Prone Positioning for ARDS. still misunderstood and misused

Acute respiratory distress syndrome (ARDS) is a clinical syndrome characterized by a non-cardiogenic pulmonary edema with bilateral chest X-ray opacities and hypoxemia refractory to oxygen therapy and low level of positive end-expiratory pressure (1). Recently, a large observational study reported an ARDS prevalence of 10.4% of all ICU admissions and of 23.4% of all subjects receiving mechanical ventilation (2). Despite these alarming numbers, according to the most recent literature, ARDS is still under-recognized, undertreated, and associated with a mortality rate that in the most severe forms is close to 50% (2)

HST emission-line images of nearby 3CR radio galaxies: two photoionization, accretion and feedback modes

We present HST/ACS narrow-band images of a low-z sample of 19 3C radio galaxies to study the H$\alpha$ and [OIII] emissions from the narrow-line region (NLR). Based on nuclear emission line ratios, we divide the sample into High and Low Excitation Galaxies (HEGs and LEGs). We observe different line morphologies, extended line emission on kpc scale, large [OIII]/H$\alpha$ scatter across the galaxies, and a radio-line alignment. In general, HEGs show more prominent emission line properties than LEGs: larger, more disturbed, more luminous, and more massive regions of ionized gas with slightly larger covering factors. We find evidence of correlations between line luminosities and (radio and X-ray) nuclear luminosities. All these results point to a main common origin, the active nucleus, which ionize the surrounding gas. However, the contribution of additional photoionization mechanism (jet shocks and star formation) are needed to account for the different line properties of the two classes. A relationship between the accretion, photoionization and feedback modes emerges from this study. For LEGs (hot-gas accretors), the synchrotron emission from the jet represents the main source of ionizing photons. The lack of cold gas and star formation in their hosts accounts for the moderate ionized-gas masses and sizes. For HEGs (cold-gas accretors), an ionizing continuum from a standard disk and shocks from the powerful jets are the main sources of photoionization, with the contribution from star formation. These components, combined with the large reservoir of cold/dust gas brought from a recent merger, account for the properties of their extended emission-line regions.Comment: accepted for publication on ApJ (22 pages, 12 figures

Spectral Energy Distributions of low-luminosity radio galaxies at z~1-3: a high-z view of the host/AGN connection

We study the Spectral Energy Distributions, SEDs, (from FUV to MIR bands) of the first sizeable sample of 34 low-luminosity radio galaxies at high redshifts, selected in the COSMOS field. To model the SEDs we use two different template-fitting techniques: i) the Hyperz code that only considers single stellar templates and ii) our own developed technique 2SPD that also includes the contribution from a young stellar population and dust emission. The resulting photometric redshifts range from z ~0.7 to 3 and are in substantial agreement with measurements from earlier work, but significantly more accurate. The SED of most objects is consistent with a dominant contribution from an old stellar population with an age ~1 - 3 10^{9} years. The inferred total stellar mass range is ~10^{10} - 10^{12} M(sun). Dust emission is needed to account for the 24micron emission in 15 objects. Estimates of the dust luminosity yield values in the range L_{dust} ~10^{43.5} -10^{45.5} erg s^{-1}. The global dust temperature, crudely estimated for the sources with a MIR excess, is ~ 300-850 K. A UV excess is often observed with a luminosity in the range ~ 10^{42}-10^{44} erg s^{-1} at 2000 A rest frame. Our results show that the hosts of these high-z low-luminosity radio sources are old massive galaxies, similarly to the local FRIs. However, the UV and MIR excesses indicate the possible significant contribution from star formation and/or nuclear activity in such bands, not seen in low-z FRIs. Our sources display a wide variety of properties: from possible quasars at the highest luminosities, to low-luminosity old galaxies.Comment: 28 pages, 15 figures, Accepted for publication in the Astrophysical Journa

Chronic heart failure is characterized by altered mitochondrial function and structure in circulating leucocytes

Oxidative stress is currently viewed as a key factor in the genesis and progression of Heart Failure (HF). The aim of this study was to characterize the mitochondrial changes linked to oxidative stress generation in circulating peripheral blood mononuclear cells isolated from chronic HF patients (HF_PBMCs) in order to highlight the involvement of mitochondrial dysfunction in the pathophysiology of HF. To assess the production of reactive oxygen species (ROS), mitochondrial function and ultrastructure and the mitophagic flux in circulating PBMCs we enrolled 15 patients with HF and a control group of ten healthy subjects. The HF_PBMCs showed a mitochondrial population consisting of damaged and less functional organelles responsible of higher superoxide anion production both at baseline and under in vitro stress conditions, with evidence of cellular apoptosis. Although the mitophagic flux at baseline was enhanced in HF_PBMCs at level similar to those that could be achieved in control PBMCs only under inflammatory stress conditions, the activation of mitophagy was unable to preserve a proper mitochondrial dynamics upon stress stimuli in HF. In summary, circulating HF_PBMCs show structural and functional derangements of mitochondria with overproduction of reactive oxidant species. This mitochondrial failure sustains a leucocyte dysfunctional status in the blood that may contribute to development and persistence of stress conditions within the cardiovascular system in HF

Classical EIS and square pattern signals comparison based on a well-known reference impedance

