Mechanical ventilation with high tidal volume induces inflammation in patients without lung disease

Introduction: Mechanical ventilation (MV) with high tidal volumes may induce or aggravate lung injury in critical ill patients. We compared the effects of a protective versus a conventional ventilatory strategy, on systemic and lung production of tumor necrosis factor-a (TNF-a) and interleukin-8 (IL-8) in patients without lung disease. Methods: Patients without lung disease and submitted to mechanical ventilation admitted to one trauma and one general adult intensive care unit of two different university hospitals were enrolled in a prospective randomizedcontrol study. Patients were randomized to receive MV either with tidal volume (VT) of 10 to 12 ml/kg predicted body weight (high VT group) (n = 10) or with VT of 5 to 7 ml/kg predicted body weight (low VT group) (n = 10) with an oxygen inspiratory fraction (FIO2) enough to keep arterial oxygen saturation >90% with positive endexpiratory pressure (PEEP) of 5 cmH2O during 12 hours after admission to the study. TNF-a and IL-8 concentrations were measured in the serum and in the bronchoalveolar lavage fluid (BALF) at admission and after 12 hours of study observation time. Results: Twenty patients were enrolled and analyzed. At admission or after 12 hours there were no differences in serum TNF-a and IL-8 between the two groups. While initial analysis did not reveal significant differences, standardization against urea of logarithmic transformed data revealed that TNF-a and IL-8 levels in bronchoalveolar lavage (BAL) fluid were stable in the low VT group but increased in the high VT group (P = 0.04 and P = 0.03). After 12 hours, BALF TNF-a (P = 0.03) and BALF IL-8 concentrations (P = 0.03) were higher in the high VT group than in the low VT group. Conclusions: The use of lower tidal volumes may limit pulmonary inflammation in mechanically ventilated patients even without lung injury. Trial Registration: Clinical Trial registration: NCT00935896

Kaons production at finite temperature and baryon density in an effective relativistic mean field model

We investigate the kaons production at finite temperature and baryon density by means of an effective relativistic mean-field model with the inclusion of the full octet of baryons. Kaons are considered taking into account of an effective chemical potential depending on the self-consistent interaction between baryons. The obtained results are compared with a minimal coupling scheme, calculated for different values of the anti-kaon optical potential.Comment: 3 pages, contribution presented to the International Conference on Exotic Atoms and Related Topic

Simultaneous Integrated Boost in Once-weekly Hypofractionated Radiotherapy for Breast Cancer in the Elderly: Preliminary Evidence

Aim: To evaluate once-weekly hypofractionated radiotherapy in elderly patients affected by early breast cancer, reporting acute and late toxicity profiles, and treatment feasibility. Patients and Methods: Fifty patients were treated with a hypofractionated regimen: 28.5\ub12.5 Gy in five fractions at one fraction weekly. Simultaneous integrated boost (SIB) to the tumor bed in high-risk cases. Inclusion criteria: patients over 70 years old, pT1-2, N0-1a. Acute and late toxicities were assessed based on Radiation Therapy Oncology Group. Results: The median follow-up was 20 months and the median patient age was 79 years. SIB was added for 22 patients (44%). Grade 3-4 acute cutaneous toxicities were not observed; grade 2 toxicity occurred only in four patients (8%). Late subcutaneous tissue toxicity consisted of grade 2 fibrosis in two patients (4%), grade 1 in five (10%) and grade 0 in 41(85%). Conclusion: Limiting fraction numbers with a safer profile may improve the management of breast cancer for the elderly

Comparison of local recurrence among early breast cancer patients treated with electron intraoperative radiotherapy vs hypofractionated photon radiotherapy an observational study

