149 research outputs found

    Critical illness is associated with elevated parathyroid hormone

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    Chitosan-Based Polyelectrolyte Complex in Combination with Allotropic Forms of Carbon as a Basis for Thin-Film Organic Electronics

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    Received: 30.05.2024. Revised: 11.06.2024. Accepted: 19.06.2024. Available online: 28.06.2024.Samples of a new polymer composite material based on a PEC doped with various allotropic forms of carbon were prepared.Based on the films studied, field-effect transistors were created and their output and transfer characteristics were measured.If a combination of both GO and SWCNT is incorporated into the nanocomposite, the mobility of carriers increases sharply.Using atomic force microscopy, scanning electron microscopy, cyclic voltammetry and electrochemical impedance spectroscopy, the morphology and mobility of charge carriers in composite films with a thickness of no more than 500 nm obtained on the basis of a polyelectrolyte complex of chitosan and chitosan succinamide with addition of particles of carbon materials were studied and estimated. The following carbon materials were used: single-walled carbon nanotubes, graphene oxide, and carbon-containing sorbents with different specific surfaces (Carboblack C and Carbopack). Moreover, the studied materials in the form of films were used as a transport layer in the structure of field-effect transistors. The output and transfer characteristics of the transistors obtained were measured. According to the measurement results, the mobility of charge carriers, μ, ranges from 0.341 to 1.123 cm2 V–1·s–1, depending on the type of carbon material added. The best result was demonstrated by films based on a composite containing simultaneously single-walled carbon nanotubes and graphene oxide (μ = 10.972 cm2 V–1·s–1).This work was supported by the Ministry of Science and Higher Education of the Russian Federation (scientific code FZWU-2023-0002) and by the Russian Science Foundation (Grant № 23-73-00119), https://rscf.ru/project/23-73-00119/

    APACHE III outcome prediction in patients admitted to the intensive care unit after liver transplantation: a retrospective cohort study

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    <p>Abstract</p> <p>Background</p> <p>The Acute Physiology and Chronic Health Evaluation (APACHE) III prognostic system has not been previously validated in patients admitted to the intensive care unit (ICU) after orthotopic liver transplantation (OLT). We hypothesized that APACHE III would perform satisfactorily in patients after OLT</p> <p>Methods</p> <p>A retrospective cohort study was performed. Patients admitted to the ICU after OLT between July 1996 and May 2008 were identified. Data were abstracted from the institutional APACHE III and liver transplantation databases and individual patient medical records. Standardized mortality ratios (with 95% confidence intervals) were calculated by dividing the observed mortality rates by the rates predicted by APACHE III. The area under the receiver operating characteristic curve (AUC) and the Hosmer-Lemeshow C statistic were used to assess, respectively, discrimination and calibration of APACHE III.</p> <p>Results</p> <p>APACHE III data were available for 918 admissions after OLT. Mean (standard deviation [SD]) APACHE III (APIII) and Acute Physiology (APS) scores on the day of transplant were 60.5 (25.8) and 50.8 (23.6), respectively. Mean (SD) predicted ICU and hospital mortality rates were 7.3% (15.4) and 10.6% (18.9), respectively. The observed ICU and hospital mortality rates were 1.1% and 3.4%, respectively. The standardized ICU and hospital mortality ratios with their 95% C.I. were 0.15 (0.07 to 0.27) and 0.32 (0.22 to 0.45), respectively.</p> <p>There were statistically significant differences in APS, APIII, predicted ICU and predicted hospital mortality between survivors and non-survivors. In predicting mortality, the AUC of APACHE III prediction of hospital death was 0.65 (95% CI, 0.62 to 0.68). The Hosmer-Lemeshow C statistic was 5.288 with a p value of 0.871 (10 degrees of freedom).</p> <p>Conclusion</p> <p>APACHE III discriminates poorly between survivors and non-survivors of patients admitted to the ICU after OLT. Though APACHE III has been shown to be valid in heterogenous populations and in certain groups of patients with specific diagnoses, it should be used with caution – if used at all – in recipients of liver transplantation.</p

    Hospital mortality is associated with ICU admission time

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    Previous studies have shown that patients admitted to the intensive care unit (ICU) after "office hours" are more likely to die. However these results have been challenged by numerous other studies. We therefore analysed this possible relationship between ICU admission time and in-hospital mortality in The Netherlands. This article relates time of ICU admission to hospital mortality for all patients who were included in the Dutch national ICU registry (National Intensive Care Evaluation, NICE) from 2002 to 2008. We defined office hours as 08:00-22:00 hours during weekdays and 09:00-18:00 hours during weekend days. The weekend was defined as from Saturday 00:00 hours until Sunday 24:00 hours. We corrected hospital mortality for illness severity at admission using Acute Physiology and Chronic Health Evaluation II (APACHE II) score, reason for admission, admission type, age and gender. A total of 149,894 patients were included in this analysis. The relative risk (RR) for mortality outside office hours was 1.059 (1.031-1.088). Mortality varied with time but was consistently higher than expected during "off hours" and lower during office hours. There was no significant difference in mortality between different weekdays of Monday to Thursday, but mortality increased slightly on Friday (RR 1.046; 1.001-1.092). During the weekend the RR was 1.103 (1.071-1.136) in comparison with the rest of the week. Hospital mortality in The Netherlands appears to be increased outside office hours and during the weekends, even when corrected for illness severity at admission. However, incomplete adjustment for certain confounders might still play an important role. Further research is needed to fully explain this differenc
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