Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Health as Human Capital in Entrepreneurship: Individual, Extension, and Substitution Effects on Entrepreneurial Success

This study investigates how entrepreneurial health and spousal health influence monetary and non-monetary entrepreneurial success. Drawing on human capital theory in combination with a family embeddedness perspective on entrepreneurship and applying actor–partner interdependence models to longitudinal data, we conclude that overall spousal health constitutes an important extension of entrepreneurs’ human capital influencing entrepreneurial success. This study further contributes to human capital research by offering interesting insights and novel theorizing on substitution effects for different types of entrepreneurial human capital, and adds to a biological perspective on entrepreneurship by considering the differential role of biological sex in the health–success relationship

The Role of Emotional Intelligence in Entrepreneurs' Perceptions of Success: An Exploratory Study

This study contributes to the entrepreneurship literature by introducing emotional intelligence (EI) as an additional factor that explains how entrepreneurs perceive their own success. Using survey data from a sample of Dutch entrepreneurs, we find that emotionally intelligent entrepreneurs are more likely to judge positively their entrepreneurial success in terms of: employee satisfaction, social responsibility, personal satisfaction, customer satisfaction and business performance. Furthermore, not all EI dimensions are equally relevant to explain self-perceived success. In this respect, we find that the (self-perceived) ability to regulate emotions of other people is most strongly linked to entrepreneurial success

Toward a complex adaptive system: The case of the Zhongguancun entrepreneurship ecosystem

Viable entrepreneurship ecosystems (EEs), which provide sustainable competitive advantages to innovative regions, have become increasingly important for producing high-impact entrepreneurial firms. However, little is known about the complexity nature that viable EEs uncover under specific regional entrepreneurial contexts. By integrating the EE literature and complex adaptive system (CAS) theory, we conducted a case study on the Zhongguancun EE in China. We demonstrate six interrelated complexity properties of a viable EE: a large number of self-organized agents, nonlinear interactions, (in)sensitivity to initial conditions, adaptation to the environment, emergence of successful entrepreneurial firms, and coevolution. Moreover, the integration of these six complexity properties offers an overarching understanding of how the Zhongguancun EE maintained its viability over time. We contribute to the EE literature by developing a more nuanced complexity-based understanding of a viable EE and extend CAS theory at the ecosystem level by highlighting an EE's adaptive process to maintain its viability