Background Awake prone positioning (awake-PP) in non-intubated coronavirus disease 2019 (COVID-19) patients could avoid endotracheal intubation, reduce the use of critical care resources, and improve survival. We aimed to examine whether the combination of high-flow nasal oxygen therapy (HFNO) with awake-PP prevents the need for intubation when compared to HFNO alone. Methods Prospective, multicenter, adjusted observational cohort study in consecutive COVID-19 patients with acute respiratory failure (ARF) receiving respiratory support with HFNO from 12 March to 9 June 2020. Patients were classified as HFNO with or without awake-PP. Logistic models were fitted to predict treatment at baseline using the following variables: age, sex, obesity, non-respiratory Sequential Organ Failure Assessment score, APACHE-II, C-reactive protein, days from symptoms onset to HFNO initiation, respiratory rate, and peripheral oxyhemoglobin saturation. We compared data on demographics, vital signs, laboratory markers, need for invasive mechanical ventilation, days to intubation, ICU length of stay, and ICU mortality between HFNO patients with and without awake-PP. Results A total of 1076 patients with COVID-19 ARF were admitted, of which 199 patients received HFNO and were analyzed. Fifty-five (27.6%) were pronated during HFNO; 60 (41%) and 22 (40%) patients from the HFNO and HFNO + awake-PP groups were intubated. The use of awake-PP as an adjunctive therapy to HFNO did not reduce the risk of intubation [RR 0.87 (95% CI 0.53–1.43), p = 0.60]. Patients treated with HFNO + awake-PP showed a trend for delay in intubation compared to HFNO alone [median 1 (interquartile range, IQR 1.0–2.5) vs 2 IQR 1.0–3.0] days (p = 0.055), but awake-PP did not affect 28-day mortality [RR 1.04 (95% CI 0.40–2.72), p = 0.92]. Conclusion In patients with COVID-19 ARF treated with HFNO, the use of awake-PP did not reduce the need for intubation or affect mortality.

Standardised MDR-TB regimens may be effective at the national level, even in resource-poor settings.

High levels of preoperative and postoperative NT-proBNP are predictors of cardiovascular complications, including all-cause mortality, during the first 30 days after noncardiac surgery in adults with cardiovascular risk factors.

Beans (Phaseolus vulgaris L.) originated on the American continent, specifically in the Mesoamerican zone, and their domestication took place independently in the Mesoamerican area and the Andean zone, giving rise to two well-differentiated genetic pools. It was also noted that the Andean wild populations originated from only a few thousand individuals from the Mesoamerican wild populations, which produced a great bottleneck in the formation of the Andean population. During centuries of cultivation in the Iberian Peninsula after its introduction in the 16th century, beans adapted to new environments, evolving numerous local landraces. Twenty-four local landraces of P. vulgaris from Spain were analyzed in the greenhouse during two consecutive seasons. From each genotype, five plants were grown and characterized for 17 quantitative and 15 qualitative traits using the International Board for Plant Genetic Resources (IBPGR) descriptors. Data were analyzed statistically by analysis of variance (ANOVA), principal component analysis (PCA), and cluster analysis. The results obtained indicate a high variability for most traits, especially those related to the yield and its components. The PCA and cluster analysis separated the landraces according to the color of the seed, the yield, and the pod and seed traits related to yield. Numerous traits exhibited interactions between the genotype and the environment. Most accessions reached higher yields in spring, in which solar radiation favors photosynthesis and, consequently, photoassimilation. The different response to the changing environment of the set of accessions studied in the present work is of great interest, and it can be exploited in breeding cultivars adapted to a broader range of environmental conditions.

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