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Highlights: [•] A biofilter filled with wood chips was tested to treat NH3 emissions of piggery air. [•] Biofiltration was suitable for NH3 treatment of piggery air. [•] A significant part of the inlet NH3 was converted into N2O. [•] Maximal N2O production was around 1g N2O–Nm−3 packed-bed h−1. [•] No correlation between NH3 removal and N2O generation could be found. [ABSTRACT FROM AUTHOR]

An aboveground pilot-scale biofilter filled with wood chips was tested to treat ammonia emissions from a piggery located in Brittany (France). Two long-term tests (“summer” and “autumn” experiments) were carried out to improve biofilter applications for agriculture. The influence of climatic conditions on biofilter performance was taken into account. During summer 2012, the biofilter was operated for 74 days at different empty bed residence times (EBRTs) from 6 to 15 s. Inlet NH3 concentrations were relatively constant (around 15 mg m−3). Significant NH3 reductions were achieved at EBRT = 12 s (removal efficiencies, RE, ranged between 90 and 100% for loading rates, LR, of around 4 g m−3 h−1). At a lower EBRT (6 s), RE dropped to roughly 30–50%. This was due to the dramatic increase in the loading rate (LR up to 12 g m−3 h−1) but the results showed that the change in atmospheric conditions (temperature and relative humidity) also had a significant influence on biofilter performance. It was evidenced that the use of a humidifier upstream of the biofilter must be taken into account for large-scale biofilter design, but only for specific conditions (the spraying of the biofilter having to be carried out exceptionally). During autumn 2012, the biofilter was operated for 116 days at EBRT = 12 s. RE were around 80% for LR of around 3 g m−3 h−1. In such autumnal atmospheric conditions, a demister system should be installed upstream of the biofilter in order to avoid water accumulation in the bed material. Although biofiltration was suitable for NH3 treatment of piggery air, the need to control accurately the medium moisture content implies that biofilters would not be easily managed by a pig farmer. [Copyright &y& Elsevier]

