Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

I TEMPI DELL'APOCALYPSIS NOVA: PROFEZIA E POLITICA AL TEMPO DI GIULIO II

Lo studio intende rileggere criticamente le fonti contemporanee e appena successive alla stesura dell'Apocalypsis Nova, attribuita al beato Amedeo Menez de Sylva, inserendole nel più ampio dibattito sulla profezia e sulle attese apocalittiche della fine del XV secolo.This study is a critically re-read of the contemporary sources of the Apocalypsis Nova, attributed to Blessed Amedeo Menez de Sylva. The sources are inserting in the broader debate on prophecy and apocalyptic expectations of the late 15th century

Subsistence hunting and conservation issues in the Game Riserve of Gile, Mozambique

Ethnozoological research was conducted to gather information on the hunting activities and their relevance for the subsistence of local people in 8 villages around the game reserve of Gile, Mozambique. Two series of data were gathered by questionnaires to: (a) 510 householders from eight villages located in the outskirts of the Reserve; (b) 10 hunters from the village of Gile, the main centre of the study area. Several hunting techniques were recorded: spears, nets, traps (including gin-traps) and wildfires, while the use of guns did not appear relevant. The importance of subsistence hunting for local people was underlined by the high percentage of respondents who declared that they usually conduct this activity and sell bushmeat. The proportion of hunters per village was related to the village size but not to its geographical location of villages and the household composition. A positive relationship existed between the proportion of hunters, crop production and fishing activities, indicating that hunting is part of an integrated system of subsistence activities. Most animals harvested were mammals (89.5%, of which 46.7% were ungulates) and most were captured within the Reserve (96%). A higher percentage of animals was sold (56%), representing a relevant income source for the villagers. Small animals were mainly captured by traps during solitary hunting, medium-sized animals in collective net hunting; larger prey were captured by gin-traps adopted by both solitary and collective hunting. In the diet of the local people wild animals represented a higher protein source than domestic animals

Schede

Il volume traccia lo sviluppo del tema del Compianto ligneo e fittile nell'area lombardo-piemontese tra Quattrocento e Cinquecento, con particolare attenzione ai gruppi realizzati da personalit\ue0 di alto profilo come i De Fondulis, Zamara, Amatore e Fantoni

Intact fibroblast growth factor 23 in heart failure with reduced and mildly reduced ejection fraction

Background: Fibroblast growth factor-23 (FGF23) has been associated to left ventricular (LV) hypertrophy and heart failure (HF) severity. We aimed to investigate the clinical correlates and prognostic value of intact FGF23 (iFGF23) in HF patients. Methods: Patients with stable HF and left ventricular ejection fraction (LVEF) &lt; 50% were prospectively enrolled, managed according to current recommendations and followed over time. iFGF23 was measured at baseline with a fully automated immuno-chemiluminescent assay. Results: We enrolled 150 patients (82% males; median age 65 years). First, second, and third iFGF23 tertiles were &lt; 35.2 pg/mL, 35.2-50.9 pg/mL, and &gt; 50.9 pg/mL. LVEF decreased from the first iFGF23 tertile to the third tertile (p = 0.014). N-terminal pro-B-type natriuretic peptide (NT-proBNP) increased from the first to the third tertile (p = 0.001), while peak oxygen consumption decreased (p &lt; 0.001). Thirty-five patients (23%) experienced the primary endpoint (all-cause death or HF hospitalization at 5 years), and 26 (17%) the secondary endpoint (all-cause death at 5 years). On multivariable analysis, iFGF23 independently predicted the primary endpoint on top of age, gender and LVEF (HR 4.6 [95% CI 2.1-10.3], p &lt; 0.001), age, gender and eGFR (HR 4.1 [95% CI 1.6-10.3], p = 0.003), as well as age, gender and NT-proBNP (HR 3.6 [95% CI 1.6-8.2], p = 0.002). iFGF23 even reclassified patient risk on top of all the 3 models, with NRI values of 0.65 (95% CI 0.30-1.01), 0.55 (95% CI 0.25-0.88), and 0.60 (95% CI 0.24-0.96), respectively (both p &lt; 0.001). Conclusions: Circulating iFGF23 is associated with disease severity and outcome in HF patients with reduced and mildly reduced ejection fraction

QTL Mapping in Eggplant Reveals Clusters of Yield-Related Loci and Orthology with the Tomato Genome

<div><p>In spite of its widespread cultivation and nutritional and economic importance, the eggplant (<i>Solanum melongena</i> L.) genome has not been extensively explored. A lack of knowledge of the patterns of inheritance of key agronomic traits has hindered the exploitation of marker technologies to accelerate its genetic improvement. An already established F₂ intraspecific population of eggplant bred from the cross ‘305E40’ x ‘67/3’ was phenotyped for 20 agronomically relevant traits at two sites. Up to seven quantitative trait loci (QTL) per trait were identified and the percentage of the phenotypic variance (PV) explained per QTL ranged from 4 to 93%. Not all the QTL were detectable at both sites, but for each trait at least one major QTL (PV explained ≥10%) was identified. Although no detectable QTL x environment interaction was found, some QTL identified were location-specific. Many of the fruit-related QTL clustered within specific chromosomal regions, reflecting either linkage and/or pleiotropy. Evidence for putative tomato orthologous QTL/genes was obtained for several of the eggplant QTL. Information regarding the inheritance of key agronomic traits was obtained. Some of the QTL, along with their respective linked markers, may be useful in the context of marker-assisted breeding.</p></div

Epistatic effects detected at p<0.05.

<p>AD, DA DD: additive x dominant, dominant x additive, dominant x dominant interactions, respectively. PV(AD), PV (DA) and PV (DD)%: the contribution of, respectively, the AD, DA and DD interaction.</p