Recruitment manoeuvres dislodge mucus towards the distal airways in an experimental model of severe pneumonia.

BACKGROUND: Recruitment manoeuvres generate a transient increase in trans-pulmonary pressure that could open collapsed alveoli. Recruitment manoeuvres might generate very high inspiratory airflows. We evaluated whether recruitment manoeuvres could displace respiratory secretions towards the distal airways and impair gas exchange in a porcine model of bacterial pneumonia. METHODS: We conducted a prospective randomised study in 10 mechanically ventilated pigs. Pneumonia was produced by direct intra-bronchial introduction of Pseudomonas aeruginosa. Four recruitment manoeuvres were applied randomly: extended sigh (ES), maximal recruitment strategy (MRS), sudden increase in driving pressure and PEEP (SI-PEEP), and sustained inflation (SI). Mucus transport was assessed by fluoroscopic tracking of radiopaque disks before and during each recruitment manoeuvre. The effects of each RM on gas exchange were assessed 15 min after the intervention. RESULTS: Before recruitment manoeuvres, mucus always cleared towards the glottis. Conversely, mucus was displaced towards the distal airways in 28.6% ES applications and 50% of all other recruitment manoeuvres (P=0.053). Median mucus velocity was 1.26 mm min-1 [0.48-3.89] before each recruitment manoeuvre, but was reversed (P=0.007) during ES [0.10 mm min-1 [-0.04-1.00]], MRS [0.10 mm min-1 [-0.4-0.48]], SI-PEEP [0.02 mm min-1 [-0.14-0.34]], and SI [0.10 mm min-1 [-0.63-0.75]]. When PaO2 failed to improve after recruitment manoeuvre, mucus was displaced towards the distal airways in 68.7% of the cases, compared with 31.2% recruitment manoeuvres associated with improved PaO2 (odds ratio: 4.76 (95% confidence interval: 1.13-19.97). CONCLUSIONS: Recruitment manoeuvres dislodge mucus distally, irrespective of airflow generated by different recruitment manoeuvres. Further investigation in humans is warranted to corroborate these pre clinical findings, as there may be limited benefits associated with lung recruitment in pneumonia.

Why is gold such a good catalyst for oxygen reduction in alkaline media?

The two faces of gold: the reduction of oxygen on gold electrodes in alkaline solutions has been investigated theoretically. The most favorable reaction leads directly to adsorbed O(2)(-), but the activation energy for a two-step pathway, in which the first step is an outer-sphere electron transfer to give solvated O(2)(-), is only slightly higher. d-band catalysis, which dominates oxygen reduction in acid media, plays no role. The reason why the reaction is slow in acid media is also explained.

Ab initio studies of Ag-S bond formation during the adsorption of L-cysteine on Ag(111).

Ab initio studies of Ag-S bond formation during the adsorption of L-cysteine on Ag(111) have been performed by combining density functional theory with a quantum mechanical model developed in our group. The adsorbate-silver bond formation has been investigated by analyzing the projected density of states onto the different atoms of the molecule and by charge density difference calculations when the zwitterion radical approaches the surface. The polar character of the bond can be distinguished. For the first time, the coupling constants of the sulfur orbitals with the d and sp bands have been calculated by fitting the density of states. The role of the sp bands in the stabilization of the sulfur-silver bond is analyzed. The differences with the catalysis of hydrogen adsorption are discussed. Copper, gold, and silver are not good catalysts for the adsorption of hydrogen because of the position of the d bands lying too far below the Fermi level. However, the coin metals are excellent for the adsorption of thiols. The reason is that at the equilibrium position the sulfur atom is much farther from the surface than hydrogen, and thus the interactions with the sp bands stabilize its bond to the surface.

Ab initio studies of the electronic structure of L-cysteine adsorbed on Ag(111).

We have performed ab initio calculations for the adsorption of L-cysteine on Ag(111) using density functional theory. We have focused on two possible adsorbed species: the L-cysteine radical (•S-CH(2)-CH-NH(2)-COOH) adsorbed almost flat at a bridge site, slightly displaced toward an fcc location, and the zwitterionic radical Z-cysteine (•S-CH(2)-CH-NH(3)(+)-COO(-)) adsorbed at a bridge site, shifted to a hcp site forming a (4 × 4) unit cell (θ = 0.06) and a (√3 × âˆš3) R 30° unit cell (θ = 0.33), respectively. Special attention has been paid to the electronic structure of the system. The adsorbate-silver bond formation has been exhaustively investigated by analyzing the density of states projected onto the different atoms of the molecule, and by charge density difference calculations. A complicated interplay between sp and d states of silver in the formation of bonds between the adsorbates and the surface has been found. The role of the carboxyl group in the interaction with the surface has been also analyzed.

Adaptive cerebellar spiking model embedded in the control loop: context switching and robustness against noise.

This work evaluates the capability of a spiking cerebellar model embedded in different loop architectures (recurrent, forward, and forward&recurrent) to control a robotic arm (three degrees of freedom) using a biologically-inspired approach. The implemented spiking network relies on synaptic plasticity (long-term potentiation and long-term depression) to adapt and cope with perturbations in the manipulation scenario: changes in dynamics and kinematics of the simulated robot. Furthermore, the effect of several degrees of noise in the cerebellar input pathway (mossy fibers) was assessed depending on the employed control architecture. The implemented cerebellar model managed to adapt in the three control architectures to different dynamics and kinematics providing corrective actions for more accurate movements. According to the obtained results, coupling both control architectures (forward&recurrent) provides benefits of the two of them and leads to a higher robustness against noise.

An experimental model of pneumonia induced by methicillin-resistant Staphylococcus aureus in ventilated piglets.

The objectives of the study were to validate a model of methicillin-resistant Staphylococcus aureus (MRSA) pneumonia in ventilated piglets and to study the time-course of biological markers and histopathological changes. 12 piglets were intubated and inoculated with 15 mL of a suspension of 10(6) colony forming units of MRSA in every lobe through the bronchoscope channel. The piglets were ventilated for 12 h (n = 6) and 24 h (n = 6). Clinical parameters were assessed every 6 h and pro-inflammatory cytokines were measured in serum and in bronchoalveolar lavage (BAL) at baseline and sacrifice. Histopathology of each lobe and cultures from blood, lungs and BAL were performed. Animals developed histopathological evidence of pneumonia at necropsy. At 12 h, pneumonia was present in all animals and was severe pneumonia at 24 h. Microbiological studies confirmed the presence of MRSA. A significant increase in interleukin (IL)-6, IL-8 and tumour necrosis factor-α values was seen in BAL at 24 h and IL-6 at 12 h. In serum, only IL-6 levels had increased significantly at 24 h. In ventilated piglets, bronchoscopic inoculation of MRSA induces pneumonia at 12 h and severe pneumonia at 24 h. This severity was associated with a corresponding increase in systemic and local inflammatory response.

Silver electrodeposition on nanostructured gold: from nanodots to nanoripples.

Silver nanodots and nanoripples have been grown on nanocavity-patterned polycrystalline Au templates by controlled electrodeposition. The initial step is the growth of a first continuous Ag monolayer followed by preferential deposition at nanocavities. The Ag-coated nanocavities act as preferred sites for instantaneous nucleation and growth of the three-dimensional metallic centres. By controlling the amount of deposited Ag, dots of approximately 50 nm average size and approximately 4 nm average height can be grown with spatial and size distributions dictated by the template. The dots are in a metastable state. Further Ag deposition drives the dot surface structure to nanoripple formation. Results show that electrodeposition on nanopatterned electrodes can be used to prepare a high density of nanostructures with a narrow size distribution and spatial order.