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- Jung, Christian, et al.
(author)
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A comparison of very old patients admitted to intensive care unit after acute versus elective surgery or intervention
- 2019
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In: Journal of critical care. - : W B SAUNDERS CO-ELSEVIER INC. - 0883-9441 .- 1557-8615. ; 52, s. 141-148
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Journal article (peer-reviewed)abstract
- Background: We aimed to evaluate differences in outcome between patients admitted to intensive care unit (ICU) after elective versus acute surgery in a multinational cohort of very old patients (80 years; VIP). Predictors of mortality, with special emphasis on frailty, were assessed.Methods: In total, 5063 VIPs were induded in this analysis, 922 were admitted after elective surgery or intervention, 4141 acutely, with 402 after acute surgery. Differences were calculated using Mann-Whitney-U test and Wilcoxon test. Univariate and multivariable logistic regression were used to assess associations with mortality.Results: Compared patients admitted after acute surgery, patients admitted after elective surgery suffered less often from frailty as defined as CFS (28% vs 46%; p < 0.001), evidenced lower SOFA scores (4 +/- 5 vs 7 +/- 7; p < 0.001). Presence of frailty (CFS >4) was associated with significantly increased mortality both in elective surgery patients (7% vs 12%; p = 0.01), in acute surgery (7% vs 12%; p = 0.02).Conclusions: VIPs admitted to ICU after elective surgery evidenced favorable outcome over patients after acute surgery even after correction for relevant confounders. Frailty might be used to guide clinicians in risk stratification in both patients admitted after elective and acute surgery.
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- Bender, A. N., et al.
(author)
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Galaxy cluster scaling relations measured with APEX-SZ
- 2016
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In: Monthly Notices of the Royal Astronomical Society. - : Oxford University Press (OUP). - 0035-8711 .- 1365-2966. ; 460:4, s. 3432-3446
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Journal article (peer-reviewed)abstract
- We present thermal Sunyaev-Zel'dovich effect (SZE) measurements for 42 galaxy clusters observed at 150 GHz with the APEX-SZ experiment. For each cluster, we model the pressure profile and calculate the integrated Comptonization Y to estimate the total thermal energy of the intraclustermedium (ICM). We compare the measured Y values to X-ray observables of the ICM from the literature (cluster gas mass M-gas, temperature T-X, and Y-X = MgasTX) that relate to total cluster mass. We measure power-law scaling relations, including an intrinsic scatter, between the SZE and X-ray observables for three subsamples within the set of 42 clusters that have uniform X-ray analysis in the literature. We observe that differences between these X-ray analyses introduce significant variance into the measured scaling relations, particularly affecting the normalization. For all three subsamples, we find results consistent with a selfsimilarmodel of cluster evolution dominated by gravitational effects. Comparing to predictions from numerical simulations, these scaling relations prefer models that include cooling and feedback in the ICM. Lastly, we measure an intrinsic scatter of similar to 28 per cent in the Y - Y-X scaling relation for all three subsamples.
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- Ade, Peter, et al.
(author)
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The Simons Observatory : science goals and forecasts
- 2019
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In: Journal of Cosmology and Astroparticle Physics. - : IOP Publishing. - 1475-7516. ; :2
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Journal article (peer-reviewed)abstract
- The Simons Observatory (SO) is a new cosmic microwave background experiment being built on Cerro Toco in Chile, due to begin observations in the early 2020s. We describe the scientific goals of the experiment, motivate the design, and forecast its performance. SO will measure the temperature and polarization anisotropy of the cosmic microwave background in six frequency bands centered at: 27, 39, 93, 145, 225 and 280 GHz. The initial con figuration of SO will have three small-aperture 0.5-m telescopes and one large-aperture 6-m telescope, with a total of 60,000 cryogenic bolometers. Our key science goals are to characterize the primordial perturbations, measure the number of relativistic species and the mass of neutrinos, test for deviations from a cosmological constant, improve our understanding of galaxy evolution, and constrain the duration of reionization. The small aperture telescopes will target the largest angular scales observable from Chile, mapping approximate to 10% of the sky to a white noise level of 2 mu K-arcmin in combined 93 and 145 GHz bands, to measure the primordial tensor-to-scalar ratio, r, at a target level of sigma(r) = 0.003. The large aperture telescope will map approximate to 40% of the sky at arcminute angular resolution to an expected white noise level of 6 mu K-arcmin in combined 93 and 145 GHz bands, overlapping with the majority of the Large Synoptic Survey Telescope sky region and partially with the Dark Energy Spectroscopic Instrument. With up to an order of magnitude lower polarization noise than maps from the Planck satellite, the high-resolution sky maps will constrain cosmological parameters derived from the damping tail, gravitational lensing of the microwave background, the primordial bispectrum, and the thermal and kinematic Sunyaev-Zel'dovich effects, and will aid in delensing the large-angle polarization signal to measure the tensor-to-scalar ratio. The survey will also provide a legacy catalog of 16,000 galaxy clusters and more than 20,000 extragalactic sources.
