Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Adapting to altered auditory cues: Generalization from manual reaching to head pointing

International audienceLocalising sounds means having the ability to process auditory cues deriving from the interplay among sound waves, the head and the ears. When auditory cues change because of temporary or permanent hearing loss, sound localization becomes difficult and uncertain. The brain can adapt to altered auditory cues throughout life and multisensory training can promote the relearning of spatial hearing skills. Here, we study the training potentials of sound-oriented motor behaviour to test if a training based on manual actions toward sounds can learning effects that generalize to different auditory spatial tasks. We assessed spatial hearing relearning in normal hearing adults with a plugged ear by using visual virtual reality and body motion tracking. Participants performed two auditory tasks that entail explicit and implicit processing of sound position (head-pointing sound localization and audio-visual attention cueing, respectively), before and after having received a spatial training session in which they identified sound position by reaching to auditory sources nearby. Using a crossover design, the effects of the above-mentioned spatial training were compared to a control condition involving the same physical stimuli, but different task demands (i.e., a non-spatial discrimination of amplitude modulations in the sound). According to our findings, spatial hearing in one-ear plugged participants improved more after reaching to sound trainings rather than in the control condition. Training by reaching also modified head-movement behaviour during listening. Crucially, the improvements observed during training generalize also to a different sound localization task, possibly as a consequence of acquired and novel head-movement strategies

Reaching to Sounds Improves Spatial Hearing in Bilateral Cochlear Implant Users

International audienceObjectives: We assessed if spatial hearing training improves sound localization in bilateral cochlear implant (BCI) users and whether its benefits can generalize to untrained sound localization tasks. Design: In 20 BCI users, we assessed the effects of two training procedures (spatial versus nonspatial control training) on two different tasks performed before and after training (head-pointing to sound and audiovisual attention orienting). In the spatial training, participants identified sound position by reaching toward the sound sources with their hand. In the nonspatial training, comparable reaching movements served to identify sound amplitude modulations. A crossover randomized design allowed comparison of training procedures within the same participants. Spontaneous head movements while listening to the sounds were allowed and tracked to correlate them with localization performance. Results: During spatial training, BCI users reduced their sound localization errors in azimuth and adapted their spontaneous head movements as a function of sound eccentricity. These effects generalized to the head-pointing sound localization task, as revealed by greater reduction of sound localization error in azimuth and more accurate first head-orienting response, as compared to the control nonspatial training. BCI users benefited from auditory spatial cues for orienting visual attention, but the spatial training did not enhance this multisensory attention ability. Conclusions: Sound localization in BCI users improves with spatial reaching-to-sound training, with benefits to a nontrained sound localization task. These findings pave the way to novel rehabilitation procedures in clinical contexts

Efficacia di nuove molecole sinergizzanti nei confronti di Blattella germanica (L.)

Uno degli insetti infestanti gli ambienti antropici più diffusi a livello globale è Blattella germanica (L.). In questa specie la resistenza agli insetticidi è andata crescendo negli anni e si è tramutata in uno dei maggiori ostacoli all’attuazione di efficienti strategie di controllo. Attualmente le esche insetticide con formulazione gel mantengono una buona efficacia mentre i trattamenti convenzionali che prevedono l’uso di formulazioni spray, soprattutto di piretroidi, hanno dimostrato molti limiti. In letteratura risultano numerosi casi di inefficacia per diversi principi attivi nei confronti di B. germanica, rendendolo il secondo insetto urbano più resistente nella classifica mondiale. Una possibile soluzione a questo problema può venire dall’uso di sinergizzanti come il piperonil butossido (PBO), molecole senza o con trascurabile attività insetticida che, quando sono applicate in abbinamento a vari prodotti insetticidi, ne potenziano l’efficacia inibendo i sistemi metabolici di detossificazione presenti nell’insetto bersaglio. In questo studio, eseguito nell’ambito del progetto europeo “Ecosyn” (EcoSyn - Ecofriendly synergists for insecticide formulations, finanziato dal Settimo Programma Quadro dell’Unione Europea – Contratto no 605740), il PBO e alcuni suoi nuovi derivati sono stati combinati con insetticidi di già nota efficacia, quali cipermetrina e S-metoprene, per valutarne il possibile effetto sinergico. Per le prove con il piretroide è stato sviluppato un test per contatto lasciando gli insetti a contatto della superficie trattata per 30 minuti e valutando l’effetto knock-down ogni 5 minuti. La mortalità è stata valutata dopo 24 ore. In generale i vari sinergici non hanno aumentato l’effetto knock-down ma hanno causato un significativo aumento di mortalità rispetto all’insetticida usato da solo. Uno solo dei nuovi derivati ha dimostrato, quando usato da solo, una limitata tossicità nei confronti di B. germanica. L’esperimento con S-metoprene è stato effettuato somministrando solo a femmine vergini esche umide contenenti insetticida e sinergico, per una settimana. Dopo l’accoppiamento con maschi non trattati, ogni giorno sono state misurate sia la mortalità, sia la comparsa, l’aborto o la schiusa dell’ooteca. I dati, sia pure con differenze tra i vari sinergici, evidenziano che le blatte trattate, rispetto a quelle di controllo, hanno un ritardo nella formazione delle ooteche, un incremento della percentuale di aborto delle stesse e una riduzione nel numero dei nati

