Electrical Impedance Tomography during Abdominal Laparoscopic Surgery: A Physiological Pilot Study.

BACKGROUND: Both general anesthesia and pneumoperitoneum insufflation during abdominal laparoscopic surgery can lead to atelectasis and impairment in oxygenation. Setting an appropriate level of external PEEP could reduce the occurrence of atelectasis and induce an improvement in gas exchange. However, in clinical practice, it is common to use a fixed PEEP level (i.e., 5 cmH2O), irrespective of the dynamic respiratory mechanics. We hypothesized setting a PEEP level guided by EIT in order to obtain an improvement in oxygenation and respiratory system compliance in lung-healthy patients than can benefit a personalized approach. METHODS: Twelve consecutive patients scheduled for abdominal laparoscopic surgery were enrolled in this prospective study. The EIT Timpel Enlight 1800 was applied to each patient and a dedicated pneumotachograph and a spirometer flow sensor, integrated with EIT, constantly recorded respiratory mechanics. Gas exchange, respiratory mechanics and hemodynamics were recorded at five time points: T0, baseline; T1, after induction; T2, after pneumoperitoneum insufflation; T3, after a recruitment maneuver; and T4, at the end of surgery after desufflation. RESULTS: A titrated mean PEEP of 8 cmH2O applied after a recruitment maneuver was successfully associated with the "best" compliance (58.4 ± 5.43 mL/cmH2O), with a low percentage of collapse (10%), an acceptable level of hyperdistention (0.02%). Pneumoperitoneum insufflation worsened respiratory system compliance, plateau pressure, and driving pressure, which significantly improved after the application of the recruitment maneuver and appropriate PEEP. PaO2 increased from 78.1 ± 9.49 mmHg at T0 to 188 ± 66.7 mmHg at T4 (p < 0.01). Other respiratory parameters remained stable after abdominal desufflation. Hemodynamic parameters remained unchanged throughout the study. CONCLUSIONS: EIT, used as a non-invasive intra-operative monitor, enables the rapid assessment of lung volume and regional ventilation changes in patients undergoing laparoscopic surgery and helps to identify the "optimal" PEEP level in the operating theatre, improving ventilation strategies.

Dataset from RNAseq analysis of bud differentiation in Ficus carica.

The presented data regards the transcriptome profiling and differential analysis with RNA-Seq approach with the following goals: de novo transcriptome assembly and genome annotation of Ficus carica and the differential expression analysis of parthenocarpic and non-partenocarpic varieties in order to identify candidate genes for the production of seedless fig. Two fig varieties Dottato and Petrelli and the caprifig were grown at the fig repository at the 'P. Martucci' experimental station in Valenzano (Bari) of University of Bari 'Aldo Moro'. The data included: RNA-seq data obtained from fruits of parthenocarpic and non-parthenocarpic varieties, gene expression in the different genetic materials; genes up and down regulated. The data in this article support information presented in the research article "I. Marcotuli, A. Mazzeo, P. Colasuonno, R. Terzano, D. Nigro, C. Porfido, A. Tarantino, R. Aiese Cigliano, W. Sanseverino, A. Gadaleta, G. Ferrara, Fruit Development in Ficus carica L.: Morphological and Genetic Approaches to Fig Buds for an Evolution From Monoecy Toward Dioecy. Front. Plant Sci.(2020) 11:1208. doi: 10.3389/fpls.2020.01208.

Advanced Magnetic Resonance Imaging in the Evaluation of Treated Glioblastoma: A Pictorial Essay.

MRI plays a key role in the evaluation of post-treatment changes, both in the immediate post-operative period and during follow-up. There are many different treatment's lines and many different neuroradiological findings according to the treatment chosen and the clinical timepoint at which MRI is performed. Structural MRI is often insufficient to correctly interpret and define treatment-related changes. For that, advanced MRI modalities, including perfusion and permeability imaging, diffusion tensor imaging, and magnetic resonance spectroscopy, are increasingly utilized in clinical practice to characterize treatment effects more comprehensively. This article aims to provide an overview of the role of advanced MRI modalities in the evaluation of treated glioblastomas. For a didactic purpose, we choose to divide the treatment history in three main timepoints: post-surgery, during Stupp (first-line treatment) and at recurrence (second-line treatment). For each, a brief introduction, a temporal subdivision (when useful) or a specific drug-related paragraph were provided. Finally, the current trends and application of radiomics and artificial intelligence (AI) in the evaluation of treated GB have been outlined.