Purpose: To evaluate local recurrence (LR) in women with early breast cancer (BC) who underwent intraoperative radiation therapy with electrons particles (IORT-E) or adjuvant hypofractionated external radiotherapy (HYPOFX). Materials and methods: We retrospectively analyzed 470 patients with early BC treated at our center from September 2009 to December 2012. 235 women were treated with breast-conserving surgery and immediate IORT-E (21 Gy/1 fraction) while 235 patients underwent wide excision followed by hypofractionated whole-breast irradiation. Radiotherapy modality was chosen according to an individualized decision based on tumor features, stage, technical feasibility, age, and acceptance to be enrolled in the IORT-E group. Results: After a median follow-up of 6 years, we observed 8 (3.4%) and 1 (0.42%) LR in the IORT-E and in the HYPOFX group (p = 0.02), respectively. The two groups differed in the prevalence of clinical characteristics (p < 0.05): age, tumor size, surgical margins, receptors, ki67, and histology. 4 and 1 woman in the IORT-E and HYPOFX group died of BC, respectively (p = 0.167). OS and DFS hazard ratio [HR] were 2.14 (95% IC, 1.10-4.15) and 2.09 (95% IC, 1.17-3.73), respectively. Conclusion: Our comparison showed that IORT-E and HYPOFX are two effective radiotherapy modalities after conservative surgery in early BC. However, at 6 years a significant higher rate of LR occurred in patients submitted to IORT-E with respect to HYPOFX. This finding may be correlated to some subsets of patients who, depending on the biological characteristics of the BC, may be less suitable to IORT-E

Évaluation de l'utilisation d'îles forestières par des espèces de perroquets dans une savane néotropicale

Understanding the effect of habitat fragmentation is a fundamental yet complicated aim of many ecological studies. Beni savanna is a naturally fragmented forest habitat, where forest islands exhibit variation in resources and threats. To understand how the availability of resources and threats affect the use of forest islands by parrots, we applied occupancy modeling to quantify use and detection probabilities for 12 parrot species on 60 forest islands. The presence of urucuri (Attalea phalerata) and macaw (Acrocomia aculeata) palms, the number of tree cavities on the islands, and the presence of selective logging,and fire were included as covariates associated with availability of resources and threats. The model-selection analysis indicated that both resources and threats variables explained the use of forest islands by parrots. For most species, the best models confirmed predictions. The number of cavities was positively associated with use of forest islands by 11 species. The area of the island and the presence of macaw palm showed a positive association with the probability of use by seven and five species, respectively, while selective logging and fire showed a negative association with five and six species, respectively. The Blue-throated Macaw (Ara glaucogularis), the critically endangered parrot species endemic to our study area, was the only species that showed a negative association with both threats. Monitoring continues to be essential to evaluate conservation and management actions of parrot populations. Understanding of how species are using this natural fragmented habitat will help determine which fragments should be preserved and which conservation actions are needed.La compréhension de l'effet de la fragmentation de l'habitat est l'objectif fondamental mais compliqué de nombreuses recherches en écologie. La savane de Beni est un milieu forestier naturellement fragmenté dans lequel les îles forestières diffèrent sur le plan des ressources et des menaces. Afin de comprendre à quel point la disponibilité des ressources et les menaces ont une influence sur l'utilisation d'îles forestières par les perroquets, nous avons appliqué des modèles de présence pour quantifier l'utilisation et la probabilité de détection de 12 espèces de perroquets sur 60 îles forestières. La présence de palmiers canne (Acrocomia aculeata) et de palmiers urucuri (Attalea phalerata), le nombre de cavités d'arbres sur les îles et la présence de coupes sélectives et de feu ont été inclus comme covariables associées à la disponibilité des ressources et aux menaces. L'analyse de la sélection de modèles a indiqué que les variables relatives aux ressources et celles relatives aux menaces expliquaient l'utilisation d'îles forestières par les perroquets. Pour la plupart des espèces de perroquets, les meilleurs modèles ont confirmé les prédictions. Le nombre de cavités était positivement associé avec l'utilisation d'îles forestières chez 11 espèces. La superficie de l'île et la présence de palmiers canne étaient positivement associées avec la probabilité d'utilisation chez 7 et 5 espèces, respectivement, tandis que la coupe sélective et le feu étaient négativement associés chez 5 et 6 espèces, respectivement. L'Ara canindé (Ara glaucogularis), espèce de perroquet en voie de disparition critique endémique à notre aire d'étude, a été la seule espèce qui a montré une association négative avec les deux menaces. Le suivi demeure essentiel pour l'évaluation des mesures de conservation et de gestion des populations de perroquets. La compréhension de l'utilisation de ce milieu naturellement fragmenté par les espèces contribuera à déterminer quelles parcelles devraient être protégées et quelles mesures de conservation sont nécessaires.Facultad de Ciencias Naturales y Muse

Corporate Security Responsibility: Towards a Conceptual Framework for a Comparative Research Agenda