Studio in vitro sull\u2019inibizione di alcuni sistemi enzimatici di Apis mellifera L. ad opera di nuovi derivati del PBO

I prodotti sinergizzanti (come il piperonil-butossido - PBO) sono molecole senza o con trascurabile attivit\ue0 insetticida ma che quando sono applicate in abbinamento a vari prodotti fitosanitari ne potenziano l\u2019efficacia inibendo i sistemi metabolici di detossificazione dell\u2019insetto bersaglio. Nell\u2019ambito del progetto europeo \u201cEcosyn\u201d (EcoSyn -Ecofriendly synergists for insecticide formulations, finanziato dal Settimo Programma Quadro dell\u2019Unione Europea \u2013 Contratto no 605740) sono stati sviluppati e sintetizzati nuovi sinergizzanti, partendo dalla struttura molecolare del PBO. Oltre alla valutazione della capacit\ue0 di queste nuove molecole di inibire i meccanismi di resistenza metabolica di varie specie di interesse agrario e veterinario si \ue8 voluto verificare se il loro utilizzo potesse avere ripercussioni negative sui pronubi e in particolare su Apis mellifera L. Sono stati considerati il classico PBO, una serie di derivati del benzodiossolo, indicati rispettivamente come EN1-213, EN1-216, EN1-218, e due derivati del 2,3-diidrobenzofurano, indicati come EN16-55 e EN16-41. E\u2019 stata indagata la capacit\ue0 di questi composti di inibire l\u2019attivit\ue0 di enzimi di cui \ue8 ampiamente nota, in molte specie di artropodi, la capacit\ue0 di intervenire nei processi di detossificazione e sequestro di varie classi di insetticidi. In questa fase, ancora preliminare, sono state prese in considerazione le esterasi e le glutatione S-transferasi. \uc8 stata anche indagata la possibilit\ue0 che questi sinergizzanti possano avere effetti sull\u2019attivit\ue0 delle acetilcolinesterasi. L\u2019attivit\ue0 enzimatica \ue8 stata misurata tramite analisi spettrofotometrica in assorbanza sia in presenza che in assenza dei sinergici per poter calcolare l\u2019attivit\ue0 residua, dopo preincubazione dell\u2019omogenato con acetone o con il sinergico. I risultati preliminari indicano che in vitro l\u2019attivit\ue0 degli enzimi studiati \ue8 solo parzialmente inibita dai derivati del 2,3-diidrobenzofurano (EN16-41 e EN16-55) e che non lo \ue8 dai sinergici derivati dal benzodiossolo (EN1-213, EN1-216 e EN1-218). L\u2019utilizzo in campo di questi ultimi, contro insetti dannosi resistenti agli insetticidi, potrebbe quindi essere considerato sicuro nei confronti delle api. Ulteriori indagini sono in corso per valutare l\u2019effetto \u201cin vitro\u201d di differenti concentrazioni e tempi di esposizione del sinergico, anche su altri sistemi enzimatici come le monossigenasi