Severity assessment tools in ICU patients with 2009 influenza A (H1N1) pneumonia.

The aim of this study was to determine if severity assessment tools (general severity of illness and community-acquired pneumonia specific scores) can be used to guide decisions for patients admitted to the intensive care unit (ICU) due to pandemic influenza A pneumonia. A prospective, observational, multicentre study included 265 patients with a mean age of 42 (±16.1) years and an ICU mortality of 31.7%. On admission to the ICU, the mean pneumonia severity index (PSI) score was 103.2 ± 43.2 points, the CURB-65 score was 1.7 ± 1.1 points and the PIRO-CAP score was 3.2 ± 1.5 points. None of the scores had a good predictive ability: area under the ROC for PSI, 0.72 (95% CI, 0.65-0.78); CURB-65, 0.67 (95% CI, 0.59-0.74); and PIRO-CAP, 0.64 (95% CI, 0.56-0.71). The PSI score (OR, 1.022 (1.009-1.034), p 0.001) was independently associated with ICU mortality; however, none of the three scores, when used at ICU admission, were able to reliably detect a low-risk group of patients. Low risk for mortality was identified in 27.5% of patients using PIRO-CAP, but above 40% when using PSI (I-III) or CURB65 (<2). Observed mortality was 13.7%, 13.5% and 19.4%, respectively. Pneumonia-specific scores undervalued severity and should not be used as instruments to guide decisions in the ICU.

Use of early corticosteroid therapy on ICU admission in patients affected by severe pandemic (H1N1)v influenza A infection.

INTRODUCTION Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection, although relatively common, remains controversial. METHODS Prospective, observational, multicenter study from 23 June 2009 through 11 February 2010, reported in the European Society of Intensive Care Medicine (ESICM) H1N1 registry. RESULTS Two hundred twenty patients admitted to an intensive care unit (ICU) with completed outcome data were analyzed. Invasive mechanical ventilation was used in 155 (70.5%). Sixty-seven (30.5%) of the patients died in ICU and 75 (34.1%) whilst in hospital. One hundred twenty-six (57.3%) patients received corticosteroid therapy on admission to ICU. Patients who received corticosteroids were significantly older and were more likely to have coexisting asthma, chronic obstructive pulmonary disease (COPD), and chronic steroid use. These patients receiving corticosteroids had increased likelihood of developing hospital-acquired pneumonia (HAP) [26.2% versus 13.8%, p < 0.05; odds ratio (OR) 2.2, confidence interval (CI) 1.1-4.5]. Patients who received corticosteroids had significantly higher ICU mortality than patients who did not (46.0% versus 18.1%, p < 0.01; OR 3.8, CI 2.1-7.2). Cox regression analysis adjusted for severity and potential confounding factors identified that early use of corticosteroids was not significantly associated with mortality [hazard ratio (HR) 1.3, 95% CI 0.7-2.4, p = 0.4] but was still associated with an increased rate of HAP (OR 2.2, 95% CI 1.0-4.8, p < 0.05). When only patients developing acute respiratory distress syndrome (ARDS) were analyzed, similar results were observed. CONCLUSIONS Early use of corticosteroids in patients affected by pandemic (H1N1)v influenza A infection did not result in better outcomes and was associated with increased risk of superinfections.

OSL-thermochronometry of feldspar from the KTB borehole, Germany

The reconstruction of thermal histories of rocks (thermochronometry) is a fundamental tool both in Earth science and in geological exploration. However, few methods are currently capable of resolving the low-temperature thermal evolution of the upper ∼2 km of the Earth's crust. Here we introduce a new thermochronometer based on the infrared stimulated luminescence (IRSL) from feldspar, and validate the extrapolation of its response to artificial radiation and heat in the laboratory to natural environmental conditions. Specifically, we present a new detailed Na-feldspar IRSL thermochronology from a well-documented thermally-stable crustal environment at the German Continental Deep Drilling Program (KTB). There, the natural luminescence of Na-feldspar extracted from twelve borehole samples (0.1–2.3 km depth, corresponding to 10–70 °C) can be either (i) predicted within uncertainties from the current geothermal gradient, or (ii) inverted into a geothermal palaeogradient of 29 ± 2  °C km−1, integrating natural thermal conditions over the last ∼65 ka. The demonstrated ability to invert a depth–luminescence dataset into a meaningful geothermal palaeogradient opens new venues for reconstructing recent ambient temperatures of the shallow crust (<0.3 Ma, 40–70 °C range), or for studying equally recent and rapid transient cooling in active orogens (<0.3 Ma, >200 °C Ma−1 range). Although Na-feldspar IRSL is prone to field saturation in colder or slower environments, the method's primary relevance appears to be for borehole and tunnel studies, where it may offer remarkably recent (<0.3 Ma) information on the thermal structure and history of hydrothermal fields, nuclear waste repositories and hydrocarbon reservoirs.

