Weaning from Mechanical Ventilation

For most patients who require mechanical ventilation weaning and extubation is simple. In these patients a variety of strategies can be successful. In addition, sim ple criteria may predict when the patient is ready for extubation. For the small group of patients who require prolonged mechanical ventilation, however, contro versy exists about how best to remove ventilator sup port by weaning, and available data are sparse. Much of the controversy has centered on T-piece weaning ver sus intermittent mandatory ventilation. To date no con trolled study has demonstrated the superiority of either intermittent mandatory ventilation or T-piece weaning in difficult-to-wean patients. In the evolution of this con troversy, concern has developed over the potential for increased inspiratory work and expiratory resistance that may be associated with certain intermittent manda tory ventilation systems. The possibility that significant inspiratory work may occur during assist-control venti lation has also been demonstrated. Respiratory muscle weakness and fatigue is likely important in failure to wean. Other possible causes are failure of the cardiovas cular system and impaired ability of the lung to carry out gas exchange. In this article we first examine criteria and techniques for weaning short-term ventilator pa tients. We then examine criteria to begin the weaning process in prolonged ventilation patients, potential causes of failure to wean, and techniques that can be used to remove ventilator support from patients who are difficult to wean. Much literature has been devoted to techniques and criteria for weaning and extubation of patients from mechanical ventilation. For most patients who require ventilatory support, weaning and extuba tion can be easily accomplished by a variety of tech niques [1-4]. At one referral center 77.2% of all surviving patients were weaned from the ventilator within 72 hours of the onset of mechanical ventila tion, and 91% were weaned within 7 days [1]. Less than 10% of ventilated patients potentially posed problems in weaning from mechanical ventilation. Similarly, at a community hospital, few surviving patients required prolonged ventilatory support [2]. In easy-to-wean patients, Sahn and Lakshminarayan [5] described simple criteria that are predictive of successful discontinuation of ventilator support. For the small group of patients who require pro longed mechanical ventilation, however, minimal data are available. In these patients criteria to deter mine weaning ability or which measurements to follow are not clearly defined. Furthermore, no controlled trials are available to compare the differ ent weaning techniques proposed. In this article we first address routine weaning of the patient who has not required prolonged ventilator support. We then examine the difficult-to-wean patient and dis cuss criteria to begin the weaning process, poten tial causes of failure to wean, and available weaning techniques.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68923/2/10.1177_088506668800300207.pd

Variation of morphological descriptors for the evaluation of tomato germplasm and their stability across different growing conditions

[EN] Germplasm and breeding materials are usually characterized using morphological and agronomic descriptors, which should have a high heritability. Despite the widespread use of tomato (Solanum lycopersicum) standardized descriptors, little information exists on environmental effects on descriptor values and their heritability. We have evaluated 12 tomato accessions from seven cultivar groups in three different environments (open-field conventional, open-field organic, and greenhouse) and characterized them with 36 descriptors. A wide range of variation was found for most descriptors, demonstrating their utility for describing tomato materials and their diversity and relationships. The analysis of descriptors variation reveals that while for some descriptors with a simple genetic control the accession effect accounts for 100% of the variation, for others like yield per plant only 10.83% of the variation observed is due to the accession effect. Although significant differences were found among environments for most descriptors, including a much higher yield in the open-field conventional environment than in the two others, the environmental effect was low for most traits. However, the genotype×environment effect generally had an important contribution to the structure of variation for many descriptors, and for three traits it had the highest contribution to the percentage of the sum of squares. As a result of the variation structure, the heritability values are high (> 0.7) for only 10 descriptors, while for five is low (< 0.3). Principal components analysis (PCA) reveals that projections in the PCA graph of a same accession grown in different environments plot together in the same area of the PCA graph. Although cultivar groups are generally clearly separated in the PCA graph, accessions from the same cultivar group in some cases are intermixed. These results have important implications for detecting tomato duplicates and establishing core collections, as well as for analyzing germplasm and breeding results, when using data sets containing data of accessions grown in different environments.This work has been partially funded by the TRADITOM (Traditional tomato varieties and cultural practices: a case for agricultural diversification with impacto n food security and health of European population) and G2P-SOL (Linking genetic resources, genomes and phenotypes of Solanaceous crops) projects. These projects have received funding from the European Union's Horizon 2020 research and innovation programme under grant agreements No 634561 (TRADITOM) and No 677379 (G2P-SOL). Authors are grateful to Mr. Jonatan Cerdan for his technical help.Figás-Moreno, MDR.; Prohens Tomás, J.; Casanova-Calancha, C.; Fernández De Córdova Martínez, PJ.; Soler Aleixandre, S. (2018). Variation of morphological descriptors for the evaluation of tomato germplasm and their stability across different growing conditions. Scientia Horticulturae. 238:107-115. https://doi.org/10.1016/j.scienta.2018.04.039S10711523

Ancestral predisposition toward a domesticated lifestyle in the termite-cultivated fungus Termitomyces

