On interpreting Fuzzy IF-THEN rule bases by concepts of functional analysis

Starting with ZADEH's fundamental paper 'The Calculus of Fuzzy IF-THEN Rules' we mention five possible interpretations of a Fuzzy IF-THEN Rule Base. The interpretation of a given Fuzzy IF-THEN Rule Base strongly depends on the area where it is to be applied. In the paper presented we restrict this area to fuzzy control and approximate reasoning. Consequently, we interpret a Fuzzy IF-THEN Rule Base as a system of functional equations for determining a special functional operator. Then using the concepts of functional analysis and metric spaces we introduce the principles FATI and FITA and study their correctness and equivalence. (orig.)SIGLEAvailable from TIB Hannover: RR 8071(98-19)+a / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman

General practitioners’ views and experiences in caring for patients after sepsis: a qualitative interview study

Background Patients surviving critical illnesses, such as sepsis, often suffer from long-term complications. After discharge from hospital, most patients are treated in primary care. Little is known how general practitioners (GPs) perform critical illness aftercare and how it can be improved. Within a randomised controlled trial, an outreach training programme has been developed and applied.Objectives The aim of this study is to describe GPs’ views and experiences of caring for postsepsis patients and of participating a specific outreach training.Design Semistructured qualitative interviews.Setting 14 primary care practices in the metropolitan area of Berlin, Germany.Participants 14 GPs who had participated in a structured sepsis aftercare programme in primary care.Results Themes identified in sepsis aftercare were: continuity of care and good relationship with patients, GP’s experiences during their patient’s critical illness and impact of persisting symptoms. An outreach education as part of the intervention was considered by the GPs to be acceptable, helpful to improve knowledge of the management of postintensive care complications and useful for sepsis aftercare in daily practice.Conclusions GPs provide continuity of care to patients surviving sepsis. Better communication at the intensive care unit–GP interface and training in management of long-term complications of sepsis may be helpful to improve sepsis aftercare.Trial registration number ISRCTN61744782

Randomized controlled multicentre study of albumin replacement therapy in septic shock (ARISS): protocol for a randomized controlled trial

Background!#!Albumin is a key regulator of fluid distribution within the extracellular space and has several properties beyond its oncotic activity. The accumulating evidence suggests that supplementation of albumin may provide survival advantages only when the insult is severe as in patients with septic shock.!##!Methods/design!#!The randomized controlled multicentre study of albumin replacement therapy in septic shock (ARISS) investigates whether the replacement with albumin and the maintenance of its serum levels of at least 30 g/l for 28 days improve survival in patients with septic shock compared to resuscitation and volume maintenance without albumin. Adult patients (≥ 18 years) with septic shock are randomly assigned within a maximum of 24 h after the onset of septic shock after obtaining informed consents to treatment or control groups. Patients assigned to the treatment group receive a 60-g loading dose of human albumin 20% over 2-3 h. Serum albumin levels are maintained at least at 30 g/l in the ICU for a maximum of 28 days following randomization using 40-80 g human albumin 20% infusion. The control group is treated according to the usual practice with crystalloids as the first choice for the resuscitation and maintenance phase of septic shock. The primary endpoint is 90 days mortality and secondary endpoints include 28-day, 60-day, ICU, and in-hospital mortality, organ dysfunction/failure, total amount of fluid administration and total fluid balance in the ICU, and lengths of ICU and hospital stay. In total, 1412 patients need to be analysed, 706 per group. For the sample size estimation, a 15% reduction in 90-day mortality is assumed, i.e. an absolute reduction of 7.5% points to 42.5% (relative risk 1.18). Assuming a dropout rate of 15%, a total of 1662 patients need to be allocated.!##!Discussion!#!The results of the clinical trial may influence the treatment of patients with septic shock. The expected improvement in patient survival may result in a reduction in the resources currently used in the treatment of these patients and in the socioeconomic burden of this disease.!##!Trial registration!#!ClinicalTrials.gov NCT03869385 . Registration on 18 July 2019. Protocol version: Final 3.0

Erratum to: The Intensive Care Global Study on Severe Acute Respiratory Infection (ICâGLOSSARI): a multicenter, multinational, 14-day inception cohort study (Intensive Care Medicine, (2016), 42, 5, (953), 10.1007/s00134-016-4317-4)

In both the original publication (DOI 10.1007/s00134-015-4206-2) and the first erratum (DOI 10.1007/s00134-016-4317-4), the members of the IC-GLOSSARI Investigators and the ESICM Trials Group were provided in such a way that they could not be indexed as collaborators on PubMed. The publisher apologizes for these errors and is pleased to list the members of the groups here: (Table presented.)