Na 1 Nachlass Max Horkheimer, 37 - Korrespondenzen u.a. mit Dorthy I. Mulgrave (p. I 18, 335-517)

1 Brief von Margot von Mendelssohn an Max Horkheimer, 20.05.1948; 6 Briefe zwsichen Charles E. Merriam und Max Horkheimer, 1940-1941; 4 Briefe zwischen Josef Messinger und Max Horkheimer, 1940; 1 Curriculum Vitae von Alfred Meusel an Max Horkheimer; 1 Brief von Max Horkheimer an Gerhard Meyer, 17.10.1938; 3 Briefe zwischen Hans A. Meyer und Max Horkheimer´09.10.1939, 1947; 2 Briefe zwischen Julie Meyer und Max Horkheimer, 12.04.1941, 15.04.1941; 43 Briefe zwischen Hermann Meyer-Lindenberg, Oscar Meyer und Max Horkheimer sowie Briefwechsel mit Hadley Cantril; 2 Briefe zwischen Hadley Cantril und Theodor W. Adorno, 22.05.1941, 28.05.1941; 1 Brief von Jerome Michael an Margot von Mendelssohn, 10.01.1941; 2 Briefe und 2 Beilagen zwischen Joseph Mire und Max Horkheimer, 16.03.1941, 28.03.1941; 6 Briefe zwischen Mitchell, Silberberg & Knupp, Los Angeles und Max Horkheimer, 1942, 1943; 1 Brief von Friedrich Pollock an Wesley C. Mitchell, 06.08.1940; 3 Briefe zwischen Hans Mohr und Max Horkheimer, 29.03.1946, 1946; 1 Brief von Herbert Moeller Morton an Max Horkheimer, 25.02.1940; 1 Brief von Max Horkheimer an den Chairman of the Committee on General Scholarships, Cambridge Massachusetts, 01.03.1940; 2 Briefe von David H. Moses an Max Horkheimer, 1939; 1 Brief von Franz Neumann an Philip Mosley, 28.04.1941; 49 Briefe zwischen Dorthy I. Mulgrave und Max Horkheimer, 1936-1940; 1 Brief von Max Horkheimer an das Municipal Court, San Francisco, 24.12.1948;

Texas laboratory healthcare workforce: Meeting the needs in 2015

The purpose of this research was to study groups of students and young professionals in the clinical laboratory science field using exploratory discovery and inductive logic regarding the attitudes of four groups in Texas: (1) 3rd and 4th year college biology students, (2) students currently enrolled in Clinical Laboratory Science/Clinical Laboratory Technician (CLS/CLT) programs, (3) young CLS/CLT professionals (1-2 years post education), and (4) mid-career CLS/CLTs (4-10 years post education). It was also a comparative study looking at these four groups and their attitudes and perception regarding: career selection factors and legislative incentive measures which might attract individuals to an allied health care career, the field of practice and factors needed to keep individuals in the chosen field of practice. ^ The study found that the career is attractive to individuals who enjoy laboratory work and find the various areas in which to choose to work very attractive. Government programs offering grants/scholarships or loan forgiveness programs offered by health care institutions would be beneficial in attracting students to study in the clinical laboratory sciences. Students are unsure if there is a viable career ladder associated with the field and are anticipating the possibility of going on to other fields in the future. ^ While young and mid-career professionals share many of the same points of view on some aspects (skills used, trends) of the CLS/CLT profession there were a few areas were opinions diverged; perceptions of the field itself and if they plan to remain in the profession for the next 5 years. The mid-career professionals had a much more negative outlook on the profession (low salary, no visible career ladder, lack of respect from other health care professionals) and only a small number plan to be in the field within the next 5 years. ^ The lower salaries in the profession as compared to other similar health care careers, lack of a career ladder and lack of respect from laboratory and institutional management and other health care providers are critical missing pieces to the retention of CLS/CLT professionals. ^

Caring Minds

Greetings Pacesetter Grads Feel Boost in Entry to Nursing Workforce UTHealth-UH Dual Bachelors Program for First-Time Students UTHealth School of Nursing – By the Numbers 2012 PARTNERS Spring Luncheon – honored “Generations of Nurses” – guest speaker Naomi Judd UT Health Services Expands Care for Patients When I Grow Up, – A UTHealth Nursing Student’s Story Donors Support Start of New Accelerated Family Nurse Practitioner Program Giuseppe Colasurdo, M.D. – Appointed Sixth President in U THealth’s 40-Year History Dean Starck Named to UT Academy of Health Science Education, Marcus Honored by Regents for Outstanding Teaching Students Select Two for 2012 McGovern Awards Endowed scholarships Former home of School of Nursing for 30 years disappears in dust cloud Ruppert Named 2012 FAAN

