Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine.

OBJECTIVE: Circulatory shock is a life-threatening syndrome resulting in multiorgan failure and a high mortality rate. The aim of this consensus is to provide support to the bedside clinician regarding the diagnosis, management and monitoring of shock. METHODS: The European Society of Intensive Care Medicine invited 12 experts to form a Task Force to update a previous consensus (Antonelli et al.: Intensive Care Med 33:575-590, 2007). The same five questions addressed in the earlier consensus were used as the outline for the literature search and review, with the aim of the Task Force to produce statements based on the available literature and evidence. These questions were: (1) What are the epidemiologic and pathophysiologic features of shock in the intensive care unit ? (2) Should we monitor preload and fluid responsiveness in shock ? (3) How and when should we monitor stroke volume or cardiac output in shock ? (4) What markers of the regional and microcirculation can be monitored, and how can cellular function be assessed in shock ? (5) What is the evidence for using hemodynamic monitoring to direct therapy in shock ? Four types of statements were used: definition, recommendation, best practice and statement of fact. RESULTS: Forty-four statements were made. The main new statements include: (1) statements on individualizing blood pressure targets; (2) statements on the assessment and prediction of fluid responsiveness; (3) statements on the use of echocardiography and hemodynamic monitoring. CONCLUSIONS: This consensus provides 44 statements that can be used at the bedside to diagnose, treat and monitor patients with shock

Nitrogen and chlorophyll status determination in durum wheat as influenced by fertilization and soil management: Preliminary results

Handheld chlorophyll meters as Soil Plant Analysis Development (SPAD) have proven to be useful tools for rapid, no-destructive assessment of chlorophyll and nitrogen status in various crops. This method is used to diagnose the need of nitrogen fertilization to improve the efficiency of the agricultural system and to minimize nitrogen losses and deficiency. The objective of this study is to evaluate the effect of repeated conservative agriculture practices on the SPAD readings, leaves chlorophyll concentration and Nitrogen Nutrition Index (NNI) relationships in durum wheat under Mediterranean conditions. The experimental site is a part of a long-term-experiment established in 1994 and is still on-going where three tillage managements and three nitrogen fertilizer treatments were repeated in the same plots every year. We observed a linear relationship between the SPAD readings performed in the central and distal portion of the leaf (R2 = 0.96). In fertilized durum wheat, we found all positive exponential relationships between SPAD readings, chlorophyll leaves concentration (R2 = 0.85) and NNI (R2 = 0.89). In the unfertilized treatment, the SPAD has a good attitude to estimate leaves chlorophyll concentration (R2 = 0.74) and NNI (R2 = 0.77) only in crop grow a soil with relative high content of soil organic matter and nitrogen availability, as observed in the no tilled plots. The results show that the SPAD can be used for a correct assessment of chlorophyll and nitrogen status in durum wheat but also to evaluate indirectly the content of soil organic matter and nitrogen availability during different growth stages of the crop cycle

Isolated Intracranial Hypertensions as Onset of Myelin Oligodendrocyte Glycoprotein Antibody Disease

Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is characterized by multiple phenotypic conditions such as acute disseminated encephalomyelitis, optic neuritis, and myelitis. MOGAD's spectrum is expanding, with potential symptoms of increased intracranial pressure that are similar to idiopathic intracranial hypertension (IIH). We report a boy with new-onset continuous headache and a brain MRI at onset suggesting idiopathic intracranial hypertension (IIH). The patient showed resistance to treatment with acetazolamide and, after one month, developed optic neuritis in the left eye. Laboratory tests documented positive MOG antibodies (anti-MOG) in the serum. The final diagnosis was MOGAD, with the initial symptoms resembling IIH

Vegetative propagation of bird’s-foot trefoil (Lotus corniculatus L.) using different rooting agents

Objective: To evaluate the growth dynamics based on the dry matter production of Lotus corniculatus L. variety 202700 and its morphological composition.Design/Methodology/Approach: The study was carried out in greenhouses conditions, from December 2020 to May 2021. The effect of indole butyric acid (IBA) growth promoter in solid Radix 1500 and liquid Radix T 3000 presentation (SRSolid and SRLiquid) and a control (Substrate) was evaluated. A completely randomized design with three replications was used, each with twenty pots as replications. 1300 pots were planted, of which 20 were taken monthly from each treatment (30, 60, 90, 120 and 150 days) for subsequent data recording.Results: SRSolid was the one that presented the highest values followed by SRLiquid and Control (S) respectively.Study Limitations/Implications: Destructive sampling of less than 30 days or greater than 150 days was not considered.Findings/Conclusions: The plants with the application of 1500 ppm of IBA registered the greatest response in terms of variables: number of leaves, number of stems, leaves (g), stems (g), roots (g), root height (cm), root volume (cm3), greenness index, leaf area (cm2/g) and plant height (cm), with respect to the rest of the treatments

Duration of heat treatment and true digestibility of amino acids in meat meal for Leghorn cockerels

Knowledge of the true digestibility of amino acids in the ingredients of a poultry ration is important in order to use them properly, especially the proteinic ingredients that have been heated during processing, such as meat meal. Protein solubility is a good indicator of heat damage. To estimate true digestibility, Leghorn White cockerels were fasted for 24 h and then force fed with meat meal autoclaved at 121°C and 1.5 kg/cm2 for 0, 15, 30, 45 and 60 minutes. A correction for endogenous amino acids was included. Nitrogen was determined by micro Kjeldahl; protein solubility by the methods of 2% KOH and coomassie blue; amino acids concentrations were also determined by HPLC. Treatments had an effect (P<.05) on meat meal protein solubility, means being 89% and 84% for the KOH and coomassie blue methods, respectively. However, protein solubility increased until 30 minutes and then decreased according to the KOH method, whereas it increased until 15 minutes (P<.05) and then remained constant by the coomassie blue method. Autoclaving had an effect on true digestibility of all amino acids, except methionine. There was a high and significant correlation (0.81) between protein solubility by the KOH method and true digestibility of amino acids

Rethinking resilience: home gardening, food sharing and everyday resistance

Resilience and food self-provisioning (FSP), terms that until recently were deployed primarily in the study of livelihoods in the Global South, are now attracting attention from alternative food scholarship in the Global North. Drawing on a large-scale survey conducted in the Czech Republic, this article investigates FSP as a social resilience-enhancing set of practices. In addition to the traditional reading of FSP as a passive, defensive and crisis-deflecting form of resilience, this article puts forward an alternative conceptualisation of resilience as a proactive, preventative, future-oriented and transformation-enabling capacity that runs counter to the tenets of neoliberalism