Diabetes mellitus is associated with 90-day mortality in old critically ill COVID-19 patients: a multicenter prospective observational cohort study.

BACKGROUND: Several studies have found an association between diabetes mellitus, disease severity and outcome in COVID-19 patients. Old critically ill patients are particularly at risk. This study aimed to investigate the impact of diabetes mellitus on 90-day mortality in a high-risk cohort of critically ill patients over 70 years of age. METHODS: This multicentre international prospective cohort study was performed in 151 ICUs across 26 countries. We included patients ≥ 70 years of age with a confirmed SARS-CoV-2 infection admitted to the intensive care unit from 19th March 2020 through 15th July 2021. Patients were categorized into two groups according to the presence of diabetes mellitus. Primary outcome was 90-day mortality. Kaplan-Meier overall survival curves until day 90 were analysed and compared using the log-rank test. Mixed-effect Weibull regression models were computed to investigate the influence of diabetes mellitus on 90-day mortality. RESULTS: This study included 3420 patients with a median age of 76 years were included. Among these, 37.3% (n = 1277) had a history of diabetes mellitus. Patients with diabetes showed higher rates of frailty (32% vs. 18%) and several comorbidities including chronic heart failure (20% vs. 11%), hypertension (79% vs. 59%) and chronic kidney disease (25% vs. 11%), but not of pulmonary comorbidities (22% vs. 22%). The 90-day mortality was significantly higher in patients with diabetes than those without diabetes (64% vs. 56%, p < 0.001). The association of diabetes and 90-day mortality remained significant (HR 1.18 [1.06-1.31], p = 0.003) after adjustment for age, sex, SOFA-score and other comorbidities in a Weibull regression analysis. CONCLUSION: Diabetes mellitus was a relevant risk factor for 90-day mortality in old critically ill patients with COVID-19. STUDY REGISTRATION: NCT04321265, registered March 19th, 2020

Ultrasensitive Molecule Detection Based on Infrared Metamaterial Absorber with Vertical Nanogap

Surface-enhanced infrared absorption (SEIRA) spectroscopy is a powerful methodology for sensing and identifying small quantities of analyte molecules via coupling between molecular vibrations and an enhanced near-field induced in engineered structures. A metamaterial absorber (MA) is proposed as an efficient SEIRA platform; however, its efficiency is limited because it requires the appropriate insulator thickness and has a limited accessible area for sensing. SEIRA spectroscopy is proposed using an MA with a 10 nm thick vertical nanogap, and a record-high reflection difference SEIRA signal of 36% is experimentally achieved using a 1-octadecanethiol monolayer target molecule. Theoretical and experimental comparative studies are conducted using MAs with three different vertical nanogaps. The MAs with a vertical nanogap are processed using nanoimprint lithography and isotropic dry etching, which allow cost-effective large-area patterning and mass production. The proposed structure may provide promising routes for ultrasensitive sensing and detection applications

Polarization-dependent vibrational shifts on dielectric substrates

The interaction of light with matter at surfaces of dielectrics strongly depends on polarization. Here, we present the first infrared spectroscopic evidence for significant polarization effects in the spectroscopic detection of adsorbate vibrational frequencies. In addition to much larger peak intensities for p-polarized light relative to s-polarization, a small but distinct blue shift was identified for CO adsorbed at the surfaces of two prototype dielectric substrates, CeO$_{2}$(111) and CaCO$_{3}$(10.4). A simulation using a layer model yields very good agreement with experiment

Beer's Law‐Why Integrated Absorbance Depends Linearly on Concentration

As derived by Max Planck in 1903 from dispersion theory, Beer's law has a fundamental limitation. The concentration dependence of absorbance can deviate from linearity, even in the absence of any interactions or instrumental nonlinearities. Integrated absorbance, not peak absorbance, depends linearly on concentration. The numerical integration of the absorbance leads to maximum deviations from linearity of less than 0.1 %. This deviation is a consequence of a sum rule that was derived from the Kramers-Kronig relations at a time when the fundamental limitation of Beer's law was no longer mentioned in the literature. This sum rule also links concentration to (classical) oscillator strengths and thereby enables the use of dispersion analysis to determine the concentration directly from transmittance and reflectance measurements. Thus, concentration analysis of complex samples, such as layered and/or anisotropic materials, in which Beer's law cannot be applied, can be achieved using dispersion analysis. ©2019 The Authors. Published by Wiley-VCH Verlag GmbH & Co. KGaA

