Exploring the Relationship between Callous-Unemotional Traits and Implicit Attitudes toward Violence.

Past research has associated callous-unemotional traits (CU) in young people with serious conduct problems and antisocial behavior. However, whether CU traits influence implicit attitudes toward violence remains largely unexplored. We assess this hypothesis in two independent samples: a sample of youth with no criminal records (Study 1, N = 86), and in a sample of young offenders (Study 2, N = 61). Both groups were not compared due to theoretical (very different demographics) and statistical reasons (the total sample was insufficient to be able to reach the statistical power required in the comparison of both groups). Further, we use an implicit procedure to examine whether CU traits modulate wanting for violent stimuli. Across two samples of youth, we found little evidence of an association between CU traits and implicit violent cognition. In youth with no criminal records, implicit attitudes toward violence were related to the unemotional factor of CU traits, but unrelated to other factors and to a global CU traits score. CU traits were not associated with implicit attitudes toward violence in young offenders. The latter finding was mirrored in the implicit wanting task. Overall, our findings cast some doubts on the adequacy of implicit measures to assess implicit violent cognition in youth with CU traits. We discuss potential methodological limitations of this research (e.g., characteristics of the sample and performance in the implicit procedures) that may impact our results.

StrainSelect: A novel microbiome reference database that disambiguates all bacterial strains, genome assemblies and extant cultures worldwide.

Motivation: Microbial metagenomic profiling software and databases are advancing rapidly for development of novel disease biomarkers and therapeutics yet three problems impede analyses: 1) the conflation of "genome assembly" and "strain" in reference databases; 2) difficulty connecting DNA biomarkers to a procurable strain for laboratory experimentation; and 3) absence of a comprehensive and unified strain-resolved reference database for integrating both shotgun metagenomics and 16S rRNA gene data. Results: We demarcated 681,087 strains, the largest collection of its kind, by filtering public data into a knowledge graph of vertices representing contiguous DNA sequences, genome assemblies, strain monikers and bio-resource center (BRC) catalog numbers then adding inter-vertex edges only for synonyms or direct derivatives. Surprisingly, for 10,043 important strains, we found replicate RefSeq genome assemblies obstructing interpretation of database searches. We organized each strain into eight taxonomic ranks with bootstrap confidence inversely correlated with genome assembly contamination. The StrainSelect database is suited for applications where a taxonomic, functional or procurement reference is needed for shotgun or amplicon metagenomics since 636,568 strains have at least one 16S rRNA gene, 245,005 have at least one annotated genome assembly, and 36,671 are procurable from at least one BRC. The database overcomes all three aforementioned problems since it disambiguates strains from assemblies, locates strains at BRCs, and unifies a taxonomic reference for both 16S rRNA and shotgun metagenomics. Availability: The StrainSelect database is available in igraph and tabular vertex-edge formats compatible with Neo4J. Dereplicated MinHash and fasta databases are distributed for sourmash and usearch pipelines at http://strainselect.secondgenome.com. Contact:todd.desantis@gmail.com. Supplementary information: Supplementary data are available online.

Consistency and validity of the inventory of callous- unemotional traits in a multi-centric community sample.

The purpose of this research was to validate the Inventory of Callous Unemotional Traits in a multi-centric community sample of Colombian children and adolescents aged between 9 and 18 years. An adapted version to the Colombian Spanish was applied to 903 school students without significant medical background (neurotypical behavior), and 118 with a clinical history of internalizing or externalizing conditions. A group of specialized judges approved the content validity of the instrument in terms of relevance and intelligibility, but concept factorial validity was low for the uncaring and callousness factors. Exploratory factor analysis confirmed the existence of three dimensions (uncaring, unemotional, and callousness), but only 17 out of 24 items demonstrated adequate psychometric statistics. The consistency for the 17-item Colombian adaptation was acceptable (α = .78). Goodness-of-fit calculated through confirmatory analysis was satisfactory for a bifactor structure (model C). Neurotypical participants showed lower total scores in comparison to the other groups. Participants with internalizing conditions had higher unemotional traits, while those with externalizing behaviors more commonly presented uncaring behaviors. This study is important for psychopathy research in Colombia as provides a validated adaption of the most used instrument to assess callous-unemotional traits in children and adolescents.

Spectrum of Kidney Diseases in Patients With Hepatitis C Virus Infection.

