Cardoso, Thiago de Araujo; Roncada, Cristian; Silva, Emerson Rodrigues da; Pinto, Leonardo Araujo; Jones, Marcus Herbert; Stein, Renato Tetelbon; Pitrez, Paulo Márcio
2017-01-01
To present official longitudinal data on the impact of asthma in Brazil between 2008 and 2013. This was a descriptive study of data collected between 2008 and 2013 from an official Brazilian national database, including data on asthma-related number of hospitalizations, mortality, and hospitalization costs. A geographical subanalysis was also performed. In 2013, 2,047 people died from asthma in Brazil (5 deaths/day), with more than 120,000 asthma-related hospitalizations. During the whole study period, the absolute number of asthma-related deaths and of hospitalizations decreased by 10% and 36%, respectively. However, the in-hospital mortality rate increased by approximately 25% in that period. The geographic subanalysis showed that the northern/northeastern and southeastern regions had the highest asthma-related hospitalization and in-hospital mortality rates, respectively. An analysis of the states representative of the regions of Brazil revealed discrepancies between the numbers of asthma-related hospitalizations and asthma-related in-hospital mortality rates. During the study period, the cost of asthma-related hospitalizations to the public health care system was US$ 170 million. Although the numbers of asthma-related deaths and hospital admissions in Brazil have been decreasing since 2009, the absolute numbers are still high, resulting in elevated direct and indirect costs for the society. This shows the relevance of the burden of asthma in middle-income countries. Apresentar dados longitudinais oficiais sobre o impacto da asma no Brasil entre 2008 e 2013. Estudo descritivo de dados extraídos de um banco de dados do governo brasileiro entre 2008 e 2013, no qual foram analisados as hospitalizações e óbitos por asma, bem como o custo das hospitalizações. Foi também realizada uma subanálise geográfica. Em 2013, 2.047 pessoas morreram de asma no Brasil (5 óbitos/dia), com mais de 120.000 hospitalizações por asma. Durante o período de estudo, o número absoluto de óbitos e hospitalizações por asma diminuiu 10% e 36%, respectivamente. No entanto, a taxa de mortalidade hospitalar aumentou aproximadamente 25%. A subanálise geográfica mostrou que as regiões Norte/Nordeste e Sudeste apresentaram as maiores taxas de hospitalização e mortalidade hospitalar por asma, respectivamente. A análise dos estados representativos de cada região mostrou discrepâncias entre as hospitalizações por asma e as taxas de mortalidade hospitalar por asma. Durante o período de estudo, as hospitalizações por asma custaram US$ 170 milhões ao sistema público de saúde. Embora os óbitos e hospitalizações por asma no Brasil estejam diminuindo desde 2009, os números absolutos ainda são altos, com elevados custos diretos e indiretos para a sociedade, o que mostra a relevância do impacto da asma em países de renda média.
HOSPITALIZATIONS FOR CHOLECYSTITIS AND CHOLELITHIASIS IN THE STATE OF RIO GRANDE DO SUL, BRAZIL.
Nunes, Emeline Caldana; Rosa, Roger Dos Santos; Bordin, Ronaldo
2016-01-01
The cholelithiasis is disease of surgical resolution with about 60,000 hospitalizations per year in the Sistema Único de Saúde (SUS - Brazilian National Health System) of the Rio Grande do Sul state. To describe the profile of hospitalizations for cholecystitis and cholelithiasis performed by the SUS of Rio Grande do Sul state, 2011-2013. Hospital Information System data from the National Health System through morbidity list for cholelithiasis and cholecystitis (ICD-10 K80-K81). Variables studied were sex, age, number of hospitalizations and approved Hospitalization Authorizations (AIH), total amount and value of hospital services generated, days and average length of stay, mortality, mortality and case fatality ratio, from health regions of the Rio Grande do Sul. During 2011-2013 there were 60,517 hospitalizations for cholecystitis and cholelithiasis, representing 18.86 hospitalizations per 10,000 inhabitants/year, most often in the age group from 60 to 69 years (41.34 admissions per 10,000 inhabitants/year) and female (27.72 hospitalizations per 10,000 inhabitants/year). The fatality rate presented an inverse characteristic: 13.52 deaths per 1,000 admissions/year for males, compared with 7.12 deaths per 1,000 admissions/year in females. The state had an average total amount spent and value of hospital services of R$ 16,244,050.60 and R$ 10,890,461.31, respectively. The health region "Capital/Gravataí Valley" exhibit the highest total expenditure and hospital services, and the largest number of deaths, and average length of stay. The hospitalization and lethality coefficients, the deaths, the length of stay and spending related to admissions increased from 50 years old. Females had a higher frequency and higher values spent on hospitalization, while the male higher coefficient of mortality and mean hospital stay. A colelitíase é doença de resolução cirúrgica com cerca de 60.000 internações por ano no Sistema Único de Saúde no estado do Rio Grande do Sul. Descrever o perfil das internações por colecistite e colelitíase na rede pública do estado no triênio 2011-2013. Emprego de dados do Sistema de Informações Hospitalares do Sistema Único de Saúde, através da lista de morbidades para colelitíase e colecistite (CID-10 K80-K81). As variáveis estudadas foram: sexo, idade, número de internações e de Autorizações de Internação Hospitalar aprovadas, valor total e valor dos serviços hospitalares gerados, dias e média de permanência, óbitos, coeficiente de mortalidade e letalidade, a partir das regiões de saúde do estado. No triênio ocorreram 60.517 internações por colecistite e colelitíase, o que representou 18,86 internações por 10.000 habitantes/ano, mais frequente na faixa etária dos 60 aos 69 anos (41,34 internações por 10.000 habitantes/ano) e no sexo feminino (27,72 hospitalizações por 10.000 habitantes/ano). O coeficiente de letalidade apresentou característica inversa: 13,52 óbitos para 1.000 internações/ano para o sexo masculino, contra 7,12 óbitos para 1.000 internações/ano no sexo feminino. O estado apresentou médias de valor total gasto e de valor dos serviços hospitalares de R$16.244.050,60 e R$10.890.461,31, respectivamente. A região de saúde "Capital/Vale do Gravataí" apresentou o maior valor total gasto e de serviços hospitalares, e o maior número de óbitos, média e dias de permanência. Os coeficientes de internação e de letalidade, os óbitos, os dias de permanência e os gastos referentes às internações aumentam a partir dos 50 anos de idade. O sexo feminino apresentou maior frequência e maiores valores gastos com a internação, enquanto o masculino maior coeficiente de letalidade e média de permanência hospitalar.
