23 research outputs found
A rationale basis for airways conditioning: too wet or not too wet?
No full textMedical gases conditioning during mechanical invasive ventilation is nowadays a problem. In fact, in spite of conditioning guidelines, absolute humidity (AH) into 25-35 mg/l, clinical evaluation of the optimal level of airway humidification has not yet been established with certainty. Physiologically, during spontaneous respiration the airway hydric balance, inspiratory AH expiratory AH, is negative of 27 mg/l about. Usually the patients on mechanical ventilation have an expiratory AH of 32-33 mg/l. An overhumidification of inspired gases, positive airway hydric balance, gives anatomic-physiological alterations of airways and lung parenchyma. During invasive mechanical ventilation, the practice of active hot humidifiers has a positive or level airway hydric balance. We think that inspired AH must be equal to expired AH to maintain an airway hydric balance at least level. At last, the temperature of inspired gases, with active hot humidifiers, shouldn't exceed 32-34 degrees C
A rationale basis for airways conditioning: Too wet or not too wet? [Una base razionale per il condizionamento delle vie aeree: Umidificare troppo o non troppo?]
No full textMedical gases conditioning during mechanical invasive ventilation is nowadays a problem. In fact, in spite of conditioning guidelines, absolute humidity (AH) into 25-35 mg/l, clinical evaluation of the optimal level of airway humidification has not yet been established with certainty. Physiologically, during spontaneous respiration the airway hydric balance, inspiratory AH expiratory AH, is negative of 27 mg/l about. Usually the patients on mechanical ventilation have an expiratory AH of 32-33 mg/l. An overhumidification of inspired gases, positive airway hydric balance, gives anatomic-physiological alterations of airways and lung parenchyma. During invasive mechanical ventilation, the practice of active hot humidifiers has a positive or level airway hydric balance. We think that inspired AH must be equal to expired AH to maintain an airway hydric balance at least level. At last, the temperature of inspired gases, with active hot humidifiers, shouldn't exceed 32-34 degrees C
A rationale basis for airways conditioning : too wet or not too wet?
No full textMedical gases conditioning during mechanical invasive ventilation is nowadays a problem. In fact, in spite of conditioning guidelines, absolute humidity (AH) into 25-35 mg/l, clinical evaluation of the optimal level of airway humidification has not yet been established with certainty. Physiologically, during spontaneous respiration the airway hydric balance, inspiratory AH expiratory AH, is negative of 27 mg/l about. Usually the patients on mechanical ventilation have an expiratory AH of 32-33 mg/l. An overhumidification of inspired gases, positive airway hydric balance, gives anatomic-physiological alterations of airways and lung parenchyma. During invasive mechanical ventilation, the practice of active hot humidifiers has a positive or level airway hydric balance. We think that inspired AH must be equal to expired AH to maintain an airway hydric balance at least level. At last, the temperature of inspired gases, with active hot humidifiers, shouldn't exceed 32-34 degrees C
Redemption: A Performance Journey
No full textAfter an injury severely limited the author’s ability to play guitar, he searched for a way to continue performing. In Redemption, the author explores different iterations of the artist’s relationship to technology through live performance. This will include both live instruments and electronics as sound sources, as well as a visual component. The author uses different configurations of live electronics, prerecorded loops, live instruments, and live recorded loops throughout the performance. Using Ableton Live, the author has found a new path to performing original music, bringing all of his skills together into one live performance.https://remix.berklee.edu/graduate-studies-production-technology/1422/thumbnail.jp
The discovery of biological subphenotypes in ARDS: a novel approach to targeted medicine?
No full textThe acute respiratory distress syndrome (ARDS) is a severe lung disorder with a high morbidity and mortality which affects all age groups. Despite active research with intense, ongoing attempts in developing pharmacological agents to treat ARDS, its mortality rate remains unaltered high and treatment is still only supportive. Over the years, there have been many attempts to identify meaningful subgroups likely to react differently to treatment among the heterogenous ARDS population, most of them unsuccessful. Only recently, analysis of large ARDS cohorts from randomized controlled trials have identified the presence of distinct biological subphenotypes among ARDS patients: a hypoinflammatory (or uninflamed; named P1) and a hyperinflammatory (or reactive; named P2) subphenotype have been proposed and corroborated with existing retrospective data. The hyperinflammatory subphenotyope was clearly associated with shock state, metabolic acidosis, and worse clinical outcomes. Core features of the respective subphenotypes were identified consistently in all assessed cohorts, independently of the studied population, the geographical location, the study design, or the analysis method. Additionally and clinically even more relevant treatment efficacies, as assessed retrospectively, appeared to be highly dependent on the respective subphenotype. This discovery launches a promising new approach to targeted medicine in ARDS. Even though it is now widely accepted that each ARDS subphenotype has distinct functional, biological, and mechanistic differences, there are crucial gaps in our knowledge, hindering the translation to bedside application. First of all, the underlying driving biological factors are still largely unknown, and secondly, there is currently no option for fast and easy identification of ARDS subphenotypes. This narrative review aims to summarize the evidence in biological subphenotyping in ARDS and tries to point out the current issues that will need addressing before translation of biological subohenotypes into clinical practice will be possible.Full Tex