Role of aspirin, beta-blocker, statins, and heparin therapy in septic patients under mechanical ventilation: a narrative review.

Sepsis is the main cause of death among patients admitted to intensive care units. Management of sepsis includes fluid resuscitation, vasopressors, intravenous antimicrobials, source control, mechanical ventilation, and others. New insights into the potential benefits of non-antimicrobial drugs in sepsis have evolved based on the pathophysiology of the disease and the mechanism of action of some drugs, but the findings are still controversial. In this study, we aimed to evaluate the effect of beta-blockers, aspirin, statins, and heparin as adjunctive treatments in septic patients under mechanical ventilation with non-cardiovascular diseases and their effect on mortality. We searched PubMed with relevant keywords (beta-blockers, aspirin, statins, or heparin, and critically ill or sepsis) for the last 10 years and some personal collection of relevant articles, and then we assessed studies according to prespecified inclusion and exclusion criteria. Our results show that beta-blockers, aspirin, and heparin may have promising feedback on reducing mortality. However, new well-controlled, randomized, multicenter studies are needed to confirm that, and multiple issues regarding their usage need to be addressed. On the other hand, the feedback regarding the effectiveness of statins was not as strong as that of the other drugs studied, and we suggest that further research is needed to confirm these results.

Datasets for genetic diversity assessment in a collection of wild and cultivated pomegranates (Punica granatum L.) by microsatellite markers.

Data described in this article refer to molecular characterization and assessment of genetic diversity within a wide collection of pomegranate genotypes including both selections and cultivars from different geographical origin/disseminations by using microsatellite (SSR, Simple Sequence Repeats) markers. Supplied datasets refer to a set of 63 genotypes including 55 accessions (landraces) from Italy, Turkmenistan, Japan, and USA and 8 cultivars from Israel, established at the pomegranate repository of the Fruit Tree Unit of the Department of Soil, Plant and Food Science at University of Bari "Aldo Moro", Italy. Pomegranate accessions differed for end-use purpose (edible, ornamental) and some morpho-pomological traits including juice taste, inner tegmen hardness, and skin/seed color. Molecular data were opportunely employed to build a similarity matrix to establish phylogenetic relationships (genetic similarity and distances) among pomegranate accessions and compare genetic clustering to morpho-pomological classification. The present data article provides detailed information and methodological protocols on SSR markers, PCR amplification and banding profiling aimed to molecular characterization of pomegranate collection. This latter was conducted by amplifying a set of informative polymorphic SSR markers on the genomic DNA of each pomegranate accession, and then comparing the different molecular profiles by capillary electrophoresis. The banding patterns obtained from microsatellite markers were used to build a binary matrix containing the scores for each individual SSR fragment, which was transformed into a similarity matrix and finally used for cluster analysis and dendrogram building based on the UPGMA algorithm. This paper supplies data potentially useful for the identification of polymorphic markers suitable for varietal identification and traceability, or discrimination between tightly related pomegranate accessions with very high morphological similarity and/or geographical identity. Data described in this paper support the published original research article titled "Exploiting DNA-based molecular tools to assess genetic diversity in pomegranate (Punica granatum L.) selections and cultivars" [1].

Metabolomics and genetics of reproductive bud development in Ficus carica var. sativa (edible fig) and in Ficus carica var. caprificus (caprifig): similarities and differences.

In figs, reproductive biology comprises cultivars requiring or not pollination, with female trees (edible fig) and male trees (caprifig) bearing different types of fruits. Metabolomic and genetic studies may clarify bud differentiation mechanisms behind the different fruits. We used a targeted metabolomic analysis and genetic investigation through RNA sequence and candidate gene investigation to perform a deep analysis of buds of two fig cultivars, 'Petrelli' (San Pedro type) and 'Dottato' (Common type), and one caprifig. In this work, proton nuclear magnetic resonance (1H NMR-based metabolomics) has been used to analyze and compare buds of the caprifig and the two fig cultivars collected at different times of the season. Metabolomic data of buds collected on the caprifig, 'Petrelli', and 'Dottato' were treated individually, building three separate orthogonal partial least squared (OPLS) models, using the "y" variable as the sampling time to allow the identification of the correlations among metabolomic profiles of buds. The sampling times revealed different patterns between caprifig and the two edible fig cultivars. A significant amount of glucose and fructose was found in 'Petrelli', differently from 'Dottato', in the buds in June, suggesting that these sugars not only are used by the ripening brebas of 'Petrelli' but also are directed toward the developing buds on the current year shoot for either a main crop (fruit in the current season) or a breba (fruit in the successive season). Genetic characterization through the RNA-seq of buds and comparison with the literature allowed the identification of 473 downregulated genes, with 22 only in profichi, and 391 upregulated genes, with 21 only in mammoni.