OBJECTIVES: To study the pathologic spectrum of kidney diseases in patients with hepatitis C virus infection (HCV+). METHODS: Native kidney biopsy specimens in HCV+ patients were reviewed. RESULTS: A total of 9,836 native kidney biopsy specimens were evaluated from January 2007 to December 2016, of which 273 (2.8%) were from HCV+ patients, and of these, 115 (42.1%) had diagnoses consistent with HCV-associated glomerulonephritis (GN). Non-HCV-associated kidney diseases comprised most diagnoses (158 cases, 57.9%) including non-immune complex-mediated kidney diseases (127 cases, 46.5%) and other immune complex-mediated glomerular diseases (31 cases, 11.4%). Forty-one (40.6%) patients had HCV-associated GN among 101 HCV+ patients from 2007 to 2011 vs 74 (43.0%) patients with HCV-associated GN among 172 HCV+ patients from 2012 to 2016. HCV-associated GN showed five morphologic patterns: focal proliferative (5.2%), diffuse mesangial proliferative (50.4%), diffuse membranoproliferative (28.7%), proliferative GN with crescentic lesions (7.8%), and membranous patterns (7.8%). CONCLUSIONS: We found a spectrum of pathologic changes in renal biopsy specimens of HCV+ patients, with most having diseases unrelated to HCV infection, HCV-associated GN showing five morphologic patterns, and availability of effective HCV antiviral therapy not yet resulting in major changes in the spectrum of kidney diseases in these patients.

Eficacia de una vía de alta resolución en la evaluación del cólico renoureteral no complicado en un servicio de urgencias hospitalario: un ensayo clínico aleatorizado (Estudio STONE) / Efficacy of a fast-track pathway for managing uncomplicated renal orureteral colic in a hospital emergency department: the STONE randomized clinical trial of Sonography and Testing of a Nephrolithiasis Episode

OBJETIVO: Evaluar una vía de alta resolución (vía POC) que utiliza análisis en el punto de atención (point-of-care testing-POCT-) y ecografía en el punto de atención (point-of-care ultrasonography -POCUS-) en la sospecha del cólico renoureteral (CRU) no complicado y compararla con la vía estándar (vía STD). MÉTODO: Ensayo clínico aleatorizado, controlado, no ciego, realizado en un servicio de urgencias hospitalario (SUH). Incluyó pacientes con sospecha clínica de CRU agudo y se aleatorizaron 1:1 a seguir vía POC o vía STD. Se analizó el tiempo de estancia en el SUH, el tratamiento administrado, la proporción de diagnósticos alternativos a CRU y las complicaciones a 30 días. RESULTADOS: Entre noviembre de 2018 y octubre de 2019, se reclutaron 140 pacientes de los que se analizaron 124.El tiempo de estancia total en el SUH de la vía POC fue de 112 minutos (DE 45) y en la vía STD 244 minutos (DE102) (p < 0,001). No hubo diferencias en el tratamiento administrado en urgencias, en el número de diagnósticos alternativos, ni en las complicaciones a 30 días. CONCLUSIONES: La utilización de una vía de alta resolución del manejo del CRU en un SUH es eficaz, segura y reduce el tiempo de estancia en urgencias

OBJECTIVES: To evaluate a fast-track pathway utilizing point-of-care (POC) testing and sonography as soon as uncomplicated renal or ureteral colic is suspected and to compare the POC clinical pathway to a standard one. METHODS: Unblinded randomized controlled clinical trial in a hospital emergency department (ED). We enrolled patients with suspected uncomplicated renal or ureteral colic and randomized them to a POC or standard pathway(1:1 ratio). Duration of ED stay, treatments, the proportion of diagnoses other than uncomplicated colic, and 30-daycomplications were analyzed. RESULTS: One hundred forty patients were recruited between November 2018 and October 2019; data for 124 were analyzed. The mean (SD) total time in the ED was 112 (45) minutes in the POC arm and 244 (102) in the standard arm (P< .001). Treatments, alternative diagnoses, and complication rates did not differ. CONCLUSION: The use of a fast-track POC pathway to manage uncomplicated colic in the ED is effective and safe. It also reduces the amount of time spent in the ED

Efficacy of a fast-track pathway for managing uncomplicated renal or ureteral colic in a hospital emergency department: the STONE randomized clinical trial of Sonography and Testing of a Nephrolithiasis Episode. / Eficacia de una vía de alta resolución en la evaluación del cólico renoureteral no complicado en un servicio de urgencias hospitalario: un ensayo clínico aleatorizado (Estudio STONE).

