Background: Neonates and infants requiring anaesthesia are at risk of physiological instability and complications, but triggers for peri-anaesthetic interventions and associations with subsequent outcome are unknown. Methods: This prospective, observational study recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. The primary aim was to identify thresholds of pre-determined physiological variables that triggered a medical intervention. The secondary aims were to evaluate morbidities, mortality at 30 and 90 days, or both, and associations with critical events. Results: Infants (n¼5609) born at mean (standard deviation [SD]) 36.2 (4.4) weeks postmenstrual age (35.7% preterm) underwent 6542 procedures within 63 (48) days of birth. Critical event(s) requiring intervention occurred in 35.2% of cases, mainly hypotension (>30% decrease in blood pressure) or reduced oxygenation (SpO 2 <85%). Postmenstrual age influenced the incidence and thresholds for intervention. Risk of critical events was increased by prior neonatal medical conditions, congenital anomalies, or both (relative risk [RR]¼1.16; 95% confidence interval [CI], 1.04e1.28

The Brazilian power generation sector faces a paradigm change driven by, on one hand, a shift from a hydropower dominated mix and, on the other hand, international goals for reducing greenhouse gas emissions. The objective of this work is to evaluate five scenarios for the Brazilian power sector until 2050 using a multi-criteria decision analysis tool. These scenarios include a baseline trend and low carbon policy scenarios based on carbon taxes and carbon emission limits. To support the applied methodology, a questionnaire was elaborated to integrate the perceptions of experts on the scenario evaluation process. Considering the results from multi-criteria analysis, scenario preference followed the order of increasing share of renewables in the power sector. The preferable option for the future Brazilian power sector is a scenario where wind and biomass have a major contribution. The robustness of the multi-criteria tool applied in this study was tested by a sensitivity analysis. This analysis demonstrated that, regardless of the respondents' preferences and backgrounds, scenarios with higher shares of fossil fuel sources are the least preferable option, while scenarios with major contributions from wind and biomass are the preferable option to supply electricity in Brazil through 2050.

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a b s t r a c tAdsorption equilibrium of fructose, glucose and sucrose was evaluated on sulfonated poly(styrene-codivinylbenzene) cation-exchange resins. Two types of resins were used: potassium (K + ) gel-type and sodium (Na + ) macroporous resins. Influence of the cation and effect of the resin structure on adsorption were studied. The adsorption isotherms were determined by the static method in batch mode for monocomponent and multi-component sugar mixtures, at 25 and 40• C, in a range of concentrations between 5 and 250 g L −1 . All adsorption isotherms were fitted by a linear model in this range of concentrations. Sugars were adsorbed in both resins by the following order: fructose > glucose > sucrose. Sucrose was more adsorbed in the Na + macroporous resin, glucose was identically adsorbed, and fructose was more adsorbed in the K + gel-type resin. Data obtained from the adsorption of multi-component mixtures as compared to the mono-component ones showed a competitive effect on the adsorption at 25• C, and a synergetic effect at 40• C. The temperature increase conducted to a decrease on the adsorption capacity for mono-component sugar mixtures, and to an increase for the multi-component mixtures. Based on the selectivity results, K + gel-type resin seems to be the best choice for the separation of fructose, glucose and sucrose, at 25• C.

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A method for the separation and fractionation of the major whey proteins from a whey protein concentrate (WPC80) by anion-exchange chromatography coupled to a Fast Protein Liquid Chromatography (FPLC) system is proposed. The method is based on the use of an ionic column (Mono Q) and a salt gradient elution by increasing the ionic strength of the elution buffer (Tris-HCl 20 mM plus 0 to 1 M NaCl). The proposed method was found to be suitable to fractionate the major whey proteins from the WPC80 in different fractions, namely one fraction containing all the a-Lactalbumin and immunoglobulins; another fraction containing all the bovine serum albumin; and two distinct fractions each containing a different variant of b-Lactoglobulin. A 60.5% (w/w) recovery of the two main b-Lactoglobulin variants was obtained.

Background: Neonates and infants are susceptible to hypoxaemia in the perioperative period. The aim of this study was to analyse interventions related to anaesthesia tracheal intubations in this European cohort and identify their clinical consequences. Methods: We performed a secondary analysis of tracheal intubations of the European multicentre observational trial (NEonate and Children audiT of Anaesthesia pRactice IN Europe [NECTARINE]) in neonates and small infants with difficult tracheal intubation. The primary endpoint was the incidence of difficult intubation and the related complications. The secondary endpoints were the risk factors for severe hypoxaemia attributed to difficult airway management, and 30 and 90 day outcomes. Results: Tracheal intubation was planned in 4683 procedures. Difficult tracheal intubation, defined as two failed attempts of direct laryngoscopy, occurred in 266 children (271 procedures) with an incidence (95% confidence interval [CI]) of 5.8% (95% CI, 5.1e6.5). Bradycardia occurred in 8% of the cases with difficult intubation, whereas a significant decrease in oxygen saturation (SpO 2 <90% for 60 s) was reported in 40%. No associated risk factors could be identified among comorbidities, surgical, or anaesthesia management. Using propensity scoring to adjust for confounders, difficult anaesthesia tracheal intubation did not lead to an increase in 30 and 90 day morbidity or mortality. Conclusions:The results of the present study demonstrate a high incidence of difficult tracheal intubation in children less than 60 weeks post-conceptual age commonly resulting in severe hypoxaemia. Reassuringly, the morbidity and mortality at 30 and 90 days was not increased by the occurrence of a difficult intubation event. Clinical trial registration: NCT02350348.

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