International audienceElectrochemical impedance spectroscopy or ac impeda nce methods are popularly used for the diagnosis of electrochemical generators (batteries or fuel cell) . It is now possible to acquire and quantitatively interpret the experimental electrical impedances of such syst ems, whose evolutions indirectly reflect the modifications of the internal electrochemical proce ss. The scope of these measurement methods is to identify the frequency response function of the sys tem under test by applying a small signal perturbat ion to the system input, and measuring the corresponding r esponse. Once identified, and according to the application, frequency response functions can provi de useful information about the characteristics of the system. Classical EIS consists in applying a set of frequency-controlled sine waves to the input of th e system. However, the most difficult problem is the integration of this type of measuring device in embedded systems. In order to overcome this problem , we propose to apply squared pattern excitation signals to perform such impedance measurements. In this paper, we quantify and compare the performance of classical EIS and the proposed broadband identif ication method applied to a well-known impedance circuit

High resolution X-ray spectroscopy and imaging of Mrk573

We present a detailed analysis of the XMM-Newton RGS high resolution X-ray spectra of the Seyfert 2 galaxy, Mrk573. This analysis is complemented by the study of the Chandra image, and its comparison to optical (HST) and radio (VLA) data. The soft X-ray emission is mainly due to gas photoionised by the central AGN, as indicated by the detection of radiative recombination continua from OVII and OVIII, as well as by the prominence of the OVII forbidden line. This result is confirmed by the best fit obtained with a self-consistent CLOUDY photoionisation model. However, a collisionally excited component is also required, in order to reproduce the FeXVII lines, accounting for about 1/3 of the total luminosity in the 15-26 A band. Once adopted the same model in the Chandra ACIS data, another photoionised component, with higher ionisation parameter, is needed to take into account emission from higher Z metals. The broadband ACIS spectrum also confirms the Compton-thick nature of the source. The imaging analysis shows the close morphological correspondence between the soft X-ray and the [OIII] emission. The radio emission appears much more compact, although clearly aligned with the narrow line region. The collisional phase of the soft X-ray emission may be due to starburst, requiring a star formation rate of $\simeq5-9$ M$_\odot$ yr$^{-1}$, but there is no clear evidence of this kind of activity from other wavelengths. On the other hand, it may be related to the radio ejecta, responsible for the heating of the plasma interacting with the outflow, but the estimated pressure of the hot gas is much larger than the pressure of the radio jets, assuming equipartition and under reasonable physical parameters.Comment: 12 pages, 6 figures, accepted for publication in Monthly Notices of the Royal Astronomical Society Main Journa

When pressure does not mean volume? Body mass index may account for the dissociation

Low tidal volume (VT 6 ml/predicted body weight) pressure limited (plateau pressure <30 cmH2O) protective ventilation as proposed by the ARDS Network was associated with an improvement in mortality and is considered the gold standard for acute respiratory distress syndrome (ARDS) ventilation strategies. Limiting plateau pressure minimizes ventilator-induced lung injury by reducing the trans-pulmonary pressure, which is the real alveolar distending pressure. However, in the presence of chest wall elastance impairment, as observed in obese patients, plateau pressure underestimates the trans-pulmonary pressure and derecrutiment at low distending pressure could occur. Moreover, low tidal volume to keep plateau pressure <30 cmH2O could be associated with large differences compared to measured total lung capacity. Quantitative bedside techniques that are able to measure lung volumes together with trans-pulmonary pressure could expand our chances to tailor mechanical ventilation in ARDS patients

Preliminary observations on scleral ossicles in performing functionalized 3D vascularized scaffolds for “critical-size” bone defect healing

The problem of “critical-size” bone defects occurs when a severe lesion is difficult to be self-recovered. Many strategies of regenerative medicine were used in the last decade, with translational approaches, to mimic both structure and function of the native bone tissue, making use of synthetic materials, nanotechnologies, bio/synthetic constructs or some of their combination. The main obstacle to engineering strategies is mostly due to the lack of a proper vascularization of the construct used. In this feasibility study, our attention is directed towards the main tissue engineering items: scaffolds, cells and conditioning factors. We propose the use of scleral ossicles of lower vertebrates (1), as natural scaffolds which will be functionalized to allow the best adhesion of endothelial cells along a geometrically controlled pattern on the bony surface of the construct; successively, on the functionalized scaffold, osteogenic cell lines will be cultured. In the preliminary phases of the study, the ossicles were scratched to remove soft tissue residues, variously flattened with different methods to reach a regular morphology on both sides, and finally autoclaved to eliminate cellular remnants and to annul antigenic properties. Ossicles were observed under SEM and subjected to micro-assay, to establish the best scaffold preparation and to characterize morphological properties more suitable for engineering phases. Functionalization will be made by immobilizing on the engineered ossicles specific growth factors for endothelial cells; later, mouse primary lung endothelial cells (ECs) and immortalized osteogenic cells (IDG-SW3) will be used. As expected results ECs should adhere to the ossicle surface and organize to form lumenized microvascular-like structures; later, supported by the vascular-like network, the osteogenic lineage should produce bone matrix on the construct. The production of newly-formed bone around vascular-like buds will be verify. 3D tissue constructs generated in vitro will be used in successive in vivo study for the healing of “critical-size” bone defects experimentally induced in mice