Validation of Messenger Ribonucleic Acid Markers Differentiating Among Human Acute Respiratory Distress Syndrome Subgroups in an Ovine Model of Acute Respiratory Distress Syndrome Phenotypes
No full textBackground: The discovery of biological subphenotypes in acute respiratory distress syndrome (ARDS) might offer a new approach to ARDS in general and possibly targeted treatment, but little is known about the underlying biology yet. To validate our recently described ovine ARDS phenotypes model, we compared a subset of messenger ribonucleic acid (mRNA) markers in leukocytes as reported before to display differential expression between human ARDS subphenotypes to the expression in lung tissue in our ovine ARDS phenotypes model (phenotype 1 (Ph1): hypoinflammatory; phenotype 2 (Ph2): hyperinflammatory). Methods: We studied 23 anesthetized sheep on mechanical ventilation with observation times between 6 and 24 h. They were randomly allocated to the two phenotypes (n = 14 to Ph1 and n = 9 to Ph2). At study end, lung tissue was harvested and preserved in RNAlater. After tissue homogenization in TRIzol, total RNA was extracted and custom capture and reporter probes designed by NanoString Technologies were used to measure the expression of 14 genes of interest and the 6 housekeeping genes on a nCounter SPRINT profiler. Results: Among the 14 mRNA markers, in all animals over all time points, 13 markers showed the same trend in ovine Ph2/Ph1 as previously reported in the MARS cohort: matrix metalloproteinase 8, olfactomedin 4, resistin, G protein-coupled receptor 84, lipocalin 2, ankyrin repeat domain 22, CD177 molecule, and transcobalamin 1 expression was higher in Ph2 and membrane metalloendopeptidase, adhesion G protein-coupled receptor E3, transforming growth factor beta induced, histidine ammonia-lyase, and sulfatase 2 expression was higher in Ph1. These expression patterns could be found when different sources of mRNA – such as blood leukocytes and lung tissue – were compared. Conclusion: In human and ovine ARDS subgroups, similar activated pathways might be involved (e.g., oxidative phosphorylation, NF-κB pathway) that result in specific phenotypes.Full Tex
Reduced prevalence of ischemic events and abnormal supraortic flow patterns in patients with liver cirrhosis.
No full textBackground: A reduced prevalence of cardiovascular diseases has
been reported in liver cirrhosis. However, studies focusing on supraortic
district of cirrhotic patients are lacking. Methods: By ultrasound duplex
scanning, the presence and severity of atherosclerotic plaques and flow
pattern abnormalities were assessed in carotid and vertebral arteries of 118
cirrhotics aged 60.7 12.8 (1 standard deviation) years, and in 236 controls
matched with cirrhotic patients according to age, sex and cigarette smoking.
Results: Previous ischemic strokes were significantly less numerous in
cirrhotic patients than in controls (0.8% vs. 10.5%; P50.0009); also the
prevalence of myocardial infarction was significantly reduced (1.7% vs.
6.4%; P50.0532). Moreover, cirrhotic patients differed from controls for a
lower prevalence of hypertension and hypercholesterolemia, and for a greater
proportion of diabetics. Although the presence and severity of atherosclerotic
plaques was similar in the two groups, liver cirrhosis was associated with a
lower prevalence of abnormal flow patterns (13.6% vs. 29.2%; P50.0011).
The inverse association of hemodynamic changes with liver cirrhosis persisted
after all main risk factors were simultaneously taken into account by multiple
logistic regression. However, in the presence of hypertension,
hypercholesterolemia and cigarette smoking, the ‘protective’ effect of
cirrhosis on the occurrence of abnormal flow patterns was no longer
detectable. Conclusions: Advanced liver disease is associated with a reduced
prevalence of ischemic stroke, which seems to be related to a decreased
prevalence of abnormal flow patterns in the supraortic vessels, especially
among non-smoker
Density and sp<sup>3</sup> Content in Diamond-Like Carbon Films by X-ray Reflectivity and Electron Energy Loss Spectroscopy
No full textABSTRACTGrazing angle x-ray reflectivity (XRR) is used to study density, thickness, internal layering and roughness of a variety of carbon samples, with and without hydrogen and nitrogen. The bulk mass density of optimised tetrahedral amorphous carbon (ta-C) is 3.26 g/cm2, for which Electron Energy Loss Spectroscopy (EELS) found a sp3 fraction of 85%. Combining XRR and EELS we benchmark the dependence of sp3 fraction on density for hydrogen-free carbons. Hydrogenated ta-C (ta-C:H) deposited by electron cyclotron wave resonance (ECWR) reactor from acetylene gas, has a density of 2.35 g/cm3, 75% sp3 and ∼30% hydrogen. These data provide a similar validation for density and sp3 EELS data for hydrogenated DLCs. XRR can also reveal internal layering in films, and indeed less dense layers may be found at the surface or interface of ta-C films, but no such layers are found in ta-C:H films.</jats:p
Predictive value of hepatofugal flow for rick on bleeding and survival rate in liver cirrhosis
No full textDensity, sp<sup>3</sup> content and internal layering of DLC films by X-ray reflectivity and electron energy loss spectroscopy
No full textA variety of hydrogenated and non-hydrogenated amorphous carbon thin films have been characterized by means of grazing-incidence X-ray reflectivity (XRR) to give information about their density, thickness, surface roughness and layering. We used XRR to validate the density of ta-C, ta-C:H and a-C:H films derived from the valence plasmon in electron energy loss spectroscopy measurements, up to 3.26 and 2.39 g/cm3 for ta-C and ta-C:H, respectively. By comparing XRR and electron energy loss spectroscopy (EELS) data, we have been able for the first time to fit a common electron effective mass of m*/me = 0.87 for all amorphous carbons and diamond, validating the `quasi-free' electron approach to density from valence plasmon energy. While hydrogenated films are found to be substantially uniform in density across the film, ta-C films grown by the filtered cathodic vacuum arc (FCVA) show a multilayer structure. However, ta-C films grown with an S-bend filter show a high uniformity and only a slight dependence on the substrate bias of both sp3 and layering
