Background: There is increasing interest in the use of eliciting doses (EDs) to inform allergen risk management. EDs can be estimated from the distribution of threshold doses for allergic subjects undergoing food challenges within a specified population. Estimated ED05 values for cow’s milk (the dose expected to cause objective allergic symptoms in 5% of the milk-allergic population) range from 0.5mg to 13.9mg cow’s milk protein. We undertook a single-dose challenge study to validate a predicted ED05 for cow’s milk of 0.5mg protein. Methods: Participants were recruited from 4 clinical centres. Predetermined criteria were used to identify patients reacting to 0.5mg cow’s milk protein (approximately 0.015ml of fresh cow’s milk). Children over 1 year underwent formal challenge to cow’s milk to confirm clinical reactivity. Results: 172 children (median age 6 (IQR 0.7-11) years, 57% male) were included in this analysis. Twelve (7.0%, 95% CI 3.7-11.9%) children experienced objective symptoms that met the predetermined criteria. One participant had mild anaphylaxis which responded to a single dose of adrenaline, the remainder experienced only mild symptoms with no treatment required. We did not identify any baseline predictors of sensitisation which were associated with objective reactivity to the single-dose challenge using 0.5mg cow’s milk protein. Conclusions: These data support an estimated ED05 for cow’s milk of 0.5mg protein. Values for ED05 above 0.5mg for cow’s milk protein proposed for allergen risk management need to be reviewed.

Unicoloniality, or the absence of behavioral boundaries between nests, is thought to promote ant abundance due to reduced intraspecific competition. Workers within unicolonial populations may increase their own inclusive fitness by preferentially caring for more related individuals (nepotism), but nepotism has only rarely been documented in ants. We tested for unicoloniality and nepotism in polygyne red imported fire ants (Solenopsis invicta; hereafter fire ants). Fire ants occur in two social forms: monogyne (i.e., colonies with a single egg-laying queen) and polygyne (i.e., colonies with multiple egg-laying queens). Introduced populations of polygyne fire ants are commonly referred to as unicolonial, but cooperation between and within colonies is poorly documented. To delimit boundaries between colonies in the field, we quantified the exchange of a 15N-glycine tracer dissolved in a sucrose solution and correlated this exchange with colony genetic structure. We also quantified within-colony conflict between workers and larvae using close siblings (i.e., from the same mother) and non-siblings (i.e., from a different mother). Counter to our expectations, polygyne colonies did not exchange resources or workers, indicating distinct colony boundaries. Polygyne workers also preferentially fed larval sibling and may have preferentially cannibalized non-siblings. Polygyne colony behavior was correlated with higher levels of within-mound relatedness between workers in the field than those previously reported in North America (mean ± SE: 0.269 ± 0.037). Our study challenges fundamental assumptions about introduced populations of polygyne fire ants and suggests that polygyne colonies are multicolonial and likely engage in high levels of intraspecific competition.

Over 16 million people die every year by cardiovascular diseases, acute coronary syndrome is part of the spectrum.\cite{2000-20162018}A widely used approach is platelet aggregation inhibition by clopidogrel, drastically diminishing mortality but it doesn't works the same for everyone, a CYP2C19* 2 polymorphism could led your patient to a shorter life. How common is this? What about intermediate metabolizers? Do we need to think in alternative treatment? what is the importance of CYP2C19* 2 polymorphism versus other polymorphism? this and other topics would be addressed in this review.

Fat is recognized as low thermoconductivity (k) tissue and barrier for thermal transmission. We here identify and characterize morphologically, radiologically, and thermo-physically fat-enabled bilateral integrated blood/fat/skin thermal pathways, referred as Brain-eyelid Thermal Tunnels (BTT), that enable undisturbed thermal transmission between brain and uniquely radiant high-k skin in the right and left eyelids. We elucidated cranial "aberrancies", justified the facial "death triangle" and uncovered perihypothalamic thermoregulatory-sensory triunal inherent to brain thermal homeostasis that revealed thermal communication among brain, heart, and environment. Our results introduce the first evidence for a brain↔surface thermo-physical pathway and biological thermal waveguide. Said transmission was documented by an isolated beam of emission at the ipsilateral BTT terminus. We showed brain thermal transfer via BTT during neurosurgery by comparison of noninvasive temperature measurement at the BTT site (BTT°) to direct temperature measurement in brain parenchyma (Parenchyma°) in open craniotomy (BTT° - Parenchyma° = 0.012±0.2°C, p=0.91), as opposed to 0.45°C difference between BTT° and core temperature. This indicates that BTT° provides an accurate noninvasive method for measuring human brain temperature unimpeded by the body's thermal barrier through transorbital thermo-physical configurations. 

