Grafting affects yield and phenolic profile of Solanum melongena L. landraces

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GUT microbiota change and time of restore in intensive care therapy : a case report

Exposure of gut microbiota to antibiotics can promote antibiotic resistance and development of diseases caused by multi-drug-resistant organisms. Here we present a case of a 54-year-old male patient with a diagnosis of acute cholecystitis with significant biliary duct leakage, admitted to Intensive Care Unit (ICU) due to a septic syndrome after surgery. Fecal microbial population was analyzed by DGGE and Real Time PCR during and after a combined antibiotic therapy and enteral nutritional feeding. Gut microbiota dysbiosis was demonstrated during ICU recovery. After antibiotic therapy discontinuation and the switch to normal diet, microbial gut population gradually increased up to values comparable with those of a healthy subject. Bifidobacterium spp. took longer to re-stabilize, reaching normal value after two weeks. Our case report corroborates the resilient nature of gut microbiota, but points out the long time needed to recover after antibiotic treatment, paving the way to supplementation with key probiotic species

Cluster magnetic fields through the study of polarized radio halos in the SKA era

Galaxy clusters are unique laboratories to investigate turbulent fluid motions and large scale magnetic fields. Synchrotron radio halos at the center of merging galaxy clusters provide the most spectacular and direct evidence of the presence of relativistic particles and magnetic fields associated with the intracluster medium. The study of polarized emission from radio halos is extremely important to constrain the properties of intracluster magnetic fields and the physics of the acceleration and transport of the relativistic particles. However, detecting this polarized signal is a very hard task with the current radio facilities.We use cosmological magneto-hydrodynamical simulations to predict the expected polarized surface brightness of radio halos at 1.4 GHz. We compare these expectations with the sensitivity and the resolution reachable with the SKA1. This allows us to evaluate the potential for studying intracluster magnetic fields in the surveys planned for SKA1.Comment: 11 pages, 4 figures; to appear as part of 'Cosmic Magnetism' in Proceedings 'Advancing Astrophysics with the SKA (AASKA14)', PoS(AASKA14)10

Performance determinants and flexible ICU organisation

We faced some of the most important aspects of the problem of the appropriateness of ICU resources use, that are the relationship between volume of activity and mortality, the analysis of cost-effectiveness in intensive care medicine, and the monitoring of the human resource use in ICU. For this aim three different surveys were utilized: one at European level, the second at country level and, third, a regional survey. After developing a new measure of volume called \u201chigh-risk volume\u201d, we explored the relationship between outcome and volume, founding that such association was very strong (from 3 to 17\u201319% decrease in ICU/hospital mortality every five extra high-risk patients treated per bed per year), and that an occupancy rate larger than 80% was associated with higher mortality. Therefore, patients in all levels of risk are better treated in high-risk volume ICUs with a reasonable occupancy rate. Analysing cost-effectiveness in intensive care medicine using a national case-mix categorized in different diagnostic groups, we identified brain haemorrhage, ALI/ARDS and surgical unscheduled patients as users a high volume of monetary resources less efficiently, while the scheduled abdominal surgery patients admitted to receive intensive care and patients on the ICU for minor organ support made the best use of the fewer resources spent. Finally, we designed a new approach to measure the rate and appropriateness of nursing resource use in ICU on a daily basis. Testing this approach on a group of general non-specialist ICUs, we found that the method was powerful enough to adequately distinguish between \u201cover\u201d and \u201cunder-utilization\u201d and to identify all the theoretical scenarios of nurse/resource utilization

Stressors in the ICU: different perceptions of patients, relatives and staff members

