COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

L'effet de la L1 et la L2 sur l'acquisition de français L3

Denne oppgaven ønsket å undersøke hvordan L1 og L2 påvirker innlæring av fransk L3 når det kommer til innlæring av plassering av verb hos norske skoleelever. Dette har blitt gjort ved en litteraturstudie der fire forskningsartikler har blitt sammenlignet. Deltakere, metoder og resultater har blitt sammenlignet og diskutert for å finne ut hvilke antydninger vi kan ha når det gjelder transfer fra norsk L1 og engelsk L2 hos norske skoleelever som lærer fransk. Det ble funnet at man trolig vil se påvirkning fra begge språkene i fransklæringen, særlig fra L1 i tidlig læringsfase, men også fra L2. Jo lenger man har lært fransk, jo mindre påvirkning viser man fra L1 og L2

Direct Search for Low Energy Nuclear Isomeric Transition of Th-229m with TES Detector

Precise knowledge of the energy and lifetime of 229mTh isomeric state has notable importance as a basis for a nuclear clock. Such a clock would be capable to extend precision on the oscillator frequency by up to four orders of magnitude compared to the presently best atomic clocks. However, the technique proposed for the clock requires that the isomeric state energy is accessible with existing laser systems. Previous measurement placed this state at 3c8 eV (150 nm), in the Vacuum Ultra Violet (VUV) range of the electromagnetic spectrum. A precise direct measurement of the energy of this state is necessary to determine whether the nuclear clock can be made using existing laser technology. We are developing a cryogenic microcalorimeter to measure the energy and lifetime of the 229mTh isomeric state directly. The experiment will use a 233U source whose alpha-decay will populate the 229mTh isomeric state with 2% probability. The subsequent decay of 229mTh will be measured by a Transition Edge Sensor (TES) with <1 eV resolution. Such a technique will allow to observe all possible types of decays of 229mTh in the range of energy from 3 to 50 eV and lifetimes >5 microseconds. The single-photon TES has sufficient resolving power combined with high efficiency in the whole energy band for this experiment. Here we present a prototype of TES based on a 200 nm thick iridium-gold (Ir/Au) film which was tested with a pulsed laser source and demonstrated 3c0.8 eV energy resolution and 5.8 \ub1 2.1 \u3bcs signal recovery time

Novel molecular targets for hepatocellular carcinoma

SIMPLE SUMMARY: HCC is a disease with highly unmet medical needs. Specific target antigens for the development of active (vaccine) and/or passive (adoptive T-cell therapy) cancer immunotherapy strategies are needed. The aim of our study was to exploit the high number of data derived from a public dataset to identify HCC-specific overexpressed proteins, leading to potential epitopes recognized by CD8(+) cytotoxic T cells, which may share homology to viral epitopes. Circulating CD8(+) T cells were revealed to be targeting both HCC and viral-related epitopes, suggesting the possible use in HCC-specific immunotherapies. ABSTRACT: Hepatocellular carcinoma (HCC) is the third leading cause of death from cancer globally. Indeed, only a few treatments are available, most of which are effective only for the early stages of the disease. Therefore, there is an urgent needing for potential markers for a specifically targeted therapy. Candidate proteins were selected from datasets of The Human Protein Atlas, in order to identify specific tumor-associated proteins overexpressed in HCC samples associated with poor prognosis. Potential epitopes were predicted from such proteins, and homology with peptides derived from viral proteins was assessed. A multiparametric validation was performed, including recognition by PBMCs from HCC-patients and healthy donors, showing a T-cell cross-reactivity with paired epitopes. These results provide novel HCC-specific tumor-associated antigens (TAAs) for immunotherapeutic anti-HCC strategies potentially able to expand pre-existing virus-specific CD8(+) T cells with superior anticancer efficacy

Cross-reactive CD8⁺ T cell responses to tumor-associated antigens (TAAs) and homologous microbiota-derived antigens (MoAs)

Background We have recently shown extensive sequence and conformational homology between tumor-associated antigens (TAAs) and antigens derived from microorganisms (MoAs). The present study aimed to assess the breadth of T-cell recognition specific to MoAs and the corresponding TAAs in healthy subjects (HS) and patients with cancer (CP). Method A library of &gt; 100 peptide-MHC (pMHC) combinations was used to generate DNA-barcode labelled multimers. Homologous peptides were selected from the Cancer Antigenic Peptide Database, as well as Bacteroidetes/Firmicutes-derived peptides. They were incubated with CD8 + T cells from the peripheral blood of HLA-A*02:01 healthy individuals (n = 10) and cancer patients (n = 16). T cell recognition was identified using tetramer-staining analysis. Cytotoxicity assay was performed using as target cells TAP-deficient T2 cells loaded with MoA or the paired TuA. Results A total of 66 unique pMHC recognized by CD8+ T cells across all groups were identified. Of these, 21 epitopes from microbiota were identified as novel immunological targets. Reactivity against selected TAAs was observed for both HS and CP. pMHC tetramer staining confirmed CD8+ T cell populations cross-reacting with CTA SSX2 and paired microbiota epitopes. Moreover, PBMCs activated with the MoA where shown to release IFNγ as well as to exert cytotoxic activity against cells presenting the paired TuA. Conclusions Several predicted microbiota-derived MoAs are recognized by T cells in HS and CP. Reactivity against TAAs was observed also in HS, primed by the homologous bacterial antigens. CD8+ T cells cross-reacting with MAGE-A1 and paired microbiota epitopes were identified in three subjects. Therefore, the microbiota can elicit an extensive repertoire of natural memory T cells to TAAs, possibly able to control tumor growth (“natural anti-cancer vaccination”). In addition, non-self MoAs can be included in preventive/therapeutic off-the-shelf cancer vaccines with more potent anti-tumor efficacy than those based on TAAs.</p

Tuning the TC of Titanium Thin Films for Transition-Edge Sensors by Annealing in Argon

We present critical temperature measurements of titanium thin films annealed in an argon atmosphere at various temperatures. We are able to depress the TC by up to 200 mK from an initial TC of 540 mK by increasing the temperature at which the films are post-annealed from 80 to 275 18C. We find an anti-correlation trend between the annealing temperature and the measured TC. We also briefly discuss how we plan to use these films to produce TES detectors to be used in the LSPE/SWIPE balloon-borne cosmic microwave background polarimeter, which is slated to launch in December 2019

Broadband Photon Harvesting in Organic Photovoltaic Devices Induced by Large-Area Nanogrooved Templates

Thin-film organic photovoltaic (OPV) devices represent an attractive alternative to conventional silicon solar cells due to their lightweight, flexibility, and low cost. However, the relatively low optical absorption of the OPV active layers still represents an open issue in view of efficient devices that cannot be addressed by adopting conventional light coupling strategies derived from thick PV absorbers. The light coupling to thin-film solar cells can be boosted by nanostructuring the device interfaces at the subwavelength scale. Here, we demonstrate broadband and omnidirectional photon harvesting in thin-film OPV devices enabled by highly ordered one-dimensional (1D) arrays of nanogrooves. Laser interference lithography, in combination with reactive ion etching (RIE), provides the controlled tailoring of the height and periodicity of the silica grooves, enabling effective tuning of the anti-reflection properties in the active organic layer (PTB7:PCBM). With this strategy, we demonstrate a strong enhancement of the optical absorption, as high as 19% with respect to a flat device, over a broadband visible and near-infrared spectrum. The OPV device supported on these optimized nanogrooved substrates yields a 14% increase in short-circuit current over the corresponding flat device, highlighting the potential of this large-scale light-harvesting strategy in the broader context of thin-film technologies