The Bouguer‐Beer‐Lambert Law: Shining Light on the Obscure

The Beer-Lambert law is unquestionably the most important law in optical spectroscopy and indispensable for the qualitative and quantitative interpretation of spectroscopic data. As such, every spectroscopist should know its limits and potential pitfalls, arising from its application, by heart. It is the goal of this work to review these limits and pitfalls, as well as to provide solutions and explanations to guide the reader. This guidance will allow a deeper understanding of spectral features, which cannot be explained by the Beer-Lambert law, because they arise from electromagnetic effects/the wave nature of light. Those features include band shifts and intensity changes based exclusively upon optical conditions, i. e. the method chosen to record the spectra, the substrate and the form of the sample. As such, the review will be an essential tool towards a full understanding of optical spectra and their quantitative interpretation based not only on oscillator positions, but also on their strengths and damping constants

Beyond Beer's Law: Revisiting the Lorentz‐Lorenz Equation

In this contribution we show how the Lorentz-Lorenz and the Clausius-Mosotti equations are related to Beer's law. Accordingly, the linear concentration dependence of absorbance is a consequence of neglecting the difference between the local and the applied electric field. Additionally, it is necessary to assume that the absorption index and the related refractive index change is small. By connecting the Lorentz-Lorenz equations with dispersion theory, it becomes obvious that the oscillators are coupled via the local field. We investigate this coupling with numerical examples and show that, as a consequence, the integrated absorbance of a single band is in general no longer linearly depending on the concentration. In practice, the deviations from Beer's law usually do not set in before the density reaches about one tenth of that of condensed matter. For solutions, the Lorentz-Lorenz equations predict a strong coupling also between the oscillators of solute and solvent. In particular, in the infrared spectral region, the absorption coefficients are prognosticated to be much higher due to this coupling compared to those in the gas phase. © 2020 The Authors. Published by Wiley-VCH Verlag GmbH & Co. KGaA

Involvement of radiologists in oncologic multidisciplinary team meetings: an international survey by the European Society of Oncologic Imaging

Objectives: Multidisciplinary tumour boards (MTBs) play an increasingly important role in managing cancer patients from diagnosis to treatment. However, many problems arise around the organisation of MTBs, both in terms of organisation-administration and time management. In this context, the European Society of Oncologic Imaging (ESOI) conducted a survey among its members, aimed at assessing the quality and amount of involvement of radiologists in MTBs, their role in it and related issues. Methods: All members were invited to fill in a questionnaire consisting of 15 questions with both open and multiple-choice answers. Simple descriptive analyses and graphs were performed. Results: A total of 292 ESOI members in full standing for the year 2018 joined the survey. Most respondents (89%) declared to attend MT-Bs, but only 114 respondents (43.9%) review over 70% of exams prior to MTB meetings, mainly due to lack of time due to a busy schedule for imaging and reporting (46.6%). Perceived benefits (i.e. surgical and histological feedback (86.9%), improved knowledge of cancer treatment (82.7%) and better interaction between radiologists and referring clinicians for discussing rare cases (56.9%)) and issues (i.e. attending MTB meetings during regular working hours (71.9%) and lack of accreditation with continuing medical education (CME) (85%)) are reported. Conclusions: Despite the value and benefits of radiologists’ participation in MTBs, issues like improper preparation due to a busy schedule and no counterpart in CME accreditation require efforts to improve the role of radiologists for a better patient care. Key Points: • Most radiologists attend multidisciplinary tumour boards, but less than half of them review images in advance, mostly due to time constraints. • Feedback about radiological diagnoses, improved knowledge of cancer treatment and interaction with referring clinicians are perceived as major benefits. • Concerns were expressed about scheduling multidisciplinary tumour boards during regular working hours and lack of accreditation with continuing medical education. © 2020, The Author(s)