Background: Gastric tube insertion is necessary to support early enteral feeding of newborns during their neonatal intensive care stay. This frequent and invasive procedure is known to be painful. Very few analgesic techniques (sweet solutions, sucking, swaddling, and skin-to-skin contact) are available to reduce the pain caused by orogastric tube insertion procedure. Objective: To determine whether a new orogastric tube insertion technique modifies the pain response in newborns, we hypothesize that inserting an orogastric tube through the nipple of a bottle reduces pain caused by this procedure., Design: Prospective, controlled, randomized, multicentered and open label study., Settings: Three neonatal intensive care units in France (2 level 3 units and 1 level 2B)., Participants: Full-term or premature newborns at 32 weeks of gestation or more, postnatal age between 48 hours and 21 days, not ventilated and requiring enteral feeding, were randomized into 2 groups: usual technique ( n = 36) and experimental technique ( n = 35)., Methods: Our experimental technique was to insert the orogastric tube through a modified nipple of a bottle. This method was compared with the usual technique of inserting the tube directly into the newborn's mouth without a support to guide it accompanied by a nipple encouraging sucking with a nonnutritive solution. An association of nonnutritive sucking and orally administered 30% glucose was given to all children for analgesic purposes. Pain during the orogastric tube insertion was assessed on video recordings by 2 independent experts, using a heteroassessment behavioral scale for pain (DAN- Douleur Aiguë du Nouveau-né ; APN-Acute Pain in Newborns). The primary outcome was an Acute Pain in Newborns score of less than 3 at the time of the procedure. Comparisons were made using Fisher exact test or Mann-Whitney U test. Factors associated with an Acute Pain in Newborns score of 3 and greater were explored using univariable and multivariable regression models., Results: All but 1 video recording in each group were analyzed. Among the 34 neonates in the experimental group, 71.4% (95% CI: [53.7-85.4]) had an Acute Pain in Newborns score of less than 3 during orogastric tube insertion versus 41% (95% CI: [27.9-61.9]) in the control group ( P = .031). Gagging was frequent and nonsignificantly different between the 2 groups (69% in the control group, 51% in the experimental group, P = .13). In multivariable analysis, the experimental technique was an independent factor of pain prevention compared with the usual technique (odds ratio = 0.21 [0.06-0.71], P = .015)., Conclusions: This study suggests that a simple, inexpensive, and feasible technique of orogastric tube insertion through the nipple of a bottle limits pain associated with this procedure in newborns., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Aim: To describe a cohort of pregnant women having suffered an out-of-hospital cardiac arrest (OHCA) and to compare them with nonpregnant women of childbearing age having suffered OHCA., Methods: Study data were extracted from the French National OHCA Registry between 2011 and 2021. We compared patients in terms of characteristics, care and survival., Results: We included 3,645 women of childbearing age (15-44) who had suffered an OHCA; 55 of the women were pregnant. Pregnant women were younger than nonpregnant victims (30 vs. 35 years, p = 0.006) and were more likely to have a medical history (76.4% vs. 50.5%, p < 0.001) and a medical cause of the OHCA (85.5% vs. 57.2%, p < 0.001). Advanced Life Support was more frequently administered to pregnant women (98.2%, vs. 72.0%; p < 0.001). In pregnant women, the median time of MICU arrival was 20 minutes for the Medical Intensive Care Unit with no difference with nonpregnant women. Survival rate on admission to hospital was higher among pregnant women (43.6% vs. 27.3%; p = 0.009). There was no difference in 30-day survival between pregnant and nonpregnant groups (14.5% vs. 7.3%; p = 0.061). Fetal survival was only observed for OHCAs that occurred during the pregnancy second or third trimester (survival rates: 10.0% and 23.5%, respectively)., Conclusions: Our results show that resuscitation performance does not meet European Resuscitation Council's specific guidelines on OHCA in pregnant women. Although OHCA in pregnancy is rare, the associated prognosis is poor for both woman and fetus. Preventive measures should be reinforced, especially when pregnant women have medical history., Competing Interests: Conflict of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Introduction: Hypothermia is common in trauma patients. It contributes to increasing mortality rate. Hypothermia is multifactorial, favoured by exposure to cold, severity of the patient's state and interventions such as infusion of fluids at room temperature., Aim: To demonstrate that specific management of hypothermia (or of the risk of hypothermia) increases the number of trauma patients arriving at the hospital with a temperature >35°C., Design: This is a prospective, multicentre, open-label, pragmatic, cluster randomized clinical trial of an expected 1,200 trauma patients included by 12 out-of-hospital mobile intensive care units (MICU). Trauma patients are included in a prehospital setting if they present at least one of the following criteria known to be associated with an increased incidence of hypothermia: ambient temperature <18°C, Glasgow coma scale <15, systolic arterial blood pressure <100 mm Hg or body temperature <35°C. Patients are randomized, by cluster, to receive a conventional management or 'interventional' nursing management associating: continuous epitympanic temperature monitoring, early installation in the heated ambulance (temperature target >30°C controlled by infrared thermometer), protection by a survival blanket, and use of heated solutes (temperature objective >35°C controlled by infrared thermometer). The primary end point is the prevalence of hypothermia on arrival at the hospital. The hypothesis tested is a reduction from 20% to 13% in the prevalence of hypothermia. Secondary end points are to evaluate the interaction between the effectiveness of the measures taken and: (1) the severity of the patients assessed by the Revised Trauma Score; (2) the meteorological conditions when they are managed; (3) the time of care; and (4) therapeutic interventions., Discussion: This trial will assess the effectiveness of an invasive, out-of-hospital, temperature management on the onset of hypothermia in moderate to severe trauma patients., Impact: Specific management of hypothermia is expected to decrease hypothermia in trauma patients., (© 2021 John Wiley & Sons Ltd.)

Rationale, Aims and Objectives: Care quality is a primary concern in health field. In France, the care practice report card (CPRC) is compulsory for practitioners. It is the first step towards the culture of excellence. In this context, practitioners have to assess and improve their practices. Competent authorities define registries as reliable sources for CPRC. The first aim of this work is to describe how we designed and built a universally transposable CPRC model based on an Utstein-style cardiac arrest registry. The second aim is to measure the adherence of practitioners to this approach and to show how such a tool can be used in real situation., Methods: Our report card is adapted from in-hospital CA care quality and safety indicators. We built a 2-section grid. The first part described the quality and completeness of the analysed data. The second part distinguished medical and traumatic CA and assesses care practices. We analysed the practitioners' adherence thanks to a satisfaction survey. Finally, we presented a CPRC case study., Results: This tool was tested in 92 centres gathering 8433 patients. The satisfaction survey showed that this CPRC was well accepted by emergency professionals. We presented an implementation example of this tool in a centre in real-life situation., Conclusions: We designed and implemented a fully automated CPRC tool routinely usable for Utstein-style CA registries. This CPRC is easily transferable in all other Utstein CA registries. The debriefing report source codes are freely distributed upon request. This tool enables the care assessment and improvement., (© 2018 John Wiley & Sons, Ltd.)

