ICU, hospital and one year mortality of patients suffering from solid or haematological malignancies

OBJECTIVE: To examine the demographics, evolution and outcome of patients suffering from malignancies admitted to a medical intensive care unit. PATIENTS AND METHODS: Single centre retrospective cohort study of patients with malignancies. Data on demographics, diagnosis laboratory tests, provided therapy and outcome were retrospectively collected. Data was analysed for differences between patients suffering from solid compared to haematological malignancies as well as for predictors of one year survival. RESULTS: A total of 74 consecutive patients with a median age of 62 years were enrolled. From these, 42 (57%) suffered from solid and 32 (43%) from haematological malignancies. In total, 64% of patients with solid malignancies presented with metastatic disease. The main reason for intensive care unit admission in patients with solid malignancies was acute cardiovascular failure (39%) and infections in patients with haematological malignancies (38%). Intensive care unit mortality, hospital mortality and one year mortality were 26%, 35% and 71% overall; 17%, 29% and 69% respectively in patients with solid and 38%, 44% and 73% respectively in patients with haematological malignancies. Survival was close to 40% in patients with no or one organ failure. Survival dropped to 20% with 2 and 13% with ≥3 organs in failure. The number of organs in failure predicted hospital fatality with an AUCRoc of 0.87. CONCLUSION: The number of failing organs rather than malignancy itself drives outcome even in patients with malignancies. Thus the number of organs in failure rather than diagnosis should guide intensive care unit management in patients with malignancies

Building Coleus Academy

Coleus Academy, a nonprofit e-learning platform, has been created to address the deficits left by the de-emphasis and, at times, outright omission of practical skill-centric education in American curriculums. There exists a gap between the degree of knowledge necessary to engage with adult life and the extent of that knowledge that is actually possessed by emerging adults. Prominent legislations are among the numerous efforts to address this issue. However, there is a deeply fractured market where resources are proving too expensive, too sparse, or hyper-specific to the point of limited usability. Compounded with disparities in when, where, and to whom these resources are available, there is no guarantee that the typical young adult will have access to the information they are searching for. Unlike the resources that have previously been made available, Coleus sets out to cover the sum of topics that facilitate real-world proficiencies. Built over the course of this capstone experience, the web application targets the skills essential to adult competency and effective citizenry, and it utilizes the internet to maximize findability and shareability. ColeusAcademy.org was and continues to be programmed using HTML, CSS, JavaScript, and PHP. Described conceptually as “an encyclopedia of adulthood,” Coleus Academy prioritizes comprehensiveness and accessibility above all else. This document dives into the shortfalls of standardized education, introduces Coleus Inc., and dives into the Coleus Academy website in its current and previous forms

Making Art Work: Articulating Art and Urban Marginality in Kisumu, Kenya

This dissertation offers an inquiry into the role and reach of artistic practices in Kisumu, Kenya’s 3rd-largest city, where young people have en masse embraced the way-of-the-artist. The thesis combines anthropology with urban studies, sociology, fine and performing art studies and literary studies and weaves the many little threads of how the artists “make meaning” into a larger fabric – that is, the city as a social and political space. The dissertation is concerned with the ways in which art is made; with these ways and the practices they entail as alternatives to work construed as a salaried or regular endeavor; and with both the processes and the final products involved as building blocks of city life. The text uses the notion of Lebenskünstler as a nodal point, which, literally translated, stands for somebody who is a master in the art of living. In so doing, the thesis extends bridges between such key takes on city-making as are offered by urban sociologist AbdouMaliq Simone, literary and cultural studies theorists such as Sarah Nuttall and art historian Joanna Grabski. The thesis follows five individual artists through their work and life world. It builds on a post-Marxist understanding of discursive articulation and highlights how the artists concerned develop different articulatory responses to the structural-violence they experience as a result of enduring mass unemployment and a systemic neglect on behalf of the powers that be. These artistic articulations take different forms and draw on various art genres ranging from ‘artivism’ to spoken word to fashion modelling, as well as various communicative and performative expressions that are part of social media culture. The doctoral research was carried out between 2015 and 2018 and the thesis addresses how artists reacted to the highly-contested general elections of 2017 and the country’s subsequent constitutional crisis. Unseld’s account is neither silent on the violence that his protagonists experienced so often and that sometimes pushed them into criminal milieus, nor does it belittle their attempts to overcome the many hurdles that they had and still have to face. The thesis always recognizes that the portrayed artists are both authors of their life trajectories and victims of the circumstances that prevail in the urban neighborhoods that they inhabit. Using the device of portraiture, Unseld manages to write an account that is both balanced in its analytical propositions and a moving narrative about hope and despair in the city. The thesis opens up many important and timely questions about the multi-layered nature of the articulation between city-making and art-making, while simultaneously expanding our understanding of what the term “art” can reference in post-colonial life-worlds in the 21st century

Principles and approaches for the machining simulation of ceramic matrix composites at microscale: a review and outlook

Ceramic Matrix Composites (CMC) are advanced materials composed of ceramic fibers embedded in a ceramic matrix, resulting in a highly durable and lightweight composite structure offering exceptional high-temperature performance, excellent mechanical properties, and superior resistance to wear and corrosion. CMC find applications in industries such as aerospace, automotive, energy, and defense, where high strength and thermal stability are crucial. Despite their numerous advantages, machining CMC presents unique challenges. The hardness and brittleness of ceramics make them difficult to machine using conventional methods. The abrasive nature of ceramic particles can rapidly wear down cutting tools, leading to decreased tool life and increased costs. Numeric simulations for the machining of CMC are therefore particularly interesting due to their ability to provide insights into tool-material interactions and optimize machining parameters without the need for expensive and time-consuming physical trials. This paper discusses existing methods and approaches from different materials like Carbon Fiber Reinforced Plastics (CFRP) and monolithic ceramics and puts forward an outlook for the numerical simulation of the machining process of CMC

Differences in European mortality rates:a geometric approach on the age–period plane

AbstractAge and period are the most widely used parameters for forecasting mortality rates. Empirical mortality rate differences in multiple populations often show strong geometric patterns on the two-dimensional age–period plane. The idea of this paper is to take these geometric patterns as the starting point for the development of forecasts. A parametric approach is presented and discussed which uses simple techniques from spatial statistics. The proposed model is statistically parsimonious and yields forecasts that are consistent with the historical data and coherent for multiple populations.</jats:p