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- Adamski, Jan, et al.
(författare)
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Intensive care patient survival after limiting life-sustaining treatment-The FINNEOL* national cohort study
- 2020
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Ingår i: Acta Anaesthesiologica Scandinavica. - : WILEY. - 0001-5172 .- 1399-6576. ; 64:8, s. 1144-1153
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Tidskriftsartikel (refereegranskat)abstract
- Background Few studies have examined survival in intensive care unit (ICU) patients after the restriction of life-sustaining treatment (LST). We aimed to analyse independent factors associated with hospital and 12-month survival rates in ICU patients after treatment restrictions. Methods This retrospective observational study examined all patients treated in adult ICUs from 1 January 2016 until 31 December 2016 included in the Finnish ICU Registry. Multivariable logistic regression analysis was performed to explain the effect on survival. Results Decisions to limit LST were made for 2444 patients (13.7%; 95% CI 13.2-14.2). ICU, hospital, and 12-month survival rates were 71% (95% CI 69-73), 49% (95% CI 47-51), and 24% (95% CI 22-26), respectively. In patients for whom life support was withheld, increased 12-month survival rates were associated with admission from the operating theatre (OR 1.9, 95% CI 1.1-3.4), good pre-hospital physical fitness (OR 4.7, 95% Cl 1.2-16.8) and being housed at home (OR 2.0, 95% Cl 1.4-2.8). Decreased survival rates were associated with admission from a hospital ward (OR 0.67, 95% Cl 0.5-0.9), higher comorbidity (OR 0.6, 95% Cl 0.4-0.9), cancer (OR 0.4, 95%CI 0.2-0.9), greater illness severity (SAPS II; OR 0.98, 95% Cl 0.98-0.99), and higher care intensity (TISS-76; OR 0.93, 95% Cl 0.92-0.95). Conclusion Survival among ICU patients with limited treatment was higher than expected. Advanced age was not associated with higher mortality, potentially because treatment restrictions may be set more easily for older patients.
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| 2. |
- Adamski, Jan, et al.
(författare)
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Predictors of treatment limitations in Finnish intensive care units
- 2022
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Ingår i: Acta Anaesthesiologica Scandinavica. - : John Wiley & Sons. - 0001-5172 .- 1399-6576. ; 66:4, s. 526-538
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Tidskriftsartikel (refereegranskat)abstract
- Background Few studies have examined the factors that predict the limitations of life-sustaining treatment (LST) to patients in intensive care units (ICUs). We aimed to identify variables associated with the decision of withholding of life support (WHLS) at admission, WHLS during ICU stay and the withdrawal of ongoing life support (WDLS). Methods This retrospective observational study comprised 17,772 adult ICU patients who were included in the nationwide Finnish ICU Registry in 2016. Factors associated with LST limitations were identified using hierarchical logistic regression. Results The decision of WHLS at admission was made for 822 (4.6%) patients, WHLS during ICU stay for 949 (5.3%) patients, and WDLS for 669 (3.8%) patients. Factors strongly predicting WHLS at admission included old age (adjusted odds ratio [OR] for patients aged 90 years or older in reference to those younger than 40 years was 95.6; 95% confidence interval [CI], 47.2-193.5), dependence on help for activities of daily living (OR, 3.55; 95% CI, 3.01-4.2), and metastatic cancer (OR, 4.34; 95% CI, 3.16-5.95). A high severity of illness predicted later decisions to limit LST. Diagnoses strongly associated with WHLS at admission were cardiac arrest, hepatic failure and chronic obstructive pulmonary disease. Later decisions were strongly associated with cardiac arrest, hepatic failure, non-traumatic intracranial hemorrhage, head trauma and stroke. Conclusion Early decisions to limit LST were typically associated with old age and chronic poor health whereas later decisions were related to the severity of illness. Limitations are common for certain diagnoses, particularly cardiac arrest and hepatic failure.
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| 3. |
- Anugwom, Ikenna, et al.
(författare)
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The effect of switchable ionic liquid (SIL) treatment on the composition and crystallinity of birch chips (Betula pendula) using a novel alkanol amine-organic superbase-derived SIL
- 2014
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Ingår i: Green Processing and Synthesis. - : Walter de Gruyter GmbH. - 2191-9542 .- 2191-9550. ; 3:2, s. 147-154
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Tidskriftsartikel (refereegranskat)abstract
- Two-step treatment of birch chips (Betula pendula) was tested using diethanolamine (DEA)-1,8-diazabicyclo-[5.4.0]-undec-7-ene (DBU)-CO2-switchable ionic liquid (SIL), resulting in a 23% weight reduction in 24 h. The weight of the chips was reduced to 32% of their initial weight upon the second treatment with fresh SIL. SIL to wood ratio of 5:1, at 100°C for 24 h, without stirring, was applied in both steps. The relative amount of wood lignin reduced from 24% to 14% after two treatment cycles. The relative amount of cellulose of the undissolved fraction after SIL treatment increased from 43% (native birch wood) to 68% after the second cycle. Also, the undissolved material was efficiently fibrillated. The dissolved materials recovered from spent SIL, after treatment, contained high xylan content, about 90% of the total hemicelluloses, which was 85% of the recovered material. The powder X-ray diffraction (XRD) results revealed that the crystallinity of the undissolved material increased slightly, indicating dissolution of the amorphous material. Moreover, transformation of cellulose form I to form II in the remaining undissolved chips was not observed.
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| 4. |
- Strzalkowski, Tomek, et al.
(författare)
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Natural language information retrieval: TREC-8 report
- 1999. - 1
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Ingår i: NIST Special Publication 500-246: The Eighth Text REtrieval Conference (TREC-8).
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Konferensbidrag (refereegranskat)abstract
- This report describes the adhoc experiments performed by the GE/Rutgers/SICS/SU/Conexor team in the context of TREC-8. The research efforts went in four directions: 1. As in previous years, we performed a full linguistic analysis of the entire corpus, and used the re- sults of the analysis to provide index terms on a higher level of abstraction than can be provided by stems alone. 2. We made use of two different query expansion techniques, one automatic and one manual, both de- veloped for TREC-8. 3. The various analysis models were combined using a stream model architecture, where each stream represents an alternative text indexing method, and the stream's various overlapping knowledge was merged using a new merging algorithm derived from first principles. 4. The entire text was analyzed for various stylistic items. Due to the distributed approach, this years’ research efforts partly canceled out each other. New ex- periments in every step of the process did not result in an overwhelming overall result. We are able to determine that the manual query expansion technique developed at General Electric performed very well.
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