OBJECTIVES: To evaluate a fast-track pathway utilizing point-of-care (POC) testing and sonography as soon as uncomplicated renal or ureteral colic is suspected and to compare the POC clinical pathway to a standard one. MATERIAL AND METHODS: Unblinded randomized controlled clinical trial in a hospital emergency department (ED). We enrolled patients with suspected uncomplicated renal or ureteral colic and randomized them to a POC or standard pathway (1:1 ratio). Duration of ED stay, treatments, the proportion of diagnoses other than uncomplicated colic, and 30-day complications were analyzed. RESULTS: One hundred forty patients were recruited between November 2018 and October 2019; data for 124 were analyzed. The mean (SD) total time in the ED was 112 (45) minutes in the POC arm and 244 (102) in the standard arm (P .001). Treatments, alternative diagnoses, and complication rates did not differ. CONCLUSION: The use of a fast-track POC pathway to manage uncomplicated colic in the ED is effective and safe. It also reduces the amount of time spent in the ED.

OBJETIVO: Evaluar una vía de alta resolución (vía POC) que utiliza análisis en el punto de atención (point-of-care testing ­POCT­) y ecografía en el punto de atención (point-of-care ultrasonography ­POCUS­) en la sospecha del cólico renoureteral (CRU) no complicado y compararla con la vía estándar (vía STD). METODO: Ensayo clínico aleatorizado, controlado, no ciego, realizado en un servicio de urgencias hospitalario (SUH). Incluyó pacientes con sospecha clínica de CRU agudo y se aleatorizaron 1:1 a seguir vía POC o vía STD. Se analizó el tiempo de estancia en el SUH, el tratamiento administrado, la proporción de diagnósticos alternativos a CRU y las complicaciones a 30 días. RESULTADOS: Entre noviembre de 2018 y octubre de 2019, se reclutaron 140 pacientes de los que se analizaron 124. El tiempo de estancia total en el SUH de la vía POC fue de 112 minutos (DE 45) y en la vía STD 244 minutos (DE 102) (p 0,001). No hubo diferencias en el tratamiento administrado en urgencias, en el número de diagnósticos alternativos, ni en las complicaciones a 30 días. CONCLUSIONES: La utilización de una vía de alta resolución del manejo del CRU en un SUH es eficaz, segura y reduce el tiempo de estancia en urgencias.

Utilización de TICs en medicina de urgencias: valoración de un software de ayuda a la prescripción del paciente con hiperglucemia (DIAGETHER(R)), por parte de médicos residentes / Use of ICTs in emergency medicine: assessment of a prescription aid software for patients with hyperglycemia (DIAGETHER(R)), by resident doctors

INTRODUCCIÓN: La permisividad ante la hiperglucemia es nociva para los pacientes ingresados. DIAGETHER es una aplicación que ayuda al médico en el tratamiento del paciente diabético. OBJETIVOS: Determinar grado de usabilidad, nivel de confianza y valoración global de DIAGETHER empleada por médicos residentes en distintos escenarios clínicos. MÉTODO: Estudio descriptivo multicéntrico, basado en una encuesta de valoración sobre DIAGETHER, a 42 residentes de dos hospitales, valorando la toma de decisiones con respecto a la terapéutica de pacientes con alteraciones glucémicas en distintos escenarios clínicos. RESULTADOS: DIAGETHER fue valorado positivamente respecto a usabilidad, confianza en resolución de casos, y tiempo empleado. La valoración global de la herramienta fue del 87,5. En el lado negativo, es necesario realizar estudios en terreno real para saber la adaptación real de la herramienta al trabajo médico. CONCLUSIONES: La aplicación DIAGETHER(R) es una herramienta fácil de usar, rápida en la toma de decisiones y le da al médico seguridad en el tratamiento de pacientes con hiperglucemia, lo que hace que su valoración global sea alta. En el lado negativo, el estudio fue realizado en condiciones "no reales", sería interesante desarrollar futuros estudio en varios servicios de urgencias

