Sigh in patients with acute hypoxemic respiratory failure and acute respiratory distress syndrome: the PROTECTION pilot randomized clinical trial

Background: Sigh is a cyclic brief recruitment manoeuvre: previous physiological studies showed that its use could be an interesting addition to pressure support ventilation to improve lung elastance, decrease regional heterogeneity and increase release of surfactant. Research question: Is the clinical application of sigh during pressure support ventilation (PSV) feasible? Study design and methods: We conducted a multi-center non-inferiority randomized clinical trial on adult intubated patients with acute hypoxemic respiratory failure or acute respiratory distress syndrome undergoing PSV. Patients were randomized to the No Sigh group and treated by PSV alone, or to the Sigh group, treated by PSV plus sigh (increase of airway pressure to 30 cmH2Ofor 3 seconds once per minute) until day 28 or death or successful spontaneous breathing trial. The primary endpoint of the study was feasibility, assessed as non-inferiority (5% tolerance) in the proportion of patients failing assisted ventilation. Secondary outcomes included safety, physiological parameters in the first week from randomization, 28-day mortality and ventilator-free days. Results: Two-hundred fifty-eight patients (31% women; median age 65 [54-75] years) were enrolled. In the Sigh group, 23% of patients failed to remain on assisted ventilation vs. 30% in the No Sigh group (absolute difference -7%, 95%CI -18% to 4%; p=0.015 for non-inferiority). Adverse events occurred in 12% vs. 13% in Sigh vs. No Sigh (p=0.852). Oxygenation was improved while tidal volume, respiratory rate and corrected minute ventilation were lower over the first 7 days from randomization in Sigh vs. No Sigh. There was no significant difference in terms of mortality (16% vs. 21%, p=0.342) and ventilator-free days (22 [7-26] vs. 22 [3-25] days, p=0.300) for Sigh vs. No Sigh. Interpretation: Among hypoxemic intubated ICU patients, application of sigh was feasible and without increased risk

Conférence "Dialogue Ruralità è Cultura / Ruralité et Culture"

National audienceIl sera question de s’interroger, avec les habitants, sur les enjeux des liens ruralité et culture à Marignana et plus largement en Corse

Binder-free tableting experiments on manganese oxides and industrial mineral powders

International audienceCold, binder-free tableting experiments under controlled pressure (0-450 MPa), water addition (0-10 wt.%) and pH (4, 11) were performed on powder of pyrolusite ore concentrates, refined hausmannite, bentonite, kaolinite, as well as blends of those materials. It has been shown that increased pressure was beneficial for agglomeration of oxide materials, but pressure > 250 MPa triggered an elastic recovery in the clay minerals. Water addition up to 4 wt.% improved tabletability, increasing diametral resistance and reducing elastic recovery and fines generation. Amounts above 6 wt.% decreased diametral resistance. The presence of layered-structure minerals (such as montmorillonite, kaolinite, lithiophorite) appeared to be key to determine the agglomeration potential of a sample. This study also showed that tableting provides good performances for recycling industrial manganese oxide fines by obtaining industrial-grade resistance for tablets made with an 80/20 pyrolusite concentrate/hausmannite blends and 4 wt.% H2O

Solution structure of microcin J25, the single macrocyclic antimicrobial peptide from Escherichia coli.

International audienceThe three-dimensional solution structure of microcin J25, the single cyclic representative of the microcin antimicrobial peptide class produced by enteric bacteria, was determined using two-dimensional 1H NMR spectroscopy and molecular modeling. This hydrophobic 21-residue peptide exhibits potent activity directed to Gram-negative bacteria. Its primary structure, cyclo(-V1GIGTPISFY10GGGAGHVPEY20F-), has been determined previously [Blond, A., Péduzzi, J., Goulard, C., Chiuchiolo, M. J., Barthélémy, M., Prigent, Y., Salomón, R.A., Farías, R.N., Moreno, F. & Rebuffat, S. (1999) Eur. J. Biochem., 259, 747-755]. Conformational parameters (3JNHCαH coupling constants, quantitative nuclear Overhauser enhancement data, chemical shift deviations, temperature coefficients of amide protons, NH-ND exchange rates) were obtained in methanol solution. Structural restraints consisting of 190 interproton distances inferred from NOE data, 11 φ backbone dihedral angle and 9 χ1 angle restraints derived from the coupling constants and three hydrogen bonds in agreement with the amide exchange rates were used as input for simulated annealing calculations and energy minimization in the program xplor. Microcin J25 adopts a well-defined compact structure consisting of a distorted antiparallel β sheet, which is twisted and folded back on itself, thus resulting in three loops. Residues 7-10 and 17-20 form the more regular part of the β sheet. The region encompassing residues Gly11-His16 consists of a distorted β hairpin, which divides into two small loops and is stabilized by an inverse γ turn and a type I′β turn. The reversal of the chain leading to the Phe21-Pro6 loop results from a mixed β/γ turn. A cavity, in which the hydrophilic Ser8 side-chain is confined, is delimited by two crab pincer-like regions that comprise residues 6-8 and 18-1

Marine reserves: size and age do matter

Marine reserves are widely used throughout the world to prevent overfishing and conserve biodiversity, but uncertainties remain about their optimal design. The effects of marine reserves are heterogeneous. Despite theoretical findings, empirical studies have previously found no effect of size on the effectiveness of marine reserves in protecting commercial fish stocks. Using 58 datasets from 19 European marine reserves, we show that reserve size and age do matter: Increasing the size of the no-take zone increases the density of commercial fishes within the reserve compared with outside; whereas the size of the buffer zone has the opposite effect. Moreover, positive effects of marine reserve on commercial fish species and species richness are linked to the time elapsed since the establishment of the protection scheme. The reserve size-dependency of the response to protection has strong implications for the spatial management of coastal areas because marine reserves are used for spatial zoning.This work has been carried out with financial support from the Commission of the European Community, specific RTD programme "Specific Support to Policies", SSP-2003-006539 "European Marine Protected Areas as Tools for Fisheries Management and Conservation (EMPAFISH)"

Comparison of metabolic abnormalities and clinical lipodystrophy 48 weeks after switching from HAART to Trizivir™ versus continued HAART: The trizal study

SCOPUS: ar.jinfo:eu-repo/semantics/publishe