Comparison of the Laryngeal View during Tracheal Intubation Using Airtraq and Macintosh Laryngoscopes by Unskillful Anesthesiology Residents: A Clinical Study

Background and Objective. The Airtraq laryngoscope (Prodol Meditec, Vizcaya, Spain) is a novel tracheal intubation device. Studies, performed until now, have compared the Airtraq with the Macintosh laryngoscope, concluding that it reduces the intubation times and increase the success rate at first intubation attempt, decreasing the Cormack-Lehane score. The aim of the study was to evaluate if, in unskillful anesthesiology residents during the laryngoscopy, the Airtraq compared with the Macintosh laryngoscope improves the laryngeal view, decreasing the Cormack-Lehane score. Methods. A prospective, randomized, crossed-over trial was carried out on 60 patients. Each one of the patients were intubated using both devices by unskillful (less than two hundred intubations with the Macintosh laryngoscope and 10 intubations using the Airtraq) anesthesiology residents. The Cormack-Lehane score, the success rate at first intubation attempt, and the laryngoscopy and intubation times were compared. Results. The Airtraq significantly decreased the Cormack-Lehane score (P = 0.04). On the other hand, there were no differences in times of laryngoscopy (P = 0.645; IC 95% 3.1, +4.8) and intubation (P = 0.62; C95%  −6.1, +10.0) between the two devices. No relevant complications were found during the maneuvers of intubation using both devices. Conclusions. The Airtraq is a useful laryngoscope in unskillful anesthesiology residents improving the laryngeal view and, therefore, facilitating the tracheal intubation

Assessing the Left Ventricular Systolic Function at the Bedside: The Role of Transpulmonary Thermodilution-Derived Indices

Evaluating the systolic function of the left ventricle (LV) is important in the hemodynamic management of the critically ill patients with circulatory failure. Echocardiography is considered the standard monitor for estimating the LV function at the bedside in the intensive care unit. However, it requires a trained operator and is not a real-time monitoring tool. For monitoring of the systolic function, the pulmonary artery catheter has been the gold standard for a long time. However, now there are alternatives to this device, with transpulmonary thermodilution being one of them. This paper provides an overview of the usefulness of the transpulmonary thermodilution-derived indices for assessing systolic function at the bedside

Wersync: A WEB-BASED PLATFORM FOR DISTRIBUTED MEDIA SYNCHRONIZATION AND SOCIAL INTERACTION

This paper presents Wersync, which is an adaptive and accurate web-based platform that enables distributed media synchronization and social interaction across remote users. By using Wersync, users can create or join on-going sessions for concurrently consuming the same media content with other remote users in a synchronized manner. Besides, social interaction is provided by sharing the navigation control commands and by integrating synchronized text chat channels. Additionally, two social presence mechanisms have been added to stimulate the participation of external users in on-going sessions on Wersync. By exclusively relying on standard web-based technologies, this platform can guarantee cross-network, cross-platform and crossdevice support, which is a key point in the current heterogeneous media delivery ecosystem

Plataforma Web 2.0 para la Sincronización Distribuida de Contenidos Multimedia e Interacción Social

Shared media experiences between geographically distributed users are gaining momentum. Relevant examples are Social TV, synchronous e-learning and multi-player online games. This paper presents a first release of Wersync, an adaptive web-based platform that provides distributed media synchronization and social interaction (via shared navigation control commands and text chat channels) across remote users. By using Wersync, users can create or join on-going sessions for concurrently consuming the same media content with other remote users in a synchronized manner. Additionally, Wersync provides two social presence mechanisms to encourage the participation of external users in on-going sessions and two privacy mechanisms. Wersync has been developed by exclusively relying on standard web-based technologies, which ensures cross-network, cross-platform and cross-device support. The evaluation results and a link to a demo video prove the satisfactory performance of Wersync, and its functionalities, respectively

Intelligent transport systems harmonisation assessment: use case of some Spanish intelligent transport systems services

From the 1980s, new telematic technologies have meant a great evolution in several areas. In the transportation domain, their use has implied the development and implementation of several intelligent transport systems (ITS). However, these deployments were done in an isolated way. Traffic managers, public and private organisations, stakeholders and others have implemented ITS without much perspective, that is, without providing ITS as services for end users. In the last few years, several European Union (EU) funded projects have been dealing with the development of harmonised ITS services. For example, the EasyWay Project is involving most of the European countries (EU member states and others) to deploy harmonised ITS services taking into account the European citizen as the final target. In this study, an introduction of the EasyWay project is made, including the ITS concept services and the deployment guidelines for harmonisation. In November 2012, EasyWay presented a new version of DGs, which were approved with minor editorial changes. An overview on these DGs for the ITS services is presented and two real Spanish road traffic ITS services are analysed

