Quality of life and persisting symptoms in intensive care unit survivors: implications for care after discharge

<p>Abstract</p> <p>Background</p> <p>We assessed the quality of life of ICU survivors using SF-36 at 4 months after ICU discharge and investigated any correlation of PCS and MCS with age, illness severity and hospital or ICU length of stay. We examined the relationship between these variables, persisting physical and psychological symptoms and the perceived benefit of individual patients of follow-up.</p> <p>Findings</p> <p>For one year, adult patients admitted for multiple organ or advanced respiratory support for greater than 48 hours to a 16-bedded teaching hospital general intensive care unit were identified. Those surviving to discharge were sent a questionnaire at 4 months following ICU discharge assessing quality of life and persisting symptoms. Demographic, length of stay and illness severity data were recorded. Higher or lower scores were divided at the median value. A two-tailed Students t-test assuming equal variances was used for normally-distributed data and Mann-Whitney tests for non-parametric data.</p> <p>87 of 175 questionnaires were returned (50%), but only 65 had sufficient data giving a final response rate of 37%. Elderly patients had increased MCS as compared with younger patients. The PCS was inversely related to hospital LOS. There was a significant correlation between the presence of psychological and physical symptoms and desire for follow-up.</p> <p>Conclusion</p> <p>Younger age and prolonged hospital stay are associated with lower mental or physical quality of life and may be targets for rehabilitation. Patients with persisting symptoms at 4 months view follow-up as beneficial and a simple screening questionnaire may identify those likely to attend outpatient services.</p

p190-B RhoGAP and intracellular cytokine signals balance hematopoietic stem and progenitor cell self-renewal and differentiation

The mechanisms regulating hematopoietic stem and progenitor cell (HSPC) fate choices remain ill-defined. Here, we show that a signalling network of p190-B RhoGAP-ROS-TGF-β-p38MAPK balances HSPC self-renewal and differentiation. Upon transplantation, HSPCs express high amounts of bioactive TGF-β1 protein, which is associated with high levels of p38MAPK activity and loss of HSC self-renewal in vivo. Elevated levels of bioactive TGF-β1 are associated with asymmetric fate choice in vitro in single HSPCs via p38MAPK activity and this is correlated with the asymmetric distribution of activated p38MAPK. In contrast, loss of p190-B, a RhoGTPase inhibitor, normalizes TGF-β levels and p38MAPK activity in HSPCs and is correlated with increased HSC self-renewal in vivo. Loss of p190-B also promotes symmetric retention of multi-lineage capacity in single HSPC myeloid cell cultures, further suggesting a link between p190-B-RhoGAP and non-canonical TGF-β signalling in HSPC differentiation. Thus, intracellular cytokine signalling may serve as 'fate determinants' used by HSPCs to modulate their activity

COMPARATIVE ANALYSIS OF 3D PHOTOGRAMMETRY MODELING SOFTWARE PACKAGES FOR DRONES SURVEY

Drones are becoming popular in spatial mapping or survey. The use of drones survey can be seen from it low flying heights (capable to create a clear images), accessible on difficult or non-friendly vehicle access areas, faster data acquisition and higher data resolution henceforth improve the quality of the survey. However, this paper focuses on the post-processing of drone images for 3D surface modeling. With the motivation of producing better 3D models, four software packages are used for comparison. Those software packages are eyesMap3D, Drone Deploy, Agisoft PhotoScan and Pix4Dmapper. The equipment used to ensure a high level of quality model is the Leica GPS1200+ stationary GPS module and the DJI Phantom 4 PRO drone. The Leica GPS1200+ stationary GPS module were used to track the exact position of tie points on the ground. Meanwhile the DJI Phantom 4 PRO drone is used as data inputs (images) for the software packages stated. In addition, the drone is used to fly over a golf course, with a challenge of homogenous surface for 3D surface modeling. Based on the output, it shows that each software packages produces slightly different outputs. This paper summarizes the outputs and discusses the key elements in each software packages. This variation might be useful for future references in 3D surface modeling that can conform in different applications requirements

Health-related quality of life in transplant ineligible newly diagnosed multiple myeloma patients treated with either thalidomide or lenalidomide-based regimen until progression: a prospective, open-label, multicenter, randomized, phase 3 study

Data on the impact of long term treatment with immunomodulatory drugs (IMiD) on health-related quality of life (HRQoL) is limited. The HOVON-87/NMSG18 study was a randomized, phase 3 study in newly diagnosed transplant ineligible patients with multiple myeloma, comparing melphalan-prednisolone in combination with thalidomide or lenalidomide, followed by maintenance therapy until progression (MPT-T or MPR-R). The EORTC QLQ-C30 and MY20 questionnaires were completed at baseline, after three and nine induction cycles and six and 12 months of maintenance therapy. Linear mixed models and minimal important differences were used for evaluation. 596 patients participated in HRQoL reporting. Patients reported clinically relevant improvement in global quality of life (QoL), future perspective and role and emotional functioning, and less fatigue and pain in both arms. The latter being of large effect size