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X-ray spectral modeling is a powerful tool for studying the immediate environment of accreting objects, including supermassive black holes. Several models, either phenomenological or physically driven, have been developed over the past decade to study X-ray spectra, delivering important insights into the properties of circumnuclear material of active galactic nuclei. Despite the fact that these models are able to reproduce the data well, they often lack realistic geometries and most of them consist of simplified configurations such as a slab or a torus. We use the ray-tracing code RefleX to generate new spectral models that cover a wide energy range in the X-ray band, adopting a realistic configuration for the surrounding material. We introduce two new table models that are publicly available: (1) the RXToPo model, which features an X-ray source along with a dusty torus and a polar hollow cone; and (2) the RXagn1 model, which also includes, besides the torus and polar cone, the accretion disk and the broad line region. Both models were applied to the X-ray spectrum of NGC 424, demonstrating their potential to study sources whose X-ray emission is dominated by reprocessed radiation.

Introduction Invasive aspergillosis (IA) is a fungal infection that particularly affects immunocompromised hosts. Recently, several studies have indicated a high incidence of IA in intensive care unit (ICU) patients. However, few data are available on the epidemiology and outcome of patients with IA in this setting. Methods An observational study including all patients with a positive Aspergillus culture during ICU stay was performed in 30 ICUs in 8 countries. Cases were classified as proven IA, putative IA or Aspergillus colonization according to recently validated criteria. Demographic, microbiologic and diagnostic data were collected. Outcome was recorded 12 weeks after Aspergillus isolation. Results A total of 563 patients were included, of whom 266 were colonized (47%), 203 had putative IA (36%) and 94 had proven IA (17%). The lung was the most frequent site of infection (94%), and Aspergillus fumigatus the most commonly isolated species (92%). Patients with IA had higher incidences of cancer and organ transplantation than those with colonization. Compared with other patients, they were more frequently diagnosed with sepsis on ICU admission and more frequently received vasopressors and renal replacement therapy (RRT) during the ICU stay. Mortality was 38% among colonized patients, 67% in those with putative IA and 79% in those with proven IA ( P  < 0.001). Independent risk factors for death among patients with IA included older age, history of bone marrow transplantation, and mechanical ventilation, RRT and higher Sequential Organ Failure Assessment score at diagnosis. Conclusions IA among critically ill patients is associated with high mortality. Patients diagnosed with proven or putative IA had greater severity of illness and more frequently needed organ support than those with Aspergillus spp colonization.

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.

Mosquitoes, the major vectors of viruses like dengue, are naturally host to diverse microorganisms, which play an important role in their development, fecundity, immunity, and vector competence. The composition of their microbiota is strongly influenced by the environment, particularly their aquatic larval habitat. In this study, we used 2×300 bp 16s Illumina sequencing to compare the microbial profiles of emerging adult Aedes aegypti mosquitoes and the water collected from common types of aquatic habitat containers in Puerto Rico, which has endemic dengue transmission. We sequenced 141 mosquito and 46 water samples collected from plastic containers, septic tanks, discarded tires, underground trash cans, tree holes, or water meters. We identified 9 bacterial genera that were highly prevalent in the mosquito microbiome, and 77 for the microbiome of the aquatic habitat. The most abundant mosquito-associated bacterial OTUs were from the families Burkholderiaceae, Pseudomonadaceae, Comamonadaceae, and Xanthomonadaceae. Microbial profiles varied greatly between mosquitoes, and there were few major differences explained by container type; however, the microbiome of mosquitoes from plastic containers was more diverse and contained more unique taxa than the other groups. Container water was significantly more diverse than mosquitoes, and our data suggest that mosquitoes filter out many bacteria, with Alphaproteobacteria in particular being far more abundant in water. These findings provide novel insight into the microbiome of mosquitoes in the region and provide a platform to improve our understanding of the fundamental mosquito-microbe interactions.

Background Currently, no suitable clinical marker for detection of septic immunosuppression is available. We aimed at identifying microRNAs that could serve as biomarkers of T-cell mediated immunoparalysis in sepsis. Methods RNA was isolated from purified T-cells or from whole blood cells obtained from septic patients and healthy volunteers. Differentially regulated miRNAs were identified by miRNA Microarray ( n  = 7). Validation was performed via qPCR ( n  = 31). Results T-cells of septic patients revealed characteristics of immunosuppression: Pro-inflammatory miR-150 and miR-342 were downregulated, whereas anti-inflammatory miR-15a, miR-16, miR-93, miR-143, miR-223 and miR-424 were upregulated. Assessment of T-cell effector status showed significantly reduced mRNA-levels of IL2, IL7R and ICOS, and increased levels of IL4, IL10 and TGF-β. The individual extent of immunosuppression differed markedly. MicroRNA-143, − 150 and − 223 independently indicated T-cell immunoparalysis and significantly correlated with patient’s IL7R-/ICOS-expression and SOFA-scores. In whole blood, composed of innate and adaptive immune cells, both traits of immunosuppression and hyperinflammation were detected. Importantly, miR-143 and miR-150 – both predominantly expressed in T-cells – retained strong power of discrimination also in whole blood samples. Conclusions These findings suggest miR-143 and miR-150 as promising markers for detection of T-cell immunosuppression in whole blood and may help to develop new approaches for miRNA-based diagnostic in sepsis.

