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For many years IceCube DeepCore has measured atmospheric neutrino interactions in the optically clear, deep ice at the South Pole. Analysing only three years of data has yielded the most precise measurements of the atmospheric neutrino oscillation parameters above 5 GeV. Measuring oscillations at these high energies, well above the tau-production threshold, and over extremely long baselines, provides strong constraints on new, Beyond Standard Model physics in a region of phase space uniquely accessed with atmospheric neutrinos. Here we report on the most recent searches for non-standard atmospheric neutrino oscillations with IceCube DeepCore.

The NEMO-3 and SuperNEMO experiments search for neutrino less double beta decay (0vββ). Detection of 0vββ decay would provide direct evidence that neutrinos are Majorana particles and lepton number is not conserved. In these experiments, the isotopes of interest are separated from the active detector region, allowing for reconstruction of the full event topology. This aids in background suppression and discrimination between underlying 0vββ decay mechanisms. The NEMO-3 experiment investigated a total of seven 0vββ decay isotopes. The SuperNEMO experiment builds upon the design of NEMO-3. Upgrades to the detector technologies and radiopurity, as well as an increase in isotope mass will allow SuperNEMO to improve 0vββ half-life sensitivities by two orders of magnitude. The latest result from NEMO-3 is summarized, and an overview of the progress in the construction of the SuperNEMO demonstrator module is presented.

The interest in research on oral care in intensive care unit (ICU) patients has emerged largely from the 2000s onward after years of being a rather ignored topic in health science. Since, the focus has been on its potential contribution to preventing pneumonia by eliminating contaminated oral pathogens that might invade the lower respiratory tract. Accumulating evidence of the effectiveness of oral care with chlorhexidine gluconate (CHG) in preventing ventilator-associated pneumonia (VAP) or postoperative pneumonia [1, 2] has led to adopting CHG oral care as the gold standard for intubated patients. Recently, however, potential adverse effects of CHG on the oral mucosa [3] and reduced bacterial susceptibility [4] have been reported, as well as an even more alarming potential association of CHG oral care with an increased risk of mortality [5–8]. Although the latter association results from retrospective studies or meta-analyses, righteous calls for caution and for a thorough re-evaluation of the established gold standard have been launched [9, 10].

Purpose The management of peritonitis in critically ill patients is becoming increasingly complex due to their changing characteristics and the growing prevalence of multidrug-resistant (MDR) bacteria. Methods A multidisciplinary panel summarizes the latest advances in the therapeutic management of these critically ill patients. Results Appendicitis, cholecystitis and bowel perforation represent the majority of all community-acquired infections, while most cases of healthcare-associated infections occur following suture leaks and/or bowel perforation. The micro-organisms involved include a spectrum of Gram-positive and Gram-negative bacteria, as well as anaerobes and fungi. Healthcare-associated infections are associated with an increased likelihood of MDR pathogens. The key elements for success are early and optimal source control and adequate surgery and appropriate antibiotic therapy. Drainage, debridement, abdominal cleansing, irrigation, and control of the source of contamination are the major steps to ensure source control. In life-threatening situations, a \"damage control\" approach is the safest way to gain time and achieve stability. The initial empirical antiinfective therapy should be prescribed rapidly and must target all of the micro-organisms likely to be involved, including MDR bacteria and fungi, on the basis of the suspected risk factors. Dosage adjustment needs to be based on pharmacokinetic parameters. Supportive care includes pain management, optimization of ventilation, haemodynamic and fluid monitoring, improvement of renal function, nutrition and anticoagulation. Conclusions The majority of patients with peritonitis develop complications, including worsening of pre-existing organ dysfunction, surgical complications and healthcare-associated infections. The probability of postoperative complications must be taken into account in the decision-making process prior to surgery.

To investigate the relationship between communication and job satisfaction and their association with intention to leave and burnout among intensive care unit nurses. A multicentre questionnaire study. Intensive care nurses (n = 303) from three Flemish hospitals. Communication satisfaction assessed by the Communication Satisfaction Questionnaire, intention to leave through the Turnover Intention Scale (from the Questionnaire for the Perception and Assessment of Labour) and burnout by the Maslach Burnout Inventory. Job satisfaction was measured by a visual analogue scale. Average job satisfaction was 7.66 ± 1.34/10. Nurses were most satisfied about ‘Communication with supervisor’ (68.46%), and most dissatisfied about ‘Organisational perspectives’ (34.12%). Turnover intention was low among 49.5% (150/290) and high among 6.6% (20/290). Three percent (9/299) of intensive care nurses were at risk for burnout. All dimensions of communication satisfaction were moderately associated with job satisfaction, intention to leave and burnout. This study demonstrated high levels of communication and job satisfaction in a sample of nurses in Flanders. Intention to leave and burnout prevalence were low. To a certain extent, communication satisfaction might be associated with job satisfaction, intention to leave and burnout.

The NEMO-3 results for the double- [Formula omitted] decay of [Formula omitted]Nd to the 0 [Formula omitted] and 2 [Formula omitted] excited states of [Formula omitted]Sm are reported. The data recorded during 5.25 year with 36.6 g of the isotope [Formula omitted]Nd are used in the analysis. The signal of the [Formula omitted] transition to the 0 [Formula omitted] excited state is detected with a statistical significance exceeding 5 [Formula omitted]. The half-life is measured to be [Formula omitted] year, which is the most precise value that has been measured to date. 90% confidence-level limits are set for the other decay modes. For the [Formula omitted] decay to the 2 [Formula omitted] level the limit is [Formula omitted]. The limits on the [Formula omitted] decay to the 0 [Formula omitted] and 2 [Formula omitted] levels of [Formula omitted]Sm are significantly improved to [Formula omitted] and [Formula omitted].

