Evaluation of enteral feeding success in head injured patients placed in pentobarbital induced comas

Abstract of Distinction from Clinical Nutrition Week, Las Vegas, NV, February 8-10, 2010

Impact of early enteral versus parenteral nutrition on mortality in patients requiring mechanical ventilation and catecholamines: study protocol for a randomized controlled trial (NUTRIREA-2)

BACKGROUND: Nutritional support is crucial to the management of patients receiving invasive mechanical ventilation (IMV) and the most commonly prescribed treatment in intensive care units (ICUs). International guidelines consistently indicate that enteral nutrition (EN) should be preferred over parenteral nutrition (PN) whenever possible and started as early as possible. However, no adequately designed study has evaluated whether a specific nutritional modality is associated with decreased mortality. The primary goal of this trial is to assess the hypothesis that early first-line EN, as compared to early first-line PN, decreases day 28 all-cause mortality in patients receiving IMV and vasoactive drugs for shock. METHODS/DESIGN: The NUTRIREA-2 study is a multicenter, open-label, parallel-group, randomized controlled trial comparing early PN versus early EN in critically ill patients requiring IMV for an expected duration of at least 48 hours, combined with vasoactive drugs, for shock. Patients will be allocated at random to first-line PN for at least 72 hours or to first-line EN. In both groups, nutritional support will be started within 24 hours after IMV initiation. Calorie targets will be 20 to 25 kcal/kg/day during the first week, then 25 to 30 kcal/kg/day thereafter. Patients receiving PN may be switched to EN after at least 72 hours in the event of shock resolution (no vasoactive drugs for 24 consecutive hours and arterial lactic acid level below 2 mmol/L). On day 7, all patients receiving PN and having no contraindications to EN will be switched to EN. In both groups, supplemental PN may be added to EN after day 7 in patients with persistent intolerance to EN and inadequate calorie intake. We plan to recruit 2,854 patients at 44 participating ICUs. DISCUSSION: The NUTRIREA-2 study is the first large randomized controlled trial designed to assess the hypothesis that early EN improves survival compared to early PN in ICU patients. Enrollment started on 22 March 2013 and is expected to end in November 2015. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01802099 (registered 27 February 2013)

Use of ring-expanded diamino- and diamidocarbene ligands in copper catalyzed azide-alkyne "click" reactions

The two-coordinate ring-expanded N-heterocyclic carbene copper­(I) complexes [Cu­(RE-NHC)₂]⁺ (RE-NHC = 6-Mes, 7-<i>o</i>-Tol, 7-Mes) have been prepared and shown to be effective catalysts under neat conditions for the 1,3-dipolar cycloaddition of alkynes and azides. In contrast, the cationic diamidocarbene analogue [Cu­(6-MesDAC)₂]⁺ and the neutral species [(6-MesDAC)­CuCl]₂ and [(6-MesDAC)₂(CuCl)₃] show good activity when the catalysis is performed on water

Current Developments and Future Challenges of Coordination in Pervasive Environments

With the miniaturization of computing elements, their in- creasing number, interconnection, and penetration of our daily lives, pervasive computing environments start to be- come more and more complex. This results in an apparent claim for improved coordination mechanisms, to optimize, to enhance effectiveness and eventually to provide the users with a sufficient level of quality. We took this as our mo- tivation to investigate the concept of coordination applied to pervasive environments in more details. This report is the summary of the CoMA workshop held at IEEE WET- ICE 2007 and highlights the current research efforts and outlines potential future challenges with respect to coordi- nation in pervasive environment

Task-based and geo-based management of emergency situations

In this paper, the WORKPAD project, concluded in 2009, is presented and the main features of the system are highlighted. They are the interplay of process management (i.e., task-driven coordination of operators during emergency situations) with geoawareness of the team about the area and the team itself (real-time position of colleagues), also based on data integration techniques. © Societá Italiana di Fotogrammetria e Topografia (SIFET) 2011

A context-sensitive infrastructure for coordinating agents in ubiquitous environments

The combination of contextual information about the real world (e.g., collected by sensors) with information coming from the virtual world (e.g., the Web 2.0), may represent an enormous enrichment particularly for services organized and provided by agents in ubiquitous environments. To address the challenging need for coordination in such environments, and to provide the user a high-level of service quality, an engineered approach to exploit such information is required. Such an approach should generate added-value by offering means for combining diverse data sources, should allow delivering context-sensitive information and, hence, should promote context-dependent coordination of entities in ubiquitous environments. In this paper, we report the scenario-based analysis of key requirements for ubiquitous environments that we have used as the basis for the design of our proposal. Following, our proposal for the Ubiquitous Coordination Model (UbiCoMo) and its associated infrastructure is detailed. The UbiCoMo model covers an expressive data model based on four-field tuples to represent contextual information, data distribution and management concepts based on tuple spaces, and the integration of coordination patterns to resolve reoccurring coordination problems in ubiquitous scenarios. The UbiCoMo infrastructure integrates the fundamental mechanisms for agent-based coordination in ubiquitous environments, and is well-suited to provide the specific means required to offer high-level services and context-sensitive functionalities. A concrete ubiquitous application, the living diary, is assumed as a case study both to illustrate the requirements analysis and to exemplify the usage and the suitability of UbiCoMo

Designing mobile systems in highly dynamic scenarios : the WORKPAD methodology

The design of interactive systems to be used in mobile and pervasive scenarios, such as emergency management, requires novel methodologies which combine user-centred design approaches and software engineering approaches tailored for distributed architectures. In this paper, the methodology adopted in a successful research project is presented together with a case study. Keywords: User-centred design - Requirement collection - Interaction design - Emergency scenarios - Mobile systems