Early goal-directed nutrition in icU patients (EAT-ICU):protocol for a randomised trial

INTRODUCTION: Extensive weight loss has been documented in intensive care unit (ICU) survivors, primarily as the result of muscle loss, leading to impaired physical function and reduced quality of life. The aim of the EAT-ICU trial is to test the effect of early goal-directed protein-energy nutrition based on measured requirements on short-term clinical outcomes and long-term physical quality of life in ICU patients. METHODS: The EAT-ICU trial is a single-centre, randomised, parallel-group trial with concealed allocation and blinded outcome assessment. A total of 200 consecutive, acutely admitted, mechanically ventilated intensive care patients will be randomised 1: 1 to early goal-directed nutrition versus standard of care to show a potential 15% relative risk reduction in the primary outcome measure (physical function) at six months (two-sided significance level alpha = 0.05; power beta = 80%). Secondary outcomes include energy-and protein balances, metabolic control, new organ failure, use of life support, nosocomial infections, ICU- and hospital length of stay, mortality and cost analyses. CONCLUSION : The optimal nutrition strategy for ICU patients remains unsettled. The EAT-ICU trial will provide important data on the effects of early goal-directed proteinenergy nutrition based on measured requirements in these patients.Copenhagen University Hospital; Rigshospitalet; Fresenius Kabi A/S; European Society for Clinical Nutrition and Metabolism (ESPEN)SCI(E)[email protected]

GeoERA Raw Materials Monograph : the past and the future

ABSTRACT: GeoERA Minerals projects have produced data aimed at supporting Europe’s minerals sector and to assist the European Commission to realise its goals for raw materials. Data has been compiled on mineral occurrences and mineral provinces across Europe, in particular, areas with potential to host Critical Raw Materials. Anecdotal evidence from the minerals sector provides an indication of the likelihood of exploration leading to mine development. For every 1,000 mineral showings examined, only 100 may receive further exploration work and of those 100, only 10 may warrant more detailed sampling either through trenching, drilling or other means and of those 10 only 1 may proceed to an evaluation through a full feasibility study which itself has only 50% chance of being positive. Following this, any project for which a mine proposal is made must undergo a full evaluation and permitting by authorities including full public consultation. The proposal may or may not pass this scrutiny. In terms of a schedule, the generally accepted minimum time frame from discovery to production is 10 years and usually much more, up to 20 years.info:eu-repo/semantics/publishedVersio

A review of the human vs. porcine female genital tract and associated immune system in the perspective of using minipigs as a model of human genital Chlamydia infection

International audienceAbstractSexually transmitted diseases constitute major health issues and their prevention and treatment continue to challenge the health care systems worldwide. Animal models are essential for a deeper understanding of the diseases and the development of safe and protective vaccines. Currently a good predictive non-rodent model is needed for the study of genital chlamydia in women. The pig has become an increasingly popular model for human diseases due to its close similarities to humans. The aim of this review is to compare the porcine and human female genital tract and associated immune system in the perspective of genital Chlamydia infection. The comparison of women and sows has shown that despite some gross anatomical differences, the structures and proportion of layers undergoing cyclic alterations are very similar. Reproductive hormonal cycles are closely related, only showing a slight difference in cycle length and source of luteolysing hormone. The epithelium and functional layers of the endometrium show similar cyclic changes. The immune system in pigs is very similar to that of humans, even though pigs have a higher percentage of CD4+/CD8+ double positive T cells. The genital immune system is also very similar in terms of the cyclic fluctuations in the mucosal antibody levels, but differs slightly regarding immune cell infiltration in the genital mucosa - predominantly due to the influx of neutrophils in the porcine endometrium during estrus. The vaginal flora in Göttingen Minipigs is not dominated by lactobacilli as in humans. The vaginal pH is around 7 in Göttingen Minipigs, compared to the more acidic vaginal pH around 3.5–5 in women. This review reveals important similarities between the human and porcine female reproductive tracts and proposes the pig as an advantageous supplementary model of human genital Chlamydia infection