The objective of this work was to optimize and comparatively evaluate the potential benefit of pulsed electric fields (PEF) and high pressure processing (HPP) processes on the yield, quality, and oxidative stability of olive oil. Olive paste was subjected to various PEF (0.5–2.0 kV/cm, 0–2500 pulses) or HPP (100–600 MPa, 0–30 min) pretreatments, followed by malaxation (15–30 °C, 0–60 min). The effect on olive oil yield and phenolic content was studied as a function of the malaxation temperature and time and HPP and PEF pretreatment conditions. The response surface methodology was applied for selecting optimum PEF- and HPP-assisted malaxation conditions. Quality, bioactive compounds, oxidative stability, and sensory evaluation of olive oils produced at optimal conditions (PEF: 1.5 kV/cm, 100 pulses; HPP: 600 MPa, 5 min; malaxation at 26 °C, 35 min) were compared to ones obtained conventionally (no pretreatment malaxation: 30 °C, 45 min). PEF and HPP pretreatments led to an increase in olive oil yield by 10.6 and 9.3%, respectively, compared to control. Pretreated olive oils had increased oxidative stability attributed to enhanced extraction of polyphenols and a-tocopherols. The combination of each pretreatment with low malaxation temperature led to improved sensorial characteristic of the olive oil.

Purpose Risk factors for β-lactam antibiotic underdosing in critically ill patients have not been described in large-scale studies. The objective of this study was to describe pharmacokinetic/pharmacodynamic (PK/PD) target non-attainment envisioning empirical dosing in critically ill patients and considering a worst-case scenario as well as to identify patient characteristics that are associated with target non-attainment. Methods This analysis uses data from the DALI study, a prospective, multi-centre pharmacokinetic point-prevalence study. For this analysis, we assumed that these were the concentrations that would be reached during empirical dosing, and calculated target attainment using a hypothetical target minimum inhibitory concentration (MIC), namely the susceptibility breakpoint of the least susceptible organism for which that antibiotic is commonly used. PK/PD targets were free drug concentration maintained above the MIC of the suspected pathogen for at least 50 % and 100 % of the dosing interval respectively (50 % and 100 % f T >MIC ). Multivariable analysis was performed to identify factors associated with inadequate antibiotic exposure. Results A total of 343 critically ill patients receiving eight different β-lactam antibiotics were included. The median (interquartile range) age was 60 (47–73) years, APACHE II score was 18 (13–24). In the hypothetical situation of empirical dosing, antibiotic concentrations remained below the MIC during 50 % and 100 % of the dosing interval in 66 (19.2 %) and 142 (41.4 %) patients respectively. The use of intermittent infusion was significantly associated with increased risk of non-attainment for both targets; creatinine clearance was independently associated with not reaching the 100 % f T >MIC target. Conclusions This study found that—in empirical dosing and considering a worst-case scenario—19 % and 41 % of the patients would not achieve antibiotic concentrations above the MIC during 50 % and 100 % of the dosing interval. The use of intermittent infusion (compared to extended and continuous infusion) was the main determinant of non-attainment for both targets; increasing creatinine clearance was also associated with not attaining concentrations above the MIC for the whole dosing interval. In the light of this study from 68 ICUs across ten countries, we believe current empiric dosing recommendations for ICU patients are inadequate to effectively cover a broad range of susceptible organisms and need to be reconsidered.

The objective of this work was to evaluate the potential of Pulsed Electric Field application on the enhancement of air-drying and frying kinetics of zucchini in terms of quality of final zucchini products. PEF-caused electroporation could enhance drying process, facilitating moisture removal with reduced energy consumption, or soften the surface, leading to fried products with reduced oil content. Fresh whole zucchinis ( Cucurbita pepo ) were PEF treated at 0.5–1.5 kV cm −1 electric field strength for up to 0.5 s, achieving a cell disintegration index in the range of 0.12 to 0.77 (0.5–110 kJ kg −1 ). Drying experiments of zucchini slices were carried out at mild drying temperatures 40–70 °C. The moisture diffusion coefficients D eff of all studied samples were compared. Deep frying of untreated and PEF treated (1.5 kV cm −1 , 500 pulses, Z equal to 0.6, PEF energy input 8.2 kJ kg −1 ) zucchini slices was carried out at temperatures 150–170 °C for 0–12 min. Water loss, oil uptake and browning index were determined for all studied samples. The obtained results indicate a potential benefit of PEF on drying rates of zucchini tissues. At low drying temperatures, PEF treated samples increased the effective moisture diffusivity D eff up to 35%, reducing the corresponding drying time up to 25 min and leading to energy savings of 169 MJ kg −1 compared to the untreated sample. In addition, PEF treatment led to final fried zucchinis with reduced oil content up to 36% compared to untreated samples while maintaining the same levels of desirable brown color.

Aspergillus fumigatus is commonly found in cystic fibrosis (CF) airways. Our aim was to assess the relationship between A. fumigatus chronic colonization and lung function in CF patients. A case–control study of CF patients born from 1989 to 2002 was performed. Medical records were reviewed from the time of initial diagnosis until December 2013. Chronic colonization was defined as two or more positive sputum cultures in a given year. Each patient chronically colonized with A. fumigatus was matched with three control patients (never colonized by A. fumigatus ) for age, sex, and year of birth (±3 years). A number of parameters were recorded and analyzed prospectively. The primary outcome measure was the difference in forced expiratory volume in 1 s (FEV 1 ) in percent predicted between groups. Linear mixed models were used for longitudinal analyses to evaluate the relationship between A. fumigatus chronic colonization and lung function during a 7-year period and study the lung function 4 years before the time of enrollment (t 0 ). Twenty patients had chronic colonization and were matched with 60 controls. A significant difference in lung function was detected throughout the 7-year period after adjustment for confounders (est = 8.66, p  = 0.020). Four years before t 0 , FEV 1 baseline was the only factor associated with the course of lung function (est = 0.64, p  < 0.001) and was significantly different between groups ( p  = 0.001). In conclusion, a decreased FEV 1 baseline appears to be a risk factor for chronic colonization by A. fumigatus , which, in turn, may cause a faster deterioration of lung function.