The impact of religion on changes in end-of-life practices in European intensive care units: a comparative analysis over 16 years.

PURPOSE Religious beliefs affect end-of-life practices in intensive care units (ICUs). Changes over time in end-of-life practices were not investigated regarding religions. METHODS Twenty-two European ICUs (3 regions: Northern, Central, and Southern Europe) participated in both Ethicus-1 (years 1999-2000) and Ethicus-2 studies (years 2015-2016). Data of ICU patients who died or had limitations of life-sustaining therapy were analysed regarding changes in end-of-life practices and patient/physician religious affiliations. Frequencies, timing of decision-making, and religious affiliations of physicians/patients were compared using the same definitions. RESULTS In total, 4592 adult ICU patients (n = 2807 Ethicus-1, n = 1785 Ethicus-2) were analysed. In both studies, patient and physician religious affiliations were mostly Catholic, Greek Orthodox, Jewish, Protestant, or unknown. Treating physicians (but not patients) commonly reported no religious affiliation (18%). Distribution of end-of-life practices with respect to religion and geographical regions were comparable between the two studies. Withholding [n = 1143 (40.7%) Ethicus-1 and n = 892 (50%) Ethicus-2] and withdrawing [n = 695 (24.8%) Ethicus-1 and n = 692 (38.8%) Ethicus-2] were most commonly decided. No significant changes in end-of-life practices were observed for any religion over 16 years. The number of end-of-life discussions with patients/ families/ physicians increased, while mortality and time until first decision decreased. CONCLUSIONS Changes in end-of-life practices observed over 16 years appear unrelated to religious affiliations of ICU patients or their treating physicians, but the effects of religiosity and/or culture could not be assessed. Shorter time until decision in the ICU and increased numbers of patient and family discussions may indicate increased awareness of the importance of end-of-life decision-making in the ICU

Current Status of the EU-VGOS Project

The EU-VGOS project began in 2018 with\ua0the aim of using the VGOS infrastructure in Europe\ua0to investigate methods for VGOS data processing. The\ua0project is now structured into Working Groups dealing\ua0with operations (stations), e-transfer, correlation and\ua0post-processing, and analysis. This is a report on the\ua0status of the project

Influence of bacteria on cell size development and morphology of cultivated diatoms

Vegetative cell division in diatoms often results in a decreased cell size of one of the daughter cells, which during long-term cultivation may lead to a gradual decrease of the mean cell size of the culture. To restore the initial cell size, sexual reproduction is required, however, in many diatom cultures sexual reproduction does not occur. Such diatom cultures may lose their viability once the average size of the cells falls below a critical size. Cell size reduction therefore seriously restrains the long-term stability of many diatom cultures. In order to study the bacterial influence on the size diminution process, we observed cell morphology and size distribution of the diatoms Achnanthidium minutissimum, Cymbella affiniformis and Nitzschia palea for more than two years in bacteria-free conditions (axenic cultures) and in cultures that contain bacteria (xenic cultures). We found considerable morphological aberrations of frustule microstructures in A. minutissimum and C. affiniformis when cultivated under axenic conditions compared to the xenic cultures. These variations comprise significant cell length reduction, simplification and rounding of the frustule contour and deformation of the siliceous cell walls, features that are normally found in older cultures shortly before they die off. In contrast, the xenic cultures were well preserved and showed less cell length diminution. Our results show that bacteria may have a fundamental influence on the stability of long-term cultures of diatoms

Nationwide analysis of hospital admissions and outcomes of patients with SARS-CoV-2 infection in Austria in 2020 and 2021

Abstract This retrospective study evaluated temporal and regional trends of patient admissions to hospitals, intensive care units (ICU), and intermediate care units (IMCU) as well as outcomes during the COVID-19 pandemic in Austria. We analysed anonymous data from patients admitted to Austrian hospitals with COVID-19 between January 1st, 2020 and December 31st, 2021. We performed descriptive analyses and logistic regression analyses for in-hospital mortality, IMCU or ICU admission, and in-hospital mortality following ICU admission. 68,193 patients were included, 8304 (12.3%) were primarily admitted to ICU, 3592 (5.3%) to IMCU. Hospital mortality was 17.3%; risk factors were male sex (OR 1.67, 95% CI 1.60–1.75, p < 0.001) and high age (OR 7.86, 95% CI 7.07–8.74, p < 0.001 for 90+ vs. 60–64 years). Mortality was higher in the first half of 2020 (OR 1.15, 95% CI 1.04–1.27, p = 0.01) and the second half of 2021 (OR 1.11, 95% CI 1.05–1.17, p < 0.001) compared to the second half of 2020 and differed regionally. ICU or IMCU admission was most likely between 55 and 74 years, and less likely in younger and older age groups. We find mortality in Austrian COVID-19-patients to be almost linearly associated with age, ICU admission to be less likely in older individuals, and outcomes to differ between regions and over time

Tailoring doped organic nanoparticles as selective hole transporters for printed non-fullerene organic solar cells

