Flow Index accurately identifies breaths with low or high inspiratory effort during pressure support ventilation

Background Flow Index, a numerical expression of the shape of the inspiratory flow-time waveform recorded during pressure support ventilation, is associated with patient inspiratory effort. The aim of this study was to assess the accuracy of Flow Index in detecting high or low inspiratory effort during pressure support ventilation and to establish cutoff values for the Flow index to identify these conditions. The secondary aim was to compare the performance of Flow index,of breathing pattern parameters and of airway occlusion pressure (P0.1) in detecting high or low inspiratory effort during pressure support ventilation. Methods Data from 24 subjects was included in the analysis, accounting for a total of 702 breaths. Breaths with high inspiratory effort were defined by a pressure developed by inspiratory muscles (Pmusc) greater than 10 cmH2O while breaths with low inspiratory effort were defined by a Pmusc lower than 5 cmH2O. The areas under the receiver operating characteristic curves of Flow Index and respiratory rate, tidal volume,respiratory rate over tidal volume and P0.1 were analyzed and compared to identify breaths with low or high inspiratory effort. Results Pmusc, P0.1, Pressure Time Product and Flow Index differed between breaths with high, low and intermediate inspiratory effort, while RR, RR/VT and VT/kg of IBW did not differ in a statistically significant way. A Flow index higher than 4.5 identified breaths with high inspiratory effort [AUC 0.89 (CI 95% 0.85–0.93)], a Flow Index lower than 2.6 identified breaths with low inspiratory effort [AUC 0.80 (CI 95% 0.76–0.83)]. Conclusions Flow Index is accurate in detecting high and low spontaneous inspiratory effort during pressure support ventilation

A Specific Mutation in Muc2 Determines Early Dysbiosis in Colitis-Prone Winnie Mice

BACKGROUND: Inflammatory bowel disease (IBD), including Crohn disease (CD) and ulcerative colitis (UC), is a multifactorial disorder characterized by chronic inflammation and altered gut barrier function. Dysbiosis, a condition defined by dysregulation of the gut microbiome, has been reported in patients with IBD and in experimental models of colitis. Although several factors have been implicated in directly affecting gut microbial composition, the genetic determinants impacting intestinal dysbiosis in IBD remain relatively unknown. METHODS: We compared the microbiome of normal, uninflamed wild-type (WT) mice with that of a murine model of UC (ie, Winnie strain). Winnie mice possess a missense mutation in Muc2 that manifests in altered mucus production as early as 4 weeks of age, with ensuing colonic inflammation. To better address the potential role of mutant Muc2 in promoting dysbiosis in Winnie mice, we evaluated homozygous mutant mice (Winnie-/-) with their WT littermates that, after weaning from common mothers, were caged separately according to genotype. Histologic and inflammatory status were assessed over time, along with changes in their respective microbiome compositions. RESULTS: Dysbiosis in Winnie mice was already established at 4 weeks of age, before histologic evidence of gut inflammatory changes, in which microbial communities diverged from that derived from their mothers. Furthermore, dysbiosis persisted until 12 weeks of age, with peak differences in microbiome composition observed between Winnie and WT mice at 8 weeks of age. The relative abundance of Bacteroidetes was greater in Winnie compared with WT mice. Verrucomicrobia was detected at the highest relative levels in 4-week-old Winnie mice; in particular, Akkermansia muciniphila was among the most abundant species found at 4 weeks of age. CONCLUSIONS: Our results demonstrate that mutant genetic determinants involved in the complex regulation of intestinal homeostasis, such as that observed in Winnie mice, are able to promote early gut dysbiosis that is independent from maternal microbial transfer, including breastfeeding. Our data provide evidence for intestinal dysbiosis attributed to a Muc2-driven mucus defect that leads to colonic inflammation and may represent an important target for the design of future interventional studies

Practice patterns and 90-day treatment-related morbidity in early-stage cervical cancer

