LAUSR

The January 2018 issue of Shock: We start anew, filled with hopes for exciting science, improvements in care, new plans for collaboration! Allow me to expand this non-standard opening by adding some general reflections before delving into the purely scientific narrative. When reviewing the articles in this issue, I immediately noticed the widespread geographic origins of their authors. The papers are authored by scientists from 10 different countries on four continents. I was even happier to note that one-third of the papers are the fruit of international collaborations, such as those between researchers in China and the United States, and in Thailand and Indonesia. It is a very positive reflection on the scientific community that science is not contained by national borders, but rather—what is even more valuable—it connects people. In contrast to our sad (international) reality of rising walls and deep social divisions along national and political lines, science does connect people! I sincerely wish that all of us will promote and nourish this positive trend in 2018—and beyond. The January melting pot of clinical and basic research offers two review articles, six of the former (clinical) and seven of the latter (basic) sort. The first review focuses on the most vulnerable patient groups including the aged and malnourished and those with severe systemic infections and trauma. Nomellini et al. (1) concentrate on the development of chronic illness phenomenon characterized by concurrent signs of persistent inflammation and immunosuppression. The article integrates the most recent concepts of chronic illness in the critical care patients. It analyzes the main triggers of chronic illness, its progression pathways as well as current definition deficits and knowledge gaps precluding its comprehension. The authors argue that the immune dysfunction in chronic critical illness shares many common denominators regardless by which specific ‘‘vulnerability pathway’’ progresses the decline in the affected patients. Thus, those common chronic illness blueprints, once clearly defined and standardized, could be potentially exploited for patient risk stratification and more efficient treatment strategies. The second review by the Chinese colleagues addresses hemodynamic monitoring in critically ill patients (2). The timing of this article is just right given the ongoing controversy on the early goal-directed therapy in septic shock patients after the recently published findings