Statin therapy in critical illness : an international survey of intensive care physicians' opinions, attitudes and practice

Background Pleotropic effects of statins on inflammation are hypothesised to attenuate the severity of and possibly prevent the occurrence of the host inflammatory response to pathogen and infection-related acute organ failure. We conducted an international survey of intensive care physicians in Australia, New Zealand (ANZ) and United Kingdom (UK). The aims of the survey were to assess the current prescribing practice patterns, attitudes towards prescribing statin therapy in critically ill patients and opinions on the need for an interventional trial of statin therapy in critically ill patients. Methods Survey questions were developed through an iterative process. An expert group reviewed the resulting 26 items for face and content validity and clarity. The questions were further refined following pilot testing by ICU physicians from Australia, Canada and the UK. We used the online Smart SurveyTM software to administer the survey. Results Of 239 respondents (62 from ANZ and 177 from UK) 58% worked in teaching hospitals; most (78.2%) practised in ‘closed’ units with a mixed medical and surgical case mix (71.0%). The most frequently prescribed statins were simvastatin (77.6%) in the UK and atorvastatin (66.1%) in ANZ. The main reasons cited to explain the choice of statin were preadmission prescription and pharmacy availability. Most respondents reported never starting statins to prevent (65.3%) or treat (89.1%) organ dysfunction. Only a minority (10%) disagreed with a statement that the risks of major side effects of statins when prescribed in critically ill patients were low. The majority (84.5%) of respondents strongly agreed that a clinical trial of statins for prevention is needed. More than half (56.5%) favoured rates of organ failure as the primary outcome for such a trial, while a minority (40.6%) favoured mortality. Conclusions Despite differences in type of statins prescribed, critical care physicians in the UK and ANZ reported similar prescription practices. Respondents from both communities agreed that a trial is needed to test whether statins can prevent the onset of new organ failure in patients with sepsis

Network sensitivity of systemic risk

A growing body of studies on systemic risk in financial markets has emphasized the key importance of taking into consideration the complex interconnections among financial institutions. Much effort has been put into modeling the contagion dynamics of financial shocks and into assessing the resilience of specific financial markets, either using real network data, reconstruction techniques or simple toy networks. Here, we address the more general problem of how shock propagation dynamics depend on the topological details of the underlying network. To this end, we consider different realistic network topologies, all consistent with balance sheet information obtained from real data on financial institutions. In particular, we consider networks of varying density and with different block structures. In addition, we diversify in the details of the shock propagation dynamics. We confirm that the systemic risk properties of a financial network are extremely sensitive to its network features. Our results can aid in the design of regulatory policies to improve the robustness of financial markets

Hydrogeology of Stromboli volcano, Aeolian Islands (Italy) from the interpretation of resistivity tomograms, self-potential, soil temperature and soil CO2 concentration measurements

International audienceTo gain a better insight of the hydrogeology and the location of the main tectonic faults of Stromboli volcano in Italy, we collected electrical resistivity measurements, soil CO2 concentrations, temperature and self-potential measurements along two profiles. These two profiles started at the village of Ginostra in the southwest part of the island. The first profile (4.8 km in length) ended up at the village of Scari in the north east part of the volcano and the second one (3.5 km in length) at Forgia Vecchia beach, in the eastern part of the island. These data were used to provide insights regarding the position of shallow aquifers and the extension of the hydrothermal system. This large-scale study is complemented by two high-resolution studies, one at the Pizzo area (near the active vents) and one at Rina Grande where flank collapse areas can be observed. The Pizzo corresponds to one of the main degassing structure of the hydrothermal system. The main degassing area is localized along a higher permeability area corresponding to the head of the gliding plane of the Rina Grande sector collapse. We found that the self-potential data reveal the position of an aquifer above the villages of Scari and San Vincenzo. We provide an estimate of the depth of this aquifer from these data. The lateral extension of the hydrothermal system (resistivity ∼15-60 ohm m) is broader than anticipated extending in the direction of the villages of Scari and San Vincenzo (in agreement with temperature data recorded in shallow wells). The lateral extension of the hydrothermal system reaches the lower third of the Rina Grande sector collapse area in the eastern part of the island. The hydrothermal body in this area is blocked by an old collapse boundary. This position of the hydrothermal body is consistent with low values of the magnetization (<2.5 A m−1) from previously published work. The presence of the hydrothermal body below Rina Grande raises questions about the mechanical stability of this flank of the edifice

Adventive hydrothermal circulation on Stromboli volcano (Aeolian Islands, Italy) revealed by geophysical and geochemical approaches: Implications for general fluid flow models on volcanoes