Three to 6 months after an acute coronary syndrome (ACS), cognitive impairment is observed in more than 30 % of the patients, mainly in executive functioning. The aim of this study was to investigate, using multimodal MRI, cerebral anatomo-functional substratum of executive dysfunction. Thirty-three patients were recruited 4 ± 1 months after a first ACS. Executive functions were evaluated with the Trail-Making-Test-B (TMTB) at baseline (ie 4 ± 1 months after ACS) and 6 months later (ie 10 ± 1 months after ACS). Using both time-points, we identified 3 groups of patients according to normative data based on age, gender and education level: 15 'cognitively normal' patients without impairment at each follow-up, 10 'transient impaired' patients with an impairment only at baseline and 8 'impairing' patients with an impairment only at follow-up. We explored, in the whole-brain, the structural integrity using Voxel-Based Morphometry and Tract-Based Spatial Statistics and the resting-state functional connectivity using Network-Based Statistics. No structural difference was observed between impaired and cognitively normal patients. At the functional level, compared to the 'cognitively normal' group, the 'transient impaired' patients presented an increased functional connectivity in a network centered on middle-orbito-frontal regions, whereas the 'impairing' patients presented only a non-significant decrease of functional connectivity. Executive dysfunction in ACS patients is associated to functional but no structural characteristics, particularly to an increased functional connectivity in cognitive networks in transient impaired patients. Further studies with larger sample size are needed to confirm these results and to determine if these patients could be at higher risk for developing permanent cognitive disorders.

Objective: Preparation of drug solutions used with electronic syringe infusion pumps plays a crucial role in the delivery of an accurate drug concentration. Is there a correlation between drug concentrations during syringe pump infusion and preparation protocols?, Method: Norepinephrine, insulin, and sufentanil were prepared in 3 different ways: (1) the drug was taken from the vial, then the solvent was added followed by an air bubble, and mixing was performed by turning the syringe top-to-bottom in a 180° shaking movement 5 consecutive times; (2) the drug was taken from the vial, then the solvent was added and not mixed; and (3) the solvent was taken from a stock solution, then the drug was added and not mixed. Concentrations of drugs were determined at different times during administration by reverse-phase high-performance liquid chromatography with ultraviolet detection. All analyses were performed in triplicate and were based on measurement of peak areas., Results: With no shaking of the syringe, the concentration of the injected drugs varies widely. In any case, mixing of the syringe contents by turning the syringe in a top-to-bottom 180° shaking movement 5 times with an air bubble would ensure administration of the drug at a constant concentration., Conclusions: Without mixing, the concentrations of all drug solutions varied widely when administered via an electronic syringe infusion pump. Mixing syringe contents should be made part of the compulsory curriculum for administering medications at all levels of medical education. (Critical Care Nurse. 2016;36[4]:36-45)., (©2016 American Association of Critical-Care Nurses.)

