29 research outputs found

    Characterization of the asymmetry of the cardiac and sympathetic arms of the baroreflex from spontaneous variability during incremental head-up tilt

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    Hysteresis of the baroreflex (BR) is the result of the different BR sensitivity (BRS) when arterial pressure (AP) rises or falls. This phenomenon has been poorly studied and almost exclusively examined by applying pharmacological challenges and static approaches disregarding causal relations. This study inspects the asymmetry of the cardiac BR (cBR) and vascular sympathetic BR (sBR) in physiological closed loop conditions from spontaneous fluctuations of physiological variables, namely heart period (HP) and systolic AP (SAP) leading to the estimation of cardiac BRS (cBRS) and muscle sympathetic nerve activity (MSNA) and diastolic AP (DAP) leading to the estimation of vascular sympathetic BRS (sBRS). The assessment was carried out in 12 young healthy subjects undergoing incremental head-up tilt with table inclination gradually increased from 0 to 60掳. Two analytical methods were exploited and compared, namely the sequence (SEQ) and phase-rectified signal averaging (PRSA) methods. SEQ analysis is based on the detection of joint causal schemes representing the HP and MSNA burst rate delayed responses to spontaneous SAP and DAP modifications, respectively. PRSA analysis averages HP and MSNA burst rate patterns after aligning them according to the direction of SAP and DAP changes, respectively. Since cBRSs were similar when SAP went up or down, hysteresis of cBR was not detected. Conversely, hysteresis of sBR was evident with sBRS more negative when DAP was falling than rising. sBR hysteresis was no longer visible during sympathetic activation induced by the orthostatic challenge. These results were obtained via the SEQ method, while the PRSA technique appeared to be less powerful in describing the BR asymmetry due to the strong association between BRS estimates computed over positive and negative AP variations. This study suggests that cBR and sBR provide different information about the BR control, sBR exhibits more relevant non-linear features that are evident even during physiological changes of AP, and the SEQ method can be fruitfully exploited to characterize the BR hysteresis with promising applications to BR branches different from cBR and sBR.Beatrice De Maria, Vlasta Bari, Beatrice Cairo, Emanuele Vaini, Murray Esler, Elisabeth Lambert, Mathias Baumert, Sergio Cerutti, Laura Dalla Vecchia, and Alberto Port

    The AMMA mulid network for aerosol characterization in West Africa

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    Three ground based portable low power consumption microlidars (MULID) have been built and deployed at three remote sites in Banizoumbou (Niger), Cinzana (Mali) and M'Bour (Senegal) in the framework of the African Monsoon Multidisciplinary Analyses (AMMA) project for the characterization of aerosols optical properties. A description of the instrument and a discussion of the data inversion method, including a careful analysis of measurement uncertainties (systematic and statistical errors) are presented. Some case studies of typical lidar profiles observed over the Banizoumbou site during 2006 are shown and discussed with respect to the AERONET 7-day back-trajectories and the biomass burning emissions from the Combustion Emission database for the AMMA campaign

    Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

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    Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74路0%) had emergency surgery and 280 (24路8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26路1%) patients. 30-day mortality was 23路8% (268 of 1128). Pulmonary complications occurred in 577 (51路2%) of 1128 patients; 30-day mortality in these patients was 38路0% (219 of 577), accounting for 81路7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1路75 [95% CI 1路28鈥2路40], p\textless0路0001), age 70 years or older versus younger than 70 years (2路30 [1路65鈥3路22], p\textless0路0001), American Society of Anesthesiologists grades 3鈥5 versus grades 1鈥2 (2路35 [1路57鈥3路53], p\textless0路0001), malignant versus benign or obstetric diagnosis (1路55 [1路01鈥2路39], p=0路046), emergency versus elective surgery (1路67 [1路06鈥2路63], p=0路026), and major versus minor surgery (1路52 [1路01鈥2路31], p=0路047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

    Measurement of the charge asymmetry in top-quark pair production in the lepton-plus-jets final state in pp collision data at s=8TeV\sqrt{s}=8\,\mathrm TeV{} with the ATLAS detector