Introduction The high-risk critically ill are exposed to signifi cant stressors, along with diffi culties in communicating them to relatives and members of the staff . The aim of this study was to compare the perception of stressors as reported by patients (P), relatives (R) and ICU staff members (S). Methods A validated questionnaire [1] was used to quantitatively assess discomforts related to the ICU stay. Items were clustered into categories; higher scores refer to a higher stressfulness. The median (IQR) was calculated for each category. Twenty-eight high-risk critically ill at discharge, 55 relatives 48 hours after admission of their next of kin, and a total of 125 staff members (55 attending physicians, 40 nurses and 30 medical students/specialist trainees) were interviewed. Fifty-six of the staff members were used to keep patients consciously sedated as for local guidelines; the remaining used deeper levels of sedation. Nonparametric tests were used as needed. Results All stressor categories were diff erently reported by the three groups analysed: environmental (S = 17 (15 to 19), R = 15 (13 to 18), P = 10 (8 to 11), P <0.01), relationships (S = 23 (21 to 25), R = 20.5 (17 to 24.5), P = 14 (11 to 17), P <0.01), emotional (S = 25.5 (23 to 28), R = 24 (20 to 26), P = 18 (15 to 22), P <0.01), and physical (S = 35 (31 to 38), R = 33 (26.5 to 37), P = 27 (21 to 30), P <0.01). Among the staff members, nurses overestimated more than attending physicians, while trainees are closer to relatives\u2019 perception (P = 0.03). Staff members used to conscious sedation overestimate less the impact of environmental stressors (P = 0.03). Years of experience (r = 0.24, P = 0.03) and age (r = 0.27, P = 0.01) are related to stressor overestimation among staff members. Conclusion Members of the staff should reconsider their beliefs on patients\u2019 perception of stressors. We argue that such an overestimation may bring inappropriate administration of analgesic and sedative drugs, particularly for nurses and older members of staff . Relatives might be useful intermediaries to have a better insight of patients\u2019 perception

Lung response to prone positioning in mechanically-ventilated patients with COVID-19

Background: Prone positioning improves survival in moderate-to-severe acute respiratory distress syndrome (ARDS) unrelated to the novel coronavirus disease (COVID-19). This benefit is probably mediated by a decrease in alveolar collapse and hyperinflation and a more homogeneous distribution of lung aeration, with fewer harms from mechanical ventilation. In this preliminary physiological study we aimed to verify whether prone positioning causes analogue changes in lung aeration in COVID-19. A positive result would support prone positioning even in this other population. Methods: Fifteen mechanically-ventilated patients with COVID-19 underwent a lung computed tomography in the supine and prone position with a constant positive end-expiratory pressure (PEEP) within three days of endotracheal intubation. Using quantitative analysis, we measured the volume of the non-aerated, poorly-aerated, well-aerated, and over-aerated compartments and the gas-to-tissue ratio of the ten vertical levels of the lung. In addition, we expressed the heterogeneity of lung aeration with the standardized median absolute deviation of the ten vertical gas-to-tissue ratios, with lower values indicating less heterogeneity. Results: By the time of the study, PEEP was 12 (10–14)&nbsp;cmH2O and the PaO2:FiO2 107 (84–173)&nbsp;mmHg in the supine position. With prone positioning, the volume of the non-aerated compartment decreased by 82 (26–147)&nbsp;ml, of the poorly-aerated compartment increased by 82 (53–174) ml, of the normally-aerated compartment did not significantly change, and of the over-aerated compartment decreased by 28 (11–186)&nbsp;ml. In eight (53%) patients, the volume of the over-aerated compartment decreased more than the volume of the non-aerated compartment. The gas-to-tissue ratio of the ten vertical levels of the lung decreased by 0.34 (0.25–0.49)&nbsp;ml/g per level in the supine position and by 0.03 (− 0.11 to 0.14) ml/g in the prone position (p &lt; 0.001). The standardized median absolute deviation of the gas-to-tissue ratios of those ten levels decreased in all patients, from 0.55 (0.50–0.71) to 0.20 (0.14–0.27) (p &lt; 0.001). Conclusions: In fifteen patients with COVID-19, prone positioning decreased alveolar collapse, hyperinflation, and homogenized lung aeration. A similar response has been observed in other ARDS, where prone positioning improves outcome. Therefore, our data provide a pathophysiological rationale to support prone positioning even in COVID-19

Reduced basis isogeometric mortar approximations for eigenvalue problems in vibroacoustics

We simulate the vibration of a violin bridge in a multi-query context using reduced basis techniques. The mathematical model is based on an eigenvalue problem for the orthotropic linear elasticity equation. In addition to the nine material parameters, a geometrical thickness parameter is considered. This parameter enters as a 10th material parameter into the system by a mapping onto a parameter independent reference domain. The detailed simulation is carried out by isogeometric mortar methods. Weakly coupled patch-wise tensorial structured isogeometric elements are of special interest for complex geometries with piecewise smooth but curvilinear boundaries. To obtain locality in the detailed system, we use the saddle point approach and do not apply static condensation techniques. However within the reduced basis context, it is natural to eliminate the Lagrange multiplier and formulate a reduced eigenvalue problem for a symmetric positive definite matrix. The selection of the snapshots is controlled by a multi-query greedy strategy taking into account an error indicator allowing for multiple eigenvalues