suPAR as a prognostic biomarker in sepsis

Sepsis is the clinical syndrome derived from the host response to an infection and severe sepsis is the leading cause of death in critically ill patients. Several biomarkers have been tested for use in diagnosis and prognostication in patients with sepsis. Soluble urokinase-type plasminogen activator receptor (suPAR) levels are increased in various infectious diseases, in the blood and also in other tissues. However, the diagnostic value of suPAR in sepsis has not been well defined, especially compared to other more established biomarkers, such as C-reactive protein (CRP) and procalcitonin (PCT). On the other hand, suPAR levels have been shown to predict outcome in various kinds of bacteremia and recent data suggest they may have predictive value, similar to that of severity scores, in critically ill patients. This narrative review provides a descriptive overview of the clinical value of this biomarker in the diagnosis, prognosis and therapeutic guidance of sepsis

Leptin, IL-6, and suPAR reflect distinct inflammatory changes associated with adiposity, lipodystrophy and low muscle mass in HIV-infected patients and controls

BACKGROUND: HIV-infected patients could exhibit accelerated ageing, since age-associated complications like sarcopenia; increased inflammation; lipodystrophy with loss of subcutaneous adipose tissue and/or gain of visceral adipose tissue (VAT); and cardiovascular disease occur at an earlier age. Inflammation is involved in age-associated complications. However, it is not understood whether it is the same inflammatory changes that are involved in the various ageing-associated complications. Our objective was to study whether leptin, interleukin 6 (IL-6), and soluble urokinase plasminogen activator receptor (suPAR) were associated distinctively with adiposity, lipodystrophy and sarcopenia, in HIV-infected patients and healthy Controls. RESULTS: Systemic leptin levels were significantly higher in patients with lipodystrophy than without, whereas there was no difference in IL-6 or suPAR levels. Leptin was significantly positively associated with fat mass index (FMI) and abdominal VAT, but not with lean mass index (LMI). IL-6 was significantly associated with both FMI and VAT, and low LMI. High suPAR was associated with low LMI, and weakly with high FMI and VAT. CONCLUSIONS: Leptin reflected adiposity- and lipodystrophy-related inflammation, but not sarcopenia. IL-6 reflected both adiposity-, but also sarcopenia-related inflammation; and suPAR was a marker of sarcopenia-related inflammation. Our results indicate that different inflammatory processes can be active simultaneously contributing to the systemic low grade inflammatory state. Identifying major contributors to circulating leptin, IL-6, and suPAR levels could levels could therefore improve our understanding of which inflammatory processes are involved in the various age-related complications

Introduction of a prognostic biomarker to strengthen risk stratification of acutely admitted patients: rationale and design of the TRIAGE III cluster randomized interventional trial

BACKGROUND: Several biomarkers have shown to carry prognostic value beyond current triage algorithms and may aid in initial risk stratification of patients in the emergency department (ED). It has yet to be established if information provided by biomarkers can be used to prevent serious complications or deaths. Our aim is to determine whether measurement of the blood level of the biomarker soluble urokinase plasminogen activator receptor (suPAR) can enhance early risk stratification leading to reduced mortality, lower rate of complications, and improved patient flow in acutely admitted adult patients at the ED. The main hypothesis is that the availability of suPAR can reduce all-cause mortality, assessed at least 10 months after admission, by drawing attention towards patients with an unrecognized high risk, leading to improved diagnostics and treatment. METHODS: The study is designed as a cross-over cluster randomized interventional trial. SuPAR is measured within 2 h after admission and immediately reported to the treating physicians in the ED. All ED physicians are educated in the prognostic capabilities of suPAR prior to the inclusion period. The inclusion period began January 11(th) 2016 and ends June 6(th) 2016. The study aims to include 10.000 patients in both the interventional and control arm. The results will be presented in 2017. DISCUSSION: The present article aims to describe the design and rationale of the TRIAGE III study that will investigate whether the availability of prognostic information can improve outcome in acutely admitted patients. This might have an impact on health care organization and decision-making. TRIAL REGISTRATION: The trial is registered at clinicaltrials.gov (ID NCT02643459, November 13, 2015) and at the Danish Data Protection agency (ID HGH-2015-042 I-Suite no. 04087)