de León González, Enrique Díaz; Pérez, Héctor Eloy Tamez; Hermosillo, Hugo Gutiérrez; Rodríguez, Javier Armando Cedillo; Torres, Gabriela
2016-01-01
Fundamento y objetivo Determinar la asociación entre fragilidad y mortalidad, dependencia funcional, caídas y hospitalizaciones en el Estudio Nacional de Salud y Envejecimiento en México (ENASEM). Sujetos y métodos Estudio prospectivo poblacional en México en el que se seleccionaron sujetos de 60 años o más, que fueron evaluados en las variables de fragilidad durante la primera vuelta del estudio en el año 2001 y que incluyó: dificultad para levantarse de una silla después de haber estado sentado(a) durante largo tiempo, pérdida de peso de 5 kilogramos o más en los últimos dos años y falta de energía. Los sujetos fueron catalogados como robustos, prefrágiles y frágiles cuando tenían cero, una o dos de las características anteriores, respectivamente. La mortalidad, hospitalizaciones, caídas y dependencia funcional fueron evaluadas en la segunda vuelta del estudio en el año 2003. Se calculó el riesgo relativo para cada una de las complicaciones, así como análisis multivariado con regresión de Cox para el caso de mortalidad y regresión logística para el resto. Resultados Los estados de prefragilidad y fragilidad se asociaron independientemente con mortalidad, con índices de riesgo ajustados de 1,61 (intervalo de confianza del 95% [IC 95%] 1,01-2,55) y 1,94 (IC 95% 1,20-3,13), respectivamente. Sólo el estado de fragilidad se asoció independientemente con hospitalización y dependencia funcional, con una razón de momios ajustada de 1,53 (IC 95% 1,13-2,07) y 3,07 (IC 95% 1,76-5,34), respectivamente. No hubo asociación entre los estados de prefragilidad y fragilidad con caídas. Conclusión El estado de fragilidad se asocia independientemente con mortalidad, hospitalizaciones y disfuncionalidad en actividades básicas de la vida diaria en los siguientes dos años en población mexicana. PMID:21612803
Risk factors for mortality in ventilator-associated tracheobronchitis: a case-control study.
Pontes, Leonilda Giani; Menezes, Fernando Gatti de; Gonçalves, Priscila; Toniolo, Alexandra do Rosário; Silva, Claudia Vallone; Kawagoe, Julia Yaeko; Santos, Camila Marques Dos; Castagna, Helena Maria Fernandes; Martino, Marinês Dalla Valle; Corrêa, Luci
2017-01-01
To describe the microbiological characteristics and to assess the risk factors for mortality of ventilator-associated tracheobronchitis in a case-control study of intensive care patients. This case-control study was conducted over a 6-year period in a 40-bed medical-surgical intensive care unit in a tertiary care, private hospital in São Paulo, Brazil. Case patients were identified using the Nosocomial Infection Control Committee database. For the analysis of risk factors, matched control subjects were selected from the same institution at a 1:8.8 ratio, between January 2006 and December 2011. A total of 40 episodes of ventilator-associated tracheobronchitis were evaluated in 40 patients in the intensive care unit, and 354 intensive care patients who did not experience tracheobronchitis were included as the Control Group. During the 6-year study period, a total of 42 organisms were identified (polymicrobial infections were 5%) and 88.2% of all the microorganisms identified were Gram-negative. Using a logistic regression model, we found the following independent risk factors for mortality in ventilator-associated tracheobronchitis patients: Acute Physiology and Chronic Health Evaluation I score (odds ratio 1.18 per unit of score; 95%CI: 1.05-1.38; p=0.01), and duration of mechanical ventilation (odds ratio 1.09 per day of mechanical ventilation; 95%CI: 1.03-1.17; p=0.004). Our study provided insight into the risk factors for mortality and microbiological characteristics of ventilator-associated tracheobronchitis. Descrever as características microbiológicas e avaliar os fatores de risco para mortalidade na traqueobronquite associada à ventilação mecânica em um estudo caso-controle de pacientes de terapia intensiva. Estudo realizado ao longo de 6 anos em uma unidade de terapia intensiva médico-cirúrgica de 40 leitos, em um hospital privado e de nível terciário em São Paulo, Brasil. O Grupo Caso foi identificado usando o banco de dados da Comissão de Controle de Infecção Hospitalar. O Grupo Controle foi pareado na proporção de 1:8,8 entre janeiro de 2006 e dezembro de 2011. Quarenta episódios de traqueobronquites associadas à ventilação foram avaliados em 40 pacientes na unidade de terapia intensiva, e 354 pacientes não apresentaram traqueobronquite Grupo Controle. Foram identificados 42 microrganismos (dos quais 5% foram infecções polimicrobianas), sendo que 88,2% de todos os microrganismos eram bactérias Gram-negativas. Usando um modelo de regressão logística, encontramos os seguintes fatores de risco independentes para mortalidade em pacientes com traqueobronquites associadas à ventilação: pontuação da Acute Physiology and Chronic Health Evaluation I (odds ratio 1,18 por uma unidade de pontuação; IC95%: 1,05-1,38; p=0,01) e duração da ventilação mecânica (odds ratio 1,09 por dia de ventilação mecânica; IC95%: 1,03-1,17; p=0,004). Nosso estudo forneceu informações sobre os fatores de risco para mortalidade e características microbiológicas da traqueobronquite associada à ventilação mecânica.
Trends in corrected lung cancer mortality rates in Brazil and regions.
Malta, Deborah Carvalho; Abreu, Daisy Maria Xavier de; Moura, Lenildo de; Lana, Gustavo C; Azevedo, Gulnar; França, Elisabeth
2016-06-27
To describe the trend in cancer mortality rates in Brazil and regions before and after correction for underreporting of deaths and redistribution of ill-defined and nonspecific causes. The study used data of deaths from lung cancer among the population aged from 30 to 69 years, notified to the Mortality Information System between 1996 and 2011, corrected for underreporting of deaths, non-registered sex and age , and causes with ill-defined or garbage codes according to sex, age, and region. Standardized rates were calculated by age for raw and corrected data. An analysis of time trend in lung cancer mortality was carried out using the regression model with autoregressive errors. Lung cancer in Brazil presented higher rates among men compared to women, and the South region showed the highest death risk in 1996 and 2011. Mortality showed a trend of reduction for males and increase for women. Lung cancer in Brazil presented different distribution patterns according to sex, with higher rates among men and a reduction in the mortality trend for men and increase for women. Descrever a tendência da mortalidade por câncer de pulmão no Brasil e regiões, antes e após as correções por sub-registro de óbitos, redistribuição de causas mal definidas e causas inespecíficas. Foram utilizados dados de óbitos por câncer de pulmão da população de 30 a 69 anos, notificados ao Sistema de Informação sobre Mortalidade, entre 1996 e 2011, corrigidos para sub-registro de óbitos, declaração de sexo e idade ignorados e causas com códigos mal definidos e inespecíficos segundo sexo, idade e região. Foram calculadas taxas padronizadas por idade para dados brutos e corrigidos. Realizou-se análise da tendência temporal da mortalidade por câncer de pulmão por meio do modelo de regressão com erros autorregressivos. O câncer de pulmão no Brasil apresentou taxas mais elevadas em homens que em mulheres e a região Sul foi a que apresentou maior risco de morte em 1996 e 2011. A mortalidade tendeu a reduzir para o sexo masculino e a aumentar para o sexo feminino. O câncer de pulmão no Brasil apresenta padrão de distribuição diferente segundo sexo, com taxas mais elevadas em homens e com redução da tendência de mortalidade para o sexo masculino e aumento das taxas para o sexo feminino.