INTRODUCTION: Permissiveness to hyperglycemia is harmful to admitted patients. DIAGETHER is an application that helps the doctor in the treatment of the diabetic patient. OBJECTIVES: Determine degree of usability, level of confidence and overall assessment of DIAGETHER used by physicians resident in different clinical settings. Method. Multicenter descriptive study, based on a DIAGETHER assessment survey, of 42 residents of two hospitals, assessing decision-making regarding the therapeutics of patients with glycemic disorders in different clinical settings. RESULTS: DIAGETHER was positively assessed regarding usability, confidence in case resolution, and time spent. The overall assessment of the tool was 87.5. On the negative side, it is necessary to conduct real-field studies to know the real adaptation of the tool to medical work. CONCLUSIONS: The DIAGETHER(R) application is an easy-to-use, quick decision-making tool and gives the doctor safety in the treatment of patients with hyperglycemia, which makes their overall assessment high. On the negative side, the study was conducted under "non-real" conditions, it would be interesting to develop future studies in several emergency departments

Niveles de ansiedad y depresión en médicos de urgencias de Madrid durante la pandemia por el virus SARS-CoV-2 / Levels of anxiety and depression among emergency physicians in Madrid during the SARS-CoV-2 pandemic

No disponible

Chemical composition of material extractives influences microbial growth and dynamics on wetted wood materials.

The impact of material chemical composition on microbial growth on building materials remains relatively poorly understood. We investigate the influence of the chemical composition of material extractives on microbial growth and community dynamics on 30 different wood species that were naturally inoculated, wetted, and held at high humidity for several weeks. Microbial growth was assessed by visual assessment and molecular sequencing. Unwetted material powders and microbial swab samples were analyzed using reverse phase liquid chromatography with tandem mass spectrometry. Different wood species demonstrated varying susceptibility to microbial growth after 3 weeks and visible coverage and fungal qPCR concentrations were correlated (R2 = 0.55). Aspergillaceae was most abundant across all samples; Meruliaceae was more prevalent on 8 materials with the highest visible microbial growth. A larger and more diverse set of compounds was detected from the wood shavings compared to the microbial swabs, indicating a complex and heterogeneous chemical composition within wood types. Several individual compounds putatively identified in wood samples showed statistically significant, near-monotonic associations with microbial growth, including C11H16O4, C18H34O4, and C6H15NO. A pilot experiment confirmed the inhibitory effects of dosing a sample of wood materials with varying concentrations of liquid C6H15NO (assuming it presented as Diethylethanolamine).

Earth microbial co-occurrence network reveals interconnection pattern across microbiomes.

BACKGROUND: Microbial interactions shape the structure and function of microbial communities; microbial co-occurrence networks in specific environments have been widely developed to explore these complex systems, but their interconnection pattern across microbiomes in various environments at the global scale remains unexplored. Here, we have inferred an Earth microbial co-occurrence network from a communal catalog with 23,595 samples and 12,646 exact sequence variants from 14 environments in the Earth Microbiome Project dataset. RESULTS: This non-random scale-free Earth microbial co-occurrence network consisted of 8 taxonomy distinct modules linked with different environments, which featured environment specific microbial co-occurrence relationships. Different topological features of subnetworks inferred from datasets trimmed into uniform size indicate distinct co-occurrence patterns in the microbiomes of various environments. The high number of specialist edges highlights that environmental specific co-occurrence relationships are essential features across microbiomes. The microbiomes of various environments were clustered into two groups, which were mainly bridged by the microbiomes of plant and animal surface. Acidobacteria Gp2 and Nisaea were identified as hubs in most of subnetworks. Negative edges proportions ranged from 1.9% in the soil subnetwork to 48.9% the non-saline surface subnetwork, suggesting various environments experience distinct intensities of competition or niche differentiation. Video abstract CONCLUSION: This investigation highlights the interconnection patterns across microbiomes in various environments and emphasizes the importance of understanding co-occurrence feature of microbiomes from a network perspective.

Gender differences in the association between theory of mind, empathy and conduct disorder: A cross-sectional study / Diferencias de género en la asociación entre teoría de la mente, empatía y trastorno de conducta: Un estudio transversal

Abstract The purpose of this research was to explore gender differences regarding theory of mind and empathy abilities in a sample of adolescents with conduct disorder (n=46; males=28 and females=18). Empathy (cognitive and emotional dimensions) and theory of mind (reading the mind through the eyes) were tested based on an observational method with a crosssectional design. Statistical analysis included: description of variables according to their type, assessment of quantitative correlations and logistic multivariate modelling for identifying variables that differentiate female from male patients. The results demonstrated significant gender differences in empathy and theory of mind evaluations. Particularly, women showed different scores for cognitive/emotional empathy and in the Reading the Mind through the Eyes test, with a lower number of behavioural symptoms. The results are discussed in light of the current empirical evidence, and some future directions in the study of conduct disorder are suggested.

