Framework for Research Gaps in Pediatric Ventilator Liberation

BackgroundThe 2023 International Pediatric Ventilator Liberation Clinical Practice Guidelines provided evidence-based recommendations to guide pediatric critical care providers on how to perform daily aspects of ventilator liberation. However, because of the lack of high-quality pediatric studies, most recommendations were conditional based on very low to low certainty of evidence.Research QuestionWhat are the research gaps related to pediatric ventilator liberation that can be studied to strengthen the evidence for future updates of the guidelines?Study Design and MethodsWe conducted systematic reviews of the literature in eight predefined Population, Intervention, Comparator, Outcome (PICO) areas related to pediatric ventilator liberation to generate recommendations. Subgroups responsible for each PICO question subsequently identified major research gaps by synthesizing the literature. These gaps were presented at an international symposium at the Pediatric Acute Lung Injury and Sepsis Investigators meeting in spring 2022 for open discussion. Feedback was incorporated, and final evaluation of research gaps are summarized herein. Although randomized controlled trials (RCTs) represent the highest level of evidence, the panel sought to highlight areas where alternative study designs also may be appropriate, given challenges with conducting large multicenter RCTs in children.ResultsSignificant research gaps were identified in six broad areas related to pediatric ventilator liberation. Several of these areas necessitate multicenter RCTs to provide definitive results, whereas other gaps can be addressed with multicenter observational studies or quality improvement initiatives. Furthermore, a need for some physiologic studies in several areas remains, particularly regarding newer diagnostic methods to improve identification of patients at high risk of extubation failure.InterpretationAlthough pediatric ventilator liberation guidelines have been created, the certainty of evidence remains low and multiple research gaps exist that should be filled through high-quality RCTs, multicenter observational studies, and quality improvement initiatives

Stress compensation by gap monolayers for stacked InAs/GaAs quantum dots solar cells

In this work we report the stacking of 10 and 50 InAs quantum dots layers using 2 monolayers of GaP for stress compensation and a stack period of 18 nm on GaAs (001) substrates. Very good structural and optical quality is found in both samples. Vertical alignment of the dots is observed by transmission electron microscopy suggesting the existence of residual stress around them. Photocurrent measurements show light absorption up to 1.2 μm in the nanostructures together with a reduction in the blue response of the device. As a result of the phosphorus incorporation in the barriers, a very high thermal activation energy (431 meV) has also been obtained for the quantum dot emission

Conocimiento y viabilidad de uso del preservativo femenino en jóvenes universitarios españoles

La importancia del control por parte de las mujeres de métodos anticonceptivos y aquellos que previenen la infección de enfermedades de transmisión sexual, especialmente el VIH/SIDA, es un tema que adquiere importancia en el marco del aumento de las mujeres afectadas por la epidemia. El objetivo de este trabajo, un estudio de poblaciones mediante encuestas con muestras probabilísticas transversal, es evaluar el conocimiento y viabilidad de uso del preservativo femenino en jóvenes universitarios utilizando una metodología cuantitativa. La muestra estuvo formada por 225 chicas y 105 chicos. Los resultados muestran que casi la mitad de los sujetos han oído hablar del preservativo femenino, pero el 98,8% nunca lo ha usado. Las variables que predicen la asociación de beneficios asociados al uso del preservativo femenino son, para los chicos, las actitudes frente a la sexualidad y para las chicas la disposición a probarlo y los costes. En cuanto a la disposición a usarlo, las variables más influyentes para los chicos son disposición a hablar con la pareja, la disposición a participar y la utilización de métodos anticonceptivos y, para las chicas, la disposición a recomendar el preservativo femenino y estar de acuerdo en que la mujer lo utilice. Estos resultados adquieren una relevancia especial en las investigaciones centradas en reducir el aumento de embarazos no deseados y casos de VIH/SIDA en la población de mujeres y abren nuevas perspectivas alrededor de esta temática.Control of the contraceptive methods by women, specially which one that prevent sexually transmitted illness and HIV/AIDS, it is a subject with so much importance around the topic of affected women by HIV/AIDS epidemic. This is a transversal descriptive research, their objective is assess the knowledge and the viability of the female condom use in high school young people by using quantitative methodology. The sample was composed by 225 females and 105 males. The results show that almost the half of the participants have knowledge about female condom, but 98.8% in the sample never used it. The variables which predict the benefits association to the female condom are, in the males, attitudes about the sexuality, and in the case of the females, the predisposition to prove it and the costs. In relation to the disposition to use the female condom, the variables more influents in the male case is the disposition to speak with the partner about it, the disposition to take part, and using contraceptive methods. In the female case, the disposition to recommend the female condom and to be in agreement about condom use by the women, are the predictors variables about the use. These results have a special relevance in the investigation focused in reducing the increasing of non-wished pregnant and HIV/AIDS in the female population. So, this topic opens new perspectives around this subject.A importância do controlo por parte das mulheres de métodos anticoncepcionais e aqueles que previnem a infecção de doenças sexualmente transmissíveis, especialmente a VIH/SIDA, é um tema que adquire importância no marco do aumento de mulheres afectadas pela epidemia. O objectivo deste trabalho, um estudo de populações a través de inquérito com amostras probabilísticas transversal, é avaliar o conhecimento e viabilidade do uso de preservativo feminino em jovens universitárias utilizando uma metodologia quantitativa. A amostra esteve formada por 225 raparigas e 105 rapazes. Os resultados mostram que quase metade dos sujeitos ouviram falar do preservativo feminino, mas 98,8% nunca o usou. As variáveis que predizem a associação de benefícios associados ao uso de preservativo feminino são, para os rapazes, as atitudes face à sexualidade e para as raparigas a disposição a experimentá-lo e os custos. Quanto à disposição a usá-lo, as variáveis mais influentes para os rapazes são a disposição para falar com a companheira, a disposição a participar e a utilização de métodos anticoncepcionais e, para as raparigas, a disposição em recomendar o preservativo feminino e estar de acordo em que a mulher o utilize. Estes resultados adquirem uma relevância especial nas investigações centradas em reduzir o aumento de gravidezes não desejadas e casos de VIH/SIDA na população de mulheres e abrem novas perspectivas em volta desta temática