Pérez-Flores, Juan Emmanuel; Chávez-Tostado, Mariana; Larios-Del-Toro, Youné Elizabeth; García-Rentería, Jesús; Rendrón-Félix, Jorge; Salazar-Parra, Marcela; Irusteta-Jiménez, Leire; Michel-Espinoza, Luis Rodrigo; Márquez-Valdez, Aída Rebeca; Cuesta-Márquez, Lisbeth; Álvarez-Villaseñor, Andrea Socorro; Fuentes-Orozco, Clotilde; González Ojeda, Alejandro
2016-07-19
Introducción: la desnutrición intrahospitalaria se ha descrito hace más de 70 años como un problema frecuente. En México se reportan cifras de entre el 20% al 50%; sin embargo no se ha estudiado su prevalencia ni su asociación con la morbilidad y mortalidad hospitalaria.Objetivos: evaluar el estado nutricional y su relación con la morbimortalidad hospitalaria en pacientes mexicanos.Métodos: cohorte prospectiva de pacientes que ingresaron en un hospital de referencia para una estancia hospitalaria mayor de 5 días. Se capturó peso, talla, índice de masa corporal (IMC), estado nutricional de acuerdo con la valoración global subjetiva (VGS) a su ingreso y egreso hospitalario, así como diagnóstico médico, complicaciones y mortalidad. Los datos fueron analizados mediante la prueba T de Student, prueba Chi-cuadrado y prueba Exacta de Fisher.Resultados: se incluyeron 610 pacientes en total, con un promedio de edad de 50,8 ± 17,32 años, 267 mujeres (43,8%) y 343 hombres (56,2%). Del total, 154 fueron catalogados con sospecha de desnutrición o desnutrición (pacientes expuestos, 25,2%) y 456 bien nutridos (pacientes no expuestos, 74,8%), con una relación de 1 a 3. La morbilidad total de la cohorte tuvo un RR = 2,70, IC 95 % (2,06-3,55) y la mortalidad con un RR = 2,64, IC 95% (1,74-4,0), siendo ambas estadísticamente significativas (p = 0,001).Conclusiones: el diagnóstico de desnutrición al ingreso hospitalario constituye un factor de riesgo para el desarrollo de complicaciones y mortalidad. Este padecimiento al ingreso en comparación con el paciente que no presenta desnutrición incrementó el riesgo de mortalidad hasta en 2.64 veces.
PYOGENIC LIVER ABSCESS: DIAGNOSTIC AND THERAPEUTIC MANAGEMENT.
Santos-Rosa, Otto Mauro Dos; Lunardelli, Henrique Simonsen; Ribeiro-Junior, Marcelo Augusto Fontenelle
2016-01-01
The pyogenic liver abscess has an incidence of 1.1/1,000 habitants. Mortality can reach 100%. The use of less invasive procedures diminish morbidity and hospital stay. Identify risk factors in patients who underwent percutaneous drainage guided by ultrasound as treatment. Were analyzed 10 patients submitted to the method. Epidemiological characteristics, laboratory markers and imaging exams (ultrasound and CT) were evaluated. The majority of the patients were men with mean age of 50 years old. Liver disease, alcoholism and biliary tract disease were the most common prodromes. Abdominal pain (90%), fever (70%) and jaundice (40%) were the most common clinical manifestations. Mortality of 20% was observed in this series. Hypoalbuminemia and days of hospitalization had a statistically significant positive association with death. The pyogenic liver abscess has subacute evolution which makes the diagnosis difficult. Image exams have high sensitivity in diagnosis, particularly computed tomography. Percutaneous drainage associated with antibiotic therapy is safe and effective therapeutic resource. O abscesso hepático piogênico tem incidência de 1,1 por 1.000 habitantes com mortalidade podendo chegar a 100%. O uso de recursos menos invasivos diminuem morbimortalidade e tempo de internação hospitalar. Identificar fatores de risco no abscesso hepático piogênico tratado por drenagem percutânea guiada por ultrassom. Total de 10 pacientes foram submetidos ao procedimento. Foram avaliadas características epidemiológicas, marcadores laboratoriais exames de imagem (ultrassom e tomografia). Na amostra houve predominância do sexo masculino, com média de idade de 50 anos. Hepatopatia, etilismo e doença da via biliar foram os pródromos mais frequentes. Dor abdominal (90%), febre (70%) e icterícia (40%) foram manifestações clínicas mais comuns. Houve mortalidade de 20% nesta série. Hipoalbuminemia e dias de internação hospitalar tiveram associação positiva com óbito estatisticamente significante. O abscesso hepático piogênico tem evolução subaguda o que dificulta o diagnóstico. Exames de imagem têm sensibilidade alta na propedêutica diagnóstica, notadamente a tomografia computadorizada. A drenagem percutânea, associada à antibioticoterapia, mostrou ser recurso terapêutico seguro e eficaz.
Analysis of the Revised Trauma Score (RTS) in 200 victims of different trauma mechanisms.
