Automatic detection of AutoPEEP during controlled mechanical ventilation

ABSTRACT: BACKGROUND: Dynamic hyperinflation, hereafter called AutoPEEP (auto-positive end expiratory pressure)with some slight language abuse, is a frequent deleterious phenomenon in patients undergoingmechanical ventilation. Although not readily quantifiable, AutoPEEP can be recognized onthe expiratory portion of the flow waveform. If expiratory flow does not return to zero beforethe next inspiration, AutoPEEP is present. This simple detection however requires the eye ofan expert clinician at the patient's bedside. An automatic detection of AutoPEEP should behelpful to optimize care. METHODS: In this paper, a platform for automatic detection of AutoPEEP based on the flow signalavailable on most of recent mechanical ventilators is introduced. The detection algorithms aredeveloped on the basis of robust non-parametric hypothesis testings that require no priorinformation on the signal distribution. In particular, two detectors are proposed: one is basedon SNT (Signal Norm Testing) and the other is an extension of SNT in the sequentialframework. The performance assessment was carried out on a respiratory system analog andex-vivo on various retrospectively acquired patient curves. RESULTS: The experiment results have shown that the proposed algorithm provides relevant AutoPEEPdetection on both simulated and real data. The analysis of clinical data has shown that theproposed detectors can be used to automatically detect AutoPEEP with an accuracy of 93%and a recall (sensitivity) of 90%. CONCLUSIONS: The proposed platform provides an automatic early detection of AutoPEEP. Such functionalitycan be integrated in the currently used mechanical ventilator for continuous monitoring of thepatient-ventilator interface and, therefore, alleviate the clinician task.     

Brief communication: Prenatal and early postnatal stress exposure influences long bone length in adult rat offspring

Stress during the prenatal and early postnatal periods (perinatal stress, PS) is known to impact offspring cognitive, behavioral, and physical development, but effects on skeletal growth are not clear. Our objective was to analyze effects of variable, mild, daily PS exposure on adult offspring long bone length. Twelve pregnant rat dams were randomly assigned to receive variable stress from gestational days 14–21 (Prenatal group), postpartum days 2–9 (Postnatal), both periods (Pre–Post), or no stress (Control). Differences in adult offspring tibia and femur length were analyzed among treatment groups. Mean tibia length differed among groups for males (P = 0.016) and females (P = 0.009), and differences for femur length approached significance for males (P = 0.051). Long bone length was shorter among PS‐exposed offspring, especially those exposed to postnatal stress (Postnatal and Pre–Post groups). Results persisted when controlling for nose–tail length. These differences might reflect early stunting that is maintained in adulthood, or delayed growth among PS‐exposed offspring. This study suggests that PS results in shorter long bones in adulthood, independently of effects on overall body size. Stunting and growth retardation are major global health burdens. Our study adds to a growing body of evidence suggesting that PS is a risk factor for poor linear growth. Am J Phys Anthropol 149:307–311, 2012. © 2012 Wiley Periodicals, Inc.     

Armeniaspiroles, a new class of antibacterials: antibacterial activities and total synthesis of 5-chloro-Armeniaspirole A

Armeniaspiroles, a novel class of natural products isolated from Streptomyces armeniacus, are characterized by a novel spiro[4.4]non-8-ene scaffold. Various derivatives of Armeniaspiroles could be obtained by halogenation, alkylation, addition/elimination or reductions. A total synthesis of the 5-chloro analog of Armeniaspirole A has been accomplished in a linear six-step sequence. 5-Chloro-Armeniaspirole A exhibits good activity against a range of multidrug-resistant, Gram-positive bacterial pathogens.     

Radical-induced oxidation of trans-resveratrol

trans-Resveratrol (RVT) (3,5,4'-trihydroxystilbene), a polyphenolic constituent of red wine, is thought to be beneficial in reducing the incidence of cardiovascular diseases, partly via its antioxidant properties. However, the mechanism of action by which trans-resveratrol displays its antioxidant effect has not been totally unravelled. This study aimed at establishing a comprehensive scheme of the reaction mechanisms of the direct scavenging of HO(*) and O(2)(*-) radicals generated by water gamma radiolysis. Aerated aqueous solutions of trans-RVT (from 10 to 100μmolL(-1)) were irradiated with increasing radiation doses (from 25 to 400Gy) and further analyzed by UV-visible absorption spectrophotometry for detection of trans-RVT oxidation products. Separation and quantification of RVT and its four oxidation products previously identified by mass spectrometry, i.e., piceatannol (PCT), 3,5-dihydroxybenzoic acid (3,5-DHBA), 3,5-dihydroxybenzaldehyde (3,5-DHB) and para-hydroxybenzaldehyde (PHB), were performed by HPLC/UV-visible spectrophotometry. Determination of the radiolytic yields of trans-RVT consumption and oxidation product formation has allowed us to establish balance between trans-RVT disappearance and the sum of oxidation products formation. Under our conditions, O(2)(-) radicals seemed to poorly initiate oxidation of trans-RVT, whereas the latter, whatever its initial concentration, quantitatively reacted with HO() radicals, via a dismutation mechanism. Two reaction pathways involving HO()-induced trans-RVT primary radicals have been proposed to explain the formation of the oxidation end-products of trans-RVT.     