New Materials and Technologies for Durability and Conservation of Building Heritage.

The increase in concrete structures' durability is a milestone to improve the sustainability of buildings and infrastructures. In order to ensure a prolonged service life, it is necessary to detect the deterioration of materials by means of monitoring systems aimed at evaluating not only the penetration of aggressive substances into concrete but also the corrosion of carbon-steel reinforcement. Therefore, proper data collection makes it possible to plan suitable restoration works which can be carried out with traditional or innovative techniques and materials. This work focuses on building heritage and it highlights the most recent findings for the conservation and restoration of reinforced concrete structures and masonry buildings.

Experimental Characterisation of Lime-Based Textile-Reinforced Mortar Systems Made of Either Jute or Flax Fabrics.

Existing buildings are often in need of strengthening interventions, and several technical solutions have been recently developed for this purpose. Among them, the use of textile-reinforced mortar (TRM) composites has gained consensus as a technically viable and economically convenient option. Moreover, TRM has the potential to be employed as a reversible and sustainable strengthening technique for masonry buildings. In this context, the present paper aims to investigate the mechanical properties of TRM systems consisting of sustainable phases, such as lime-based matrices and natural fabrics produced by waiving fibers obtained from plants, such as Jute or Flax. This class composite system can be referred to as natural TRM and is denoted by the acronym NTRM. The present study moves from the geometric and mechanical characterisation of fibres and fabrics and, after having also investigated the properties of the mortar, it reports the results of tensile tests carried out on specimens of the NTRM systems under consideration, with the main aim of providing the empirical bases of the relationships between the geometric and physical properties of the constituents and the resulting mechanical response of the composite system. The obtained results show that the considered Flax-TRM system has an apparent composite behavior, as its response to tension is clearly characterised by the well-known three stages corresponding to the elastic response, the formation of cracks, and the reinforcement response up to rupture. Conversely, the Jute-TRM system needs to be further improved in terms of balance between the properties of the matrix and the internal reinforcement. Further studies will be devoted to this specific aspect and, more generally, to investigating the relationships between constituents' properties and the NTRM behavior.

Mechanical Characterisation of GFRP Frame and Beam-to-Column Joints Including Steel Plate Fastened Connections.

The study is part of the MOOVABAT project aiming at defining innovative technological buildings with low environmental impact and characterised by the capacity to constantly adapt to the changing of their users' needs. In this context, the mechanical performance of a fibre-reinforced polymer (FRP) frame, chosen as a structural solution for the building assembly, was investigated. Specifically, the research study aims to experimentally define the moment-rotation behaviour of screw-connected joints by using steel plates. For this purpose, two different configurations, a beam-to-column joint and a whole portal frame, were tested to evaluate the strength and the stiffness of the connection. In addition, the beam-to-column element was also subjected to cyclic loads to assess the joint energy dissipation capacity. The experimental results show that the strength of the connection is higher than that required to satisfy both serviceability limit state (SLS) and ultimate limit state (ULS) loading conditions. Moreover, it also provided an accurate characterisation of the semi-rigid connection useful for designing purposes and raising the possibility of considering an optimisation of the system. All in all, with respect to mechanical aspects, the study confirms the suitability of pultrude FRP element assemblies for modular building applications and paves the way for further analysis aimed at enhancing their efficiency.

Immunological effects of glutamine supplementation in polytrauma patients in intensive care unit.