Alvarez, Bruno Durante; Razente, Danilo Mardegam; Lacerda, Daniel Augusto Mauad; Lother, Nicole Silveira; VON-Bahten, Luiz Carlos; Stahlschmidt, Carla Martinez Menini
2016-01-01
to analyze the epidemiological profile and mortality associated with the Revised Trauma Score (RTS) in trauma victims treated at a university hospital. we conducted a descriptive, cross-sectional study of trauma protocols (prospectively collected) from December 2013 to February 2014, including trauma victims admitted in the emergency room of the Cajuru University Hospital. We set up three groups: (G1) penetrating trauma to the abdomen and chest, (G2) blunt trauma to the abdomen and chest, and (G3) traumatic brain injury. The variables we analyzed were: gender, age, day of week, mechanism of injury, type of transportation, RTS, hospitalization time and mortality. we analyzed 200 patients, with a mean age of 36.42 ± 17.63 years, and 73.5% were male. The mean age was significantly lower in G1 than in the other groups (p <0.001). Most (40%) of the visits occurred on weekends and the most common pre-hospital transport service (58%) was the SIATE (Emergency Trauma Care Integrated Service). The hospital stay was significantly higher in G1 compared with the other groups (p <0.01). Regarding mortality, there were 12%, 1.35% and 3.95% of deaths in G1, G2 and G3, respectively. The median RTS among the deaths was 5.49, 7.84 and 1.16, respectively, for the three groups. the majority of patients were young men. RTS was effective in predicting mortality in traumatic brain injury, however failing to predict it in patients suffering from blunt and penetrating trauma. analisar o perfil epidemiológico e a mortalidade associada ao escore de trauma revisado (RTS) em vítimas de trauma atendidas em um hospital universitário. estudo transversal descritivo de protocolos de trauma (coletados prospectivamente) de dezembro de 2013 a fevereiro de 2014, incluindo vítimas de trauma admitidas na sala de emergência do Hospital Universitário Cajuru. Três grupos foram criados: (G1) trauma penetrante em abdome e tórax, (G2) trauma contuso em abdome e tórax, e (G3) trauma cranioencefálico. As variáveis analisadas foram: sexo, idade, dia da semana, mecanismo de trauma, tipo de transporte, RTS, tempo de internamento e mortalidade. analisou-se 200 pacientes, com média de idade de 36,42 ± 17,63 anos, sendo 73,5% do sexo masculino. A média de idade no G1 foi significativamente menor do que nos demais grupos (p <0,001). A maioria (40%) dos atendimentos ocorreu nos finais de semana e o serviço de transporte pré-hospitalar mais frequente (58%) foi o SIATE (Serviço Integrado de Atendimento ao Trauma em Emergência). O tempo de internamento foi significativamente maior no G1, em comparação aos demais grupos (p <0,01). Quanto à mortalidade, houve 12%, 1,35% e 3,95% de óbitos nos grupos G1, G2 e G3, respectivamente. A mediana do RTS entre os óbitos foi 5,49, 7,84 e 1,16, respectivamente, para os três grupos. a maioria dos pacientes eram homens jovens. O RTS mostrou-se efetivo na predição de mortalidade no trauma cranioencefálico, entretanto falhou ao analisar pacientes vítimas de trauma contuso e penetrante.
[An automated registry program for nosocomial infections].
Castañón-González, Jorge Alberto; Polanco-González, Carlos; Samaniego-Mendoza, José Lino; Buhse, Thomas
2014-12-01
Las infecciones nosocomiales presentan un gran reto para la medicina hospitalaria, en general, y para las Unidades de Cuidados Intensivos, en particular. Su elevada prevalencia, la gran morbilidad y mortalidad asociadas, el incremento de la estancia hospitalaria y, en consecuencia, los costos de la atención médica han hecho que los programas de vigilancia, control y prevención de infecciones nosocomiales sean una parte toral de los protocolos de seguridad para el paciente y un indicador de calidad de la atención médica.
Trends in asthma mortality in the 0- to 4-year and 5- to 34-year age groups in Brazil.
Graudenz, Gustavo Silveira; Carneiro, Dominique Piacenti; Vieira, Rodolfo de Paula
2017-01-01
To provide an update on trends in asthma mortality in Brazil for two age groups: 0-4 years and 5-34 years. Data on mortality from asthma, as defined in the International Classification of Diseases, were obtained for the 1980-2014 period from the Mortality Database maintained by the Information Technology Department of the Brazilian Unified Health Care System. To analyze time trends in standardized asthma mortality rates, we conducted an ecological time-series study, using regression models for the 0- to 4-year and 5- to 34-year age groups. There was a linear trend toward a decrease in asthma mortality in both age groups, whereas there was a third-order polynomial fit in the general population. Although asthma mortality showed a consistent, linear decrease in individuals ≤ 34 years of age, the rate of decline was greater in the 0- to 4-year age group. The 5- to 34-year group also showed a linear decline in mortality, and the rate of that decline increased after the year 2004, when treatment with inhaled corticosteroids became more widely available. The linear decrease in asthma mortality found in both age groups contrasts with the nonlinear trend observed in the general population of Brazil. The introduction of inhaled corticosteroid use through public policies to control asthma coincided with a significant decrease in asthma mortality rates in both subsets of individuals over 5 years of age. The causes of this decline in asthma-related mortality in younger age groups continue to constitute a matter of debate. Apresentar uma atualização das tendências da mortalidade da asma no Brasil em duas faixas etárias: 0-4 anos e 5-34 anos. Dados relativos ao período de 1980 a 2014 referentes à mortalidade da asma, conforme se definiu na Classificação Internacional de Doenças, foram extraídos Sistema de Informação sobre Mortalidade do Departamento de Tecnologia da Informação do Sistema Único de Saúde. Para analisar as tendências temporais das taxas padronizadas de mortalidade da asma, realizou-se um estudo ecológico de séries temporais com modelos de regressão para as faixas etárias de 0 a 4 anos e 5 a 34 anos. Houve uma tendência linear de redução da mortalidade da asma em ambas as faixas etárias e uma tendência polinomial de terceira ordem na população geral. Embora a mortalidade da asma tenha apresentado redução linear consistente em indivíduos com idade ≤ 34 anos, a taxa de declínio foi maior na faixa etária de 0 a 4 anos. A faixa etária de 5 a 34 anos também apresentou redução linear da mortalidade, e essa redução tornou-se mais pronunciada após o ano de 2004, quando o tratamento com corticosteroides inalatórios tornou-se mais amplamente disponível. A redução linear da mortalidade da asma em ambas as faixas etárias contrasta com a tendência não linear observada na população geral do Brasil. A introdução do uso de corticosteroides inalatórios por meio de políticas públicas de controle da asma coincidiu com uma diminuição significativa das taxas de mortalidade da asma em ambos os subgrupos de indivíduos com mais de 5 anos de idade. As causas dessa redução da mortalidade da asma em faixas etárias mais jovens ainda são objeto de debate.
Assessment of Management to Mitigate Anthropogenic Effects on Large Whales
Van Der Hoop, Julie M; Moore, Michael J; Barco, Susan G; Cole, Timothy VN; Daoust, Pierre-Yves; Henry, Allison G; McAlpine, Donald F; McLellan, William A; Wimmer, Tonya; Solow, Andrew R
2013-01-01
Abstract United States and Canadian governments have responded to legal requirements to reduce human-induced whale mortality via vessel strikes and entanglement in fishing gear by implementing a suite of regulatory actions. We analyzed the spatial and temporal patterns of mortality of large whales in the Northwest Atlantic (23.5°N to 48.0°N), 1970 through 2009, in the context of management changes. We used a multinomial logistic model fitted by maximum likelihood to detect trends in cause-specific mortalities with time. We compared the number of human-caused mortalities with U.S. federally established levels of potential biological removal (i.e., species-specific sustainable human-caused mortality). From 1970 through 2009, 1762 mortalities (all known) and serious injuries (likely fatal) involved 8 species of large whales. We determined cause of death for 43% of all mortalities; of those, 67% (502) resulted from human interactions. Entanglement in fishing gear was the primary cause of death across all species (n = 323), followed by natural causes (n = 248) and vessel strikes (n = 171). Established sustainable levels of mortality were consistently exceeded in 2 species by up to 650%. Probabilities of entanglement and vessel-strike mortality increased significantly from 1990 through 2009. There was no significant change in the local intensity of all or vessel-strike mortalities before and after 2003, the year after which numerous mitigation efforts were enacted. So far, regulatory efforts have not reduced the lethal effects of human activities to large whales on a population-range basis, although we do not exclude the possibility of success of targeted measures for specific local habitats that were not within the resolution of our analyses. It is unclear how shortfalls in management design or compliance relate to our findings. Analyses such as the one we conducted are crucial in critically evaluating wildlife-management decisions. The results of these analyses can provide managers with direction for modifying regulated measures and can be applied globally to mortality-driven conservation issues. Evaluación del Manejo para Mitigar Efectos Antropogénicos sobre Ballenas Mayores Resumen Los gobiernos de Estados Unidos y Canadá han respondido a requerimientos legales para reducir la mortalidad de ballenas inducida por humanos por medio de impacto con embarcaciones y enmarañamiento en artes de pesca mediante la implementación de un conjunto de acciones reguladoras. Analizamos los patrones espaciales y temporales de la mortalidad de ballenas mayores en el Atlántico Noroccidental (23.5°N a 48.0°N), de 1970 a 2009, en el contexto de cambios de manejo. Utilizamos un modelo logístico multinomial ajustado por la máxima probabilidad de detección de tendencias en mortalidades por causa específica en el tiempo. Comparamos el número de muertes provocadas por humanos con los niveles de remoción biológica potencial (i.e., mortalidad específica provocada por humanos sustentable). De 1970 a 2009, hubo 1762 muertes (conocidas) y lesiones serias (casi fatales) involucrando 8 especies de ballenas mayores. Determinamos la causa de 43% de todas las muertes; de ellas, 67% (502) resultaron de interacciones humanas. El enmarañamiento en artes de pesca fue la causa principal de muerte en todas las especies (n = 323), seguida de causas naturales (n = 248) e impacto de embarcaciones (n = 171). Los niveles sustentables de mortalidad establecidos fueron excedidos consistentemente hasta en 650% en 2 especies. Las probabilidades de muerte por enmarañamiento y por impacto de embarcaciones incrementaron significativamente de 1990 a 2009. No hubo cambio significativo en la intensidad local de mortalidad por todas las causas o por impacto de embarcaciones antes y después de 2003, año en el que se implementaron numerosos esfuerzos de mitigación. Hasta ahora, los esfuerzos regulatorios no han reducido los efectos letales de las actividades humanas sobre las ballenas a nivel de población, aunque no excluimos la posibilidad de éxito de medidas enfocadas a hábitats locales específicos que no estuvieron dentro de la resolución de nuestro análisis. No es claro como se relacionan con nuestros resultados las deficiencias en el diseño o implementación del manejo. Análisis como el que realizamos son cruciales para la evaluación crítica de decisiones para el manejo de vida silvestre, y los resultados de estos análisis pueden proporcionar directrices a los manejadores para que modifiquen medidas regulatorias y puedan ser aplicadas globalmente en temas de conservación relacionadas con mortalidad. PMID:23025354
MORTALITY OF URGENCY VERSUS ELECTIVE VIDEOLAPAROSCOPIC CHOLECYSTECTOMY FOR ACUTE CHOLECYSTITIS.
Felício, Saulo José Oliveira; Matos, Ediriomar Peixoto; Cerqueira, Antonio Maurício; Farias, Kurt Wolfgang Schindler Freire de; Silva, Ramon de Assis; Torres, Mateus de Oliveira
2017-01-01
Surgical approach is still controversial in patients with acute cholecystitis: to treat clinically the inflammatory process and operate electively later or to operate immediately on an emergency basis? To test the hypothesis that urgent laparoscopic cholecystectomy in acute cholecystitis has a higher mortality than elective laparoscopic cholecystectomy. From the data available in Datasus, mortality was compared between patients undergoing elective laparoscopic cholecystectomy for cholelithiasis and in urgency. Calculations were made of the relative reduction in risk of death, absolute reduction of risk of death and number needed to treat. From 2009 to 2014 in Brazil, there were 250.439 laparoscopic cholecystectomy and 74.6% were electives. Mortality in the emergency group was 4.8 times higher compared to the elective group (0.0023% vs. 0.00048%). Despite the relative reduction in risk of death (RRR) was 83%, in the calculation of absolute risk was found 0.0018 and number needed to treat of 55,555. Despite the relative risk reduction for mortality was high comparing elective vs. urgent basis, the absolute risk reduction was minimal, since this outcome is very low in both groups, suggesting that mortality should not have much influence on surgical decision. Continua controversa a conduta nos pacientes com colecistite aguda: compensar o processo inflamatório e operar eletivamente ou operar imediatamente em caráter de urgência? Testar a hipótese de que a colecistectomia videolaparoscópica de urgência por colecistite aguda apresenta maior mortalidade que a colecistectomia videolaparoscópica eletiva. A partir dos dados disponíveis no Datasus, foi comparada a mortalidade entre os pacientes submetidos à colecistectomia videolaparoscópica eletiva por colelitíase e a de urgência. Foram realizados cálculos da redução relativa de risco de morte, redução absoluta do risco de morte e número necessário para tratar . De 2009 a 2014 no Brasil, foram realizadas 250.439 colecistectomias videolaparoscópicas sendo 74,6% eletivas. A mortalidade no grupo de emergência foi 4,8 vezes mais elevada em comparação com o grupo eletivo (0,0023% vs. 0,00048%). Apesar da redução relativa do risco de morte (RRR) ser de 83%, no cálculo do risco absoluto encontrou-se 0,0018 e número necessário para tratar de 55.555. Apesar da redução relativa de risco para mortalidade ser alta comparando o caráter eletivo vs. urgência, a redução de risco absoluto é mínima, já que esse desfecho é muito baixo nos dois grupos, sugerindo que a mortalidade não deve ter muita influência na tomada de decisão cirúrgica.
Social Networking Family of Caregivers during Hospitalization of Children.
Menezes, Marina; Moré, Carmen Leontina Ojeda Ocampo; Barros, Luísa
2016-06-01
To identify and analyze the significant networks of family, social and hospital support described by the family caregivers of hospitalized children 5-12 years during the hospital stay. Descriptive study, exploratory and qualitative study conducted with 20 caregivers of children hospitalized in a hospital in a city in southern Brazil, through semi-structured interviews and significant social networks maps, tailored to the hospital setting. Data analysis showed that the most active social network was comprised of families through emotional support, material aid and services. Relations with hospital health care team and the hospital context were cited as providing support to the caregivers of the hospitalized child. The identification of social networks in the child's hospitalization course enables equip professionals working in the institution aiming at better targeting of actions and care for the family and hospitalized children. Identificar e analisar as redes significativas de suporte familiar, social e hospitalar descritas pelos familiares acompanhantes de crianças hospitalizadas de 5 a 12 anos, durante o período de internação. Estudo descritivo, exploratório e de cunho qualitativo realizado com 20 acompanhantes de crianças hospitalizadas em uma unidade hospitalar em uma cidade do Sul do Brasil, por meio de entrevistas semiestruturadas e dos Mapas de Redes sociais significativas, adaptado para o contexto hospitalar. A análise dos dados demonstrou que a rede social mais atuante foi composta por familiares, através de apoio emocional, ajuda material e de serviços. As relações com a equipe de saúde do hospital e com o contexto hospitalar foram citadas como capazes de fornecer apoio ao acompanhante da criança internada. a identificação das redes sociais no curso da hospitalização da criança possibilita instrumentalizar os profissionais que atuam na instituição objetivando um melhor direcionamento de ações e cuidados destinados à família e a criança hospitalizada.
Neoliberalist influences on nursing hospital work process and organization.
Souza, Norma Valéria Dantas de Oliveira; Gonçalves, Francisco Gleidson de Azevedo; Pires, Ariane da Silva; David, Helena Maria Scherlowski Leal
2017-01-01
To describe and analyze the influence of the neoliberal economic and political model on the nursing hospital work process and organization. Qualitative descriptive research, having as its scenery a university hospital. The subjects were 34 nursing workers. The data collection took place from March to July 2013, through semi-structured interview. The data treatment technique used was content analysis, which brought up the following category: working conditions precariousness and its consequences to the hospital work process and organization in the neoliberal context. The consequences of neoliberalism on hospital work process and organization were highlighted, being observed physical structure, human resources and material inadequacies that harms the assistance quality. In addition to wage decrease that cause the need of second jobs and work overload. There is a significant influence of the neoliberal model on hospital work, resulting on working conditions precariousness. Descrever e analisar a influência do modelo econômico e político neoliberal na organização e no processo de trabalho hospitalar de enfermagem. Pesquisa qualitativa e descritiva, tendo como cenário um hospital universitário. Os participantes foram 34 trabalhadores de enfermagem. A coleta ocorreu de março a julho de 2013, por meio de entrevista semiestruturada. A técnica de tratamento dos dados foi a análise de conteúdo, que fez emergir a seguinte categoria: precarização das condições laborais e suas repercussões para organização e processo de trabalho hospitalar no contexto neoliberal. Evidenciaram-se repercussões do neoliberalismo na organização e no processo de trabalho hospitalar, verificando-se inadequações na estrutura física, nos recursos humanos e materiais, que afetavam a qualidade da assistência. Além de perdas salariais que levam à necessidade de outros empregos e sobrecarga de trabalho. Há forte influência do modelo neoliberal no trabalho hospitalar, resultando na precarização das condições laborais.
Educational intervention in Primary Care for the prevention of congenital syphilis.
Lazarini, Flaviane Mello; Barbosa, Dulce Aparecida
2017-01-30
to evaluate the efficiency of educational interventions related to the knowledge of health care professionals of Primary Care and to verify the impact on the vertical transmission rates of congenital syphilis. a quasi-experimental study conducted in the city of Londrina, Paraná, between 2013 and 2015. An educational intervention on diagnosis, treatment and notification was carried out with 102 professionals with knowledge measurement before and after the intervention. Incidence and mortality data from congenital syphilis were taken from the system for notifiable diseases (SINAN) and the Mortality Information System (SIM). Excel tabulation and statistical analysis was done in the Statistical Package for Social Sciences, version 2.1. A descriptive and inferential analysis was performed. the mean number of correct responses increased from 53% to 74.3% after the intervention (p < 0.01). The adherence to professional training was 92.6%. There was a significant reduction in the vertical transmission rate of syphilis from 75% in 2013 to 40.2% in 2015. In 2014 and 2015 there were no records of infant mortality from this condition. the educational intervention significantly increased the knowledge of health professionals about syphilis and collaborated to reduce the rate of vertical transmission of the disease. avaliar a eficiência da intervenção educacional no conhecimento dos profissionais de saúde da Atenção Básica e verificar o impacto nas taxas de transmissão vertical da sífilis congênita. estudo quase-experimental, conduzido na cidade de Londrina, Paraná, no período entre 2013 e 2015. Foi realizada intervenção educacional sobre diagnóstico, tratamento e notificação com 102 profissionais com medida do conhecimento antes e após a intervenção. Os dados de incidência e mortalidade pela sífilis congênita foram retirados do Sistema de Informação de Agravos de Notificação (SINAN) e do Sistema de Informação sobre Mortalidade (SIM). A tabulação em Excel e a análise estatística no Statistical Package for Social Sciences, versão 2.1. Realizou-se análise descritiva e inferencial. a média de respostas corretas passou de 53% para 74,3% após a intervenção (p < 0,01). A adesão ao treinamento dos profissionais foi de 92,6%. Existiu redução importante na taxa de transmissão vertical da sífilis de 75% em 2013 para 40,2% em 2015. Em 2014 e 2015 não ocorreram registros de mortalidade infantil por esse agravo. a intervenção educacional aumentou significativamente o conhecimento dos profissionais de saúde sobre a sífilis e colaborou para a redução da taxa de transmissão vertical do agravo. evaluar la eficiencia de la intervención educacional en el conocimiento de los profesionales de la salud de la Atención Primaria y verificar el impacto en las tasas de transmisión vertical de la sífilis congénita. estudio casi experimental, realizado en la ciudad de Londrina, Paraná, en el período entre 2013 y 2015. Fue realizada una intervención educacional sobre diagnóstico, tratamiento y notificación, con 102 profesionales, midiendo el conocimiento antes y después de la intervención. Los datos de incidencia y mortalidad por la sífilis congénita fueron obtenidos del Sistema de Información de Enfermedades de Notificación (SINAN) y del Sistema de Información sobre Mortalidad (SIM). La tabulación fue realizada en el Excel y el análisis estadístico en el Statistical Package for Social Sciences, versión 2.1. Se realizó un análisis descriptivo e inferencial. la media de respuestas correctas pasó de 53% para 74,3%, después de la intervención (p < 0,01). La adhesión al entrenamiento de los profesionales fue de 92,6%. Existió reducción importante en la tasa de transmisión vertical de la sífilis de 75% en 2013 para 40,2% en 2015. En 2014 y 2015 no ocurrieron registros de mortalidad infantil por esa enfermedad. la intervención educacional aumentó significativamente el conocimiento de los profesionales de la salud sobre la sífilis y colaboró para la reducción de la tasa de transmisión vertical de la enfermedad.
Guanais, Frederico C.