{\it cis\/} -acting determinants in the control of MuSVts110 RNA splicing

Like other simple retroviruses the murine sarcoma virus ts110 (MuSVts110) displays an inefficient mode of genome splicing. But, unlike the splicing phenotypic of other retroviruses, the splicing event effected upon the transcript of MuSVts110 is temperature sensitive. Previous work in this laboratory has established that the conditionally defective nature of MuSVts110 RNA splicing is mediated in cis by features in the viral transcript. Here we show that the 5$\sp\prime$ splice site of the MuSVts110 transcript acts as a point of control of the overall splicing efficiency at both permissive and nonpermissive temperatures for splicing. We strengthened and simultaneously weakened the nucleotide structure of the 5$\sp\prime$ splice site in an attempt to elucidate the differential effects each of the two known critical splicing components which interact with the 5$\sp\prime$ splice site have on the overall efficiency of intron excision. We found that a transversion of the sixth nucleotide, resulting in the formation of a near-consensus 5$\sp\prime$ splice site, dramatically increased the overall efficiency of MuSVts110 RNA splicing and abrogated the thermosensitive nature of this splicing event. Various secondary mutations within this original transversion mutant, designed to selectively decrease specific splicing component interactions, lead to recovery of inefficient and thermosensitive splicing. We have further shown that a sequence of 415 nucleotides lying in the downstream exon of the viral RNA and hypothesized to act as an element in the temperature-dependent inhibition of splicing displays a functional redundancy throughout its length; loss and/or replacement of any one sequence of 100 nucleotides within this sequence does not, with one exception detailed below, diminish the degree to which MuSVts110 RNA is inhibited to splice at the restrictive temperature. One specific deletion, though, fortuitously juxtaposed and activated cryptic consensus splicing signals for the excision of a cryptic intron within the downstream exon and markedly potentiated--across a newly defined cryptic exon--the splicing event effected upon the upstream, native intron. We have exploited this mutant of MuSVts110 to further an understanding of the process of exon definition and intron definition and show that the polypyrimidine tract and consensus 3$\sp\prime$ splice site, as well as the 5$\sp\prime$ splice site, within the intron at the 3$\sp\prime$ flank of the defined exon are required for the exon's definition; implying that definition of the downstream intron is required for the in vivo definition of the proximal, upstream exon. Finally; we have shown, through the construction of heterologous mutants of MuSVts110 employing a foreign 3$\sp\prime$ end-forming sequence, that efficiency of transcript splicing can be increased--to a degree which abrogates its thermosensitive nature--in direct proportion to increasing proximity of the 3$\sp\prime$ end-forming signal to the terminal 3$\sp\prime$ splice site. ^

La cooperación internacional : el desempeño del CIFOT

El programa de cooperación entre SECYT, Universidad Nacional de Cuyo, Mendoza, Argentina, y la oficina Internacional de la DLR de Bonn/Alemania permitió la elaboración de numerosos proyectos bilaterales desde el año 1994 y por un lapso de seis años. El objetivo de este artículo es dar a conocer las actividades realizadas en dicho marco, como proyectos de cooperación científico- tecnológica, publicaciones, congresos y seminarios, talleres, intercambio de científicos, doctorados y pasantías. Por otra parte, se subraya el apoyo financiero en equipamiento, amoblamientos y becas para estudiantes, proveniente de las entidades alemanas que se destinan al CIFOT. Se concluye que el programa de cooperación internacional de CIFOT con Alemania permitió el perfeccionamiento de recursos humanos, la obtención de equipamiento para este Centro y, lo más importante, estrechar vínculos entre ambos países.

Equity and Guidance : The challenge of following up young graduates

In this paper we present a support strategy of guidance for the young people from vulnerable population, both urban and rural, who have completed high school and are involved in an extension program so called Equity and guidance: the challenge of a proposal in state educational institutions from the La Plata, Berisso and Ensenada districts. This program gives them a reflection space to analyze their personal, social and community situation as a self-managed process towards a project of life. For some time we have supported young people with the purpose of helping them to make a life project. When doing so, we've always noticed the need of finding strategies to provide reasons to carry on the project of completing high school, to search new knowledge, request scholarships, to think of alternatives according to their circumstances, etc. In this sense, the Project: ?Equity and Guidance: the challenge of following up young graduates? is a revealing experience since it shows the urgent need to provide real means to enable communities we work with to make the most of opportunities. For the young people who belong to a vulnerable community, a project of life doesn't mean just thinking of the choice of careers, trainings or jobs. It also means to find how to make it possible in their daily life. Everything we make, think and manage in this project has the same purpose: help them so they can make a life project according to their subjectivity