Fetal undernutrition is associated with perinatal sex-dependent alterations in oxidative status

This is the published version of a work that was accepted for publication in The Journal of Nutritional Biochemestry. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in The Journal of Nutritional Biochemestry 26.12 (2015). DOI: 10.1016/jnubio.2015.09.004Intrauterine growth retardation predisposes to hypertension development, known as fetal programming. Females are less susceptible, which has been mainly attributed to estrogen influence. We hypothesize that perinatal differences in oxidative status might also contribute. We studied 21-day-old (prepuberal) and 6-month-old male and female Intrauterine growth retardation predisposes to hypertension development, known as fetal programming. Females are less susceptible, which has been mainly attributed to estrogen influence. We hypothesize that perinatal differences in oxidative status might also contribute. We studied 21-day-old (prepuberal) and 6-month-old male and female offspring from rats fed ad libitum during gestation (Control) or with 50% of Control daily intake from day 10 to delivery (maternal undernutrition, MUN). We assessed in vivo blood pressure and the following plasma biomarkers of oxidative status: protein carbonyls, thiols, reduced glutathione (GSH), total antioxidant capacity, superoxide anion scavenging activity (SOSA) and catalase activities; we calculated a global score (oxy-score) from them. Estradiol and melatonin concentration was measured in young rats. Prepuberal MUN males were normotensive but already exhibited increased carbonyls and lower thiols, GSH, SOSA and melatonin; oxy-score was significantly lower compared to Control males. Prepuberal MUN females only exhibited reduced SOSA compared to Control females. Adult rats from all experimental groups showed a significant increase in carbonyls and a decrease in antioxidants compared to prepuberal rats; oxy-score was negative in adult rats suggesting the development of a prooxidative status as rat age. Adult MUN males were hypertensive and exhibited the highest increase in carbonyls despite similar or even higher antioxidant levels compared to Controls. Adult MUN females remained normotensive and did not exhibit differences in any of the biomarkers compared to Controls. The better global antioxidant status developed by MUN females during perinatal life could contribute to their protection against hypertension programming.offspring from rats fed ad libitum during gestation (Control) or with 50% of Control daily intake from day 10 to delivery (maternal undernutrition, MUN). We assessed in vivo blood pressure and the following plasma biomarkers of oxidative status: protein carbonyls, thiols, reduced glutathione (GSH), total antioxidant capacity, superoxide anion scavenging activity (SOSA) and catalase activities; we calculated a global score (oxy-score) from them. Estradiol and melatonin concentration was measured in young rats. Prepuberal MUN males were normotensive but already exhibited increased carbonyls and lower thiols, GSH, SOSA and melatonin; oxy-score was significantly lower compared to Control males. Prepuberal MUN females only exhibited reduced SOSA compared to Control females. Adult rats from all experimental groups showed a significant increase in carbonyls and a decrease in antioxidants compared to prepuberal rats; oxy-score was negative in adult rats suggesting the development of a prooxidative status as rat age. Adult MUN males were hypertensive and exhibited the highest increase in carbonyls despite similar or even higher antioxidant levels compared to Controls. Adult MUN females remained normotensive and did not exhibit differences in any of the biomarkers compared to Controls. The better global antioxidant status developed by MUN females during perinatal life could contribute to their protection against hypertension programming.This work was supported by Ministerio de Economía y Competitividad Spain (grant number FEM2012-37634-C03-01 to S. M. Arribas) and Universidad Autónoma de Madrid Banco - Santander (Interuniversity Cooperation Project, Center for Latin American Studies, Santander, USA 2013–2014 to M. A. Martín-Cabrejas)

