BACKGROUND: Findings on the association between early high protein provision and mortality in ICU patients are inconsistent. The relation between early high protein provision and mortality in patients receiving CRRT remains unclear. The aim was to study the association between early high protein provision and hospital and ICU mortality and consistency in subgroups.METHODS: A retrospective cohort study was conducted in 2618 ICU patients with a feeding tube and mechanically ventilated ≥48 h (2003-2016). The association between early high protein provision (≥1.2 g/kg/day at day 4 vs. <1.2 g/kg/day) and hospital and ICU mortality was assessed for the total group, for patients receiving CRRT, and for non-septic and septic patients, by Cox proportional hazards analysis. Adjustments were made for APACHE II score, energy provision, BMI, and age.RESULTS: Mean protein provision at day 4 was 0.96 ± 0.48 g/kg/day. A significant association between early high protein provision and lower hospital mortality was found in the total group (HR 0.48, 95% CI 0.39-0.60, p = <0.001), CRRT-receiving patients (HR 0.62, 95% CI 0.39-0.99, p = 0.045) and non-septic patients (HR 0.56, 95% CI 0.44-0.71, p = <0.001). However, no association was found in septic patients (HR 0.71, 95% CI 0.39-1.29, p = 0.264). These associations were very similar for ICU mortality. In a sensitivity analysis for patients receiving a relative energy provision >50%, results remained robust in all groups except for patients receiving CRRT.CONCLUSIONS: Early high protein provision is associated with lower hospital and ICU mortality in ICU patients, including CRRT-receiving patients. There was no association for septic patients.
The sensitivity of tropical forest carbon to climate is a key uncertainty in predicting global climate change. Although short-term drying and warming are known to affect forests, it is unknown if such effects translate into long-term responses. Here, we analyze 590 permanent plots measured across the tropics to derive the equilibrium climate controls on forest carbon. Maximum temperature is the most important predictor of aboveground biomass (−9.1 megagrams of carbon per hectare per degree Celsius), primarily by reducing woody productivity, and has a greater impact per °C in the hottest forests (>32.2°C). Our results nevertheless reveal greater thermal resilience than observations of short-term variation imply. To realize the long-term climate adaptation potential of tropical forests requires both protecting them and stabilizing Earth’s climate.
MULTIFILE
Standard SARS-CoV-2 testing protocols using nasopharyngeal/throat (NP/T) swabs are invasive and require trained medical staff for reliable sampling. In addition, it has been shown that PCR is more sensitive as compared to antigen-based tests. Here we describe the analytical and clinical evaluation of our in-house RNA extraction-free saliva-based molecular assay for the detection of SARS-CoV-2. Analytical sensitivity of the test was equal to the sensitivity obtained in other Dutch diagnostic laboratories that process NP/T swabs. In this study, 955 individuals participated and provided NP/T swabs for routine molecular analysis (with RNA extraction) and saliva for comparison. Our RT-qPCR resulted in a sensitivity of 82,86% and a specificity of 98,94% compared to the gold standard. A false-negative ratio of 1,9% was found. The SARS-CoV-2 detection workflow described here enables easy, economical, and reliable saliva processing, useful for repeated testing of individuals.