Equity and Guidance : The challenge of following up young graduates

In this paper we present a support strategy of guidance for the young people from vulnerable population, both urban and rural, who have completed high school and are involved in an extension program so called Equity and guidance: the challenge of a proposal in state educational institutions from the La Plata, Berisso and Ensenada districts. This program gives them a reflection space to analyze their personal, social and community situation as a self-managed process towards a project of life. For some time we have supported young people with the purpose of helping them to make a life project. When doing so, we've always noticed the need of finding strategies to provide reasons to carry on the project of completing high school, to search new knowledge, request scholarships, to think of alternatives according to their circumstances, etc. In this sense, the Project: ?Equity and Guidance: the challenge of following up young graduates? is a revealing experience since it shows the urgent need to provide real means to enable communities we work with to make the most of opportunities. For the young people who belong to a vulnerable community, a project of life doesn't mean just thinking of the choice of careers, trainings or jobs. It also means to find how to make it possible in their daily life. Everything we make, think and manage in this project has the same purpose: help them so they can make a life project according to their subjectivity

Equity and Guidance : The challenge of following up young graduates

In this paper we present a support strategy of guidance for the young people from vulnerable population, both urban and rural, who have completed high school and are involved in an extension program so called Equity and guidance: the challenge of a proposal in state educational institutions from the La Plata, Berisso and Ensenada districts. This program gives them a reflection space to analyze their personal, social and community situation as a self-managed process towards a project of life. For some time we have supported young people with the purpose of helping them to make a life project. When doing so, we've always noticed the need of finding strategies to provide reasons to carry on the project of completing high school, to search new knowledge, request scholarships, to think of alternatives according to their circumstances, etc. In this sense, the Project: ?Equity and Guidance: the challenge of following up young graduates? is a revealing experience since it shows the urgent need to provide real means to enable communities we work with to make the most of opportunities. For the young people who belong to a vulnerable community, a project of life doesn't mean just thinking of the choice of careers, trainings or jobs. It also means to find how to make it possible in their daily life. Everything we make, think and manage in this project has the same purpose: help them so they can make a life project according to their subjectivity

Geochemistry at DSDP Leg 82 Holes

The nine holes (556-564) drilled during DSDP Leg 82 in a region west and southwest of the Azores Platform (Fig. 1) exhibit a wide variety of chemical compositions that indicate a complex petrogenetic history involving crystal fractionation, magma mixing, complex melting, and mantle heterogeneity. The major element chemistry of each hole except Hole 557 is typical of mid-ocean ridge basalts (MORBs), whereas the trace element and rare earth element (REE) abundances and ratios are more variable, and show that both depleted Type I and enriched Type II basalts have been erupted in the region. Hole 556 (30-34 Ma), located near a flow line through the Azores Triple Junction, contains typically depleted basalts, whereas Hole 557 (18 Ma), located near the same flow line but closer to the Azores Platform, is a highly enriched FeTi basalt, indicating that the Azores hot-spot anomaly has existed in its present configuration for at least 18 Ma, but less than 30-34 Ma. Hole 558 (34-37 Ma), located near a flow line through the FAMOUS and Leg 37 sites, includes both Type I and II basalts. Although the differences in Zr/Nb and light REE/heavy REE ratios imply different mantle sources, the (La/Ce)ch (>1) and Nd isotopic ratios are almost the same, suggesting that the complex melting and pervasive, small-scale mantle heterogeneity may account for the variations in trace element and REE ratios observed in Hole 558 (and FAMOUS sites). Farther south, Hole 559 (34-37 Ma), contains enriched Type II basalts, whereas Hole 561 (14-17 Ma), located further east near the same flow line, contains Type I and II basalts. In this case, the (La/Ce)ch and Nd isotopic ratios are different, indicating two distinct mantle sources. Again, the existence along the same flow line of two holes exhibiting such different chemistry suggests that mantle heterogeneity may exist on a more pervasive and transient smaller scale. (Hole 560 was not sampled for this study because the single basalt clast recovered was used for shipboard analysis.) All of the remaining three holes (562, 563, 564), located along a flow line about 100 km south of the Hayes Fracture Zone (33°N), contain only depleted Type I basalts. The contrast in chemical compositions suggests that the Hayes Fracture Zone may act as a "domain" boundary between an area of fairly homogeneous, depleted Type I basalts to the south (Holes 562-564) and a region of complex, highly variable basalts to the north near the Azores hot-spot anomaly (Holes 556-561).