A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Dose gradient assessment at the new CERN CHARM irradiation facility

CERN CHARM facility provides a unique complex radiation environment characterized by particle energy spectra representative of high-energy accelerators, ground and atmospheric conditions and space applications. CHARM is conceived to be an irradiation facility for the qualification of large electronic systems and components in a mixed field radiation environment generated from the interaction of a 24 GeV/c proton beam with a copper or aluminium target. A movable shielding made of layers of concrete and iron allows changing the hardness and the particle population (neutron, proton, kaon, pion, muon, electron, positron, and photon) in predefined test locations. To ensure a full representativeness and reproducibility of the tests, an accurate dosimetry of the complex mixed irradiation field is mandatory. The significant size of the available test area, the multiple facility configurations as well as the strong radiation gradient present in some of the test locations make the radiation monitoring a challenge. This work provides a first characterization of the absorbed dose gradient in two specific test locations: T0, a high dose rate test location close the target revolver; R11, a standard test location for irradiation tests on electronics equipment and devices. Experimental measurements conducted with RPL dosimeters and pMOS RadFET sensors were coupled with FLUKA Monte Carlo simulation. The concluding comparison shows an overall good agreement, considering the strong dose gradient and the limitation of the dosimeters in the mixed field environment

Treatment duration for central line-associated infection caused by Enterococcus spp.: a retrospective evaluation of a multicenter cohort

Objective of this study was to assess the appropriate treatment duration for enterococcal central line-associated bloodstream infections (CLABSIs). This observational, retrospective, multicenter study conducted between 2011 and 2019 enrolled all hospitalized patients with monomicrobial enterococcal CLABSI. Those with infective endocarditis and non-survivors at least 7 days from index blood culture (BC) were excluded. Primary endpoint was 30-day mortality. We enrolled 113 patients, of whom 59% were male, median age was 64 (SD ± 15) and median Charlson’s index score 5 (IQR 3–8). Enterococcus faecalis and Enterococcus faecium were found in 51% and 44% of cases, respectively. Median treatment duration was 11 days (IQR 6–17), and 32% of patients (n = 36) received ≤ 7 days. Characteristics of patients receiving more or less than 7 days of treatment were similar. Central line was removed in 82% (n = 93) of cases within a median of 3 days (1–8). At both uni- and multivariate analysis, duration of antibiotic treatment > 7 days was not associated with 30-day mortality [HR 0.41 (95% CI, 0.13–1.24), p = 0.12] even after adjustment with propensity score [HR 0.47 (95% CI 0.17–1.26), p = 0.13]. A 7-day treatment course appears to be safe in non-complicated enterococcal CLABSIs

Evolutionary changes in nectar sugar composition associated with switches between bird and insect pollination: the Canarian bird-flower element revisited

The bird-flower element of the Canary Islands is a group of endemic plants having traits characteristic of bird pollination, and some are visited by opportunistically nectar-feeding passerine birds. 2. We investigated evolutionary changes in nectar sugar composition in seven Canarian lineages of ornithophilous plant species and their entomophilous relatives. 3. We hypothesized that nectar sugar composition evolved in response to the main pollinator group of a plant. Specialist nectarivores can assimilate sucrose, whereas some opportunistic nectar-feeders digest only the simple hexoses. 4. Sugar composition of nectars was analysed using high pH anion exchange chromatography. 5. Evolution of nectar type was correlated with mode of pollination. Generally, sucrose nectars were associated with insect visitation and hexose nectars with bird visitation. Nectar sugar composition was an evolutionary labile trait within a lineage. Hence, nectar characteristics may have evolved readily, perhaps in response to opportunistically nectarivorous birds living in Canary Islands