Danmarks fjerde krone. Dronning Louises brudekrone 1743

Denmark’s fourth crown. The nuptial crown of Queen Louisa from 1743In the Royal Danish Collection at Rosenborg Castle is a small crown of gilt silver with a cap of crimson velvet and remnants of ermine trimming (figs. 2, 19). It is shaped like an English coronet consisting of a circlet with eight points, four crosses patées alternating with two fleurs-de-lys and two strawberry leaves, a combination used on the coronets of the children of the Heir Apparent in Britain today (fig. 3). The crown at Rosenborg can be traced back to an inventory from 1785, and it was thus believed to have been brought to Denmark by one of the two British princesses who became Danish queen during the eighteenth century: Caroline Mathilda, who married Christian VII in 1766 (fig. 4), or Louisa, who married Frederik V in 1743 (fig. 5). This guess must, however, be rejected. Evidence comes in the form of two silver gilt toilet sets that formed part of the brides’ trousseaus. On Caroline Mathilda’s toilet set, which was a gift from her brother George III, we find the monogram C(aroline) R(egina) under a ‘Continental’ crown with four intersecting arches (fig. 6). Likewise, the toilet set of Louisa is adorned with her initials under a coronet with alternating crosses patées and fleurs-de-lys conforming to a warrant that was issued by her father George II on his coronation in 1727 (figs. 7–8). If this be so, how can the different combination of points on the small crown at Rosenborg be explained? The answer is found partly in some hitherto unpublished invoices in the Danish privy purse, and partly in several descriptions of Louisa and Crown Prince Frederik’s entry into Copenhagen and subsequent wedding, in 1743. The day after their arrival at Frederiksberg Palace on the outskirts of the capital, Louisa met her parents-in-law, Christian VI and Sophie Magdalene, for the first time. Apparently, Louisa did not bring a coronet, and Queen Sophie Magdalene immediately ordered the present crown and an ermine robe to be made for the wedding ceremony four days later. The crown was made by goldsmith Hans Mundtberg, ‘working night and day’ and delivered on the day before the wedding in which it served as a nuptial crown for Louisa, who also wore the ermine robe.In ordering crown and robe for her daughter-in-law, Sophie Magdalene acted in perfect unison with Christian VI, who paid for both items. In close cooperation, the royal couple became the most prolific builders in Danish history, thus modernizing the state apparatus / framework of Danish absolutism. Both, however, lacked the ability to socialize and therefore avoided public representation, which made their subjects complain of an empty shell of pomp and circumstance. In 1743 the task of representation was left to the extrovert and popular crown prince and his charming wife. Their entry and wedding was staged with unprecedented splendour and magnificence that was carefully planned to include every rank of society (figs. 10–16).The ordering of the crown also raises the question of whether the use of nuptial crowns was a custom at the Danish court. A survey of the sparse and scattered sources indicates that bridal crowns were the norm rather than the exception in the period 1634–1829. Thus a nuptial crown with two cross arches and threaded diamonds was made for Caroline Mathilda in 1766

Repræsentation eller belæring?

Status versus Learning? Schatzkammer or Kunstkammer? In the 1660s Danish absolutism built up a treasure collection at Rosenborg Castle and a Kunstkammer opposite Copenhagen Castle. both of which contained applied art. It is the aim of this paper to trace this overlapping and to show that around 1690 principles were established for a division of objects that resulted in the two institutions becoming mutually supplementary. In other words the subject is royal heritage and royal collecting 1520–1920. A comparison calls for definitions. A ’treasure collection’ refers to an accumulation of valuable objects that is arranged with pomp and splendour. Three characteristics should be highlighted: the Prince or his official has the key to the collection, the objects are partially entailed as inalienable property, and viewing requires the permission of the sovereign. A ’Kunstkammer’ in this context means a collection of objects that are classified and displayed according to distinct principles which reflect human knowledge and theories about the surrounding world. Consequently the treasury represents and can provide, in time of emergency, a capital reserve, whereas the fundamental concept of the Kunstkammer is the structuring and imparting of knowledge as expressed in the publication of catalogues.