International audienceOn March 15th 2007 a paroxysmal explosion occurred at the Stromboli volcano. This event generated a large amount of products, mostly lithic blocks, some of which impacted the ground as far as down to 200 m a.s.l., about 1.5 km far away from the active vents. Two days after the explosion, a new vapour emission was discovered on the north-eastern flank of the volcanic edifice, at 560 m a.s.l., just above the area called "Nel Cannestrà". This new vapour emission was due to a block impact. In order to investigate the block impact area to understand the appearance of the vapour emission, we conducted on May 2008 a multidisciplinary study involving Electrical Resistivity Tomography (ERT), Ground Penetrating Radar (GPR), Self-Potential (SP), CO2 soil diffuse degassing and soil temperature surveys. This complementary data set revealed the presence of an anomalous conductive body, probably related to a shallow hydrothermal level, at about 10-15 m depth, more or less parallel to the topography. It is the first time that such a hydrothermal fluid flow, with a temperature close to the water boiling point (76 °C) has been evidenced at Stromboli at this low elevation on the flank of the edifice. The ERT results suggest a possible link between (1) the main central hydrothermal system of Stromboli, located just above the plumbing system feeding the active vents, with a maximum of subsurface soil temperature close to 90 °C and limited by the NeoStromboli summit crater boundary and (2) the investigated area of Nel Cannestrà, at ~ 500 m a.s.l., a buried eruptive fissure active 9 ka ago. In parallel, SP and CO2 soil diffuse degassing measurements suggest in this sector at slightly lower elevation from the block impact crater a magmatic and hydrothermal fluid rising system along the N41° regional fault. A complementary ERT profile, on May 2009, carried out from the NeoStromboli crater boundary down to the block impact crater displayed a flank fluid flow apparently connected to a deeper system. The concept of shallow hydrothermal level have been compared to similar ERT results recently obtained on Mount Etna and La Fossa cone of Vulcano. This information needs to be taken into account in general fluid flow models on volcanoes. In particular, peripheral thermal waters (as those bordering the north-eastern coast of Stromboli) could be contaminated by hydrothermal and magmatic fluids coming from regional faults but also from the summit

Search for Two-Neutrino Double Electron Capture of 124^{124}Xe with XENON100

Two-neutrino double electron capture is a rare nuclear decay where two electrons are simultaneously captured from the atomic shell. For $^{124}$Xe this process has not yet been observed and its detection would provide a new reference for nuclear matrix element calculations. We have conducted a search for two-neutrino double electron capture from the K-shell of $^{124}$Xe using 7636 kg$\cdot$d of data from the XENON100 dark matter detector. Using a Bayesian analysis we observed no significant excess above background, leading to a lower 90 % credibility limit on the half-life $T_{1/2}>6.5\times10^{20}$ yr. We also evaluated the sensitivity of the XENON1T experiment, which is currently being commissioned, and find a sensitivity of $T_{1/2}>6.1\times10^{22}$ yr after an exposure of 2 t$\cdot$yr.Comment: 6 pages, 4 figure

Removing krypton from xenon by cryogenic distillation to the ppq level

The XENON1T experiment aims for the direct detection of dark matter in a cryostat filled with 3.3 tons of liquid xenon. In order to achieve the desired sensitivity, the background induced by radioactive decays inside the detector has to be sufficiently low. One major contributor is the $\beta$-emitter $^{85}$Kr which is an intrinsic contamination of the xenon. For the XENON1T experiment a concentration of natural krypton in xenon $\rm{^{nat}}$Kr/Xe < 200 ppq (parts per quadrillion, 1 ppq = 10$^{-15}$ mol/mol) is required. In this work, the design of a novel cryogenic distillation column using the common McCabe-Thiele approach is described. The system demonstrated a krypton reduction factor of 6.4$\cdot$10$^5$ with thermodynamic stability at process speeds above 3 kg/h. The resulting concentration of $\rm{^{nat}}$Kr/Xe < 26 ppq is the lowest ever achieved, almost one order of magnitude below the requirements for XENON1T and even sufficient for future dark matter experiments using liquid xenon, such as XENONnT and DARWIN