Transnational Chinese. Fujianese Migrants in Europe

This book presents the findings of a three-year research project on Fujianese Migration to Europe. The new Chinese migration of which the Fujianese are a prominent part is one of the most visible exponents of the increasing globalization of China. The book investigates the global nature of this migration by focusing on one of the fastest growing groups of new Chinese international migrants. It specifically focuses on the landing of Fujianese migrants in Europe, where a broad range of immigration regimes has provided various incentives and disincentives that have influenced their migratory pattens across the continent. Applying intensive, multisited fieldwork research in Italy, Hungary and the United Kingdom, as well as sending areas in Fujian, the book investigates the origins and mechaniscs of Fujianese migration, the work and life of Fujianese migrants in Europe, and the many transnational spaces that connect Fujianese across Europe, The United States and China

At the Margins of the Chinese World System : the Fuzhou Diaspora in Europe, 1999-2001

Abstract copyright UK Data Service and data collection copyright owner.Beginning in January 1999, this project started by gathering basic information on immigration, through-migration and employment patterns in selected European countries (Britain, Germany, France, the Netherlands, Italy, Spain, Hungary, Romania and Russia). Subsequently, exploratory research in Fujian province was carried out, including a survey conducted in Mingxi village, the summarised results of which are included in this data collection. During the second phase of the research from September 1999 until April 2001, the project focused on three countries in Europe (Britain, Hungary and Italy) selected on the basis of the exploratory research of the first phase. Interviews were conducted with persons of Fujianese origin living in these countries, the transcripts of which form the bulk of the data collection. Some interviews were also conducted with persons resident in Germany and the USA. Britain, Hungary and Italy occupy a prominent place on the Fujianese map of Europe. Britain, with the oldest and largest of the Chinese communities, became the destination of choice to many Fujianese in the 1990s. Its close links with other Anglophone countries that are major destinations for Fujianese migrants, such as the US and Australia, also ensured its popularity. Hungary, a gateway into southern and western Europe, occupies a pivotal place in the exploration of eastern Europe by Chinese migrants. Especially in the wake of the fall of the Soviet bloc in 1989-1990. Italy became the main Chinese destination country in southern Europe in the 1980s, also attracting many Fujianese in the 1990s. Its current transition to a much more restrictive 'northern European' immigration regime provides a template for developments elsewhere in what, to Chinese migrants, is the European periphery in the future. Main Topics:Topics covered in the interviews include: personal and family background, migrations within China, time and direction of migration(s) and decision making, development of occupation and/or entrepreneurship after migration, economic situation over time, employment patterns, distribution of family members abroad and family migration strategies, contacts with family members and friends abroad, boundaries of social space and identity, remittances to family at home and evaluation of the impact of migration. Reading notes collected by the researchers are also included in the data collection, which cover relevant documents, newspapers and secondary literature. They form a useful background to the project and provide further information on Fujianese immigration issues.<br

At the Margins of the Chinese World System : the Fuzhou Diaspora in Europe, 1999-2001

Abstract copyright UK Data Service and data collection copyright owner.Beginning in January 1999, this project started by gathering basic information on immigration, through-migration and employment patterns in selected European countries (Britain, Germany, France, the Netherlands, Italy, Spain, Hungary, Romania and Russia). Subsequently, exploratory research in Fujian province was carried out, including a survey conducted in Mingxi village, the summarised results of which are included in this data collection. During the second phase of the research from September 1999 until April 2001, the project focused on three countries in Europe (Britain, Hungary and Italy) selected on the basis of the exploratory research of the first phase. Interviews were conducted with persons of Fujianese origin living in these countries, the transcripts of which form the bulk of the data collection. Some interviews were also conducted with persons resident in Germany and the USA. Britain, Hungary and Italy occupy a prominent place on the Fujianese map of Europe. Britain, with the oldest and largest of the Chinese communities, became the destination of choice to many Fujianese in the 1990s. Its close links with other Anglophone countries that are major destinations for Fujianese migrants, such as the US and Australia, also ensured its popularity. Hungary, a gateway into southern and western Europe, occupies a pivotal place in the exploration of eastern Europe by Chinese migrants. Especially in the wake of the fall of the Soviet bloc in 1989-1990. Italy became the main Chinese destination country in southern Europe in the 1980s, also attracting many Fujianese in the 1990s. Its current transition to a much more restrictive 'northern European' immigration regime provides a template for developments elsewhere in what, to Chinese migrants, is the European periphery in the future. Main Topics:Topics covered in the interviews include: personal and family background, migrations within China, time and direction of migration(s) and decision making, development of occupation and/or entrepreneurship after migration, economic situation over time, employment patterns, distribution of family members abroad and family migration strategies, contacts with family members and friends abroad, boundaries of social space and identity, remittances to family at home and evaluation of the impact of migration. Reading notes collected by the researchers are also included in the data collection, which cover relevant documents, newspapers and secondary literature. They form a useful background to the project and provide further information on Fujianese immigration issues.<br