Patients suffering from psychological impairments following critical illness are in need of information

Background: Because critical illness survivors frequently experience several long-term psychological impairments altering quality of life after ICU, there is a trend towards increasing follow-up care, mainly via ICU follow-up clinics. Despite these and other initiatives, understanding of patient's post-ICU needs to help them cope with their problems and subsequently improve quality of life is largely lacking. Our aim was therefore to assess the needs, expectations and wishes in ICU survivors to receive information with the purpose to help them better grasp ICU treatment. In addition, we assessed the perceived burden of psychological trauma after ICU treatment and the health-related quality of life (HRQoL) up to 2.5 years after ICU discharge. Methods: In a multicentre, retrospective cross-sectional cohort study, the needs and preferred intervention methods were assessed using a self-composed inventory in adult mechanically ventilated ICU survivors (n = 43). Additionally, the Impact of Event Scale Revised, the Beck Depression Inventory, the EuroQol-5D-5L, and the Short-Form 12 were used to assess psychological burden and HRQoL. Results: A substantial proportion of all ICU survivors (59%, 95% CI 44% to 74%) suffered from psychological impairments after ICU treatment. Seventy-five percent of these patients expressed a wish to receive information, but only 36% desired to receive this information using a commonly used information brochure. In contrast, 71% of these patients had a wish to receive information using a video film/VR. Furthermore, only 33% of these patients was satisfied with the information provided by their treating hospital. Patients with psychological PICS reported a worse HRQoL as compared to a normative Dutch sample (P < 0.001) and as compared to patients without psychological PICS (P < 0.01). Conclusions: In a Dutch cohort of critical illness survivors, a substantial part of ICU survivors suffer from psychological impairments, such as PTSD and depression, which was associated with a worse HRQoL. These patients are in need of information, have no desire using an information brochure, but are willing to receive information using a video film/virtual reality module. These results support the exploration of such an intervention

Methods and materials for determining relative abundance of microorganisms in mixed populations

The present invention relates to a method for determining the relative abundance of individual species or lower phylogenetic subgroups of microorganims in a mixed population of several microorganisms comprising the steps of: 1) providing a set of labelled in situ hybridization cluster oligonucleotide probes; 2) hybridization of said probes with a sample of the mixed population, and 3) quantitative analysis of the number of labelled microorganisms. Further it relates to a method for analyzing dynamics in relative abundance of individual microorganisms in a mixed population. Further it relates to a set of probes which are cluster specific and which are provided with at least one label for use in method of the invention and to a kit of parts for determining the relative abundance of individual species of microorganisms in a mixed population of several microorganisms comprising such probes together with suitable materials for pretreating the sample and/or suitable materials for carrying out hybridization and/or suitable materials for analysis of the result of the hybridization.</p

Methods and materials for determining relative abundance of microorganisms in mixed populations

The present invention relates to a method for determining the relative abundance of individual species or lower phylogenetic subgroups of microorganims in a mixed population of several microorganisms comprising the steps of: 1) providing a set of labelled in situ hybridization cluster oligonucleotide probes; 2) hybridization of said probes with a sample of the mixed population, and 3) quantitative analysis of the number of labelled microorganisms. Further it relates to a method for analyzing dynamics in relative abundance of individual microorganisms in a mixed population. Further it relates to a set of probes which are cluster specific and which are provided with at least one label for use in method of the invention and to a kit of parts for determining the relative abundance of individual species of microorganisms in a mixed population of several microorganisms comprising such probes together with suitable materials for pretreating the sample and/or suitable materials for carrying out hybridization and/or suitable materials for analysis of the result of the hybridization.</p

Detection of the onset of gait initiation using kinematic sensors and EMG in transfemoral amputees

In this study we determined if detection of the onset of gait initiation in transfemoral amputees can be useful for voluntary control of upper leg prostheses. From six transfemoral amputees inertial sensor data and EMG were measured at the prosthetic leg during gait initiation. First, initial movement was detected from the inertial sensor data. Subsequently it was determined whether EMG could predict initial movement before detection based on the inertial sensors with comparable consistency as the inertial sensors. From the inertial sensors the initial movement can be determined. If the prosthetic leg leads, the upper leg accelerometer data was able to detect initial movement best. If the intact leg leads the upper leg gyroscope data performed best. Inertial sensors at the upper leg in general showed detections at the same time or earlier than those at the lower leg. EMG can predict initial movement up to a 138 ms in advance, when the prosthetic leg leads. One subject showed consistent EMG onset up to 248 ms before initial movement in the intact leg leading condition. A new method to detect initial movement from inertial sensors was presented and can be useful for additional prosthetic control. EMG measured at the prosthetic leg can be used for prediction of gait initiation when the prosthetic leg is leading, but for the intact leg leading condition this will not be of additional value