BACKGROUND: In polytrauma intensive care unit (ICU) patients, glutamine (GLN) becomes a "conditionally essential" amino acid; its role has been extensively studied in numerous clinical trials but their results are inconclusive. We evaluated the IgA-mediated humoral immunity after GLN supplementation in polytrauma ICU patients. METHODS: All consecutive patients with polytrauma who required mechanical ventilation and enteral nutrition (EN) provided within 24 h since the admission in ICU at the University Hospital of Foggia from September 2016 to February 2017 were included. Thereafter, two groups were identified: patients treated by conventional EN (25 kcal/kg/die) and patients who have received conventional EN enriched with 50 mg/kg/ideal body weight of alanyl-GLN 20% intravenously. We analysed the plasmatic concentration of IgA, CD3+/CD4+ T helper lymphocytes, CD3+/CD8+ T suppressor lymphocytes, CD3+/CD19+ B lymphocytes, IL-4 and IL-2 at admission and at 4 and 8 days. RESULTS: We identified 30 patients, with 15 subjects per group. IgA levels increased significantly in GLN vs the control group at T0, T4 and T8. CD3+/CD4+ T helper lymphocyte and CD3+/CD8+ T suppressor lymphocyte levels significantly increased in GLN vs the control group at T4 and T8. CD3+/CD19+ B lymphocyte levels increased significantly in GLN vs the control group only at T8. IL-2 and IL-4 levels showed no significant differences when comparing GLN with the control group. CONCLUSIONS: Our study showed that there was an improvement in humoral and cell-mediated immunity with GLN supplementation in polytrauma ICU patients using recommended doses.

Machine learning and predictive models: 2 years of Sars-CoV-2 pandemic in a single-center retrospective analysis.

BACKGROUND: Since January 2020, coronavirus disease 19 (COVID-19) has rapidly spread all over the world. An early assessment of illness severity is crucial for the stratification of patients in order to address them to the right intensity path of care. We performed an analysis on a large cohort of COVID-19 patients (n=581) hospitalized between March 2020 and May 2021 in our intensive care unit (ICU) at Policlinico Riuniti di Foggia hospital. Through an integration of the scores, demographic data, clinical history, laboratory findings, respiratory parameters, a correlation analysis, and the use of machine learning our study aimed to develop a model to predict the main outcome. METHODS: We deemed eligible for analysis all adult patients (age >18 years old) admitted to our department. We excluded all the patients with an ICU length of stay inferior to 24 h and the ones that declined to participate in our data collection. We collected demographic data, medical history, D-dimers, NEWS2, and MEWS scores on ICU admission and on ED admission, PaO2/FiO2 ratio on ICU admission, and the respiratory support modalities before the orotracheal intubation and the intubation timing (early vs late with a 48-h hospital length of stay cutoff). We further collected the ICU and hospital lengths of stay expressed in days of hospitalization, hospital location (high dependency unit, HDU, ED), and length of stay before and after ICU admission; the in-hospital mortality; and the in-ICU mortality. We performed univariate, bivariate, and multivariate statistical analyses. RESULTS: SARS-CoV-2 mortality was positively correlated to age, length of stay in HDU, MEWS, and NEWS2 on ICU admission, D-dimer value on ICU admission, early orotracheal intubation, and late orotracheal intubation. We found a negative correlation between the PaO2/FiO2 ratio on ICU admission and NIV. No significant correlations with sex, obesity, arterial hypertension, chronic obstructive pulmonary disease, chronic kidney disease, cardiovascular disease, diabetes mellitus, dyslipidemia, and neither MEWS nor NEWS on ED admission were observed. Considering all the pre-ICU variables, none of the machine learning algorithms performed well in developing a prediction model accurate enough to predict the outcome although a secondary multivariate analysis focused on the ventilation modalities and the main outcome confirmed how the choice of the right ventilatory support with the right timing is crucial. CONCLUSION: In our cohort of COVID patients, the choice of the right ventilatory support at the right time has been crucial, severity scores, and clinical judgment gave support in identifying patients at risk of developing a severe disease, comorbidities showed a lower weight than expected considering the main outcome, and machine learning method integration could be a fundamental statistical tool in the comprehensive evaluation of such complex diseases.

Cover cropped and tilled table grape vineyard: Data on leaves and stems.

Data presented are on mass, length, SPAD and some physiological parameters of leaves and stems in a table grape vineyard of Italia variety grafted onto 1103 Paulsen, covered with a plastic sheet to advance ripening and managed with two soil systems in the Puglia region, South-eastern Italy in 2015 and 2016. The two systems differed for the soil management since in one area of the vineyard a cover crop was used (Trifolium repens L.), whereas in the other area only soil tillage was adopted. The data of the two seasons include: (a) mass of leaves of primary shoot, secondary shoot and opposite the cluster; (b) length of secondary shoots; (c) number of both secondary shoots and leaves of secondary shoots; (d) SPAD values and area of leaves opposite both first and second cluster on the primary shoot; (e) mass of stems of both primary and secondary shoots; and (f) some physiological parameters (Ψstem, temperature, Fv/Fm). The data in this article support and augment information presented in the research article 'Cover crops in the inter-row of a table grape vineyard managed with irrigation sensors: effects on yield, quality and glutamine synthetase activity in leaves' (Sci. Hortic. 281, 2021 https://doi.org/10.1016/j.scienta.2021.109963).