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- Nagarajan, A., et al.
(author)
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Weak-lensing mass calibration of the Sunyaev-Zel'dovich effect using APEX-SZ galaxy clusters
- 2019
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In: Monthly Notices of the Royal Astronomical Society. - : Oxford University Press (OUP). - 0035-8711 .- 1365-2966. ; 488:2, s. 1728-1759
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Journal article (peer-reviewed)abstract
- The use of galaxy clusters as precision cosmological probes relies on an accurate determination of their masses. However, inferring the relationship between cluster mass and observables from direct observations is difficult and prone to sample selection biases. In this work, we use weak lensing as the best possible proxy for cluster mass to calibrate the Sunyaev-Zel'dovich (SZ) effect measurements from the APEX-SZ experiment. For a well-defined (ROSAT) X-ray complete cluster sample, we calibrate the integrated Comptonization parameter, Y-SZ, to the weak-lensing derived total cluster mass, M-500. We employ a novel Bayesian approach to account for the selection effects by jointly fitting both the SZ Comptonization, Y-SZ-M-500, and the X-ray luminosity, Lx-M-500, scaling relations. We also account for a possible correlation between the intrinsic (lognormal) scatter of L-x and Y-SZ at fixed mass. We find the corresponding correlation coefficient to be r = 0.47(-0.35)(+0.24), and at the current precision level our constraints on the scaling relations are consistent with previous works. For our APEX-SZ sample, we find that ignoring the covariance between the SZ and X-ray observables biases the normalization of the Y-SZ-M-500 scaling high by 1-2 sigma and the slope low by similar to 1 sigma, even when the SZ effect plays no role in the sample selection. We conclude that for higher precision data and larger cluster samples, as anticipated from on-going and near-future cluster cosmology experiments, similar biases (due to intrinsic covariances of cluster observables) in the scaling relations will dominate the cosmological error budget if not accounted for correctly.
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| 10. |
- Hagstrom, H., et al.
(author)
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Outcomes of Pregnancy in Mothers With Cirrhosis: A National Population-Based Cohort Study of 1.3 Million Pregnancies
- 2018
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In: Hepatology Communications. - : Ovid Technologies (Wolters Kluwer Health). - 2471-254X. ; 2:11, s. 1299-1305
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Journal article (peer-reviewed)abstract
- There are limited data on pregnancy outcomes in women with cirrhosis. To address this gap, we examined the records of singleton births from Sweden's National Patient Register (NPR), Cause of Death Register (CDR), and Medical Birth Register (MBR) between 1997 and 2011 to assess exposure and pregnancy-related and liver-related outcomes of pregnant women with cirrhosis. Exposure status was defined as having an International Classification of Diseases (ICU) code for cirrhosis obtained prior to or during pregnancy. Poisson regression with cluster-robust standard errors was used to estimate relative risks (RRs) adjusted for maternal age, smoking, and body mass index (BMI). We identified 103 pregnancies in women with cirrhosis and compared these to 1,361,566 pregnancies in women without cirrhosis. Pregnancies in women with cirrhosis were at increased risk of caesarean delivery (36% versus 16%, respectively; adjusted RR [aRR], 2.00; 95% confidence interval [CI] 1.47-2.73), low birth weight (15% versus 3%; aRR, 3.87; 95% CI, 2.11-7.06), and preterm delivery (19% versus 5%; aRR, 3.51; 95% CI, 2.16-5.72). Rates of maternal mortality during pregnancy (no cases), gestational diabetes, preeclampsia, small for gestational age, congenital malformations, and stillbirth were not increased when compared to the pregnant women without cirrhosis. There were 12 hospitalizations during pregnancy due to liver-related events, including one case with bleeding esophageal varices. Conclusion: Women with cirrhosis are at increased risk for adverse pregnancy outcomes. However, severe maternal and fetal adverse events were rare in our study, and most pregnancies in women with cirrhosis ended without complications.
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