Development of a low-cost seismic station based on MEMS technology

L’impatto di un forte terremoto su una comunità urbana può essere ridotto con una azione tempestiva e ben pianificata da parte degli organi di Protezione Civile preposti. In tale prospettiva è di fondamentale importanza che gli organi preposti alla sorveglianza sismica del territorio nazionale si dotino di strumenti di osservazione puntuale in grado di fornire nell’immediato terremoto informazioni utilissime per la gestione ottimale delle emergenze. Ciò può essere fatto oggi mediante la realizzazione reti sismiche urbane, con funzionamento in tempo reale (OSU Osservatori Sismici Urbani), in grado di fornire in maniera tempestiva ai centri per la gestione delle emergenze, la distribuzione dell'intensità dello scuotimento a seguito di un terremoto. Le mappe di scuotimento potrebbero consentire agli organi preposti, un’ottimale gestione delle priorità e la ripartizione delle risorse in modo da ottenere una significativa riduzione del numero di vittime a seguito di un forte terremoto. Le verifiche del grado di danneggiamento e di agibilità degli edifici potrebbero così essere effettuate secondo una logica prioritaria sulla base dei massimi scuotimenti misurati dalla rete sismica urbana. La realizzazione di OSU per le finalità su preposte è l’obiettivo principale del progetto MEMS finanziato dal MIUR nell’ambito del programma SIR (Scientific Independence of young Researchers). La prima sfida affrontata nell’ambito del progetto MEMS è stata la progettazione e sviluppo di una stazione accelerometrica idonea agli scopi del progetto. Il presente lavoro ha lo scopo di descrivere nel dettaglio, la stazione accelerometrica basata su tecnologia MEMS (Micro ElectroMechanical Systems), implementata nell’abito dell’omonimo progetto. Ciò che stato realizzato è una stazione accelerometrica dalle ottime performance, estremamente versatile e a bassissimo costo.The impact of a strong earthqauke onto an urban community can be reduced taking timely actions managed by the authority in charge for the civil protection. In this view, it is of fundamental importance that the authority in charge for the seismic surveillance is provided with the appropriate monitoring tools able to give the most useful information for the best emergency management in the immediate post-event. Today this goal can be reached realizing urban-scale, real-time seismic monitoring networks (Osservatori Sismici Urbani, OSU, in Italian). The real-time OSU networks are able to promptly provide information to the emergency authority about the ground shaking at each node after an earthquake. Maps showing the spatial distribution of the ground shaking could help in the optimization of the priorities and a good management of the rescue resources in order to reduce the number of victims. Also the assessment of the damage of the buildings could be carried out according to the logic of priority given by the shakings measured by the OSU. The realisation of OSUs is the main objective of the MEMS project. This project is funded by the MIUR under the SIR program (Scientific Independence of young Researchers). The first challenge of the MEMS project was the design and the development of a devoted accelerometric stations. This work illustrates in detail the accelerometric station based on MEMS technology (Micro Electro-Mechanical Systems). The final product is a low-cost accelerometric station with high performance and great versatility

In Vitro and In Vivo Human Herpesvirus 8 Infection of Placenta

Herpesvirus infection of placenta may be harmful in pregnancy leading to disorders in fetal growth, premature delivery, miscarriage, or major congenital abnormalities. Although a correlation between human herpesvirus 8 (HHV-8) infection and abortion or low birth weight in children has been suggested, and rare cases of in utero or perinatal HHV-8 transmission have been documented, no direct evidence of HHV-8 infection of placenta has yet been reported. The aim of this study was to evaluate the in vitro and in vivo susceptibility of placental cells to HHV-8 infection. Short-term infection assays were performed on placental chorionic villi isolated from term placentae. Qualitative and quantitative HHV-8 detection were performed by PCR and real-time PCR, and HHV-8 proteins were analyzed by immunohistochemistry. Term placenta samples from HHV-8-seropositive women were analyzed for the presence of HHV-8 DNA and antigens. In vitro infected histocultures showed increasing amounts of HHV-8 DNA in tissues and supernatants; cyto- and syncitiotrophoblasts, as well as endothelial cells, expressed latent and lytic viral antigens. Increased apoptotic phenomena were visualized by the terminal deoxynucleotidyl transferase-mediated deoxyuridine nick end-labeling method in infected histocultures. Ex vivo, HHV-8 DNA and a latent viral antigen were detected in placenta samples from HHV-8-seropositive women. These findings demonstrate that HHV-8, like other human herpesviruses, may infect placental cells in vitro and in vivo, thus providing evidence that this phenomenon might influence vertical transmission and pregnancy outcome in HHV-8-infected women

Photocatalytic activity of nitrogen-doped TiO2-based nanowires: a photo-assisted Kelvin probe force microscopy study

The emerging industrial business partnerships, which feature cross-functional and cross-company development efforts, raise the barrier for the establishment of effective knowledge sharing practices in the larger organization. This chapter aims to highlight the role of knowledge as a key enabler for effective engineering activities in the light of such emerging enterprise collaboration models. Knowledge Enabled Engineering (KEE) is presented as an approach to enhance the extended organization’s capability to establish effective collaboration among its parts, in spite of different organizational structures, technologies or processes. KEE is analysed in its constituent parts, highlighting areas, methods and tools that are particularly interesting for leveraging companies’ knowledge sharing capabilities

DARWIN: towards the ultimate dark matter detector

DARk matter WImp search with liquid xenoN (DARWIN) will be an experiment forthe direct detection of dark matter using a multi-ton liquid xenon timeprojection chamber at its core. Its primary goal will be to explore theexperimentally accessible parameter space for Weakly Interacting MassiveParticles (WIMPs) in a wide mass-range, until neutrino interactions with thetarget become an irreducible background. The prompt scintillation light and thecharge signals induced by particle interactions in the xenon will be observedby VUV sensitive, ultra-low background photosensors. Besides its excellentsensitivity to WIMPs above a mass of 5 GeV/c2, such a detector with its largemass, low-energy threshold and ultra-low background level will also besensitive to other rare interactions. It will search for solar axions, galacticaxion-like particles and the neutrinoless double-beta decay of 136-Xe, as wellas measure the low-energy solar neutrino flux with <1% precision, observecoherent neutrino-nucleus interactions, and detect galactic supernovae. Wepresent the concept of the DARWIN detector and discuss its physics reach, themain sources of backgrounds and the ongoing detector design and R&D efforts