Most interface materials for organic solar cells (OSCs) were originally optimized for fullerene-based systems and are now being adapted for non-fullerene acceptor (NFA) based solar cells. This reliance on established interface materials results in a limited choice of interface materials for NFA based OSCs. For vacuum processed organic devices, the concept of doped interface materials is exceptionally successful, but has not yet been translated to modern NFA based devices due to solution processing constraints requiring orthogonal solubility. Herein, we report a novel concept for the development of solution-processed HTL in inverted n-i-p architecture OSCs using doped organic nanoparticles (D-NPs), overcoming solvent compatibility limitations and enabling scalable production processes. We demonstrate that the functional key interface properties of D-NPs HTLs can be tailored independently over a wide regime. Specifically, conductivity and work function can be optimized separately by varying the dopant concentration and the material system. By using D-NPs as HTL in the n-i-p architecture, power conversion efficiencies (PCE) of over 12 % are achieved for PM6:Y6 based devices. The D-NPs HTL concept is successfully applied to a variety of organic semiconductors used in photovoltaics and opens a new class of tailorable interface materials for solution-processed HTL materials

Vienna Vlbi And Satellite Software (Vievs) For Geodesy And Astrometry

The Vienna VLBI and Satellite Software (VieVS) is state-of-the-art Very Long Baseline Interferometry (VLBI) analysis software for geodesy and astrometry. VieVS has been developed at Technische Universitat Wien (TU Wien) since 2008, where it is used for research purposes and for teaching space geodetic techniques. In the past decade, it has been successfully applied on Very Long Baseline Interferometry (VLBI) observations for the determination of celestial and terrestrial reference frames as well as for the estimation of celestial pole offsets, universal Time (UT1-UTC), and polar motion based on least-squares adjustment. Furthermore, VieVS is equipped with tools for scheduling and simulating VLBI observations to extragalactic radio sources as well as to satellites and spacecraft, features which proved to be very useful for a variety of applications. VieVS is now available as version 3.0 and we do provide the software to all interested persons and institutions. A wiki with more information about VieVS is available at http://vievswiki.geo.tuwien.ac.at/.WoSScopu

Geodetic data analysis of VGOS experiments

Very Long Baseline Interferometry (VLBI) serves as one of the common geodetic methods to define the global reference frames and monitor Earth\u27s orientation variations. The technical upgrade of the VLBI method known as the VLBI Global Observing System (VGOS) includes a critical re-design of the observed frequencies from the dual band mode (S and X band, i.e. 2 GHz and 8 GHz) to observations in a broadband (2-14 GHz). Since 2019 the first VGOS experiments are available for the geodetic analysis in free access at the International VLBI service for Geodesy and Astrometry (IVS). Also regional-only subnetworks such as European VLBI stations have succeeded already in VGOS mode. Based on these brand-new observations we review the current geodetic data analysis workflow to build a bridge between geodetic observed delays derived from different bands

Variations in end-of-life practices in intensive care units worldwide (Ethicus-2): a prospective observational study.

BACKGROUND End-of-life practices vary among intensive care units (ICUs) worldwide. Differences can result in variable use of disproportionate or non-beneficial life-sustaining interventions across diverse world regions. This study investigated global disparities in end-of-life practices. METHODS In this prospective, multinational, observational study, consecutive adult ICU patients who died or had a limitation of life-sustaining treatment (withholding or withdrawing life-sustaining therapy and active shortening of the dying process) during a 6-month period between Sept 1, 2015, and Sept 30, 2016, were recruited from 199 ICUs in 36 countries. The primary outcome was the end-of-life practice as defined by the end-of-life categories: withholding or withdrawing life-sustaining therapy, active shortening of the dying process, or failed cardiopulmonary resuscitation (CPR). Patients with brain death were included in a separate predefined end-of-life category. Data collection included patient characteristics, diagnoses, end-of-life decisions and their timing related to admission and discharge, or death, with comparisons across different regions. Patients were studied until death or 2 months from the first limitation decision. FINDINGS Of 87 951 patients admitted to ICU, 12 850 (14·6%) were included in the study population. The number of patients categorised into each of the different end-of-life categories were significantly different for each region (p<0·001). Limitation of life-sustaining treatment occurred in 10 401 patients (11·8% of 87 951 ICU admissions and 80·9% of 12 850 in the study population). The most common limitation was withholding life-sustaining treatment (5661 [44·1%]), followed by withdrawing life-sustaining treatment (4680 [36·4%]). More treatment withdrawing was observed in Northern Europe (1217 [52·8%] of 2305) and Australia/New Zealand (247 [45·7%] of 541) than in Latin America (33 [5·8%] of 571) and Africa (21 [13·0%] of 162). Shortening of the dying process was uncommon across all regions (60 [0·5%]). One in five patients with treatment limitations survived hospitalisation. Death due to failed CPR occurred in 1799 (14%) of the study population, and brain death occurred in 650 (5·1%). Failure of CPR occurred less frequently in Northern Europe (85 [3·7%] of 2305), Australia/New Zealand (23 [4·3%] of 541), and North America (78 [8·5%] of 918) than in Africa (106 [65·4%] of 162), Latin America (160 [28·0%] of 571), and Southern Europe (590 [22·5%] of 2622). Factors associated with treatment limitations were region, age, and diagnoses (acute and chronic), and country end-of-life legislation. INTERPRETATION Limitation of life-sustaining therapies is common worldwide with regional variability. Withholding treatment is more common than withdrawing treatment. Variations in type, frequency, and timing of end-of-life decisions were observed. Recognising regional differences and the reasons behind these differences might help improve end-of-life care worldwide. FUNDING None