Circular bioeconomy in African food systems : What is the status quo? Insights from Rwanda, DRC, and Ethiopia

Increasing global food insecurity amidst a growing population and diminishing production resources renders the currently dominant linear production model insufficient to combat such challenges. Hence, a circular bioeconomy (CBE) model that ensures more conservative use of resources has become essential. Specifically, a CBE model that focuses on recycling and reusing organic waste is essential to close nutrient loops and establish more resilient rural-urban nexus food systems. However, the CBE status quo in many African food systems is not established. Moreover, scientific evidence on CBE in Africa is almost inexistent, thus limiting policy guidance to achieving circular food systems. Using a sample of about 2,100 farmers and consumers from key food value chains (cassava in Rwanda, coffee in DRC, and bananas in Ethiopia), we explored existing CBE practices; awareness, knowledge, and support for CBE practices; consumers’ opinions on eating foods grown on processed organic waste (CBE fertilizers), and determinants of such opinions. We analysed data in Stata, first descriptively, and then econometrically using the ordered logistic regression, whose proportional odds assumption was violated, thus resorting to the generalized ordered logistic regression. Results show that communities practice aspects of CBE, mainly composting, and are broadly aware, knowledgeable, supportive of CBE practices, and would broadly accept eating foods grown CBE fertilizers. Households with heads that used mobile phones, or whose heads were older, or married, or had a better education and agricultural incomes were more likely to strongly agree that they were knowledgeable and supportive of CBE practices and would eat CBE foods (foods grown on processed organic waste). However, the reverse was true for households that were severely food insecure or lived farther from towns. Rwandan and Ethiopian households compared to DRC were less likely to eat CB foods. Policies to stimulate CBE investments in all three countries were largely absent, and quality scientific evidence to guide their development and implementation is currently insufficient

Rapid identification of lettuce seed germination mutants by bulked segregant analysis and whole genome sequencing.

Lettuce (Lactuca sativa) seeds exhibit thermoinhibition, or failure to complete germination when imbibed at warm temperatures. Chemical mutagenesis was employed to develop lettuce lines that exhibit germination thermotolerance. Two independent thermotolerant lettuce seed mutant lines, TG01 and TG10, were generated through ethyl methanesulfonate mutagenesis. Genetic and physiological analyses indicated that these two mutations were allelic and recessive. To identify the causal gene(s), we applied bulked segregant analysis by whole genome sequencing. For each mutant, bulked DNA samples of segregating thermotolerant (mutant) seeds were sequenced and analyzed for homozygous single-nucleotide polymorphisms. Two independent candidate mutations were identified at different physical positions in the zeaxanthin epoxidase gene (ABSCISIC ACID DEFICIENT 1/ZEAXANTHIN EPOXIDASE, or ABA1/ZEP) in TG01 and TG10. The mutation in TG01 caused an amino acid replacement, whereas the mutation in TG10 resulted in alternative mRNA splicing. Endogenous abscisic acid contents were reduced in both mutants, and expression of the ABA1 gene from wild-type lettuce under its own promoter fully complemented the TG01 mutant. Conventional genetic mapping confirmed that the causal mutations were located near the ZEP/ABA1 gene, but the bulked segregant whole genome sequencing approach more efficiently identified the specific gene responsible for the phenotype

Rapid identification of lettuce seed germination mutants by bulked segregant analysis and whole genome sequencing.

Lettuce (Lactuca sativa) seeds exhibit thermoinhibition, or failure to complete germination when imbibed at warm temperatures. Chemical mutagenesis was employed to develop lettuce lines that exhibit germination thermotolerance. Two independent thermotolerant lettuce seed mutant lines, TG01 and TG10, were generated through ethyl methanesulfonate mutagenesis. Genetic and physiological analyses indicated that these two mutations were allelic and recessive. To identify the causal gene(s), we applied bulked segregant analysis by whole genome sequencing. For each mutant, bulked DNA samples of segregating thermotolerant (mutant) seeds were sequenced and analyzed for homozygous single-nucleotide polymorphisms. Two independent candidate mutations were identified at different physical positions in the zeaxanthin epoxidase gene (ABSCISIC ACID DEFICIENT 1/ZEAXANTHIN EPOXIDASE, or ABA1/ZEP) in TG01 and TG10. The mutation in TG01 caused an amino acid replacement, whereas the mutation in TG10 resulted in alternative mRNA splicing. Endogenous abscisic acid contents were reduced in both mutants, and expression of the ABA1 gene from wild-type lettuce under its own promoter fully complemented the TG01 mutant. Conventional genetic mapping confirmed that the causal mutations were located near the ZEP/ABA1 gene, but the bulked segregant whole genome sequencing approach more efficiently identified the specific gene responsible for the phenotype

Psychologic Distress and Quality of Life After ICU Treatment for Coronavirus Disease 2019: A Multicenter, Observational Cohort Study

