Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

Interactions normatives dans quelques corpus de discours scientifique

The present paper aims at illustrating the conditions that govern the compilation of discourse corpora so that every selected textual sequence may contribute to the homogeneity and functionality of the construct. We will also comment upon the functioning of any discourse in different contexts, exemplify and discuss the degree of discursive interferences among various technical domains related to forestry

Pour une nouvelle identité dans la presse littéraire

Each society operates with linguistic and behavioral marks that influence (in) directly its socio-cultural development. Thus, it is necessary to specify that the written press represents a mirror of events, while revealing images and models of people and times that communicate through the meanings of cultural and social behaviors, transforming, through their immediate realization, the whole Romanian culture. The beginning of the last century is characterized by a remarkable evolution at the historical and cultural level. In fact, all segments of society have undergone a radical transformation in a broad process of modernization of the whole Romanian society, a key role being played by the intellectuals who visibly struggled to acquire a new status in the European world, to rally to the cultural trends of Europe

Perspectives de l’Imaginaire linguistique (Il) sur La Langue / Nos Langues – étude sur un corpus de textes de Johannes Kabatek

This contribution aims to discover new valences of the thought of Johannes Kabatek and to link it to two of the centers of interest of our journal and the Center for the Analysis of Discourse in Suceava (CADISS), namely: discourse and linguistic imaginary. Thus, we looked at five of the texts written by Johannes Kabatek, including four in French and one in Spanish

Risk of New-Onset Liver Injuries Due to COVID-19 in Preexisting Hepatic Conditions—Review of the Literature

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) impacted the world and caused the 2019 coronavirus disease (COVID-19) pandemic. The clinical manifestations of the virus can vary from patient to patient, depending on their respective immune system and comorbidities. SARS-CoV-2 can affect patients through two mechanisms: directly by targeting specific receptors or by systemic mechanisms. We reviewed data in the latest literature in order to discuss and determine the risk of new-onset liver injuries due to COVID-19 in preexisting hepatic conditions. The particular expression of angiotensin-converting enzyme 2 (ACE2) receptors is an additional risk factor for patients with liver disease. COVID-19 causes more severe forms in patients with non-alcoholic fatty liver disease (NAFLD), increases the risk of cirrhosis decompensation, and doubles the mortality for these patients. The coinfection SARS-CoV-2—viral hepatitis B or C might have different outcomes depending on the stage of the liver disease. Furthermore, the immunosuppressant treatment administered for COVID-19 might reactivate the hepatic virus. The high affinity of SARS-CoV-2 spike proteins for cholangiocytes results in a particular type of secondary sclerosing cholangitis. The impact of COVID-19 infection on chronic liver disease patients is significant, especially in cirrhosis, influencing the prognosis and outcome of these patients

Photodynamic Therapy (PDT) in Prosthodontics: Disinfection of Human Teeth Exposed to <i>Streptococcus mutans</i> and the Effect on the Adhesion of Full Ceramic Veneers, Crowns, and Inlays: An In Vitro Study

The use of PDT in prosthodontics as a disinfection protocol can eradicate bacteria from tooth surfaces by causing the death of the microorganisms to which the photosensitizer binds, absorbing the energy of laser light during irradiation. The aim of the study was to investigate the capacity of PDT to increase the bond strength of full ceramic restorations. In this study, 45 extracted human teeth were prepared for veneers, crowns, and inlays and contaminated with Streptococcus mutans. Tooth surfaces decontamination was performed using a diode laser and methylene blue as a photosensitizer. The disinfection effect and the impact on tensile bond strength were evaluated by scanning electron microscopy (SEM) and pull-out tests of the cemented ceramic prosthesis. Results show that the number of bacteria was reduced from colonized prepared tooth surfaces, and the bond strength was increased when PDT was used. In conclusion, the present study indicates that using PDT as a protocol before the final adhesive cementation of ceramic restorations could be a promising approach, with outstanding advantages over conventional methods

Comparative In Vitro Studies on the Effect of Bleaching Agents on Dental Structures in Healthy and Predialysis Patients

(1) Background: What is the effect of 16% and 40% concentration bleaching agents on dental structures in healthy patients compared to predialysis patients? (2) Methods: Forty teeth were included in the study (20 from healthy patients and 20 from predialysis patients). Each group was randomly divided into another two subgroups (n-10), depending on the bleaching agent concentration (16% and 40% gels). Color parameters were registered before and after the whitening process using a spectrophotometer. To determine enamel ultramicroscopic modifications, SEM and AFM analysis were performed before and after bleaching. (3) Results: An increasing trend was identified in the average values of ∆E and ∆L within the groups of predialysis teeth between teeth whitened with 40% concentration gel and those whitened with 16% concentration gel, while for the enamel samples from healthy patients the trend was reversed. The average values for roughness in the case of the two bleaching agents in healthy and predialysis teeth presented statistically significant differences (p &lt; 0.05). (4) Conclusions: The effects of bleaching agents are less significant on teeth from predialysis compared to healthy patients. A direct link exists in terms of the clinical effect between the concentration of the whitening gel and color modifications

Physico-Antibacterial Feature and SEM Morphology of Bio-Hydraulic Lime Mortars Incorporating Nano-Graphene Oxide and Binary Combination of Nano-Graphene Oxide with Nano Silver, Fly Ash, Zinc, and Titanium Powders

The study evaluated the impact of graphene powders used as additives in the recipe of the experimental lime mortar to a mixture ratio of 1:2.5 of NHL3.5 hydraulic lime:fine sand. The content of binder, aggregate and water was kept constant, varying only the amount and the type of the added additives in relation to the amount of natural hydraulic lime NHL3.5. The following five types of experimental mortars were prepared as follows: reference mortar (without additive); mortars containing 1 wt.% GO and 5 wt.% GO powder; mortar with the following GO powders mixture: GO powder functionalized with silver nanoparticles and with fly ash (GO-Ag + GO-fly ash); mortar with the following GO powders mixture: GO with zinc oxide and with titanium oxide (GO-ZnO + GO-TiO2). The influence of the GO-based additive addition on the porosity, surface microstructure, and water sorption coefficient of the mortar samples was evaluated. The antibacterial effect of the mortar samples against three bacterial strains was also investigated. The best results were obtained for the experimental mortar containing GO-ZnO -TiO2, which showed improved experimental properties that potentially allow its use for the rehabilitation of heritage buildings