The political debate about the role of business in armed conflicts has increasingly raised expectations as to governance contributions by private corporations in the fields of conflict prevention, peace-keeping and postconflict peace-building. This political agenda seems far ahead of the research agenda, in which the negative image of business in conflicts, seen as fuelling, prolonging and taking commercial advantage of violent conflicts,still prevails. So far the scientific community has been reluctant to extend the scope of research on ‘corporate social responsibility’ to the area of security in general and to intra-state armed conflicts in particular. As a consequence, there is no basis from which systematic knowledge can be generated about the conditions and the extent to which private corporations can fulfil the role expected of them in the political discourse. The research on positive contributions of private corporations to security amounts to unconnected in-depth case studies of specific corporations in specific conflict settings. Given this state of research, we develop a framework for a comparative research agenda to address the question: Under which circumstances and to what extent can private corporations be expected to contribute to public security

Orbital swelling as a first symptom in breast carcinoma diagnosis: a case report

<p>Abstract</p> <p>Introduction</p> <p>The frequency of intra-orbital metastasis in systemic cancer is a controversial topic. Of all metastatic tumors to the orbit of the eye, breast carcinoma is considered to be the most prevalent. Orbital findings typically present themselves after the diagnosis of the primary tumor, with an average delay of three to six years. In spite of that, this study reports a case in which orbital manifestation was the initial symptom in breast carcinoma diagnosis.</p> <p>Case presentation</p> <p>A 66-year-old Italian Caucasian woman presented with a swelling located on the lower orbit of her right eye.</p> <p>Conclusions</p> <p>Previous cases report orbital manifestations discovered secondary to breast cancer. This case demonstrates that orbital symptoms may be the primary presentation of the disease. Orbital metastasis originating from breast cancer predicts widespread metastatic disease in other organs. In the presence of an ambiguous infiltrative orbital process, diagnostic examination of the breast is recommended.</p

Her2 assessment using quantitative reverse transcriptase polymerase chain reaction reliably identifies Her2 overexpression without amplification in breast cancer cases

Background: Immunohistochemistry (IHC) and fluorescent-in situ hybridization (FISH) are standard methods to assess human epidermal growth factor receptor 2 (HER2) status in breast cancer (BC) patients. Real-time quantitative polymerase-chain-reaction (qRT-PCR) is able to detect HER2 overexpression. Here we compared FISH, IHC, quantitative PCR (qPCR), and qRT-PCR to determine the concordance rates and evaluate their relative roles in HER2 determination. Patients and methods: We determined HER2 status in 153 BC patients, using IHC, FISH, Q-PCR and qRT-PCR. In discordant cases, we directly measured HER2 protein levels using Western blotting. Results: The overall agreement (OA) between FISH and Q-PCR was 94.1, with a k value of 0.87. Assuming FISH as the standard reference, Q-PCR showed an 86.1% sensitivity and a 99.0% specificity with a global accuracy of 91.6%. OA between FISH and qRT-PCR was 90.8% with a k value of 0.81. Of interest, the disagreement between FISH and qRT-PCR was mostly restricted to equivocal cases. HER2 protein analysis suggested that qRT-PCR correlates better than FISH with HER2 protein levels, particularly where FISH fails to provide conclusive results. Significance: qRT-PCR may outperform FISH in identifying patients overexpressing HER2 protein. Q-PCR cannot be used for HER2 status assessment, due to its suboptimal level of agreement with FISH. Both FISH and Q-PCR may be less accurate than qRT-PCR as surrogates of HER2 protein determination

The Third wave in globalization theory

This essay examines a proposition made in the literature that there are three waves in globalization theory—the globalist, skeptical, and postskeptical or transformational waves—and argues that this division requires a new look. The essay is a critique of the third of these waves and its relationship with the second wave. Contributors to the third wave not only defend the idea of globalization from criticism by the skeptics but also try to construct a more complex and qualified theory of globalization than provided by first-wave accounts. The argument made here is that third-wave authors come to conclusions that try to defend globalization yet include qualifications that in practice reaffirm skeptical claims. This feature of the literature has been overlooked in debates and the aim of this essay is to revisit the literature and identify as well as discuss this problem. Such a presentation has political implications. Third wavers propose globalist cosmopolitan democracy when the substance of their arguments does more in practice to bolster the skeptical view of politics based on inequality and conflict, nation-states and regional blocs, and alliances of common interest or ideology rather than cosmopolitan global structures