Strain balanced quantum posts for intermediate band solar cells

In this work we present strain balanced InAs quantum post of exceptional length in the context of photovoltaics. We discuss the general properties of these nanostructures and their impact in the practical implementation of an intermediate band solar cell. We have studied the photocurrent generated by strain balanced quantum posts embedded in a GaAs single crystal, and compared our results with quantum dot based devices. The incorporation of phosphorous in the matrix to partially compensate the accumulated stress enables a significant increase of the quantum post maximum length. The relative importance of tunneling and thermal escape processes is found to depend strongly on the geometry of the nanostructures. tunneling and thermal escape processes is found to depend strongly on the geometry of the nanostructures

Longissimus dorsi transcriptome analysis of purebred and crossbred Iberian pigs differing in muscle characteristics

Background The two main genetic types in Iberian pig production show important phenotypic differences in growth, fattening and tissue composition since early developmental stages. The objective of this work was the evaluation of muscle transcriptome profile in piglets of both genetic types, in order to identify genes, pathways and regulatory factors responsible for their phenotypic differences. Contemporary families coming from pure Iberian pigs (IB) or from crossing with Duroc boars (DU×IB) were generated. Piglets (14 from each genetic type) were slaughtered at weaning (28 days) and longissimus dorsi was sampled for composition and gene expression studies. RNA was obtained and hybridized to Affymetrix Porcine Genechip expression arrays.Results Loin muscle chemical composition showed significant differences between genetic types in intramuscular fat content (6.1% vs. 4.3% in IB and DUxIB animals, respectively, P = 0.009) and in saturated (P = 0.019) and monounsaturated fatty acid proportions (P = 0.044). The statistical analysis of gene expression data allowed the identification of 256 differentially expressed (DE) genes between genetic types (FDR < 0.10), 102 upregulated in IB and 154 upregulated in DU×IB. Transcript differences were validated for a subset of DE genes by qPCR. We observed alteration in biological functions related to extracellular matrix function and organization, cellular adhesion, muscle growth, lipid metabolism and proteolysis. Candidate genes with known effects on muscle growth were found among the DE genes upregulated in DU×IB. Genes related to lipid metabolism and proteolysis were found among those upregulated in IB. Regulatory factors (RF) potentially involved in the expression differences were identified by calculating the regulatory impact factors. Twenty-nine RF were found, some of them with known relationship with tissue development (MSTN, SIX4, IRX3), adipogenesis (CEBPD, PPARGC1B), or extracellular matrix processes (MAX, MXI1). Correlation among the expression of these RF and DE genes show relevant differences between genetic types.Conclusion These results provide valuable information about genetic mechanisms determining the phenotypic differences on growth and meat quality between the genetic types studied, mainly related to the development and function of the extracellular matrix and also to some metabolic processes as proteolysis and lipid metabolism. Transcription factors and regulatory mechanisms are proposed for these altered biological functions. © 2014 Óvilo et al.; licensee BioMed Central Ltd

Vulnerabilidad territorial: indicadores para su medición desde los servicios sociales

