Prediction of multiple infections after severe burn trauma: a prospective cohort study.

OBJECTIVE: To develop predictive models for early triage of burn patients based on hypersusceptibility to repeated infections. BACKGROUND: Infection remains a major cause of mortality and morbidity after severe trauma, demanding new strategies to combat infections. Models for infection prediction are lacking. METHODS: Secondary analysis of 459 burn patients (≥16 years old) with 20% or more total body surface area burns recruited from 6 US burn centers. We compared blood transcriptomes with a 180-hour cutoff on the injury-to-transcriptome interval of 47 patients (≤1 infection episode) to those of 66 hypersusceptible patients [multiple (≥2) infection episodes (MIE)]. We used LASSO regression to select biomarkers and multivariate logistic regression to built models, accuracy of which were assessed by area under receiver operating characteristic curve (AUROC) and cross-validation. RESULTS: Three predictive models were developed using covariates of (1) clinical characteristics; (2) expression profiles of 14 genomic probes; (3) combining (1) and (2). The genomic and clinical models were highly predictive of MIE status [AUROCGenomic = 0.946 (95% CI: 0.906-0.986); AUROCClinical = 0.864 (CI: 0.794-0.933); AUROCGenomic/AUROCClinical P = 0.044]. Combined model has an increased AUROCCombined of 0.967 (CI: 0.940-0.993) compared with the individual models (AUROCCombined/AUROCClinical P = 0.0069). Hypersusceptible patients show early alterations in immune-related signaling pathways, epigenetic modulation, and chromatin remodeling. CONCLUSIONS: Early triage of burn patients more susceptible to infections can be made using clinical characteristics and/or genomic signatures. Genomic signature suggests new insights into the pathophysiology of hypersusceptibility to infection may lead to novel potential therapeutic or prophylactic targets.

Letter - Ian Green to Sean O'Sullivan, July 1977

A correspondence between Ian Green and Sean O'Sullivan from July 1977. The first letter is from 4 July 1977 from Sean O'Sullivan, titled "The Nation's Business". He requests a discussion about "Caucus morale". O'Sullivan requests that Joe Clark individually acknowledge members of the party and say "a few words about how proud he is of the men and women who form the P.C. Caucus, and how well they represent the country--moreover, how well they are prepared to help form the next Government." A response from Ian Green (Legislative Assistant) is positive and he forwards the memo to Jodi White, Director of Communications.

BHAKTISASTRA KE ADHAR PAR RAMCHARITMANAS KA VISLESI-IAN

HINDI

Online Discussions for Large Cohorts - Ian Harwood

This is one of a series of short case studies describing how academic tutors at the University of Southampton have made use of learning technologies to support their students.

Las habilidades sociales como herramienta en la prevención de riesgos laborales : salud y burn out laboral.

El artículo forma parte del monográfico: Prevención y riesgos laborales del docente

Burn-in policies for products having dormant states

Many systems might have a long time dormant period, during which the systems are not operated. For example, most building services products are installed while a building is constructed, but they are not operated until the building is commissioned. Warranty terms for such products may cover the time starting from their installation times to the end of their warranty periods. Prior to the commissioning of the building, the building services products are protected by warranty although they are not operating. Developing optimal burn-in policies for such products is important when warranty cost is analysed. This paper considers two burn-in policies, which incur different burn-in costs, and have different burn-in effects on the products. A special case about the relationship between the failure rates of the products at the dormant state and at the operating state is presented. Numerical examples compare the mean total warranty costs of these two burn-in policies.

Burn in policies for products having dormant states

Constructing a building is a long process which can take several years. Most building services products are installed while a building is constructed, but they are not operated until the building is commissioned. The warranty term for the building service systems may cover the time starting from their installation to the end of the warranty period. Prior to the commissioning of the building, the building services systems are protected by warranty although they are not operated. The bum in time for such systems is important when warranty costs is analyzed. In this paper, warranty cost models for products with burn in periods are presented. Two burn in policies are developed to optimize the total mean warranty cost. A special case on the relationship between the failure rates of the product at the dormant state and at the I operating state is presented.

A.P. Watt and the marketing of 'Ian Maclaren'

This article examines the role of the literary agent A.P. Watt in the successful marketing and global dissemination of the work of the popular Scottish writer 'Ian Maclaren' (Rev. John Watson). Based on extensive archival research, it analyses the magazines and periodicals which published his work in Britain and America and demonstrates the continued impact of his writing in the Scottish media in the twentieth century.

Ian's story : the complex interaction of ethnicity, class and masculinities

In this paper, a narrative is used to convey the complex connectedness that exists between class, ethnicity and masculinity. The story is of Ian, a successful academic who describes himself as Eurasian, and traces his development through parts of his childhood and into his professional career, using what Gough (1994) describes as a 'realistic fiction'. Relevant literature on masculinities and ethnicity is considered. There is some evidence to suggest that Ian has developed a fluid version of masculinity as a result of his Asian-Australian upbringing, and that he expresses different masculinities according to the social settings in which he finds himself. The paper concludes, just as Ian's story does, that masculinity interacts with class and ethnicity. This accords with Connell's (1995) caution that it is dangerous to think that there is a colored masculinity or a working class masculinity, and that the milieux of class and race need to be considered as well.