Resumen El objetivo de este estudio fue explorar las diferencias de género en habilidades de teoría de la mente y empatía en una muestra de adolescentes con trastorno de conducta (n=46; 28 hombres y 18 mujeres). Se determinó un abordaje observacional con un diseño de corte transversal mediante el cual se evaluó la empatía (dimensiones cognitiva y afectiva) y teoría de la mente (lectura de la mirada). El análisis estadístico incluyó la descripción de las variables de acuerdo con su naturaleza, la evaluación de correlaciones cuantitativas, y el diseño de un modelo logístico multivariado para identificar las variables que diferencian los pacientes según su género. Los resultados indicaron diferencias significativas por género tanto en empatía como en teoría de la mente. Las mujeres presentaron de manera consistente diferencias en los niveles de empatía cognitiva/afectiva y test de la mirada, con un menor número de síntomas de conducta. Los resultados se discuten a la luz de la evidencia empírica actual y se sugieren algunas direcciones futuras en el estudio del trastorno de conducta.

Morir en urgencias / Dying in the emergency room

No disponible

Inhaled Methoxyflurane Provides Greater Analgesia and Faster Onset of Action Versus Standard Analgesia in Patients With Trauma Pain: InMEDIATE: A Randomized Controlled Trial in Emergency Departments.

STUDY OBJECTIVE: The objective of the InMEDIATE study was to evaluate the change in intensity of traumatic pain over the first 20 min in adult patients treated with methoxyflurane versus standard analgesic treatment in Spain. This the first randomized, active-controlled, multicenter trial of methoxyflurane in the emergency setting in Europe. METHODS: This was a randomized, controlled study that enrolled adult patients with acute moderate to severe (score ≥4 on the 11-point Numeric Rating Scale) trauma-associated pain in 14 Spanish emergency departments. Patients were randomized 1:1 to methoxyflurane (up to 2×3 mL) or standard analgesic treatment. Coprimary endpoints were the change from baseline in Numeric Rating Scale pain intensity score during the first 20 minutes of treatment and time to first pain relief. RESULTS: Three hundred five patients were randomized (methoxyflurane 156; standard analgesic treatment 149). Most patients in the standard analgesic treatment group (70%) received intravenous first-step analgesics and 9.4% of patients were treated with opioids. Mean decrease from baseline in Numeric Rating Scale pain intensity score was greater for methoxyflurane than standard analgesic treatment at all points, with a significant treatment difference overall up to 20 minutes (repeated-measures model 2.47 versus 1.39; treatment difference 1.00; 95% confidence interval 0.84 to 1.32). Median time to first pain relief was significantly shorter for methoxyflurane than standard analgesic treatment (3 versus 10 minutes). Methoxyflurane achieved better patient and clinician ratings for pain control and comfort of treatment than standard analgesic treatment and exceeded patient and clinician expectations of treatment in, respectively, 77% and 72% of cases compared with 38% and 19% for standard analgesic treatment. CONCLUSION: These results support consideration of methoxyflurane as a nonnarcotic, easy-to-administer, rapid-acting, first-line alternative to currently available analgesic treatments for trauma pain.

Results of a Prospective Study to Evaluate the Impact of Point-of-Care Ultrasound in the Enhancement of Gastrointestinal Bleeding Risk Scores.