El informe da respuesta a una de las líneas de trabajo del Laboratorio de Servicios Sociales para 2019, consistente en producir conocimiento sobre los indicadores específicos que permiten considerar un territorio como "espacio vulnerable", en la línea establecida por el artículo 25 de la Ley 3/2019, de 18 de febrero, de la Generalitat, de Servicios Sociales Inclusivos de la Comunitat Valenciana, y también sobre las fuentes de datos disponibles sobre estos indicadores. Para ello, el trabajo se estructura en 4 partes y 6 anexos: (1) La primera parte consiste en una aproximación al concepto de vulnerabilidad aplicada al territorio y a otros conceptos cercanos, realizada mediante la revisión bibliográfica de la literatura científica al respecto. (2) La segunda parte contiene un análisis comparado del tratamiento que las Leyes autonómicas de Servicios Sociales en vigor dan a los territorios singulares. (3) La tercera parte consiste en, por un lado, la identificación de áreas, dimensiones e indicadores que permiten caracterizar a un territorio como "vulnerable", y, por otro lado, la identificación de las principales fuentes de datos disponibles, de alcance autonómico, para nutrir de datos los indicadores. (4) La cuarta parte presenta las conclusiones y propuestas que surgen del trabajo realizado. (5) Los anexos recogen el detalle de los resultados obtenidos en las diferentes fases del trabajo explicitados a lo largo del texto.Informe elaborado en el marco del Convenio para el fomento de la investigación sobre los indicadores sociales en Servicios Sociales de la Comunitat Valenciana (Ref. CONSELLERIAIGUALDAD1-19I), suscrito entre la Vicepresidència i Conselleria d’Igualtat i Polítiques Inclusives (Generalitat Valenciana) y la Universitat d’Alacant (Grup d’Investigació sobre Treball Social i Serveis Socials – GITSS)

A clinical method for mapping and quantifying blood stasis in the left ventricle

In patients at risk of intraventrcular thrombosis, the benefits of chronic anticoagulation therapy need to be balanced with the pro-hemorrhagic effects of therapy. Blood stasis in the cardiac chambers is a recognized risk factor for intracardiac thrombosis and potential cardiogenic embolic events. In this work, we present a novel flow image-based method to assess the location and extent of intraventricular stasis regions inside the left ventricle (LV) by digital processing flow-velocity images obtained either by phase-contrast magnetic resonance (PCMR) or 2D color-Doppler velocimetry (echo-CDV). This approach is based on quantifying the distribution of the blood Residence Time (TR) from time-resolved blood velocity fields in the LV. We tested the new method in illustrative examples of normal hearts, patients with dilated cardiomyopathy and one patient before and after the implantation of a left ventricular assist device (LVAD). The method allowed us to assess in-vivo the location and extent of the stasis regions in the LV. Original metrics were developed to integrate flow properties into simple scalars suitable for a robust and personalized assessment of the risk of thrombosis. From a clinical perspective, this work introduces the new paradigm that quantitative flow dynamics can provide the basis to obtain subclinical markers of intraventricular thrombosis risk. The early prediction of LV blood stasis may result in decrease strokes by appropriate use of anticoagulant therapy for the purpose of primary and secondary prevention. It may also have a significant impact on LVAD device design and operation set-up

Galaxy clusters and groups in the ALHAMBRA Survey

We present a catalogue of 348 galaxy clusters and groups with $0.2<z<1.2$ selected in the 2.78 $deg^2$ ALHAMBRA Survey. The high precision of our photometric redshifts, close to $1\%$, and the wide spread of the seven ALHAMBRA pointings ensure that this catalogue has better mass sensitivity and is less affected by cosmic variance than comparable samples. The detection has been carried out with the Bayesian Cluster Finder (BCF), whose performance has been checked in ALHAMBRA-like light-cone mock catalogues. Great care has been taken to ensure that the observable properties of the mocks photometry accurately correspond to those of real catalogues. From our simulations, we expect to detect galaxy clusters and groups with both $70\%$ completeness and purity down to dark matter halo masses of $M_h\sim3\times10^{13}\rm M_{\odot}$ for $z<0.85$. Cluster redshifts are expected to be recovered with $\sim0.6\%$ precision for $z<1$. We also expect to measure cluster masses with $\sigma_{M_h|M^*_{CL}}\sim0.25-0.35\, dex$ precision down to $\sim3\times10^{13}\rm M_{\odot}$, masses which are $50\%$ smaller than those reached by similar work. We have compared these detections with previous optical, spectroscopic and X-rays work, finding an excellent agreement with the rates reported from the simulations. We have also explored the overall properties of these detections such as the presence of a colour-magnitude relation, the evolution of the photometric blue fraction and the clustering of these sources in the different ALHAMBRA fields. Despite the small numbers, we observe tentative evidence that, for a fixed stellar mass, the environment is playing a crucial role at lower redshifts (z$<$0.5).Comment: Accepted for publication in MNRAS. Catalogues and figures available online and under the following link: http://bascaso.net46.net/ALHAMBRA_clusters.htm