The ancestor of termites relied on gut symbionts for degradation of plant material, an association that persists in all termite families. However, the single-lineage Macrotermitinae has additionally acquired a fungal symbiont that complements digestion of food outside the termite gut. Phylogenetic analysis has shown that fungi grown by these termites forma clade—the genus Termitomyces—but the events leading toward domestication remain unclear. To address this, we reconstructed the lifestyle of the common ancestor of Termitomyces using a combination of ecological data with a phylogenomic analysis of 21 related non-domesticated species and 25 species of Termitomyces. We show that the closely related genera Blastosporella and Arthromyces also contain insect-associated species. Furthermore, the genus Arthromyces produces asexual spores on the mycelium, which may facilitate insect dispersal when growing on aggregated subterranean fecal pellets of a plant-feeding insect. The sister-group relationship between Arthromyces and Termitomyces implies that insect association and asexual sporulation, present in both genera, preceded the domestication of Termitomyces and did not follow domestication as has been proposed previously. Specialization of the common ancestor of these two genera on an insect-fecal substrate is further supported by similar carbohydrate-degrading profiles between Arthromyces and Termitomyces. We describe a set of traits that may have predisposed the ancestor of Termitomyces toward domestication, with each trait found scattered in related taxa outside of the termite-domesticated clade. This pattern indicates that the origin of the termite-fungus symbiosis may not have required large-scale changes of the fungal partner.http://www.cell.com/current-biology/homeam2022BiochemistryForestry and Agricultural Biotechnology Institute (FABI)GeneticsMicrobiology and Plant Patholog

A new method for measuring angle-resolved phases in photoemission

Quantum mechanically, photoionization can be fully described by the complex photoionization amplitudes that describe the transition between the ground state and the continuum state. Knowledge of the value of the phase of these amplitudes has been a central interest in photoionization studies and newly developing attosecond science, since the phase can reveal important information about phenomena such as electron correlation. We present a new attosecond-precision interferometric method of angle-resolved measurement for the phase of the photoionization amplitudes, using two phase-locked Extreme Ultraviolet pulses of frequency $\omega$ and $2\omega$, from a Free-Electron Laser. Phase differences $\Delta \tilde \eta$ between one- and two-photon ionization channels, averaged over multiple wave packets, are extracted for neon $2p$ electrons as a function of emission angle at photoelectron energies 7.9, 10.2, and 16.6 eV. $\Delta \tilde \eta$ is nearly constant for emission parallel to the electric vector but increases at 10.2 eV for emission perpendicular to the electric vector. We model our observations with both perturbation and \textit{ab initio} theory, and find excellent agreement. In the existing method for attosecond measurement, Reconstruction of Attosecond Beating By Interference of Two-photon Transitions (RABBITT), a phase difference between two-photon pathways involving absorption and emission of an infrared photon is extracted. Our method can be used for extraction of a phase difference between single-photon and two-photon pathways and provides a new tool for attosecond science, which is complementary to RABBITT

Analysis of two-color photoelectron spectroscopy for attosecond metrology at seeded free-electron lasers

The generation of attosecond pulse trains at free-electron lasers opens new opportunities in ultrafast science, as it gives access, for the first time, to reproducible, programmable, extreme ultraviolet (XUV) waveforms with high intensity. In this work, we present a detailed analysis of the theoretical model underlying the temporal characterization of the attosecond pulse trains recently generated at the free-electron laser FERMI. In particular, the validity of the approximations used for the correlated analysis of the photoelectron spectra generated in the two-color photoionization experiments are thoroughly discussed. The ranges of validity of the assumptions, in connection with the main experimental parameters, are derived

Complex attosecond waveform synthesis at fel fermi

Free-electron lasers (FELs) can produce radiation in the short wavelength range extending from the extreme ultraviolet (XUV) to the X-rays with a few to a few tens of femtoseconds pulse duration. These facilities have enabled significant breakthroughs in the field of atomic, molecular, and optical physics, implementing different schemes based on two-color photoionization mechanisms. In this article, we present the generation of attosecond pulse trains (APTs) at the seeded FEL FERMI using the beating of multiple phase-locked harmonics. We demonstrate the complex attosecond waveform shaping of the generated APTs, exploiting the ability to manipulate independently the amplitudes and the phases of the harmonics. The described generalized attosecond waveform synthesis technique with an arbitrary number of phase-locked harmonics will allow the generation of sub-100 as pulses with programmable electric fields

Near threshold two photon double ionization of Kr in the vacuum ultraviolet

We report angle resolved measurements on photoelectrons emitted upon near threshold two photon double ionization TPDI of Kr irradiated by free electron laser FEL pulses. These photoelectron angular distributions PADs are compared with the results of semirelativistic R matrix calculations. As reported by Augustin et al., it is found that the presence of autoionizing resonances within the bandwidth of the exciting FEL pulse strongly influences the PADs. In contrast to measurements on lower Z targets such as Ne and Ar, the larger spin orbit interaction, inherent in 4p subshell hole states of Kr, permits us to resolve and study PADs associated with some of the fine structure components of the Kr and Kr2 ion