Introduction: Septal mass reduction is beneficial for hypertrophic obstructive cardiomyopathy (HOCM) patients with severe left ventricular outflow (LVOT) gradient and symptoms, with surgical myectomy or alcohol septal ablation (ASA) currently recommended in selected patients. Radiofrequency (RF) ablation of hypertrophied septum has been published as a novel method to alleviate LVOT obstruction in small populations. This study aims to investigate factors influencing clinical outcomes of radiofrequency septum ablation. Methods and results: In this study, twenty patients with HOCM who underwent endocardial ablation were included. Echocardiography and cardiac MRI (CMR) data was collected and analyzed pre- and (or) post- procedure. Nineteen patients underwent ablation successfully, while ablation was aborted in one patient with prior RBBB due to transient complete atrioventricular block (AVB). After six months of follow-up, NYHA heart functional class improved from III (2 - 3) to II (1 - 2) (p < 0.001), and resting LVOT gradient was significantly reduced (87.6 ± 29.5 mmHg vs. 48.1 ± 29.7, p < 0.001). LVOT gradient reduction was significantly higher in patients with limited basal septal hypertrophy (60.9 ± 8.3 vs. 27.9 ± 7.1, p = 0.01), shorter anterior mitral leaflet (56.1 ± 6.4 vs. 20.4 ± 5.0, p<0.01) and normally positioned papillary muscle (36.9 ± 7.1 vs. 75.0 ± 6.3, p <0.05). Conclusions: Endocardial septal ablation appears to be a safe and effective procedure for alleviating LVOT gradient in patients with HOCM, especially in those with limited basal septal hypertrophy, shorter anterior mitral leaflet and normal positioned papillary muscle.

A document by Eva Serrano. Click on the document to view its contents.

ABSTRACT Heart transplantation is the gold standard treatment for patients with end-stage heart failure. The limited availability of organs has led to the expansion of the donor criteria by introducing the use of marginal donors. Although the use of marginal donors has reduced waiting lists, the results are worse than with standard donors. For this reason, the use of marginal donors in clinical practice is still controversial. We describe two cases of heart transplantation from marginal donors with pre-transplant angiography evidence of coronary stenosis and normal ventricular function.

Plants acclimate their photosynthetic capacity in response to changing environmental conditions. In Arabidopsis thaliana, photosynthetic acclimation to cold requires the accumulation of the organic acid fumarate, catalysed by a cytosolic fumarase FUM2, however the role of this is currently unclear. In this study, we use an integrated experimental and modelling approach to examine the role of FUM2 and fumarate across the physiological temperature range. Using physiological and biochemical analyses, we demonstrate that FUM2 is necessary for acclimation not only to low temperatures, as previously shown, but also to increased temperature. To understand the role of FUM2 activity, we have adapted a reliability engineering technique, Failure Mode and Effect Analysis (FMEA), to apply it to a biological problem. This allows us to formalize a rigorous approach for ranking metabolites according to the potential risk they pose to the metabolic system. FMEA identifies fumarate as a low-risk metabolite. Its precursor, malate, is shown to be high-risk and liable to cause system instability. We conclude that the role of cytosolic fumarase, FUM2, is to provide a fail-safe, maintaining system stability under changing environmental conditions.

Grain size is potentially yield-determining in wheat, controlled by the ubiquitin pathway and negatively regulated by ubiquitin receptor DA1. We analysed whether increased thousand grain weight in wheat da1 mutant is translated into higher grain yield and whether additional carbon provided by elevated (e)CO2 can be better used by the da1, displaying higher grain sink strength and size. Yield-related, biomass, grain quality traits and grain dimensions were analysed by two-factorial analysis, regarding genotype and eCO2. da1 increased grain size but reduced spikes and grains per plant, grains per spike and spikelets per spike, independent of eCO2 treatment, leaving total grain yield unchanged. eCO2 increased yield and grain number additively and independently of da1, but did not overcome the trade-off between grain size and number observed for da1. eCO2 but not da1 impaired grain quality, strongly decreasing concentrations of several macro- and micro-elements. In conclusion, intrinsic stimulation of grain sink strength and grain size, achieved by da1, is not benefitting total yield unless trade-offs between grain size and numbers can be overcome. The results reveal interactions of yield components in da1-wheat under ambient and eCO2, thereby uncovering limitations enhancing wheat yield potential.