To quantify short- and long-term psychologic distress, that is, symptoms of posttraumatic stress disorder, anxiety, and depression, and the health-related quality of life in coronavirus disease 2019 ICU survivors. DESIGN: A prospective, observational cohort study. SETTING: Postcoronavirus disease 2019 clinics of three hospitals in Rotterdam, the Netherlands. PATIENTS: Adult patients admitted for coronavirus disease 2019 to the ICU, who visited the postcoronavirus disease 2019 follow-up clinic. MEASURES AND MAIN RESULTS: The primary outcomes were psychologic distress and overall and mental health-related quality of life, assessed using the Impact of Event Scale-Revised, Hospital Anxiety and Depression Scale, Short-Form 36, and European Quality of Life 5D, 6 weeks, 3 months, and 6 months post hospital discharge. Second, we compared 3-month psychologic and mental health-related quality of life outcomes with a historical critical illness survivor cohort and overall and mental health-related quality of life with the Dutch population. We included 118 patients with a median age of 61 years (95% range, 36-77 yr) of whom 79 (68%) were male. At 6 weeks, 13 patients (23%) reported psychologic distress, copresence of probable psychiatric disorders was common, and no decline in psychologic distress was observed throughout follow-up. Coronavirus disease 2019 patients tend to suffer less from posttraumatic stress disorder and reported less severe symptoms of anxiety (Hospital Anxiety and Depression Scale Anxiety Score: 3 [0-17] vs 5 [0-16]; estimated mean difference 2.3 [95% CI, 0.0-4.7]; p = 0.05) and depression (Hospital Anxiety and Depression Scale Depression Score: 3 [0-15] vs 5 [0-16]; estimated mean difference 2.4 [95% CI, 0.1-2.4]; p = 0.04) than the historical critical illness cohort. Overall and mental health-related quality of life increased over time. Coronavirus disease 2019 ICU survivors reported better mental health-related quality of life than our historical cohort, but overall and mental health-related quality of life was still poorer than the Dutch population. CONCLUSIONS: Psychologic distress was common in coronavirus disease 2019 ICU survivors and remained similar until 6 months after hospital discharge. Health-related quality of life increased over time and was higher than in a historical cohort, but was lower than in the Dutch population. Our findings highlight that coronavirus disease 2019 ICU survivors should be monitored after ICU treatment to detect possible psychologic distress

Effect of intensive care unit-specific virtual reality (ICU-VR) to improve psychological well-being and quality of life in COVID-19 ICU survivors

Background: The SARS-CoV-2 outbreak has resulted in a tremendous increase in hospital and intensive care unit (ICU) admissions all over the world. Patients with severe coronavirus disease 2019 (COVID-19) warranting ICU treatment usually have prolonged mechanical ventilation and are expected to be prone to develop psychological impairments, such as post-traumatic stress disorder (PTSD), anxiety and depression, which negatively impact quality of life. To date, no effective treatment strategy is available. In the current trial, we aim to assess the effect of an ICU-specific virtual reality (ICU-VR) intervention on psychological well-being and quality of life after COVID-19 ICU treatment. Methods: In this multicentre, randomized controlled trial, we aim to examine whether COVID-19-specific ICU-VR, offered 3 months after hospital discharge, improves psychological well-being and quality of life. Secondary objectives are, firstly, to examine the intra-group changes in psychological well-being and quality of life and the inter-group differences in psychological well-being and quality of life during follow-up, up to 12 months after hospital discharge, and secondly, to examine patients’ satisfaction with and rating of ICU care and aftercare and patients’ perspectives on ICU-VR. Eighty adult patients treated for COVID-19 in the mixed-surgical ICUs of four hospitals in Rotterdam, the Netherlands, will be included and randomized (1:1) to either early or late ICU-VR between June 29 and December 31, 2020. Patients randomized to early ICU-VR will receive the ICU-VR intervention during an outpatient clinic visit 3 months after hospital discharge, whereas patients randomized to late ICU-VR will receive ICU-VR 6 months after hospital discharge. Primary outcomes of this study are psychological well-being, assessed using the Impact of Event Scale–Revised (IES-R) and the Hospital Anxiety and Depression Scale (HADS), and quality of life, assessed using the European Quality of Life 5 Dimensions (EQ-5D) and RAND-36 questionnaires, up to 6 months after hospital discharge. Discussion: Currently, an effective treatment for psychological sequelae after ICU treatment for specific illnesses is unavailable. Results from this study will provide insight whether virtual reality is a modality that can be used in ICU aftercare to improve psychological well-being and quality of life, or satisfaction, after ICU treatment for specific illnesses such as COVID-19. Trial registration: This trial has been retrospectively registered on the Netherlands Trial Register on August 14, 2020 (NL8835).</p