Model for predicting short-term mortality of severe sepsis

International audienceABSTRACT: INTRODUCTION: To establish a prognostic model for predicting 14-day mortality in ICU patients with severe sepsis overall and according to place of infection acquisition and to sepsis episode number. METHODS: In this prospective multicentre observational study on a multicentre database (OUTCOMEREA) including data from 12 ICUs, 2268 patients with 2737 episodes of severe sepsis were randomly divided into a training cohort (n=1458) and a validation cohort (n=810). Up to four consecutive severe sepsis episodes per patient occurring within the first 28 ICU days were included. We developed a prognostic model for predicting death within 14 days after each episode, based on patient data available at sepsis onset. RESULTS: Independent predictors of death were logistic organ dysfunction (OR, 1.22 per point, p<10-4), septic shock (OR, 1.40; p=0.01), rank of severe sepsis episode (1 reference, 2: OR, 1.26; p=0.10 [greater than or equal to]3: OR, 2.64 ;10-3), multiple sources of infection (OR; 1.45, p=0.03), simplified acute physiology score II (OR, 1.02 per point; p<10-4), McCabe score ([greater than or equal to]2)(OR, 1.96; p<10-4), and number of chronic co-morbidities (1: OR, 1.75; p=10-3, [greater than or equal to]2: OR, 2.24, p= 10-3). Validity of the model was good in whole cohorts (AUC-ROC, 0.76; 95%CI [0.74; 0.79] and HL Chi-square: 15.3 (p=0.06) for all episodes pooled). CONCLUSIONS: In ICU patients, a prognostic model based on a few easily obtained variables is effective in predicting death within 14 days after the first to fourth episode of severe sepsis complicating community-, hospital-, or ICU-acquired infection

Global maps of soil temperature

Research in global change ecology relies heavily on global climatic grids derived from estimates of air temperature in open areas at around 2 m above the ground. These climatic grids do not reflect conditions below vegetation canopies and near the ground surface, where critical ecosystem functions occur and most terrestrial species reside. Here, we provide global maps of soil temperature and bioclimatic variables at a 1-km² resolution for 0–5 and 5–15 cm soil depth. These maps were created by calculating the difference (i.e., offset) between in-situ soil temperature measurements, based on time series from over 1200 1-km² pixels (summarized from 8500 unique temperature sensors) across all the world’s major terrestrial biomes, and coarse-grained air temperature estimates from ERA5-Land (an atmospheric reanalysis by the European Centre for Medium-Range Weather Forecasts). We show that mean annual soil temperature differs markedly from the corresponding gridded air temperature, by up to 10°C (mean = 3.0 ± 2.1°C), with substantial variation across biomes and seasons. Over the year, soils in cold and/or dry biomes are substantially warmer (+3.6 ± 2.3°C) than gridded air temperature, whereas soils in warm and humid environments are on average slightly cooler (-0.7 ± 2.3°C). The observed substantial and biome-specific offsets emphasize that the projected impacts of climate and climate change on near-surface biodiversity and ecosystem functioning are inaccurately assessed when air rather than soil temperature is used, especially in cold environments. The global soil-related bioclimatic variables provided here are an important step forward for any application in ecology and related disciplines. Nevertheless, we highlight the need to fill remaining geographic gaps by collecting more in-situ measurements of microclimate conditions to further enhance the spatiotemporal resolution of global soil temperature products for ecological applications

Global maps of soil temperature

Research in global change ecology relies heavily on global climatic grids derived from estimates of air temperature in open areas at around 2 m above the ground. These climatic grids do not reflect conditions below vegetation canopies and near the ground surface, where critical ecosystem functions occur and most terrestrial species reside. Here, we provide global maps of soil temperature and bioclimatic variables at a 1-km2 resolution for 0–5 and 5–15 cm soil depth. These maps were created by calculating the difference (i.e. offset) between in situ soil temperature measurements, based on time series from over 1200 1-km2 pixels (summarized from 8519 unique temperature sensors) across all the world\u27s major terrestrial biomes, and coarse-grained air temperature estimates from ERA5-Land (an atmospheric reanalysis by the European Centre for Medium-Range Weather Forecasts). We show that mean annual soil temperature differs markedly from the corresponding gridded air temperature, by up to 10°C (mean = 3.0 ± 2.1°C), with substantial variation across biomes and seasons. Over the year, soils in cold and/or dry biomes are substantially warmer (+3.6 ± 2.3°C) than gridded air temperature, whereas soils in warm and humid environments are on average slightly cooler (−0.7 ± 2.3°C). The observed substantial and biome-specific offsets emphasize that the projected impacts of climate and climate change on near-surface biodiversity and ecosystem functioning are inaccurately assessed when air rather than soil temperature is used, especially in cold environments. The global soil-related bioclimatic variables provided here are an important step forward for any application in ecology and related disciplines. Nevertheless, we highlight the need to fill remaining geographic gaps by collecting more in situ measurements of microclimate conditions to further enhance the spatiotemporal resolution of global soil temperature products for ecological applications

Global maps of soil temperature.