In this work, traditional Monte Carlo simulation and DFT-based structural optimization methods were combined to screen computation-ready experimental MOF database for the application of natural gas purification. Our results show that about half of the good performing CoRE-MOF structures displayed various degrees of deformation (even collapse) after the structure optimization. This phenomenon attributed to the strong attraction of unsaturated metals which attract nearby organic components. For some materials with deformation, unsaturated metals form new bonds with the adjacent organic linkers creating distortions that would be unrealistic in the experimental materials. For the remaining relatively stable materials whose structural characteristics did not change too much, we further studied the adsorption performance of their optimized structures. Finally, 12 good-performing MOF materials with high stability were screened out which could greatly improve the possibility for constructing robust MOFs that could hold open metal sites by experiments.

Background: Cardiac resynchronisation therapy-defibrillator (CRT-D) implantation via the cephalic vein is feasible and safe. Recent evidence has suggested a higher implantable cardioverter defibrillator (ICD) lead failure in multi-lead defibrillator therapy via the cephalic route. We evaluated the relationship between CRT-D implantation via the cephalic and ICD lead failure. Methods: Data was collected from three CRT-D implanting centres between October 2008 – September 2017. In total 631 patients were included. Patient and lead characteristics with ICD lead failure were recorded. Comparison of ‘cephalic’ (ICD lead via cephalic) vs ‘non-cephalic’ (ICD lead via non-cephalic route) cohorts was performed. Kaplan-Meier survival and a Cox-regression analysis were applied to assess variables associated with lead failure. Results: The cephalic and non-cephalic cohorts were equally male (82.2% vs 78.3%, p=0.28), similar in age (69.7±11.5 vs 68.7 ± 11.9, p=0.33) and body mass index (BMI) (27.7±5.1 vs 27.1±5.7, p=0.33). Most ICD leads were implanted via the cephalic vein (73.7%) and patients had a median of 2.8 leads implanted via this route. The rate of ICD lead failure was low and similar between both groups (0.4%/year vs 0.14%/year, p=0.34). Female gender was more common in the lead failure cohort than non-failure (50% vs 18.2%, respectively, p=0.01) as was hypertension (90% vs 54%, respectively, p=0.03). On multivariate Cox regression, female sex (p=0.007), hypertension (p=0.041) and BMI (p=0.042) were significantly associated with ICD lead failure. Conclusion: CRT-D implantation via the cephalic route is not associated with premature ICD lead failure. Female gender, BMI and hypertension correlate with lead failure.

The coronavirus disease 2019 pandemic (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused an unprecedented global social and economic impact, and numerous deaths. Many risk factors have been identified in the progression of COVID-19 into a severe and critical stage, including old age, male gender, underlying comorbidities such as hypertension, diabetes, obesity, chronic lung disease, heart, liver and kidney diseases, tumors, clinically apparent immunodeficiencies, local immunodeficiencies, such as early type-I interferon secretion capacity, and pregnancy. Possible complications include acute respiratory distress syndrome, shock, disseminated coagulopathy, acute kidney injury, pulmonary embolism, and secondary bacterial pneumonia. The development of lymphopenia and eosinopenia are laboratory indicators of COVID-19. Laboratory parameters to monitor disease progression include lactate dehydrogenase, procalcitonin, high-sensitivity C-reactive protein, proinflammatory cytokines such as interleukin (IL)-6, IL-1, Krebs von den Lungen-6 (KL-6) and ferritin. The development of a cytokine storm and extensive chest computed tomography imaging patterns are indicators of a severe disease. In addition, socioeconomic status, diet, lifestyle, geographical differences, ethnicity, exposed viral load, day of initiation of treatment, and quality of health care have been reported to influence individual outcomes. In this review, we highlight the scientific evidence on the risk factors of COVID-19.

Scimitar syndrome is a rare anomaly, most commonly including partial pulmonary venous drainage into the inferior vena cava, hypoplasia of the right lung, and systemic collaterals from the aorta. We report a pediatric case in whom this rare syndrome was associated with intracardiac lesions and a large aberrant systemic arterial supply to the right lung that originated from the abdominal aorta and fistulated in the inferior vena cava.