Calculation of the critical energy release rate Gc of the cement line in cortical bone combining experimental tests and finite element models

[EN] In this work, a procedure is proposed to estimate the critical energy release rate Gc of the so-called cement line in cortical bone tissue. Due to the difficulty of direct experimental estimations, relevant elastic and toughness material properties at bone microscale have been inferred by correlating experimental tests and finite element simulations. In particular, three-point bending tests of ovine cortical bone samples have been performed and modeled by finite elements. The initiation and growth of microcracks in the tested samples are simulated through finite elements using a damage model based on a maximum principal strain criterion, showing a good correlation with the experimental results. It is observed that microcracks evolve mainly along the cement lines and through the interstitial material but without crossing osteons. The numerical model allows the calculation of the cement line critical energy release rate Gc by approximating its definition by finite differences. This way, it is possible to estimate this property poorly documented in the literature.The authors wish to thank the Ministerio de Economia y Competitividad for the support received in the framework of the project DPI2013-46641-R and to the Generalitat Valenciana, Programme PROMETEO 2016/007. The authors also thank Dr. Jose Luis Peris, from Instituto de Biomecanica de Valencia (IBV) and Carlos Tudela Desantes for their collaboration within the context of the project.Giner Maravilla, E.; Belda, R.; Arango-Villegas, C.; Vercher Martínez, A.; Tarancón Caro, JE.; Fuenmayor Fernández, FJ. (2017). Calculation of the critical energy release rate Gc of the cement line in cortical bone combining experimental tests and finite element models. Engineering Fracture Mechanics. 184:168-182. https://doi.org/10.1016/j.engfracmech.2017.08.026S16818218

Epidemiology of invasive candidiasis in a surgical intensive care unit: an observational study

Background: Invasive candidiasis (IC) is a frequent and life-threatening infection in critically ill patients. The aim of this study was to evaluate the epidemiology of IC and the antifungal susceptibility of etiological agents in patients admitted to our surgical intensive care unit (SICU) in Spain. Methods: We designed a prospective, observational, single center, population-based study in a SICU. We included all consecutive adult patients (≥18 years old) who had documented IC, either on admission or during their stay, between January 2012 and December 2013. Results: There were a total of 22 episodes of IC in the 1149 patients admitted during the 24-month study. The overall IC incidence was 19.1 cases per 1000 admissions. Thirteen cases of IC (59.1 %) were intra-abdominal candidiasis (IAC) and 9 (40.9 %) were candidemias. All cases of IAC were patients with secondary peritonitis and severe sepsis or septic shock. The overall crude mortality rate was 13.6 %; while, it was 33 % in patients with candidemia. All patients with IAC survived, including one patient with concomitant candidemia. The most common species causing IC was Candida albicans (13; 59.1 %) followed by Candida parapsilosis (5; 22.7 %), and Candida glabrata (2; 9.1 %). There was also one case each (4.5 %) of Candida krusei and Candida tropicalis. Thus, the ratio of non-C. albicans (9) to C. albicans (13) was 1:1.4. There was resistance to fluconazole and itraconazole in 13.6 % of cases. Resistance to other antifungals was uncommon. Conclusions: Candida parapsilosis was the second most common species after C. albicans, indicating the high prevalence of non-C. albicans species in the SICU. Resistance to azoles, particularly fluconazole, should be considered when starting an empirical treatment. Although IAC is a very frequent form of IC in critically ill surgical patients, prompt antifungal therapy and adequate source control appears to lead to a good outcome. However, our results are closely related to our ICU and any generalization must be taken with caution. Therefore, further investigations are needed. Keywords: Intensive care unit, Invasive candidiasis, Candidemia, Antifungal susceptibilit

Benefits and harms of perioperative high fraction inspired oxygen for surgical site infection prevention: a protocol for a systematic review and meta-analysis of individual patient data of randomised controlled trials.

