SENJ — DER BEDEUTSAMSTE PARTISANENHAFEN AM MEER ZUR ZEIT 1943/44

Nakon kapitulacije Italije stvoreni su uvjeti za stvaranje Mornarice NOVJ. Vrhovni štab NOV i PO Jugoslavije osnovao Štab Mornarice NOVJ, kojemu su bile podređene sve dotadašnje komande partizanske mornarice. Radi lakšeg rukovođenja pojedinim komandama, Štab Mornarice NOVJ donio je 10. studenog 1943. odluku kojom je pomorski prostor Jadrana bio podijeljen u šest sektora. Drugi sektor obuhvaćao je područje od Limskog kanala na sjeveru do linije otok Grujica—otok Dolfin—sredina Paškog kanala na jugu. U skladu s ovom odlukom, partizanska mornarica na sjevernom Jadranu dobila je naziv Drugi pomorski obalni sektor — Kvarnerski. Pomorski koridor Vis — Senj bio je od listopada 1943. godine pa do kraja siječnja 1944. jedini put kojim se relativno brzo i sigurno mogao prebaciti ratni materijal, oprema, hrana i sanitetski materijal za potrebe Glavnog štaba NOV i PO Hrvatske. Istim su putem iz unutrašnjosti preko Senja i Visa prevoženi ranjenici u bolnice u južnoj Italiji. Senj je, dakle, gotovo puna tri mjeseca (od 14. 9. 1943. do 15. 1. 1944) bio najznačajnija partizanska luka na Jadranu.Durch die italienische Okkupation (September 1943) wurde die ganze adriatische Küste mit den Inseln fast ganz befreit. Aufgrund eines Bescheides des Hauptquartiers des Volksbefreiungskrieges wurden zahlreiche Kommandos der Partisanenflotte errichtet, um mit dem Feind planmässig zu kämpfen. Am 18. 10. 1943 wurde das Marinequartier des Volksbefreiungsheers errichtet und das adriatische Gebiet wurde in sechs Sektoren geteilt. Senj, mit seinem vorgebirgischen Gebiet, wurde dem zweiten See- und Küstensektor angeschlossen, um verschiedene Zivil- und Kriegsaufgaben gut ausführen zu können. Dieser Sektor verfügte mit einigen Dampfschiffen und Seebooten, welche das freie Meer befuhren. Zu dieser Zeit, vom 14. 9. 1943 bis zum 15. 1. 1944 wurde Senj ein bedeutsamer Verkehrs- und Kriegspunkt, ein freier adriatischer Partisanenhafen

RDI-a regression detectability index for quality assurance in: x-ray imaging

Novel iterative image reconstruction methods can help reduce the required radiation dose in x-ray diagnostics such as computed tomography (CT), while maintaining sufficient image quality. Since some of the established image quality measures are not appropriate for reliably judging the quality of images derived by iterative methods, alternative approaches such as task-specific quality assessment would be highly desirable for acceptance or constancy testing. Task-based image quality methods are also closer to tasks performed by the radiologists, such as lesion detection. However, this approach is usually hampered by a huge workload, since hundreds of images are usually required for its application. It is demonstrated that the proposed approach works reliably on the basis of significantly fewer images, and that it correlates well with results obtained from human observers.Radiolog

RDI-a regression detectability index for quality assurance in: x-ray imaging

Novel iterative image reconstruction methods can help reduce the required radiation dose in x-ray diagnostics such as computed tomography (CT), while maintaining sufficient image quality. Since some of the established image quality measures are not appropriate for reliably judging the quality of images derived by iterative methods, alternative approaches such as task-specific quality assessment would be highly desirable for acceptance or constancy testing. Task-based image quality methods are also closer to tasks performed by the radiologists, such as lesion detection. However, this approach is usually hampered by a huge workload, since hundreds of images are usually required for its application. It is demonstrated that the proposed approach works reliably on the basis of significantly fewer images, and that it correlates well with results obtained from human observers

Evaluation of Nutritional Practices in the Critical Care patient (The ENPIC study) : Does nutrition really affect ICU mortality?

The importance of artificial nutritional therapy is underrecognized, typically being considered an adjunctive rather than a primary therapy. We aimed to evaluate the influence of nutritional therapy on mortality in critically ill patients. Methods: This multicenter prospective observational study included adult patients needing artificial nutritional therapy for >48 h if they stayed in one of 38 participating intensive care units for ≥72 h between April and July 2018. Demographic data, comorbidities, diagnoses, nutritional status and therapy (type and details for ≤14 days), and outcomes were registered in a database. Confounders such as disease severity, patient type (e.g., medical, surgical or trauma), and type and duration of nutritional therapy were also included in a multivariate analysis, and hazard ratios (HRs) and 95% confidence intervals (95%CIs) were reported. We included 639 patients among whom 448 (70.1%) and 191 (29.9%) received enteral and parenteral nutrition, respectively. Mortality was 25.6%, with non-survivors having the following characteristics: older age; more comorbidities; higher Sequential Organ Failure Assessment (SOFA) scores (6.6 ± 3.3 vs 8.4 ± 3.7; P < 0.001); greater nutritional risk (Nutrition Risk in the Critically Ill [NUTRIC] score: 3.8 ± 2.1 vs 5.2 ± 1.7; P < 0.001); more vasopressor requirements (70.4% vs 83.5%; P=0.001); and more renal replacement therapy (12.2% vs 23.2%; P=0.001). Multivariate analysis showed that older age (HR: 1.023; 95% CI: 1.008-1.038; P=0.003), higher SOFA score (HR: 1.096; 95% CI: 1.036-1.160; P=0.001), higher NUTRIC score (HR: 1.136; 95% CI: 1.025-1.259; P=0.015), requiring parenteral nutrition after starting enteral nutrition (HR: 2.368; 95% CI: 1.168-4.798; P=0.017), and a higher mean Kcal/Kg/day intake (HR: 1.057; 95% CI: 1.015-1.101; P=0.008) were associated with mortality. By contrast, a higher mean protein intake protected against mortality (HR: 0.507; 95% CI: 0.263-0.977; P=0.042). Old age, higher organ failure scores, and greater nutritional risk appear to be associated with higher mortality. Patients who need parenteral nutrition after starting enteral nutrition may represent a high-risk subgroup for mortality due to illness severity and problems receiving appropriate nutritional therapy. Mean calorie and protein delivery also appeared to influence outcomes. ClinicaTrials.gov NCT: 03634943

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit