Background The question of an optimal strategy and outcomes in COVID-19 tracheostomy has not been answered yet. The critical focus in our case study is to evaluate the outcomes of tracheostomy on intubated COVID-19 patients. Methods A multicentric prospective observational study of 1890 COVID-19 patients undergoing tracheostomy across 120 hospitals was conducted over 7 weeks in Spain (March 28 to May 15, 2020). Data were collected with an innovative approach: instant messaging via WhatsApp. Outcome measurements: complications, achieved weaning and decannulation and survival. Results We performed 1,461 surgical (81.3%) and 429 percutaneous tracheostomies. Median timing of tracheostomy was 12 days (4-42 days) since orotracheal intubation. A close follow-up of 1616/1890 (85.5%) patients at the cutoff time of 1-month follow-up showed that in 842 (52.1%) patients, weaning was achieved, while 391 (24.2%) were still under mechanical ventilation and 383 (23.7%) patients had died from COVID-19. Decannulation among those in whom weaning was successful (n = 842) was achieved in 683 (81%) patients. Conclusion To the best of our knowledge, this is the largest cohort of COVID-19 patients undergoing tracheostomy. The critical focus is the unprecedented amount of tracheostomies: 1890 in 7 weeks. Weaning could be achieved in over half of the patients with follow-up. Almost one out of four tracheotomized patients died from COVID-19.

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et al.. Enhanced blackberry production using Pseudomonas fluorescens as elicitor. Agronomy for Sustainable Development, Springer Verlag/EDP Sciences/INRA, 2013, 33 (2), pp.Abstract This report shows for the first time the ability of Pseudomonas fluorescens N21.4 to trigger the secondary metabolism of blackberries, Rubus fruticosus, in the field. Blackberries are an excellent source of bioactive compounds as compared to other marketable berries. Biotic elicitation with plant growth-promoting rhizobacteria has been proposed to improve biomass production and to trigger secondary metabolism. However, most reports that support this statement involve controlled, in-door experiments, not real field conditions under continuous environmental changes. Furthermore, most investigations are carried out using model plants. Strain P. fluorescens N21.4 has been able to trigger secondary metabolism of plant species. Therefore we studied P. fluorescens ability to increase blackberry fitness, fruit quality, and protection against natural pests under field conditions. P. fluorescens N21.4 was delivered in the root or shoot system of blackberry plants along its entire production period, evaluating fruit quality and yield. Our results show an average increase up to 800 g per plant in total production, directly related to the increase in flowering buds. Protection against Spodoptera littoralis in inoculated plants was similar to control plants, hence contributing to increase in yield. Fruits from inoculated plants showed significant increases of up to 3°Brix, total phenolics of up to 18 %, and flavonoids of up to 22 %. We conclude that P. fluorescens N21.4 enhances plant defense and fruit quality together with an increased productivity as compared to current management practices, already obtaining high yields with economic profit.

Phytopharmaceuticals are plant secondary metabolites that are strongly inducible and especially sensitive to biotic changes. Plant cell cultures are a good alternative to obtain secondary metabolites, in case effective stimulation can be achieved. In this study, metabolic elicitors from two rhizobacteria able to enhance isoflavone content in soybean seedlings were tested on three different soybean calli cell lines. Results show that metabolic elicitors from Chryseobacterium balustinum Aur9 were not effective. However, there are at least two different metabolic elicitors from Pseudomonas fluorescens N21.4, one under 10 kDa and another over 10 kDa, that trigger isoflavone metabolism in the three cell lines with different isoflavone content. Elicitors from N21.4 achieved total isoflavone increases up to 29.7% (0.205 mg/g), 64.5% (0.487 mg/g), and 23.4% (0.726 mg/g) in the low-, intermediate-, and high-yield lines, respectively. Therefore, these elicitors have a great potential to enhance isoflavone production in cell cultures for development of functional ingredients.