INTRODUCTION The use of high fraction of inspired oxygen (FiO2) intraoperatively for the prevention of surgical site infection (SSI) remains controversial. Promising results of early randomised controlled trials (RCT) have been replicated with varying success and subsequent meta-analysis are equivocal. Recent advancements in perioperative care, including the increased use of laparoscopic surgery and pneumoperitoneum and shifts in fluid and temperature management, can affect peripheral oxygen delivery and may explain the inconsistency in reproducibility. However, the published data provides insufficient detail on the participant level to test these hypotheses. The purpose of this individual participant data meta-analysis is to assess the described benefits and harms of intraoperative high FiO2compared with regular (0.21-0.40) FiO2 and its potential effect modifiers. METHODS AND ANALYSIS Two reviewers will search medical databases and online trial registries, including MEDLINE, Embase, CENTRAL, CINAHL, ClinicalTrials.gov and WHO regional databases, for randomised and quasi-RCT comparing the effect of intraoperative high FiO2 (0.60-1.00) to regular FiO2 (0.21-0.40) on SSI within 90 days after surgery in adult patients. Secondary outcome will be all-cause mortality within the longest available follow-up. Investigators of the identified trials will be invited to collaborate. Data will be analysed with the one-step approach using the generalised linear mixed model framework and the statistical model appropriate for the type of outcome being analysed (logistic and cox regression, respectively), with a random treatment effect term to account for the clustering of patients within studies. The bias will be assessed using the Cochrane risk-of-bias tool for randomised trials V.2 and the certainty of evidence using Grading of Recommendations, Assessment, Development and Evaluation methodology. Prespecified subgroup analyses include use of mechanical ventilation, nitrous oxide, preoperative antibiotic prophylaxis, temperature (2.5 hour). ETHICS AND DISSEMINATION Ethics approval is not required. Investigators will deidentify individual participant data before it is shared. The results will be submitted to a peer-review journal. PROSPERO REGISTRATION NUMBER CRD42018090261

Microbial Diversity in the Midguts of Field and Lab-Reared Populations of the European Corn Borer Ostrinia nubilalis

Background: Insects are associated with microorganisms that contribute to the digestion and processing of nutrients. The European Corn Borer (ECB) is a moth present world-wide, causing severe economical damage as a pest on corn and other crops. In the present work, we give a detailed view of the complexity of the microorganisms forming the ECB midgut microbiota with the objective of comparing the biodiversity of the midgut-associated microbiota and explore their potential as a source of genes and enzymes with biotechnological applications. Methodological/Principal Findings: A high-throughput sequencing approach has been used to identify bacterial species, genes and metabolic pathways, particularly those involved in plant-matter degradation, in two different ECB populations (field-collected vs. lab-reared population with artificial diet). Analysis of the resulting sequences revealed the massive presence of Staphylococcus warneri and Weissella paramesenteroides in the lab-reared sample. This enabled us to reconstruct both genomes almost completely. Despite the apparently low diversity, 208 different genera were detected in the sample, although most of them at very low frequency. By contrast, the natural population exhibited an even higher taxonomic diversity along with a wider array of cellulolytic enzyme families. However, in spite of the differences in relative abundance of major taxonomic groups, not only did both metagenomes share a similar functional profile but also a similar distribution of non-redundant genes in different functional categories. Conclusions/Significance: Our results reveal a highly diverse pool of bacterial species in both O. nubilalis populations, with major differences: The lab-reared sample is rich in gram-positive species (two of which have almost fully sequenced genomes) while the field sample harbors mainly gram-negative species and has a larger set of cellulolytic enzymes. We have found a clear relationship between the diet and the midgut microbiota, which reveals the selection pressure of food on the community of intestinal bacteria. © 2011 Belda et al.The research was funded by the Spanish Ministerio de Ciencia e Innovacion, under grant agreement CIT-010000-2008-5 and by a MICINN (Ministerio de Ciencia e Innovacion) TIN2009-12359 ArtBioCom project. Arnau Montagud acknowledges Generalitat Valenciana grant BFPI/2007/283. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Belda Cuesta, EA.; Pedrola, L.; Peretó Magraner, J.; Martinez Blanch, JF.; Montagud Aquino, A.; Navarro-Peris, E.; Urchueguía Schölzel, JF.... (2011). Microbial Diversity in the Midguts of Field and Lab-Reared Populations of the European Corn Borer Ostrinia nubilalis. PLoS ONE. 6(6):21751-21751. https://doi.org/10.1371/journal.pone.0021751S21751217516