A graph-based meta-model for heterogeneous data management

The wave of interest in data-centric applications has spawned a high variety of data models, making it extremely difficult to evaluate, integrate or access them in a uniform way. Moreover, many recent models are too specific to allow immediate comparison with the others and do not easily support incremental model design. In this paper, we introduce GSMM, a meta-model based on the use of a generic graph that can be instantiated to a concrete data model by simply providing values for a restricted set of parameters and some high-level constraints, themselves represented as graphs. In GSMM, the concept of data schema is replaced by that of constraint, which allows the designer to impose structural restrictions on data in a very flexible way. GSMM includes GSL, a graph-based language for expressing queries and constraints that besides being applicable to data represented in GSMM, in principle, can be specialised and used for existing models where no language was defined. We show some sample applications of GSMM for deriving and comparing classical data models like the relational model, plain XML data, XML Schema, and time-varying semistructured data. We also show how GSMM can represent more recent modelling proposals: the triple stores, the BigTable model and Neo4j, a graph-based model for NoSQL data. A prototype showing the potential of the approach is also described

Intravenous immunoglobulin in septic shock: review of the mechanisms of action and meta-analysis of the clinical effectiveness

Sepsis is characterized by a complex immune response. In this study we aimed to provide a review of the mechanisms of action of immunoglobulin (Ig) related to sepsis and an updated meta-analysis of the clinical effectiveness of the Ig use in septic patients

Exploring alternative routes for oxygen administration

none5siHypoxemia may compromise cell metabolism and organ function. Supplemental oxygen (O2) at high concentrations may prove ineffective, and issues relating to hyperoxia, barotrauma, mechanical ventilation, and extracorporeal oxygenation are well documented. Old reports suggest the potential safety and efficacy of alternative routes for O2 administration, such as intravenous or intestinal. We re-explored these routes in rat models of hypoxemia.Damiani, Elisa; Dyson, Alex; Zacchetti, Lucia; Donati, Abele; Singer, MervynDamiani, Elisa; Dyson, Alex; Zacchetti, Lucia; Donati, Abele; Singer, Mervy

Effects of the Infusion of 4% or 20% Human Serum Albumin on the Skeletal Muscle Microcirculation in Endotoxemic Rats

Sepsis-induced microcirculatory alterations contribute to tissue hypoxia and organ dysfunction. In addition to its plasma volume expanding activity, human serum albumin (HSA) has anti-oxidant and anti-inflammatory properties and may have a protective role in the microcirculation during sepsis. The concentration of HSA infused may influence these effects. We compared the microcirculatory effects of the infusion of 4% and 20% HSA in an experimental model of sepsis

Effect of performance improvement programs on compliance with sepsis bundles and mortality: a systematic review and meta-analysis of observational studies

none8noSeveral reports suggest that implementation of the Surviving Sepsis Campaign (SSC) guidelines is associated with mortality reduction in sepsis. However, adherence to the guideline-based resuscitation and management sepsis bundles is still poor.Damiani, Elisa; Donati, Abele; Serafini, Giulia; Rinaldi, Laura; Adrario, Erica; Pelaia, Paolo; Busani, Stefano; Girardis, MassimoDamiani, Elisa; Donati, Abele; Serafini, Giulia; Rinaldi, Laura; Adrario, Erica; Pelaia, Paolo; Busani, Stefano; Girardis, Massim

Effect of Conservative vs Conventional Oxygen Therapy on Mortality Among Patients in an Intensive Care Unit: The Oxygen-ICU Randomized Clinical Trial

Despite suggestions of potential harm from unnecessary oxygen therapy, critically ill patients spend substantial periods in a hyperoxemic state. A strategy of controlled arterial oxygenation is thus rational but has not been validated in clinical practice