Abstract Objectives: The use of minimally invasive or transcatheter interventions rather than standard full sternotomy operations to treat Tricuspid valve disease is increasing. Debate however is still open regarding venous drainage management during cardiopulmonary bypass and wheatear or not superior and inferior vena cava should be occluded during opening of the right atrium to avoid air entrance in the venous line. The aim of the present study is to report operative outcomes and mid-term follow-up results of minimally invasive tricuspid valve surgery performed without caval occlusion. Methods: This is a retrospective outcome evaluation from institutional records with prospective data entry. We searched for all the patients who underwent right mini-thoracotomy tricuspid valve surgery isolated or combined with mitral valve surgery during the period June 2013 – February 2020. Results: During the study period 68 consecutive patients underwent minimally invasive tricuspid valve surgery without occlusion of cava veins. Survival at a 5-year and 8-year follow up was 100% and 79%, respectively. At follow-up no patient had an NHYA class greater than two, only one patient was re-hospitalized for heart failure for an atrial fibrillation episode. One patient was hospitalized for a pericardiocentesis twenty days after discharge No severe tricuspid regurgitation was evident at echocardiographic follow up. Five patients had 2+ TR. Conclusion Our results show that performing tricuspid surgery without caval occlusion is safe. There is no clinical evidence of gas embolism. Mid-term follow up data confirm that minimally invasive approach does not alter the quality of surgery.

Background Anaemia, a common complication of chronic kidney disease (CKD), is associated with reduced health-related quality of life and physical functioning. This study investigated the knowledge, perceptions and awareness of anaemia in patients with CKD in the United States. Methods Between 29 August and 17 September 2018, an online survey was administered to consenting patients in the United States aged ≥ 18 years with self-reported CKD, with or without anaemia; patients with cancer were excluded. The survey comprised 27 questions, exploring anaemia knowledge, health-related quality of life, anaemia management, practitioner–patient relationships, and the information sources patients used. Results Of 446 patients with CKD, 255 (57.2%) were diagnosed with anaemia and 191 (42.8%) reported not being diagnosed with anaemia, or were unsure/could not remember (non-anaemia cohort). In patients with anaemia, 71.0% were aware of the relationship between CKD and anaemia versus 52.9% of those in the non-anaemia cohort. In the anaemia cohort, 46.3% of patients were aware of their haemoglobin level, compared with 27.2% of patients in the non-anaemia cohort. Symptoms most commonly reported as being made worse by anaemia included lack of energy (82.4%), feeling ill (31.4%), and the ability to enjoy life (30.2%). Despite 67.4% of patients with anaemia in CKD believing that their condition was well or very well managed, only 50% reported being informed about different treatments without having to prompt their healthcare professional, and 43.9% were seeking more information and support about managing their condition. Conclusions In the United States, patients with anaemia and CKD perceived that anaemia had a negative impact on their physical health and emotional wellbeing. Our findings emphasize the lack of disease awareness regarding anaemia in patients with CKD, suggesting that patients would benefit from further education regarding its management, and available treatment options.

Introduction: Left atrial posterior wall (LAPW) isolation is associated with favorable outcomes for catheter ablation of persistent atrial fibrillation (PEAF). Techniques for LAPW isolation include ablation at the periphery with or without high density ablation within the LAPW. The proportion of LA isolated by the lesion set also varies greatly. The optimal technique to achieve LAPW isolation is not clear. Objective: To assess impact of ablation lesion density within and dimensions of the LAPW isolation region on arrhythmia recurrence in catheter ablation of PEAF. Methods: LAPW lesion density and surface area relative to total LA surface area were calculated using electroanatomic maps of 110 consecutive patients undergoing LAPW isolation for PEAF (CARTO 3, Biosense Webster, Inc.). LAPW isolation was performed at the discretion of 5 experienced operators after voltage mapping. LAPW PV entrance and exit block were confirmed. Arrhythmia recurrence at two years was assessed by Kaplan-Meier analysis. Results: LAPW lesion density ranged from 0% - 99%. The proportion of LA surface area isolated ranged from 35% - 75%. There was no significant difference in arrhythmia-free survival stratified by median LAPW ablation density (31% vs. 27%, p=0.8) or median proportion of electrically-isolated LA surface area (31% vs. 27%, p=0.8%). Voltage map-guided LAPW isolation did not significantly decrease arrhythmia recurrence (29% vs. 28%, p=1). Conclusion: Neither the density of ablation within nor the dimensions of the LAPW isolated region predicted arrhythmia-free survival for catheter ablation of PEAF. Voltage map-guided LAPW isolation resulted in similar ablation efficacy regardless of LA scar burden.

