Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort

Background Acute respiratory distress syndrome (ARDS) can be classified into sub-phenotypes according to different inflammatory/clinical status. Prognostic enrichment was achieved by grouping patients into hypoinflammatory or hyperinflammatory sub-phenotypes, even though the time of analysis may change the classification according to treatment response or disease evolution. We aimed to evaluate when patients can be clustered in more than 1 group, and how they may change the clustering of patients using data of baseline or day 3, and the prognosis of patients according to their evolution by changing or not the cluster.Methods Multicenter, observational prospective, and retrospective study of patients admitted due to ARDS related to COVID-19 infection in Spain. Patients were grouped according to a clustering mixed-type data algorithm (k-prototypes) using continuous and categorical readily available variables at baseline and day 3.Results Of 6205 patients, 3743 (60%) were included in the study. According to silhouette analysis, patients were grouped in two clusters. At baseline, 1402 (37%) patients were included in cluster 1 and 2341(63%) in cluster 2. On day 3, 1557(42%) patients were included in cluster 1 and 2086 (57%) in cluster 2. The patients included in cluster 2 were older and more frequently hypertensive and had a higher prevalence of shock, organ dysfunction, inflammatory biomarkers, and worst respiratory indexes at both time points. The 90-day mortality was higher in cluster 2 at both clustering processes (43.8% [n = 1025] versus 27.3% [n = 383] at baseline, and 49% [n = 1023] versus 20.6% [n = 321] on day 3). Four hundred and fifty-eight (33%) patients clustered in the first group were clustered in the second group on day 3. In contrast, 638 (27%) patients clustered in the second group were clustered in the first group on day 3.Conclusions During the first days, patients can be clustered into two groups and the process of clustering patients may change as they continue to evolve. This means that despite a vast majority of patients remaining in the same cluster, a minority reaching 33% of patients analyzed may be re-categorized into different clusters based on their progress. Such changes can significantly impact their prognosis

LIMENES. The terminology of the Mediterranean ports of the Roman Empire as documented in the literary sources [In two volumes]

This research forms part of the Portus Limen Project, which investigates Mediterranean port networks in the Roman Empire. The aim of my research is to investigate the precise semantic and pragmatic implications of the Greek and Latin terms referring to ports or anchorages, especially in relation to one another: what does each harbour form require? Where is it located? What are its singularities in relation to other harbour forms?My research represents an ontological approach to the study of the Greek and Roman port terminology. A literature review is included, where I discuss the relevant modern research methods. However, this review appears twofold, due to the novelty of combining linguistics research with archaeological finds – two disciplines that are rarely combined with one another. Next, I describe my methodology, based on text mining, decomponential analysis and prototype theory applied to ancient Greek and Latin texts as the only direct testimonies of speech acts in those languages. This leads me to the exposition of all relevant data as far as possible for the period and for the space chosen. I discuss in the first place the usage of each harbour term in isolation in order to seek its prototype. Secondly, I include two case-studies in order to verify if the conclusions reached in the theoretical discussion do apply in the realities on land, and how the different harbour terms co-exist and interact with one another by means of particular sites. Finally, I provide further discussion on the ontological relations between different port terms. In the end, I hope I am offering satisfactory conclusions on the semantics and pragmatics as to the usage of ancient Greek and Latin harbour terms, as well as some ideas for future work

Kothon, cothon et ports creusés

According to ancient literature, Kothon is the name given to the late Punic ports of Carthage, a particular type of vase and a type of harbour. Ancient definitions of a type of port seem to describe an artificially excavated basin, and this characteristic appears regularly within archaeological literature. However, if the ancient sources are examined closely, the association between Kothon and dug basin is not clear. This paper aims to analyse the sources related to the Kothon and to propose a new definition of the term

Influence of submarine groundwater discharge on 210Po and 210Pb bioaccumulation in fish tissues

This study presents the results of the accumulation of 210Po and 210Pb in fish tissues and organs in a brackish-water marshland that is characterized by high concentrations of 222Rn and 226Ra supplied by submarine groundwater discharge (SGD). Tissues and organs from Cyprinus carpio, Chelon labrosus and Carassius auratus in the wetland were significantly enriched by both 210Pb and 210Po (up to 55 and 66 times, respectively) compared to blanks. The major input route of 210Pb and 210Po into the fish body seems to be through ingestion, due to the high levels of 210Pb and 210Po found in the gut content as well as in organs involved in digestion and metabolism (i.e. gut, kidney and hepatopancreas). Results showed that 210Po was more accumulated in all fish tissues and organs except for the spine, which showed a higher affinity for 210Pb, due to its capacity to replace Ca from apatite in bones. Over all the variables analyzed, fish tissues/organs and, secondarily, fish species were the most important factors explaining the concentration of radionuclides, whereas fish length and the sampling location played a minor role. The relationship of the two radionuclides varied markedly among tissues and their concentration levels were only correlated in gills, gut and, marginally, in spines. In general, the highest values of 210Pb and 210Po concentrations in tissues were found on C. labrosus tissues rather C. auratus and C. carpio. This study demonstrates that inputs of natural radionuclides supplied by SGD to coastal semi-enclosed areas (such as marshlands, lagoons or ponds) may significantly increase the contents of 210Pb and 210Po in fish tissues/organs. Thus, this study represents one of the first evidences of direct ecological effects derived from SGD. © 2016 Elsevier Ltd

Starlikeness of Libera transformation (II) (Applications of Complex Function Theory to Differential Equations)

The GEOTRACES Intermediate Data Product 2017 (IDP2017) is the second publicly available data product of the international GEOTRACES programme, and contains data measured and quality controlled before the end of 2016. The IDP2017 includes data from the Atlantic, Pacific, Arctic, Southern and Indian oceans, with about twice the data volume of the previous IDP2014. For the first time, the IDP2017 contains data for a large suite of biogeochemical parameters as well as aerosol and rain data characterising atmospheric trace element and isotope (TEI) sources. The TEI data in the IDP2017 are quality controlled by careful assessment of intercalibration results and multi-laboratory data comparisons at crossover stations. The IDP2017 consists of two parts: (1) a compilation of digital data for more than 450 TEIs as well as standard hydrographic parameters, and (2) the eGEOTRACES Electronic Atlas providing an on-line atlas that includes more than 590 section plots and 130 animated 3D scenes. The digital data are provided in several formats, including ASCII, Excel spreadsheet, netCDF, and Ocean Data View collection. Users can download the full data packages or make their own custom selections with a new on-line data extraction service. In addition to the actual data values, the IDP2017 also contains data quality flags and 1-σ data error values where available. Quality flags and error values are useful for data filtering and for statistical analysis. Metadata about data originators, analytical methods and original publications related to the data are linked in an easily accessible way. The eGEOTRACES Electronic Atlas is the visual representation of the IDP2017 as section plots and rotating 3D scenes. The basin-wide 3D scenes combine data from many cruises and provide quick overviews of large-scale tracer distributions. These 3D scenes provide geographical and bathymetric context that is crucial for the interpretation and assessment of tracer plumes near ocean margins or along ridges. The IDP2017 is the result of a truly international effort involving 326 researchers from 25 countries. This publication provides the critical reference for unpublished data, as well as for studies that make use of a large cross-section of data from the IDP2017. This article is part of a special issue entitled: Conway GEOTRACES - edited by Tim M. Conway, Tristan Horner, Yves Plancherel, and Aridane G. González