Variations in end-of-life practices in intensive care units worldwide (Ethicus-2): a prospective observational study

Background End-of-life practices vary among intensive care units (ICUs) worldwide. Differences can result in variable use of disproportionate or non-beneficial life-sustaining interventions across diverse world regions. This study investigated global disparities in end-of-life practices. Methods In this prospective, multinational, observational study, consecutive adult ICU patients who died or had a limitation of life-sustaining treatment (withholding or withdrawing life-sustaining therapy and active shortening of the dying process) during a 6-month period between Sept 1, 2015, and Sept 30, 2016, were recruited from 199 ICUs in 36 countries. The primary outcome was the end-of-life practice as defined by the end-of-life categories: withholding or withdrawing life-sustaining therapy, active shortening of the dying process, or failed cardiopulmonary resuscitation (CPR). Patients with brain death were included in a separate predefined end-of-life category. Data collection included patient characteristics, diagnoses, end-of-life decisions and their timing related to admission and discharge, or death, with comparisons across different regions. Patients were studied until death or 2 months from the first limitation decision. Findings Of 87 951 patients admitted to ICU, 12 850 (14middot6%) were included in the study population. The number of patients categorised into each of the different end-of-life categories were significantly different for each region (p&lt;0middot001). Limitation of life-sustaining treatment occurred in 10 401 patients (11middot8% of 87 951 ICU admissions and 80middot9% of 12 850 in the study population). The most common limitation was withholding life-sustaining treatment (5661 [44middot1%]), followed by withdrawing life-sustaining treatment (4680 [36middot4%]). More treatment withdrawing was observed in Northern Europe (1217 [52middot8%] of 2305) and Australia/New Zealand (247 [45middot7%] of 541) than in Latin America (33 [5middot8%] of 571) and Africa (21 [13middot0%] of 162). Shortening of the dying process was uncommon across all regions (60 [0middot5%]). One in five patients with treatment limitations survived hospitalisation. Death due to failed CPR occurred in 1799 (14%) of the study population, and brain death occurred in 650 (5middot1%). Failure of CPR occurred less frequently in Northern Europe (85 [3middot7%] of 2305), Australia/New Zealand (23 [4middot3%] of 541), and North America (78 [8middot5%] of 918) than in Africa (106 [65middot4%] of 162), Latin America (160 [28middot0%] of 571), and Southern Europe (590 [22middot5%] of 2622). Factors associated with treatment limitations were region, age, and diagnoses (acute and chronic), and country end-of-life legislation. Interpretation Limitation of life-sustaining therapies is common worldwide with regional variability. Withholding treatment is more common than withdrawing treatment. Variations in type, frequency, and timing of end-of-life decisions were observed. Recognising regional differences and the reasons behind these differences might help improve end-of-life care worldwide. Funding None. Copyright (c) 2021 Elsevier Ltd. All rights reserved

Amplitude analysis of the B(s)0→K∗0K‾∗0B^0_{(s)} \to K^{*0} \overline{K}^{*0} decays and measurement of the branching fraction of the B0→K∗0K‾∗0B^0 \to K^{*0} \overline{K}^{*0} decay

International audienceThe ${B}^0\to {K}^{\ast 0}{\overline{K}}^{\ast 0}$ and ${B}_s^0\to {K}^{\ast 0}{\overline{K}}^{\ast 0}$ decays are studied using proton-proton collision data corresponding to an integrated luminosity of 3 fb$^{−1}$. An untagged and timeintegrated amplitude analysis of B_{( s}_{)}^{0}  → (K$^{+}$π$^{−}$)(K$^{−}$π$^{+}$) decays in two-body invariant mass regions of 150 MeV/c$^{2}$ around the K$^{∗0}$ mass is performed. A stronger longitudinal polarisation fraction in the ${B}^0\to {K}^{\ast 0}{\overline{K}}^{\ast 0}$ decay, f$_{L}$ = 0.724 ± 0.051 (stat) ± 0.016 (syst), is observed as compared to f$_{L}$ = 0.240 ± 0.031 (stat) ± 0.025 (syst) in the ${B}_s^0\to {K}^{\ast 0}{\overline{K}}^{\ast 0}$ decay. The ratio of branching fractions of the two decays is measured and used to determine $\mathrm{\mathcal{B}}\left({B}^0\to {K}^{\ast 0}{\overline{K}}^{\ast 0}\right)=\left(8.0\pm 0.9\left(\mathrm{stat}\right)\pm 0.4\left(\mathrm{syst}\right)\right)\times {10}^{-7}$