Background: Powered transvenous lead extraction (TLE) tools are commonly required to remove the leads that have long implant duration due to fibrotic adhesions. However, comparative data are lacking among different types of TLE tools. Aim: To compare the efficacy and safety of two different rotational mechanical dilator sheaths in retrospectively analyzed patients who underwent TLE. Methods and results: A total of 566 lead extractions from 302 patients using TightRailTM (333 lead extractions from 169 patients) and Evolution® (233 lead extractions from 133 patients) mechanical dilator sheaths were performed between July 2009 and June 2018. Acute and long term outcomes of study groups were compared. There is no statistically significant difference between Evolution® and TightRailTM groups in procedural success (93.9% vs. 94%), clinical success (99.2% vs. 98%) and major complications (3.8% vs. 1.2%), respectively (p>0.05). In multivariate regression analysis, lead dwell time, the number of extracted leads, and baseline leukocyte count was found as independent predictors of procedural success (p<0.05). During the median follow-up of 36.6 (0.2-118) months, all-cause mortality was observed in 73 patients (25.6% in the Evolution® vs. 23.1 in the TightRailTM group, p>0.05). Chronic renal disease, heart failure, and coagulopathy were shown as independent predictors of all-cause mortality in multivariate regression analysis (p<0.05). Conclusions: TLE using TightRailTM or Evoluation® mechanical dilator sheaths is a safe and effective therapeutic option. Both mechanical dilator sheaths showed similar efficacy, safety, and all-cause mortality at acute and long-term follow-up of patients who underwent TLE.

Twiddler’s syndrome is a rare complication where a pacemaker or implantable cardioverter-defibrillator (ICD) is displaced with or without patient manipulation of their device. There are reports on transvenous devices but a paucity of data on subcutaneous devices. A 50-year-old male with hypertrophic cardiomyopathy and non-sustained ventricular tachycardia underwent subcutaneous-ICD (S-ICD) implantation for primary prevention. Remote device interrogation 4 weeks after device placement reported a shock due to “ventricular fibrillation”. It also showed abnormal lead impedance. Chest X-ray showed lead was dislodged and coiled around the pulse generator. Patient underwent lead revision and device replacement without further complications.

A sulfur autotrophic fluidized bed reactor was established to overcome mass transfer problems and shorten the co-reduction time for perchlorate and nitrate from aqueous solution. Response surface methodology (RSM) was used to predict the subsequent extent of sulfur (S) disproportionation based on three variable parameters, namely the hydraulic retention time (HRT), co-existing nitrate concentration (C_〖inf 〗⁡〖〖NO〗_3^–N〗 ) and recirculation ratio (R). The extent of sulfur (S) disproportionation was determined by sulfate generation and alkalinity consumption. RSM results show that a long HRT and high R promoted whereas co-existing nitrate inhibited sulfate production from S disproportionation. For complete perchlorate and nitrate reduction (>98.45%) with relatively low sulfate generation (236.07 mg/L), the optimal HRT, C_〖inf 〗⁡〖〖NO〗_3^–N〗 and R were 0.50 h, 10 mg/L and 14, respectively. High-throughput sequencing revealed that Chlorobaculum was associated with S disproportionation while the abundance of Sulfurovum, an effective denitrification/perchlorate reducing bacteria, decreased over the height of the reactor.

The burbot (Lota lota) is the only member of the cod family (Gadidae) that is adapted solely to freshwater. This species shows the widest longitudinal range of freshwater fish in the world. The burbot is a good model for studies on adaptive genome evolution from marine to freshwater environment. However, no high-quality reference genome has been released. Here, the first chromosome-level genome of the burbot was constructed using PacBio long sequencing and Hi-C technology. A total of 95.24 Gb polished PacBio sequences were generated, and the preliminary genome assembly was 575.83 Mb in size with a contig N50 size of 2.15 Mb. The assembled sequences were anchored to 22 pseudo-chromosomes by using the Hi-C data. The final assembled genome after Hi-C correction was 575.92 Mb, with a contig N50 of 2.01 Mb and a scaffold N50 of 22.10 Mb. A total of 22,067 protein-coding genes were predicted, 94.82% of which were functionally annotated. Phylogenetic analyses indicated that burbot diverged with the Atlantic cod about 44.4 million years ago. In addition, 377 putative genes that appear to be under positive selection in burbot were identified. These positively selected genes might adapt to the freshwater environment. These genome data provide an invaluable resource for the ecological and evolutionary study of the order Gadiformes.

