Variability of neurally-adjusted ventilatory assist (nava) compared to pressure support ventilation (psv) during the weaning phase of mechanical ventilation.

Rationale: NAVA is an assisted ventilatory mode that uses the electrical activity of the diaphragm (Edi) to trigger and cycle the ventilator, and to offer inspiratory assistance in proportion to patient effort. Since Edi varies from breath to breath, airway pressure and tidal volume also vary according to the patient's breathing pattern. Our objective was to compare the variability of NAVA with PSV in mechanically ventilated patients during the weaning phase. Methods: We analyzed the data collected for a clinical trial that compares PSV and NAVA during spontaneous breathing trials using PSV, with PS of 5 cmH2O, and NAVA, with Nava level titrated to generate a peak airway pressure equivalent to PSV of 5 cmH2O (NCT01137271). We captured flow, airway pressure and Edi at 100Hz from the ventilator using a dedicated software (Servo Tracker v2, Maquet, Sweden), and processed the cycles using a MatLab (Mathworks, USA) code. The code automatically detects the tidal volume (Vt), respiratory rate (RR), Edi and Airway pressure (Paw) on a breath-by-breath basis for each ventilatory mode. We also calculated the coefficient of variation (standard deviation, SD, divided by the mean). Results: We analyzed data from eleven patients. The mean Vt was similar on both modes (370 ±70 for Nava and 347± 77 for PSV), the RR was 26±6 for Nava and 26±7 or PSV. Paw was higher for Nava than for PSV (14±1 vs 11±0.4, p=0.0033), and Edi was similar for both modes (12±8 for Nava and 11±6 for PSV). The variability of the respiratory pattern, assessed with the coefficient of variation, was larger for Nava than for PSV for the Vt ( 23%±1% vs 15%±1%, p=0.03) and Paw (17%±1% vs 1% ±0.1%, p=0.0033), but not for RR (21% ±1% vs 16% ±8%, p=0.050) or Edi (33%±14% vs 39% ±16%,p=0.07). Conclusion: The variability of the breathing pattern is high during spontaneous breathing trials independent of the ventilatory mode. This variability results in variability of airway pressure and tidal volume, which are higher on Nava than on PSV. Our results suggest that Nava better reflects the normal variability of the breathing pattern during assisted mechanical ventilation.

3C 273 variability at 7 mm: evidence of shocks and precession in the jet

We report on four years of observations of 3C 273 at 7mm obtained with the Itapetinga radio telescope, in Brazil, between 2009 and 2013. We detected a flare in 2010 March, when the flux density increased by 50 per cent and reached 35 Jy. After the flare, the flux density started to decrease and reached values lower than 10 Jy. We suggest that the 7-mm flare is the radio counterpart of the γ -ray flare observed by the Fermi Large Area Telescope in 2009 September, in which the flux density at high energies reached a factor of 50 of its average value. A delay of 170 d between the radio and γ -ray flares was revealed using the discrete correlation function (DCF) that can be interpreted in the context of a shock model, in which each flare corresponds to the formation of a compact superluminal component that expands and becomes optically thin at radio frequencies at latter epochs. The differences in flare intensity between frequencies and at different times are explained as a consequence of an increase in the Doppler factor δ, as predicted by the 16-yr precession model proposed by Abraham & Romero. This increase has a large effect on boosting at high frequencies while it does not affect the observed optically thick radio emission too much. We discuss other observable effects of the variation in δ, such as the increase in the formation rate of superluminal components, the variations in the time delay between flares and the periodic behaviour of the radio light curve that we have found to be compatible with changes in the Doppler factor.

Horizontal distribution of invertebrate larvae around the oceanic island of Gran Canaria: the effect of mesoscale variability

In October 1991, the horizontal distribution of invertebrate larvae was studied in the waters surrounding the island of Gran Canaria (Canary Islands). The cruise was typified by the presence of three recurrent mesoscale hydrographic structures: a cyclonic eddy southwest of the island, a warm lee region downstream of the island and the offshore boundary of an upwelling filament from the African coast reaching the southeast of the island. Decapod larvae were the most abundant group. In general, a rather high spatial variability was found. The horizontal distribution of the invertebrate larvae groups showed that the highest values of abundance occurred in an elongated zone around the island oriented in the overall direction of flow, leeward and windward of the island, while the lowest values occurred off the eastern and western flanks of the islands. On the other hand, Stomatopoda and Mollusca larvae showed a distribution associated with the boundary of the upwelling filament and decapod larvae of pelagic species were distributed around the eddy structure. Our results suggest specific retention mechanisms for the larvae of neritic invertebrate populations that are related to the particular physical oceanography around Gran Canaria. Se estudió la distribución horizontal de las larvas de invertebrados alrededor de la isla de Gran Canaria (Islas Canarias) en octubre de 1991. La campaña se caracterizó por la presencia de tres fenómenos oceanográficos de mesoescala recurrentes: un remolino ciclónico al suroeste de la isla, la estela cálida a sotavento de la misma y el borde de un filamento proveniente del afloramiento africano situado al sureste de Gran Canaria. Las larvas de crustáceos decápodos fueron las más abundantes. En general, las larvas de los diferentes taxa estudiados mostraron una gran variabilidad en cuanto a su distribución espacial. La distribución horizontal de las larvas de los diferentes grupos de invertebrados mostró que las densidades más altas se registraban alrededor de la isla en la banda cercana y orientada hacia el suroeste, en la dirección del flujo, mientras que los valores más bajos se encontraron en el norte y en los flancos este y oeste de la isla. Por otro lado, las larvas de estomatópodos y moluscos presentaron una distribución asociada al frente del filamento, mientras que las larvas de decápodos pelágicos se distribuyeron en torno al remolino ciclónico. Los resultados obtenidos sugieren la existencia de mecanismos de retención específicos para el mantenimiento de las poblaciones insulares, relacionados con los procesos físicos de mesoescala predominantes