Research in global change ecology relies heavily on global climatic grids derived from estimates of air temperature in open areas at around 2 m above the ground. These climatic grids do not reflect conditions below vegetation canopies and near the ground surface, where critical ecosystem functions occur and most terrestrial species reside. Here, we provide global maps of soil temperature and bioclimatic variables at a 1-km2 resolution for 0-5 and 5-15 cm soil depth. These maps were created by calculating the difference (i.e. offset) between in situ soil temperature measurements, based on time series from over 1200 1-km2 pixels (summarized from 8519 unique temperature sensors) across all the world's major terrestrial biomes, and coarse-grained air temperature estimates from ERA5-Land (an atmospheric reanalysis by the European Centre for Medium-Range Weather Forecasts). We show that mean annual soil temperature differs markedly from the corresponding gridded air temperature, by up to 10°C (mean = 3.0 ± 2.1°C), with substantial variation across biomes and seasons. Over the year, soils in cold and/or dry biomes are substantially warmer (+3.6 ± 2.3°C) than gridded air temperature, whereas soils in warm and humid environments are on average slightly cooler (-0.7 ± 2.3°C). The observed substantial and biome-specific offsets emphasize that the projected impacts of climate and climate change on near-surface biodiversity and ecosystem functioning are inaccurately assessed when air rather than soil temperature is used, especially in cold environments. The global soil-related bioclimatic variables provided here are an important step forward for any application in ecology and related disciplines. Nevertheless, we highlight the need to fill remaining geographic gaps by collecting more in situ measurements of microclimate conditions to further enhance the spatiotemporal resolution of global soil temperature products for ecological applications

Effects of Circular DNA Length on Transfection Efficiency by Electroporation into HeLa Cells.

The ability to produce extremely small and circular supercoiled vectors has opened new territory for improving non-viral gene therapy vectors. In this work, we compared transfection of supercoiled DNA vectors ranging from 383 to 4,548 bp, each encoding shRNA against GFP under control of the H1 promoter. We assessed knockdown of GFP by electroporation into HeLa cells. All of our vectors entered cells in comparable numbers when electroporated with equal moles of DNA. Despite similar cell entry, we found length-dependent differences in how efficiently the vectors knocked down GFP. As vector length increased up to 1,869 bp, GFP knockdown efficiency per mole of transfected DNA increased. From 1,869 to 4,257 bp, GFP knockdown efficiency per mole was steady, then decreased with increasing vector length. In comparing GFP knockdown with equal masses of vectors, we found that the shorter vectors transfect more efficiently per nanogram of DNA transfected. Our results rule out cell entry and DNA mass as determining factors for gene knockdown efficiency via electroporation. The length-dependent effects we have uncovered are likely explained by differences in nuclear translocation or transcription. These data add an important step towards clinical applications of non-viral vector delivery

Práctica Médica Sist. Nervioso y Tegumentario - ME139 201702

Curso de especialidad, de la carrera de medicina, de carácter teórico- práctico del ciclo 2 en el que los estudiantes al establecer una buena relación con el paciente y/o familiar realizan la anamnesis, que es una entrevista dirigida al problema de salud que presenta el paciente, realizan el examen físico e integra conocimientos que servirán para establecer un diagnostico por síndromes o problemas del sistema nerviosos y tegumentario. El curso de Práctica Médica Sistema Nervioso y tegumentario busca desarrollar la competencia general de ciudadanía (nivel 1) y las competencias específicas de práctica clínica-diagnóstico (nivel 1) y profesionalismosentido ético y legal y responsabilidad profesional(nivel 1), tiene el prerrequisito del curso de Fundamentos de la Salud. La elaboración de una historia clínica orientada por problemas permitirá al estudiante, plantear un adecuado plan de trabajo y terapéutico para su paciente

Prác. Méd. Sist. Endocrino, Reproductor y Excretor - ME149 201702

Curso de especialidad, de la carrera de medicina, de carácter teórico- práctico del ciclo 4, en el que los estudiantes al establecer una buena relación con el paciente y/o familiar realizan la anamnesis, que es una entrevista dirigida al problema de salud que presenta el paciente, realizan el examen físico e integran conocimientos que servirán para establecer un diagnostico por síndromes o problemas endocrino, reproductor y excretor. El curso de Práctica Médica Sistema Endocrino, Reproductor y Excretor busca desarrollar la competencia general de comunicación escrita (nivel 1) y de ciudadanía (nivel 1) y la competencia específica de práctica clínica-diagnóstico (nivel 1). La elaboración de una historia clínica orientada por problemas permitirá al estudiante en el futuro, plantear un adecuado plan de trabajo y terapéutico para su paciente

Effect of GFP knockdown as a function of DNA concentration.

<p>GFP knockdown was measured using a variety of DNA concentrations for each of the eight DNA vectors. Cells were analyzed using flow cytometry 48 hours post-transfection. The data were plotted either comparing the mass (A) or the number of molecules (B) of each of the different DNA vector lengths. Each panel shows the percentage of cells where GFP has been knocked down relative to the “no DNA” controls.</p