Quercus mongolica (Fagaceae) is an important ecological and economic tree species in East Asia. It has excellent biological characteristics, such as hardwood, strong resistance to biotic and abiotic stresses. The availability of a high-quality genome will help to further reveal the underlying mechanisms. Here we assemble the first chromosome-level reference genome of Q. mongolica. The final assembled genome was 809.84 Mb with contig and scaffold N50s of 2.64 Mb and 66.74 Mb, respectively. Hi-C scaffolding anchored twelve pseudochromosomes, accounting for 95.65% of the assembled genome. Moreover, 68.5% and 5.4% of the genomic sequence were transposon elements and tandem repeat elements, respectively. A total of 36,553 protein‐coding genes were predicted, of which 94.89% were functionally annotated. Comparative genomics analysis indicated that Q. mongolica was more closely related to Q. robur than to either Q. lobata or Q. suber. Q. mongolica and Q. robur diverged ~10.2 Mya. Q. mongolica had undergone two whole-genome duplications which occurred earlier than Q. robur. We identified multiple genes in 38 positive selection genes, including pyridoxal reductase 1 (PLR1) and switch subunit 3 (SWI3B). In addition, we identified 496 genes related to wood formation, 88 WRKY genes, and 124 NAC genes in Q. mongolica. This genomic information will be an important molecular resource for further exploring the biological characteristics and adaptive evolution of Q. mongolica. Meanwhile, the genomic resource from Asian oak will also contribute to the study of the taxonomy, evolution and conservation of Quercus species.

This manuscript reviews the book ‘Process Intensification – Breakthrough in Design, Industrial Innovation Practices, and Education’, published by Jan Harmsen and Maarten Verkert, De Gruyter (2020), ISBN: 978-3-11-065734-0, 219 pages.

Research question: Precise timed synchronization between endometrium and the embryo is essential for high implantation and pregnancy rate, it is worthy to mention that endometrial thickness is not the only factor, E2 and P levels are also regularly monitored for endometrial receptivity. So, we decided to go for this study, to investigate the impact of serum E2 and P levels on the same day of embryo transfer on pregnancy outcomes for FET cycles. Design: This was a retrospective cross sectional study for 402 FET cycles which conducted between April 2018 and May 2019. All participants started endometrial preparation for FET with 6 mg/day oral estradiol for 13 days. When endometrium reached 8 mm or greater, patients were initiated on both micronized vaginal and oral P treatment. On FET day, serum level of E2 and P were assessed. Then, transfer of PGT euploid embryos was performed. 12 days later pregnancy test was assessed, and then 4 weeks after FET date ultrasound was scheduled to check the viability and the clinical pregnancy. Results: The mean E2 value was 931.41 ± 438.65 pg/ml, while mean P value was 8.47 ± 9.4 ng/ml. 240 out of 402 cases got pregnant (59.7%) while the clinical pregnancy rate was 53.9% with no correlation between serum (E2, P & E/P ratio) and the outcome. Conclusion: Our results revealed that the association between E2 and P on FET day and the pregnancy outcome is still not proven and those markers can’t serve as predictors for the outcome.

Sepsis is characterized by a simultaneous imbalance of hyperinflammation and immunosuppression. The expression of HLA-DR in monocytes (MHLA-DR) and CD64 expression in neutrophils (NCD64) are considered, respectively, predictive and diagnostic biomarkers of infection. The ratio NCD64/MHLA-DR has been described as a prognostic biomarker of sepsis. To evaluate MHLA-DR expression and ratio NCD64/MHLA-DR in patients admitted to the Intensive Care Unit (ICU) and their relationship with the development of infection. Prospective study of 77 patients admitted to the ICU from our hospital (HUGTiP) due to stroke or severe traumatic brain injury. The MHLA-DR and NCD64 expression were analyzed in whole blood samples at baseline, +3, +6, +9, +12 and +15 days after admission, using a standardized flow cytometry protocol. During the follow-up, 71% of patients became infected (infection without sepsis, sepsis or septic shock). Infected patients showed – already after three days of admission – a lower percentage of MHLA-DR+ (85.8 ± 16.22% vs. 92.5 ± 12.13%, p <0.001) than those patients than did not develop it. Interestingly, on day +3, infected patients also had a higher ratio NCD64/MHLA-DR (0.12 ± 0.19 vs. 0.04 ± 0.08, p <0.001) than the non-infected ones. The immumonitoring of MHLA-DR expression and ratio NCD64/MHLA-DR may help to evaluate those patients with higher susceptibility to develop infection and sepsis at the ICU.