[...]although types of supporting surfaces vary widely among geographic regions, within countries and even among ICUs in the same hospital, the one and same report form needed to allow reporting of every type of supporting surface used worldwide. [...]not only for supporting surfaces but for all materials we wanted to collect information about, we had to find then write all-encompassing descriptions that every data collector worldwide could recognise and that allowed them to report the corresponding materials used in the own unit appropriately. [...]after a process of several weeks of intensive searches and correspondence with local centres, 15 May 2018 was set as the international data collection day.Challenge #3. The recruitment resulting from that approach however covered a restricted part of the globe only. [...]our next step consisted of meticulously screening the PubMed database to identify recent publications in the domain of intensive care, then to invite authors from countries where a national representative for the study was still lacking. [...]intended study participation from a number of African countries was prevented by difficulties in obtaining ethical clearance (see below).

The primary aim of this study was to collect national epidemiological data on candidaemia and to determine the reporting time of species identification and antifungal susceptibility in clinical practice. During a 1-year period (March 2013 until February 2014), every first Candida isolate from each episode of candidaemia was included prospectively from 30 Belgian hospitals. Identification and susceptibility testing were performed according to local procedures and isolates were sent to the National Reference Center for Mycosis. Species identification was checked by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS) and internal transcribed spacer (ITS) sequencing in case no reliable identification was obtained by MALDI-TOF MS. Antifungal susceptibility testing was performed according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) methodology. A total of 355 isolates were retrieved from 338 patients. The mean incidence rate of candidaemia was 0.44 (range: 0.07 to 1.43) per 1000 admissions or 0.65 (range: 0.11 to 2.00) per 10,000 patient days. Candida albicans was most frequently found (50.4 %), followed by C. glabrata (27.3 %) and C. parapsilosis sensu lato (9.8 %). The overall resistance to fluconazole was 7.6 %, ranging from 3.9 % in C. albicans to 20.0 % in C. tropicalis . Only one C. glabrata isolate was resistant to the echinocandins. Four days after blood culture positivity, 99.7 % of the identifications and 90.3 % of the antifungal profiles were reported to the treating clinician. Candidaemia incidence rates differed up to 20-fold among Belgian hospitals; no clear factors explaining this difference were identified. The overall antifungal resistance rates were low but high azole resistance rates were recorded in C. tropicalis .

Background. Central venous catheters are universally used during the treatment of critically ill patients. Their use, however, is associated with a substantial infection risk, potentially leading to increased mortality and costs. We evaluate clinical and economic outcomes associated with nosocomial central venous catheter-related bloodstream infection (CR-BSI) in intensive care unit (ICU) patients. Methods. A retrospective (1992–2002), pairwise-matched (ratio of case patients to control subjects, 1:2 or 1:1), risk-adjusted cohort study was performed at a 54-bed general ICU at a university hospital. ICU patients with microbiologically documented CR-BSI (n = 176) were matched with control subjects (n = 315) on the basis of disease severity, diagnostic category, and length of ICU stay (equivalent or longer) before the onset of CR-BSI in the index case patient. Clinical outcome was principally evaluated by in-hospital mortality. Economic outcome was evaluated on the basis of duration of mechanical ventilation, length of ICU and hospital stays, and total hospital costs, as derived from the patient's hospital invoices. Results. The attributable mortality rate for CR-BSI was estimated to be 1.8% (95% confidence interval, -6.4% to 10.0%); in-hospital mortality rates for patients with CR-BSI and matched control subjects were 27.8% and 26.0%, respectively. CR-BSI was associated with significant excesses in duration of mechanical ventilation, duration of ICU and hospital stays, and a significant increase in total hospital cost. Linear regression analysis with adjustment for duration of hospitalization and clinical covariates, revealed that CR-BSI is independently associated with higher costs. Conclusions. In ICU patients, CR-BSI does not result in increased mortality. It is, however, associated with a significant economic burden, emphasizing the importance of continuous efforts in prevention.

Duchenne Muscular Dystrophy (DMD) is a lethal muscle disorder, caused by mutations in the DMD gene and affects approximately 1:5000–6000 male births. In this report, we identified dysregulation of members of the Dlk1-Dio3 miRNA cluster in muscle biopsies of the GRMD dog model. Of these, we selected miR-379 for a detailed investigation because its expression is high in the muscle, and is known to be responsive to glucocorticoid, a class of anti-inflammatory drugs commonly used in DMD patients. Bioinformatics analysis predicts that miR-379 targets EIF4G2, a translational factor, which is involved in the control of mitochondrial metabolic maturation. We confirmed in myoblasts that EIF4G2 is a direct target of miR-379, and identified the DAPIT mitochondrial protein as a translational target of EIF4G2. Knocking down DAPIT in skeletal myotubes resulted in reduced ATP synthesis and myogenic differentiation. We also demonstrated that this pathway is GC-responsive since treating mice with dexamethasone resulted in reduced muscle expression of miR-379 and increased expression of EIF4G2 and DAPIT. Furthermore, miR-379 seric level, which is also elevated in the plasma of DMD patients in comparison with age-matched controls, is reduced by GC treatment. Thus, this newly identified pathway may link GC treatment to a mitochondrial response in DMD.