To evaluate the impact of the Laparoscopic Approach to Cervical Cancer (LACC) Trial on patterns of care and surgery-related morbidity in early-stage cervical cancer

La ricerca archeologica e le manifestazioni rituali tra metropoli e apoikiai

Analisi delle testimonianze archeologiche del culto nell'Italia meridionale e in Sicilia nei primi due secoli della colonizzazione come marcatori culturali delle trasformazioni in atto nel periodo; si affronta il tema della colonizzazione alla luce della ricerca bibliografica più recente, partendo dall'evidenza legata all'introduzione di nuovi rituali e di nuovi materiali impiegati nelle attività cultuali

Spazio sacro e culti civici

Il contributo offre una panoramica sul ruolo svolto dal culto e dalle pratiche religiose nel processo di strutturazione delle colonie della Magna Grecia. Partendo dalla storia degli studi, vengono analizzati aspetti specifici che contibuiscono a definire il sistema del sacro delle singole poleis, quali l'uso della coroplastica, il legame tra forme rituali e ripartizioni sociali, i rapporti con il pantheon della madrepatria, l'organizzazione architettonica degli spazi sacri

Saturo (Ta). Campagne di scavo 2007-2013

Saturo (Leporano, Italy) is a site about 10 km south-east of Taranto, situated on a promontory overlooking Porto Perone and Porto Saturo, two small inlets on the Gulf of Taranto, on the Ionic sea. Excavations carried out in the XXth century have shown an impressive continuity of occupation, with archaeological remains of Bronze Age and Iron Age settlements, of two Greek sanctuaries and of a very large Roman Villa. From 2007 Sapienza – University of Rome has restarted fieldwork in the two Greek sanctuaries, the so called “santuario della sorgente” (2007-2010) and the “acropolis”, at the highest point of the promontory (2011-2013). In this article are presented some preliminary results of Sapienza excavations, that confirm that Saturo is a key site for understanding interactions between natives and Greeks during the processes of colonization and for analyzing ritual and architectonic dynamics of Greek sacred spaces from Archaic to Hellestic times

Gli Ateniesi e il loro modello di città. Seminari di Storia e Archeologia greca I, Roma 25-26 giugno 2012

Il volume raccoglie gli atti del seminario, tenutosi a Roma nel 2012, sulla storia e sull'archeologia di Atene. Articolata in quattro sezioni, la pubblicazione verte sui temi della ritualità e dell'identità civica, le forme della cultura urbana, la città romana, la città tardoantic

Greci e indigeni nel golfo di Taranto. Il caso di Satyrion

Satyrion, about 12 km south-east of Laconian Taras, is one of the most important contexts for understanding the early Greek presence in Southern Italy and the dynamics between natives and colonists. The excavations carried out in 2011 by the Sapienza - University of Rome at the ‘acropolis’, on the promontory overlooking Porto Perone and Porto Saturo, discovered new structural remains and a rich votive deposit. The findings confirm that between the end of the 8th and the beginning of the 7th c. B.C. the small site, occupied by a Iapigian settlement, underwent a functional change and became a monumentalized Greek sanctuary, functioning until the 4th c. B.C

Saturo (TA). Campagne di scavo 2007-2013

Saturo (Leporano, Italy) is a site about 10 km south-east of Taranto, situated on a promontory overlooking Porto Perone and Porto Saturo, two small inlets on the Gulf of Taranto, on the Ionic sea. Excavations carried out in the XXth century have shown an impressive continuity of occupation, with archaeological remains of Bronze Age and Iron Age settlements, of two Greek sanctuaries and of a very large Roman Villa. From 2007 Sapienza – University of Rome has restarted fieldwork in the two Greek sanctuaries, the so called “santuario della sorgente” (2007-2010) and the “acropolis”, at the highest point of the promontory (2011-2013). In this article are presented some preliminary results of Sapienza excavations, that confirm that Saturo is a key site for understanding interactions between natives and Greeks during the processes of colonization and for analyzing ritual and architectonic dynamics of Greek sacred spaces from Archaic to Hellestic times