LINK
Environmental nano- and micro-plastics (NMPs) are highly diverse [2]. Accounting for this diversity is one of the main challenges to develop a comprehensive understanding of NMPs detection, quantification, fate, and risks [3]. Two major issues currently limit progresses within this field: (a) validation and broadening the current analytical tools (b) uncertainty with respect to NMPs occurrence and behaviour at small scales (< 20 micron). Tracking NMPs in environmental systems is currently limited to micron size plastics due to the size detection limit of the available analytical techniques. There are currently many uncertainties regarding detecting nanoplastics in real environmental systems, e.g. the inexistence of commercially available NMPs and incompatibility between them and those generated from plastic fragments degradation in the environment. Trying to tackle these problems some research groups synthesized NMPs dopped with metals inside [16]. However, even though elemental analysis techniques (ICP-MS) are rather sensitive, the low volume of these metals encapsulated in the nanoparticles make their detection rather challenging. At the same time, due to Sars-Cov-19 pandemic, nucleic acid identification technologies (LAMP, PCR) experienced a fast evolution and are able to provide detection at very low levels with very compact and reliable equipment. Nuclepar proposes the use of Electrohydrodynamic Atomization (EHDA) to generate NMPs coated with nucleic acids of different polymer types, sizes, and shapes, which can be used as support for detection of such particles using PCR-LAMP technology. If proven possible, Nuclepar might become a first step towards an easy NMPs detection tool. This knowledge will certainly impact current risk assessment tools, efficient interventions to limit emissions and adequate regulations related to NMPs.
Veel organisaties hebben de afgelopen jaren geïnvesteerd in een gezondere werkomgeving. Steeds meer aandacht gaat uit naar preventieve maatregelen om de gezondheid en het welzijn van werknemers op kantoor te verbeteren. Denk aan een goede inrichting, een gezond binnenklimaat, het stimuleren van vitaliteit, sociale verbondenheid en werkgeluk en het tegengaan van stress. Dit is niet alleen van belang voor individuele werknemers, maar ook voor organisaties, want: gezondheid, welzijn en productiviteit gaan samen op. Waar tot nu toe echter nog weinig aandacht voor is, is dat werknemers onderling verschillen, en dat zij dus ook verschillen in hun behoeften ten aanzien van de werkplek. Door in de werkomgeving beter in te spelen op individuele verschillen kunnen werknemers effectiever werken en worden bovendien diversiteit en inclusiviteit gestimuleerd. Een belangrijke, maar nog weinig onderzochte dimensie waar mensen op kunnen verschillen is de mate waarin zij gevoelig zijn voor prikkels en omgevingsinvloeden, oftewel: omgevingssensitiviteit. De recente ontwikkelingen rondom COVID-19, hybride werken en de ingrijpende veranderingen in de plekken waar mensen werken, maken nieuwe kennis over de effecten van omgevingssensitiviteit in de werkomgeving extra urgent. Tijdens dit postdocproject wordt in kaart gebracht wat effecten van omgevingssensitiviteit in de werkomgeving zijn, welke behoeften werknemers met een hoge omgevingssensitiviteit hebben, en hoe hierop het beste kan worden ingespeeld door aanpassingen in de werkomgeving.
Point-of-Care devices are broadly viewed as an important contribution to reduce the costs in our healthcare system. Cheap, quick, and reliable testing close to the point of need, can help early detection and thus reduce treatment costs, while improving the quality of life. An important challenge in the realization is the development of the individual cartridges that should be produced in large quantities at low costs. Especially for applications where high sensitivity is required, these cartrgidges will typically have a complex design. In this project we want to develop a manufacturing strategy for large scale production of cartridges based on photonic sensing chips, currently the most sensitive sensors available. A typical sensor cartridge with photonic sensors would comprise the sensor chip, an interface with active components (light source and detectors), the bio-active layer that captures the biomarkers to be detected and a protective package. In addition, there is the choice to integrate the active components in the package (making the interface an electrical one) or placing them in the read-out unit (making the interface an optical one). Finally, testing of the sensor cartridges should also be part of the process. A suitable manufacturing strategy would offer the lowest total-cost-of-ownership (TCO) of the production and use of the cartrdiges. Important in the considereations is that steps can be carried out at the wafer level, at the die level, and at the cartridge level. Because choices for a specific solution will strongly influence the possibilities for other steps, the development of a producitons strategy is far from straightforward. In this project we want to study the possibilities of the individual processes at the three levels mentioned (wafer, die, and cartridge), and in parallel develop a theoretical framework for finding the best strategy in this type of complex production processes.