2015-01-01
Objetivos. Examiné los efectos combinados del acceso a la atención primaria mediante el Programa de Salud Familiar (PSF) y las transferencias condicionadas de dinero en efectivo del Programa Bolsa Familia (PBF) sobre la mortalidad infantil posneonatal (MIPN) en Brasil. Métodos. Empleé un análisis ecológico longitudinal usando datos en panel de 4 583 municipios brasileños de 1998 al 2010, con 54 253 observaciones en total. Estimé modelos de regresión de efectos fijos por mínimos cuadrados ordinarios, con la tasa de MIPN como la variable dependiente y el PSF, el PBF y sus interacciones como las principales variables independientes de interés. Resultados. La asociación de una mayor cobertura del PSF con una menor tasa de MIPN se volvió más fuerte conforme aumentaba la cobertura del PBF. En los promedios de todas las demás variables, cuando la cobertura de PBF era 25%, la MIPN predicha fue 5,24 (intervalo de confianza [IC] de 95% = 4,95, 5,53) para una cobertura del PSF de 0%, y de 3,54 (IC de 95% = 2,77, 4,31) para una cobertura del PSF de 100%. Cuando la cobertura del PBF era de 60%, la MIPN predicha fue 4,65 (IC de 95% = 4,36, 4,94) para una cobertura del PSF de 0%, y de 1,38 (IC de 95% = 0,88, 1,89) para una cobertura del PSF de 100%. Conclusiones. El efecto del PSF depende de la ampliación del PBF. Para las poblaciones empobrecidas y subatendidas, la combinación de intervenciones tanto del lado de la oferta como del lado de la demanda podría ser necesaria para mejorar los resultados en salud.
Leal, Maria do Carmo; Bittencourt, Sonia Duarte de Azevedo; Torres, Raquel Maria Cardoso; Niquini, Roberta Pereira; Souza, Paulo Roberto Borges de
2017-03-02
This study aims to identify the social and demographic determinants, in addition to the determinants of reproductive health and use of health services, associated with infant mortality in small and medium-sized cities of the North, Northeast and Southeast regions of Brazil. This is a case-control study with 803 cases of death of children under one year and 1,969 live births (controls), whose mothers lived in the selected cities in 2008. The lists of the names of cases and controls were extracted from the Sistema de Informação sobre Mortalidade (SIM - Mortality Information System) and the Sistema de Informação sobre Nascidos Vivos (SINASC - Live Birth Information System) and supplemented by data obtained by the research of "active search of death and birth". Data was collected in the household using a semi-structured questionnaire, and the analysis was carried out using multiple logistic regression. The final model indicates that the following items are positively and significantly associated with infant mortality: family working in agriculture, mother having a history of fetal and infant losses, no prenatal or inadequate prenatal, and not being associated to the maternity hospital during the prenatal period. We have observed significant interactions to explain the occurrence of infant mortality between race and socioeconomic score and between high-risk pregnancy and pilgrimage for childbirth. The excessive number of home deliveries and pilgrimage for childbirth indicates flaws in the line of maternity care and a lack of collaboration between the levels of outpatient and hospital care. The study reinforces the need for an integrated management of the health care networks, leveraging the capabilities of cities in meeting the needs of pregnancy, delivery and birth with quality. Identificar os determinantes sociais, demográficos, da saúde reprodutiva e de utilização dos serviços de saúde associados ao óbito infantil em municípios de pequeno e médio porte das regiões Norte, Nordeste e Sudeste do Brasil. Trata-se de um estudo caso-controle com 803 casos de óbito de menores de um ano e 1.969 nascidos vivos (controles), cujas mães residiam em 2008 nos municípios selecionados. As listas nominais dos casos e do controles foram extraídas do Sistema de Informação sobre Mortalidade e do Sistema de Informação sobre Nascidos Vivos e completadas por dados obtidos pela pesquisa de "busca ativa de óbito e nascimento". A coleta de dados foi realizada em domicílio por meio de questionário semiestruturado, e a análise, por meio de regressão logística múltipla. O modelo final indicou que estão associadas positivamente e significativamente ao óbito infantil: a família trabalhar na agricultura, a mãe ter tido história de perdas fetais e infantis, não ter feito pré-natal ou ter tido um pré-natal inadequado e não estar vinculada à maternidade durante o pré-natal. Foram observadas interações significativas para explicar a ocorrência do óbito infantil entre cor de pele e escore socioeconômico e entre gestação classificada como de risco e peregrinação para o parto. O número excessivo de partos domiciliares e de peregrinação para o parto indica falhas na linha de cuidado da gestante e desarticulação entre os níveis de atenção ambulatorial e hospitalar. O estudo reforça a necessidade de uma gestão integrada das redes de atenção à saúde, potencializando as capacidades municipais em atender, com qualidade, à gestação, ao parto e ao nascimento.
Araujo, Ana Carla Pereira de; Santos, Bruno F de Oliveira; Calasans, Flavia Ricci; Pinto, Ibraim M Francisco; Oliveira, Daniel Pio de; Melo, Luiza Dantas; Andrade, Stephanie Macedo; Tavares, Irlaneide da Silva; Sousa, Antonio Carlos Sobral; Oliveira, Joselina Luzia Menezes
2014-11-01
Background: Studies have demonstrated the diagnostic accuracy and prognostic value of physical stress echocardiography in coronary artery disease. However, the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia is limited. Objective: To evaluate the effectiveness of physical stress echocardiography in the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia. Methods: This is a retrospective cohort in which 866 consecutive patients with exercise test positive for myocardial ischemia, and who underwent physical stress echocardiography were studied. Patients were divided into two groups: with physical stress echocardiography negative (G1) or positive (G2) for myocardial ischemia. The endpoints analyzed were all-cause mortality and major cardiac events, defined as cardiac death and non-fatal acute myocardial infarction. Results: G2 comprised 205 patients (23.7%). During the mean 85.6 ± 15.0-month follow-up, there were 26 deaths, of which six were cardiac deaths, and 25 non-fatal myocardial infarction cases. The independent predictors of mortality were: age, diabetes mellitus, and positive physical stress echocardiography (hazard ratio: 2.69; 95% confidence interval: 1.20 - 6.01; p = 0.016). The independent predictors of major cardiac events were: age, previous coronary artery disease, positive physical stress echocardiography (hazard ratio: 2.75; 95% confidence interval: 1.15 - 6.53; p = 0.022) and absence of a 10% increase in ejection fraction. All-cause mortality and the incidence of major cardiac events were significantly higher in G2 (p < 0. 001 and p = 0.001, respectively). Conclusion: Physical stress echocardiography provides additional prognostic information in patients with exercise test positive for myocardial ischemia.Fundamento: Estudos têm demonstrado a acurácia diagnóstica e o valor prognóstico da ecocardiografia com estresse físico na doença arterial coronária, mas a predição de mortalidade e de eventos cardíacos maiores, em pacientes com teste ergométrico positivo para isquemia miocárdica, é limitada. Objetivo: Avaliar a predição de mortalidade e de eventos cardíacos maiores pela ecocardiografia com estresse físico em pacientes com teste ergométrico positivo para isquemia miocárdica. Métodos: Trata-se de uma coorte retrospectiva em que foram estudados 866 pacientes consecutivos, com teste ergométrico positivo para isquemia miocárdica, submetidos à ecocardiografia com estresse físico. Os pacientes foram divididos em dois grupos: ecocardiografia com estresse físico negativa (G1) ou positiva (G2) para isquemia miocárdica. Os desfechos avaliados foram mortalidade por qualquer causa e eventos cardíacos maiores, definidos como óbito cardíaco e infarto agudo do miocárdio não fatal. Resultados: O G2 constituiu-se de 205 (23,7%) pacientes. Durante o seguimento médio de 85,6 ± 15,0 meses, ocorreram 26 óbitos, sendo seis por causa cardíaca, e 25 casos de infarto agudo do miocárdio não fatais. Os preditores independentes de mortalidade foram idade, diabetes melito e a ecocardiografia com estresse físico + (hazard ratio: 2,69; intervalo de confiança de 95%: 1,20 - 6,01; p = 0,016), com os seguintes eventos cardíacos maiores: idade, doença arterial coronária prévia, ecocardiografia com estresse físico + (hazard ratio: 2,75; intervalo de confiança de 95%: 1,15 - 6,53; p = 0,022) e ausência do incremento de 10% na fração de ejeção. A mortalidade por qualquer causa e os eventos cardíacos maiores foram significativamente superiores no G2 (p < 0, 001 e p = 0,001, respectivamente). Conclusão: A ecocardiografia com estresse físico oferece informações prognósticas adicionais em pacientes com teste ergométrico positivo para isquemia miocárdica.