OBJECTIVES: Gastrointestinal (GI) bleeding is a common illness seen in the emergency department. The prognosis varies from self-limited to potentially life threatening. Currently available GI bleeding risk scores have only a modest predictive value, limiting their wide implementation. The aim of this study was to assess the association and capability of point-of-care ultrasound (POCUS) used by emergency physicians to improve common GI bleeding scores for predicting complications and long-term outcomes of patients with GI bleeding, which to our knowledge have never been studied. METHODS: Between August 2015 and April 2017, 203 hemodynamically stable patients with acute GI bleeding admitted to the emergency department were prospectively investigated. Using ultrasound, we measured the inferior vena cava diameter, cardiac output with surrogate markers such as the velocity time integral before and after the passive leg-raising test, and the presence of systolic obliteration of the left ventricle. The Rockall and Glasgow-Blatchford scores were calculated for patients with upper GI bleeding and the Velayos score for lower GI bleeding. The patients had follow-up during hospitalization and 30 days later to assess for early and late adverse events (AEs). Then we integrated the ultrasound findings of hypovolemia into the GI bleeding scores, assessing the capability to detect AEs. RESULTS: In our cohort, patients with upper GI bleeding who showed left ventricle kissing walls had a worse evolution, with a greater presence of late AEs (odds ratio [OR], 3.8; 95% confidence interval [CI], 1.32-10.96; P = .01). Patients with lower GI bleeding who showed a collapse of the inferior vena cava (>50%) after passive leg raising had a greater presence of early AEs (OR, 3.6; 95% CI, 1.46-9.00; P = .004). The predictive performance of the Rockall score (receiver operating characteristic analysis: area under the curve [AUC], 77.6%; 95% CI, 66.3%-88.8%) increased with POCUS (AUC, 80.3%; 95% CI, 69.5%-91.1%); that of the Glasgow-Blatchford score (AUC, 72.5%; 95% CI, 59.9%-85.2%) increased with POCUS (AUC, 73.2%; 95% CI, 61.1%-85.4%); and that of Velayos score (AUC, 55.7%; 95% CI, 42.5%-69.0%) also increased with POCUS (AUC, 72.2%; 95% CI, 61.1%-83.3%). CONCLUSIONS: The use of POCUS in GI bleeding is feasible and enhances common GI bleeding risk scores, showing better predictive performance in detecting AEs.

Utilidad de la ecografía clínica en el dolor torácico del paciente consumidor de cocaína: más allá del síndrome coronario agudo / Usefulness of clinical ultrasound to evaluate an emergency in a cocaine user: beyond acute coronary syndrome

No disponible

Microbial and metabolic succession on common building materials under high humidity conditions.

Despite considerable efforts to characterize the microbial ecology of the built environment, the metabolic mechanisms underpinning microbial colonization and successional dynamics remain unclear, particularly at high moisture conditions. Here, we applied bacterial/viral particle counting, qPCR, amplicon sequencing of the genes encoding 16S and ITS rRNA, and metabolomics to longitudinally characterize the ecological dynamics of four common building materials maintained at high humidity. We varied the natural inoculum provided to each material and wet half of the samples to simulate a potable water leak. Wetted materials had higher growth rates and lower alpha diversity compared to non-wetted materials, and wetting described the majority of the variance in bacterial, fungal, and metabolite structure. Inoculation location was weakly associated with bacterial and fungal beta diversity. Material type influenced bacterial and viral particle abundance and bacterial and metabolic (but not fungal) diversity. Metabolites indicative of microbial activity were identified, and they too differed by material.

Oxygen Saturation on Admission Is a Predictive Biomarker for PD-L1 Expression on Circulating Monocytes and Impaired Immune Response in Patients With Sepsis.

Sepsis is a pathology in which patients suffer from a proinflammatory response and a dysregulated immune response, including T cell exhaustion. A number of therapeutic strategies to treat human sepsis, which are different from antimicrobial and fluid resuscitation treatments, have failed in clinical trials, and solid biomarkers for sepsis are still lacking. Herein, we classified 85 patients with sepsis into two groups according to their blood oxygen saturation (SaO2): group I (SaO2 ≤ 92%, n = 42) and group II (SaO2 > 92%, n = 43). Blood samples were taken before any treatment, and the immune response after ex vivo LPS challenge was analyzed, as well as basal expression of PD-L1 on monocytes and levels of sPD-L1 in sera. The patients were followed up for 1 month. Taking into account reinfection and exitus frequency, a significantly poorer evolution was observed in patients from group I. The analysis of HLA-DR expression on monocytes, T cell proliferation and cytokine profile after ex vivo LPS stimulation confirmed an impaired immune response in group I. In addition, these patients showed both, high levels of PD-L1 on monocytes and sPD-L1 in serum, resulting in a down-regulation of the adaptive response. A blocking assay using an anti-PD-1 antibody reverted the impaired response. Our data indicated that SaO2 levels on admission have emerged as a potential signature for immune status, including PD-L1 expression. An anti-PD-1 therapy could restore the T cell response in hypoxemic sepsis patients with SaO2 ≤ 92% and high PD-L1 levels.