The role of epigenetics in environmental and occupational carcinogenesis

Over the last few years there has been an increasing effort in identifying environmental and occupational carcinogenic agents and linking them to the incidence of a variety of human cancers. The carcinogenic process itself is multistage and rather complex involving several different mechanisms by which various carcinogenic agents exert their effect. Amongst them are epigenetic mechanisms often involving silencing of tumor suppressor genes and/or activation of proto-oncogenes, respectively. These alterations in gene expression are considered critical during carcinogenesis and have been observed in many environmental- and occupational-induced human cancers. Some of the underlying mechanisms proposed to account for such differential gene expression include alterations in DNA methylation and/or histone modifications. Throughout this article, we aim to provide a current account of our understanding on how the epigenetic pathway is involved in contributing to an altered gene expression profile during human carcinogenesis that ultimately will allow us for better cancer diagnostics and therapeutic strategies.     

Differentiated influence of off-road and on-road cycling practice on balance control and the related-neurosensory organization

This study aimed to determine the sensorimotor strategies privileged by mountain bikers (MTB) and road cyclists (RC) for balance control. Twenty-four MTB and 24 RC (off-road Olympics, world, continental and national champions, Tour-de-France participants, on-road world cup race winner) volunteered to answer a questionnaire about the characteristics of cycling practice and perform a sensory organization test, aiming to evaluate balance control in 6 different sensory situations based upon visual and support surface perturbations (C1^ES to C6^ES). RC balance performances were better than those of MTB both during quiet stance eyes opened (C1^ES, p = 0.011) and when only somatosensory information is disrupted (C4^ES, p = 0.039), highlighting a higher use of vision to control balance in RC. Moreover, a positive correlation was shown in the whole population (MTB + RC) between the visual ratio (R^VIS = C4^ES/C1^ES) and the proportion of riding distance of on-road cycling (ρ = 0.28, p = 0.054). In MTB, the use of proprioception (somatosensory ratio: R^SOM = C2^{ES(eyes closed)}/C1^ES) was increased by a higher intensity of off-road cycling (ρ = 0.49, p = 0.018) and that of vision (R^VIS) by a higher intensity of on-road cycling (ρ = 0.41, p = 0.048). The difference in sensory organization between MTB and RC could be explained by adaptive processes elaborated from environmental stimulations and technical specificities of these disciplines.     

Pluripotency of Arabidopsis xylem pericycle underlies shoot regeneration from root and hypocotyl explants grown in vitro

We have established a detailed framework for the process of shoot regeneration from Arabidopsis root and hypocotyl explants grown in vitro . Using transgenic plant lines in which the GUS or GFP genes were fused to promoters of developmental genes ( WUS , CLV1 , CLV3 , STM , CUC1 , PLT1 , RCH1 , QC25 ), or to promoters of genes encoding indicators of the auxin response ( DR5 ) or transport ( PIN1 ), cytokinin (CK) response ( ARR5 ) or synthesis ( IPT5 ), or mitotic activity ( CYCB1 ), we showed that regenerated shoots originated directly or indirectly from the pericycle cells adjacent to xylem poles. In addition, shoot regeneration appeared to be partly similar to the formation of lateral root meristems (LRMs). During pre-culture on a 2, 4-dichlorophenoxyacetic acid (2, 4-D)-rich callus-inducing medium (CIM), xylem pericycle reactivation established outgrowths that were not true calli but had many characteristics of LRMs. Transfer to a CK-rich shoot-inducing medium (SIM) resulted in early LRM-like primordia changing to shoot meristems. Direct origin of shoots from the xylem pericycle occurred upon direct culture on CK-containing media without prior growth on CIM. Thus, it appeared that the xylem pericycle is more pluripotent than previously thought. This pluripotency was accompanied by the ability of pericycle derivatives to retain diploidy, even after several rounds of cell division. In contrast, the phloem pericycle did not display such developmental plasticity, and responded to CKs with only periclinal divisions. Such observations reinforce the view that the pericycle is an 'extended meristem' that comprises two types of cell populations. They also suggest that the founder cells for LRM initiation are not initially fully specified for this developmental pathway.