Ltd. All rights reserved

Influence of the activation atmosphere on the hydrodesulfurization of Co-Mo/SBA-15 catalysts prepared from sulfur-containing precursors

RAFFINAGE:MATERIAUX+GBE:ACRMesoporous SBA-15 material was used as support of binary Co-Mo hydrodesulfurization (HDS) catalysts prepared using a novel approach based on the use of already sulfided precursors (ammonium tetrathiomolybdate and cobalt diethyldithiocarbamate). The effects of atmosphere and activation temperature were studied to optimize the preparation of highly active CoMo/SBA-15 hydrodesulfurization catalysts. Two sets of catalysts were synthesized using either a N-2/H-2 (10% H-2) or a H-2/H2S (15% H2S) atmosphere at three different temperatures of activation (723, 773 and 823 K). The catalysts were tested in the HDS of dibenzothiophene (DBT) and the catalysts were characterized by N-2 physisorption, X-ray diffraction (XRD), scanning electron microscopy (SEM) and high-resolution transmission electron microscopy (HRTEM). The use of already sulfided precursors leads to a homogeneous dispersion of the active phase inside the SBA-15 channels. Moreover, the N-2/H-2 activation procedure at 723 K allows obtaining optimized HDS active catalysts. Finally, a confinement effect of MoS2 slabs inside the SBA-15 channels leads to a high selectivity along the direct desulfurization pathway. (C) 2012 Elsevier B.V. All rights reserved

Architecture and gene repertoire of the flexible genome of the extreme acidophile acidithiobacillus caldus

Background: Acidithiobacillus caldus is a sulfur oxidizing extreme acidophile and the only known mesothermophile within the Acidithiobacillales. As such, it is one of the preferred microbes for mineral bioprocessing at moderately high temperatures. In this study, we explore the genomic diversity of A. caldus strains using a combination of bioinformatic and experimental techniques, thus contributing first insights into the elucidation of the species pangenome. Principal Findings: Comparative sequence analysis of A. caldus ATCC 51756 and SM-1 indicate that, despite sharing a conserved and highly syntenic genomic core, both strains have unique gene complements encompassing nearly 20% of their respective genomes. The differential gene complement of each strain is distributed between the chromosomal compartment, one megaplasmid and a variable number of smaller plasmids, and is directly associated to a diverse pool of mobile genetic elements (MGE). These include integrative conjugative and mobilizable elements, genomic islands and insertion sequences. Some of the accessory functions associated to these MGEs have been linked previously to the flexible gene pool in microorganisms inhabiting completely different econiches. Yet, others had not been unambiguously mapped to the flexible gene pool prior to this report and clearly reflect strain-specific adaption to local environmental conditions. Significance: For many years, and because of DNA instability at low pH and recurrent failure to genetically transform acidophilic bacteria, gene transfer in acidic environments was considered negligible. Findings presented herein imply that a more or less conserved pool of actively excising MGEs occurs in the A. caldus population and point to a greater frequency of gene exchange in this econiche than previously recognized. Also, the data suggest that these elements endow the species with capacities to withstand the diverse abiotic and biotic stresses of natural environments, in particular those associated with its extreme econiche

Architecture and gene repertoire of the flexible genome of the extreme acidophile Acidithiobacillus caldus

CITATION: Acuna, L. G. et al. 2013. Architecture and gene repertoire of the flexible genome of the extreme acidophile Acidithiobacillus caldus. PLoS ONE, 8(11):e78237, doi:10.1371/journal.pone.0078237.The original publication is available at http://journals.plos.orgBackground: Acidithiobacillus caldus is a sulfur oxidizing extreme acidophile and the only known mesothermophile within the Acidithiobacillales. As such, it is one of the preferred microbes for mineral bioprocessing at moderately high temperatures. In this study, we explore the genomic diversity of A. caldus strains using a combination of bioinformatic and experimental techniques, thus contributing first insights into the elucidation of the species pangenome. Principal Findings: Comparative sequence analysis of A. caldus ATCC 51756 and SM-1 indicate that, despite sharing a conserved and highly syntenic genomic core, both strains have unique gene complements encompassing nearly 20% of their respective genomes. The differential gene complement of each strain is distributed between the chromosomal compartment, one megaplasmid and a variable number of smaller plasmids, and is directly associated to a diverse pool of mobile genetic elements (MGE). These include integrative conjugative and mobilizable elements, genomic islands and insertion sequences. Some of the accessory functions associated to these MGEs have been linked previously to the flexible gene pool in microorganisms inhabiting completely different econiches. Yet, others had not been unambiguously mapped to the flexible gene pool prior to this report and clearly reflect strain-specific adaption to local environmental conditions. Significance: For many years, and because of DNA instability at low pH and recurrent failure to genetically transform acidophilic bacteria, gene transfer in acidic environments was considered negligible. Findings presented herein imply that a more or less conserved pool of actively excising MGEs occurs in the A. caldus population and point to a greater frequency of gene exchange in this econiche than previously recognized. Also, the data suggest that these elements endow the species with capacities to withstand the diverse abiotic and biotic stresses of natural environments, in particular those associated with its extreme econiche.http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0078237Publisher's versio

High-K band in Gd-140

High-spin states in the neutron-deficient140Gd nucleus have been studied with the 92Mo(54Fe,alpha2p) reaction at a beam energy of 240 MeV. The level scheme of 140Gd was considerably extended from what was previously known. In this work we concentrate on one of the 9 bands observed, which presents relatively strong M1 transitions and negligible signature splitting, and has an isomeric band-head, indicating a strongly coupled or high-K configuration. We compare this band to the Kpi = 8- bands observed in N=74 isotones and propose a similar configuration assignment, but with a somewhat larger deformation