Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU)

Purpose Thrombocytopenia (platelet count < 150 × 109/L) is common in intensive care unit (ICU) patients and is likely associated with worse outcomes. In this study we present international contemporary data on thrombocytopenia in ICU patients. Methods We conducted a prospective cohort study in adult ICU patients in 52 ICUs across 10 countries. We assessed frequencies of thrombocytopenia, use of platelet transfusions and clinical outcomes including mortality. We evaluated pre-selected potential risk factors for the development of thrombocytopenia during ICU stay and associations between thrombocytopenia at ICU admission and 90-day mortality using pre-specified logistic regression analyses. Results We analysed 1166 ICU patients; the median age was 63 years and 39.5% were female. Overall, 43.2% (95% confidence interval (CI) 40.4–46.1) had thrombocytopenia; 23.4% (20–26) had thrombocytopenia at ICU admission, and 19.8% (17.6–22.2) developed thrombocytopenia during their ICU stay. Non-AIDS-, non-cancer-related immune deficiency, liver failure, male sex, septic shock, and bleeding at ICU admission were associated with the development of thrombocytopenia during ICU stay. Among patients with thrombocytopenia, 22.6% received platelet transfusion(s), and 64.3% of in-ICU transfusions were prophylactic. Patients with thrombocytopenia had higher occurrences of bleeding and death, fewer days alive without the use of life-support, and fewer days alive and out of hospital. Thrombocytopenia at ICU admission was associated with 90-day mortality (adjusted odds ratio 1.7; 95% CI 1.19–2.42). Conclusion Thrombocytopenia occurred in 43% of critically ill patients and was associated with worse outcomes including increased mortality. Platelet transfusions were given to 23% of patients with thrombocytopenia and most were prophylactic.publishedVersio

Design of self-disinfecting PVC surfaces using the click chemistry

International audienc

Design of bacteria repellent PVC surfaces using the click chemistry

International audienc

Condition-based Maintenance of Overhead Travelling Cranes

The EN-HE group operates more than 350 overhead travelling cranes, requiring a regular maintenance de-fined by CERN Safety Rules (GSI-M-1). An analysis made in 2020 concluded that important savings on preven-tive maintenance could be done by changing the actual strategy based on a fixed periodicity to a strategy based on the usage of each crane. To be able to implement such change, the usage of each crane has to be known and remotely communicated on a daily basis. This prerequisite is being fulfilled thanks to an economic solution based on IoT devices connected to each crane and relying on new LoRa network in surface and the LTE (GSM) network in underground locations. This presentation focuses on the initial context including the financial stakes, the deployed solution based on IoT devices, the challenges, the results obtained and the possible perspectives for a wider usage at CERN

Maintenance Cost Working Group Implementation

The EN department has created a working group to analyse the maintenance activities with an emphasis on cost reduction. This paper reports the main four goals to be reached during the implementation activities of the working group. It shows the approaches followed by each EN group and the associated results. Their specific contexts (technical, organisational...) will be put in perspective. The paper illustrates how consensus was built to deal with the harmonisation of practices and the groups’ particularities. The innovative context of this working group influenced the specifications writing for the services contracts to be renewed. With the experience gained, it is clarified how these goals could become processes

Acquisition des matières premières lithiques et territoires dans la moitié sud de la France à la fin du Paléolithique supérieur, communication présentée dans le cadre de la séance SPF de Strasbourg

International audienc

Acquisition des matières premières lithiques et territoires dans la moitié sud de la France à la fin du Paléolithique supérieur, communication présentée dans le cadre de la séance SPF de Strasbourg

International audienc

Acquisition des matières premières lithiques et territoires dans la moitié sud de la France à la fin du Paléolithique supérieur, communication présentée dans le cadre de la séance SPF de Strasbourg

International audienc

Maintenance Cost Working Group Results

For the proper functioning of Accelerators, Experimental areas, Workshops and other CERN facilities, maintenance of infrastructure is one of the main activities in the EN department. Over the last ten years, the resources and budgets allocated to maintenance were decreased while the pool was increased. The EN groups have adapted maintenance plan to cope with this situation. In 2021 a working group was launched to analyse the existing situation and propose a common approach. This paper will present the results of this working group, starting with an inventory of the existing practices in each EN group including a comparison with applicable laws, manufacturers requirements and a benchmark with other Organisations. Another main achievement of the working group was the definition of the Key Performance Indicators to better monitor the evolution of the equipment condition as well as performance of maintenance. A common definition of criticality, maintenance annual report and CMMS guidelines was also part of the results obtained by the working grou

Quels territoires en préhistoire ? Une analyse par réseaux de lieux pour penser l’espace au Paléolithique supérieur

National audienceAddressed from the perspective of where they were obtained, lithic raw materials found in archaeological sites carry and contain data of geographical value. Thus, they are privileged witnesses to human movements in prehistoric times. By coupling the results of technological analyses with multi-scale diagnostic methodologies based on the principle of an evolutionary chain set up by some of us and recently optimised, today it is possible to evaluate the acquisition modes for raw materials, the manner of their introduction into sites, and better understand the prehistoric management of mineralogical resources. This techno-economic approach, becoming ever more precise, is being facilitated thanks to the results from a consortium of researchers interconnected in the `Reseau de lithotheques' and `Silex' projects. Detailed petro-archaeological studies of an archaeological series make it possible to identify litho-spaces that are not images of territories. Indeed, territories are not only shaped by economic constraints (where space is the basis of a society), but they are the way in which collectives build themselves by conferring meaning on places of singular use linked to each other by a complex network of values. Yet, the symbolic dimension of spaces is a central element in the cultural representations that societies have of it. Rather than limiting the analysis of the territories to the scale of a site, which in the context of nomadic societies is contradictory, it seems more efficient to analyse the relationships between places (i.e. networks of places). Taking as an example current or recently nomadic peoples - for whom networks in which materials circulate correspond to networks of places - we propose a method based on a concept of network analysis in order to escape the point of view based on single sites, and offer an approach to determining prehistoric territories. This side-step not only questions the spatial extent of archaeological records, but also their coherence as chrono-anthropological entities