Effect of Soil Management and Training System on Negroamaro Wine Aroma.

This study aimed to assess the impact of two soil managements and training systems on yield and wine aroma compounds of Negroamaro variety grown in a warm climate region (southern Italy). Cover crop (CC) and soil tillage (ST) as soil management, whilst bilateral Guyot (BG) and monolateral Guyot (MG) as training systems were compared. Free and bound volatile fractions were evaluated by GC-MS. ST and CC as well as BG and MG significantly affected yield parameters. In particular, yield was higher in ST and BG than in CC and MG, respectively; moreover, it was found to be positively influenced by interaction between BG and ST. Regarding aroma compounds, significant interactions between soil management and training system factors were observed. In case of free volatiles, the most positive interaction was found between BG and ST, whereas, for bound volatiles, the best interaction was represented by MG with both soil tillage and cover crop. Vine leaf area and development over vine growth stages along with water stress levels played an important role in determining the aroma profile as well as yield parameters. In conclusion, the training system significantly interacted with soil management and affected most of important aroma compounds in Negroamaro wine.

Mechanical Response and Analysis of Cracking Process in Hybrid TRM Composites with Flax Textile and Curauá Fibres.

In recent years, the use of plant fibres in Textile-Reinforced Mortar (TRM) composites emerged as a valuable solution to increase their sustainability. Several studies carried out to mechanically characterize the so-called Natural TRMs, although showing promising results, also emphasised some drawbacks due to a severe deformability of the system and to durability issues. This study aims at improving the mechanical behaviour of Natural TRMs including impregnated flax textile (Flax TRMs) by the addition of short curauá fibres within the matrix. Flax TRM specimens were tested in tension to assess the influence of the fibre-reinforced mortar on the composite response. The crack pattern developed during the test was investigated via Digital Image Correlation analysis and by means of an analytical simplified model proposed by the authors. The addition of curauá fibres resulted in a denser crack pattern and in a significant decrease of the mean crack width (around 20%). The overall tensile response of Flax TRMs including curauá fibres resulted closer to the ideal three-linear behaviour of strain-hardening TRM composites with respect to the conventional Flax TRMs by also presenting an increase of dissipated energy of around 45%. This study paves the way for further analysis aimed at enhancing the mechanical performance of Natural TRMs adopting sustainable improvement techniques.

Fruit Development in Ficus carica L.: Morphological and Genetic Approaches to Fig Buds for an Evolution From Monoecy Toward Dioecy.

The mechanism behind the bud evolution towards breba or main crop in Ficus carica L. is uncertain. Anatomical and genetic studies may put a light on the possible similarities/differences between the two types of fruits. For this reason, we collected complimentary data from anatomical, X-ray imaging, and genetic techniques. The RNA seq together with structural genome annotation allowed the prediction of 34,629 known genes and 938 novel protein-coding genes. Transcriptome analysis of genes during bud differentiation revealed differentially expressed genes in two fig varieties (Dottato and Petrelli) and in breba and main crop. We chose Dottato and Petrelli because the first variety does not require pollination to set main crop and the latter does; moreover, Petrelli yields many brebas whereas Dottato few. Of the 1,615 and 1,904 loci expressed in Dottato and Petrelli, specifically in breba or main crop, respectively, only 256 genes appeared to be transcripts in both varieties. The buds of the two fig varieties were observed under optical microscope and using 3D X-ray tomography, highlighting differences mainly related to the stage of development. The X-ray images of buds showed a great structural similarity between breba and main crop during the initial stages of development. Analysis at the microscope indicated that inflorescence differentiation of breba was split in two seasons whereas that of main crop started at the end of winter of season 2 and was completed within 2 to 3 months. The higher expression of floral homeotic protein AGAMOUS in breba with respect to main crop, since this protein is required for normal development of stamens and carpels in the flower, may indicate an original role of these fruits for staminate flowers production for pollination of the main crop, as profichi in the caprifig. Several genes related to auxin (auxin efflux carrier, auxin response factor, auxin binding protein, auxin responsive protein) and to GA synthesis (GA20ox) were highly expressed in brebas with respect to main crop for the development of this parthenocarpic fruit.