This study evaluated a new approach combining magnetic resonance imaging and the experience sampling method in the understanding of post-stroke mood pathophysiology. Findings revealed that emotional cognition after stroke may be related to phenotypic characteristics such as cerebellar volume, thereby suggesting that this combined approach could provide new insights into the pathophysiology of post-stroke mood disorders as well as other forms of comorbidity., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Purpose: To identify patterns of rest functional connectivity (FC) in the whole brain with the default mode network (DMN) soon after stroke and to explore the predictive accuracy of the strength of rest FC in specific areas on poststroke severity of depression and anxiety symptoms., Materials and Methods: The protocol was accepted by the local ethics board, and all patients provided informed consent to participate. Resting-state functional magnetic resonance (MR) images were acquired 10 days after a first stroke in 24 patients without a history of psychiatric illness. Independent component analysis was used to isolate the DMN in each subject. Hamilton Depression Rating Scale (HDRS) 17 and Hamilton Anxiety Rating Scale (HARS) were recorded 10 days and 3 months after the stroke. Associations between severity of anxiety or depression symptoms and DMN functional connectivity were investigated with whole-brain analyses by using statistical parametric mapping software and were adjusted for age, sex, manual laterality, and National Institutes of Health Stroke Severity scores. Correlations were considered significant if P<.001, with a cluster size of more than 50 voxels., Results: Ten days after stroke, anxiety severity was correlated with functional connectivity in the middle temporal cortex and the anterior midcingulate cortex, while at 3 months after stroke, a correlation was observed with the middle temporal cortex and the posterior cingulate cortex. Poststroke depressive symptom severity did not correlate with functional connectivity changes at 10-day follow-up, while the HDRS 17 score was correlated with functional connectivity in the left middle temporal cortex and precuneus at 3-month follow-up., Conclusion: These results suggest that a dysfunction of DMN functional connectivity involved in emotional control is associated with the severity of poststroke depression. Further studies are necessary to determine the mechanisms of this functional impairment., (© RSNA, 2012.)

Background: Despite the high prevalence and impact of post-stroke depression (PSD), questions persist concerning the nature and stability of PSD over time. The current study uses state-of-the-art computerized ambulatory monitoring techniques to assess daily life depression symptoms following stroke and examines the evolution of depression levels over a three-month period., Methods: 48 patients admitted to a university hospital neurology unit for ischemic or hemorrhagic stroke participated in ambulatory monitoring of DSM-IV depression symptoms for a one-week period after hospital discharge. Clinician-administered measures of depression were also obtained at discharge and again three months later., Results: The percentage of the sample with elevated depression scores was the same at discharge and three months later, but consistency in depression profiles was low. Ambulatory monitoring revealed that elevated depression levels at hospital discharge were most strongly associated with anhedonia (t ratio = 4.840, p < 0.001) and fatigue (t ratio = 4.00, p < 0.001), whereas individuals with elevated scores at three months were predicted by daily life negative thoughts (t ratio = 4.051, p < 0.001), anxious mood (t ratio = 3.489, p < 0.01), sad mood (t ratio = 2.621, p < 0.05) and emotional reactivity (t ratio = 2.466, p < 0.05)., Conclusions: The prevalence of depression may appear stable during the immediate weeks and months following stroke, but it is likely to be composed of very different symptom profiles. The immediate physical and psychological impact of stroke may induce somatic symptoms that explain elevated depression levels and which may not indicate a risk factor for later depression., (Copyright © 2012 S. Karger AG, Basel.)

We tested single APP (Tg2576) transgenic, PS1 (PS1dE9) transgenic, and double APP/PS1 transgenic mice at 3 and 6 months of age on the acquisition of a hippocampal-dependent operant "differential reinforcement of low rate schedule" (DRL) paradigm. In this task mice are required to wait for at least 10 seconds (DRL-10s) between 2 consecutive nose poke responses. Our data showed that while single APP and PS1 transgene expression did not affect DRL learning and performance, mice expressing double APP/PS1 transgenes were impaired in the acquisition of DRL-10s at 6 months, but not at 3 months of age. The same impaired double transgenic mice, however, were perfectly capable of normal acquisition of signaled DRL-10s (SDRL-10s) task, a hippocampal-independent task, wherein mice were required to emit responses when the end of the 10-second delay was signaled by a lighting of the chamber. The age-dependent and early deficits of APP/PS1 mice suggest that the appetitive DRL paradigm is sensitive to the amyloid pathology present in double APP/PS1 mice, and that this mouse line represents a good model with which to study the efficacy of therapeutic strategies against Alzheimer's disease., (Copyright © 2012 Elsevier Inc. All rights reserved.)

A group of 72 children with hearing aids followed in 4 different clinical settings presented progressive increase in sensorineural hearing loss. The mean hearing loss over time, the duration of hearing aid use and the gain were studied to test the hypothesis that continued progression in hearing loss was due to overly powerful amplification. No correlation was found between the progressive increased gain levels were associated with less progression in hearing loss than at lower gain levels. Therefore, the use of hearing aids was not directly and significantly related to the increase in hearing loss in the population studied. However according to the above criteria a few cases (4%) of progressive hearing loss did seem to be associated with hearing aid use.