Temporal Trends in Incidence, Sepsis-Related Mortality, and Hospital-Based Acute Care After Sepsis.

OBJECTIVES: A growing number of patients survive sepsis hospitalizations each year and are at high risk for readmission. However, little is known about temporal trends in hospital-based acute care (emergency department treat-and-release visits and hospital readmission) after sepsis. Our primary objective was to measure temporal trends in sepsis survivorship and hospital-based acute care use in sepsis survivors. In addition, because readmissions after pneumonia are subject to penalty under the national readmission reduction program, we examined whether readmission rates declined after sepsis hospitalizations related to pneumonia. DESIGN AND SETTING: Retrospective, observational cohort study conducted within an academic healthcare system from 2010 to 2015. PATIENTS: We used three validated, claims-based approaches to identify 17,256 sepsis or severe sepsis hospitalizations to examine trends in hospital-based acute care after sepsis. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: From 2010 to 2015, sepsis as a proportion of medical and surgical admissions increased from 3.9% to 9.4%, whereas in-hospital mortality rate for sepsis hospitalizations declined from 24.1% to 14.8%. As a result, the proportion of medical and surgical discharges at-risk for hospital readmission after sepsis increased from 2.7% to 7.8%. Over 6 years, 30-day hospital readmission rates declined modestly, from 26.4% in 2010 to 23.1% in 2015, driven largely by a decline in readmission rates among survivors of nonsevere sepsis, and nonpneumonia sepsis specifically, as the readmission rate of severe sepsis survivors was stable. The modest decline in 30-day readmission rates was offset by an increase in emergency department treat-and-release visits, from 2.8% in 2010 to a peak of 5.4% in 2014. CONCLUSIONS: Owing to increasing incidence and declining mortality, the number of sepsis survivors at risk for hospital readmission rose significantly between 2010 and 2015. The 30-day hospital readmission rates for sepsis declined modestly but were offset by a rise in emergency department treat-and-release visits

Molecular and biochemical characterization of a new thermostable bacterial laccase from<i> Meiothermus ruber</i> DSM 1279

A new bacterial laccase gene (mrlac) fromMeiothermus ruberDSM 1279 was successfully overexpressed to produce a laccase (Mrlac) in soluble form inEscherichia coliduring simultaneous overexpression of a chaperone protein (GroEL/ES).</p

The measurement of aircraft performance and stability and control after flight through natural icing conditions

The effects of airframe icing on the performance and stability and control of a twin-engine commuter-class aircraft were measured by the NASA Lewis Research Center. This work consisted of clear air tests with artificial ice shapes attached to the horizontal tail, and natural icing flight tests in measured icing clouds. The clear air tests employed static longitudinal flight test methods to determine degradation in stability margins for four simulated ice shapes. The natural icing flight tests employed a data acquisition system, which was provided under contract to NASA by Kohlman Systems Research Incorporated. This system used a performance modeling method and modified maximum likelihood estimation (MMLE) technique to determine aircraft performance degradation and stability and control. Flight test results with artificial ice shapes showed that longitudinal, stick-fixed, static margins are reduced on the order of 5 percent with flaps up. Natural icing tests with the KSR system corroborated these results and showed degradation in the elevator control derivatives on the order of 8 to 16 percent depending on wing flap configuration. Performance analyses showed the individual contributions of major airframe components to the overall degration in lift and drag