Queda dos homicídios em São Paulo, Brasil: uma análise descritiva
Peres, Maria Fernanda Tourinho; Vicentin, Diego; Nery, Marcelo Batista; de Lima, Renato Sérgio; de Souza, Edinilsa Ramos; Cerda, Magdalena; Cardia, Nancy; Adorno, e Sérgio
2012-01-01
Objetivo Descrever a evolução da mortalidade por homicídios no Município de São Paulo segundo tipo de arma, sexo, raça ou cor, idade e áreas de exclusão/inclusão social entre 1996 e 2008. Métodos Estudo ecológico de série temporal. Os dados sobre óbitos ocorridos no Município foram coletados da base de dados do Programa de Aprimoramento das Informações sobre Mortalidade, seguindo a Classificação Internacional de Doenças, Décima Revisão (CID-10). Foram calculadas as taxas de mortalidade por homicídio (TMH) para a população total, por sexo, raça ou cor, faixa etária, tipo de arma e área de exclusão/inclusão social. As TMH foram padronizadas por idade pelo método direto. Foram calculados os percentuais de variação no período estudado. Para as áreas de exclusão/inclusão social foram calculados os riscos relativos de morte por homicídio. Resultados As TMH apresentaram queda de 73,7% entre 2001 e 2008. Foi observada redução da TMH em todos os grupos analisados, mais pronunciada em homens (−74,5%), jovens de 15 a 24 anos (−78,0%) e moradores de áreas de exclusão social extrema (−79,3%). A redução ocorreu, sobretudo, nos homicídios cometidos com armas de fogo (−74,1%). O risco relativo de morte por homicídio nas áreas de exclusão extrema (tendo como referência áreas com algum grau de exclusão social) foi de 2,77 em 1996, 3,9 em 2001 e 2,13 em 2008. Nas áreas de alta exclusão social, o risco relativo foi de 2,07 em 1996 e 1,96 em 2008. Conclusões Para compreender a redução dos homicídios no Município, é importante considerar macrodeterminantes que atingem todo o Município e todos os subgrupos populacionais e microdeterminantes que atuam localmente, influenciando de forma diferenciada os homicídios com armas de fogo e os homicídios na população jovem, no sexo masculino e em residentes em áreas de alta exclusão social. PMID:21390415
Sociodemographic and health factors associated with mortality in community-dwelling elderly.
Borim, Flávia Silva Arbex; Francisco, Priscila Maria Stolses Bergamo; Neri, Anita Liberalesso
2017-05-04
The objective of this study is to identify factors associated with mortality, with emphasis on gender and age differences. This is a cross-sectional study, which uses data from the FIBRA-2008-2009 network in Campinas, State of São Paulo, Brazil, with information on non-institutionalized residents of the urban area and the Mortality Information System. The dependent variable has been death, in 2013. The associations have been tested by odds ratio (OR) and their 95% confidence intervals, and the analyses have been conducted using the program Stata 12.0. Average age has been 72.3 years, 69.3% have been women, and 8.9% have died. We have found greater OR for mortality in individuals aged ≥ 75 years, classified as pre-frail or frail, and in those who have reported heart disease. In this study, the analysis of specific subgroups has allowed us to better understand the relationship between the factors associated with death in the elderly. With the exception of age, strategies based on primary and secondary care, focused on priority groups, can have a positive impact on the reduction of mortality among the elderly. Identificar fatores associados à mortalidade, com ênfase nas diferenças de gênero e idade. Trata-se de estudo transversal, utilizando dados provenientes da rede FIBRA-2008-2009 em Campinas, SP, com informações de pessoas não institucionalizadas residentes na área urbana e pelo Sistema de Informações de Mortalidade. A variável dependente foi a ocorrência de óbito, verificada em 2013. As associações foram testadas pelas razões de chances (OR) e respectivos intervalos de confiança de 95%, e as análises conduzidas no programa Stata 12.0. A média de idade foi 72,3 anos, 69,3% eram mulheres e 8,9% foram a óbito. Encontrou-se maior OR para mortalidade nos indivíduos com idade ≥ 75 anos, nos classificados como pré-frágil ou frágil e naqueles que referiram doença do coração. Neste estudo, a análise para os subgrupos específicos permitiu melhor compreender a relação entre fatores que se associam ao óbito no idoso. Com exceção da idade, estratégias baseadas no cuidado específico de atenção primária e secundária, direcionadas a grupos prioritários, podem ter um impacto positivo na redução da mortalidade entre os idosos.
Infant mortality by color or race from Rondônia, Brazilian Amazon.
Gava, Caroline; Cardoso, Andrey Moreira; Basta, Paulo Cesar
2017-04-10
To analyze the quality of records for live births and infant deaths and to estimate the infant mortality rate for skin color or race, in order to explore possible racial inequalities in health. Descriptive study that analyzed the quality of records of the Live Births Information System and Mortality Information System in Rondônia, Brazilian Amazonian, between 2006-2009. The infant mortality rates were estimated for skin color or race with the direct method and corrected by: (1) proportional distribution of deaths with missing data related to skin color or race; and (2) application of correction factors. We also calculated proportional mortality by causes and age groups. The capture of live births and deaths improved in relation to 2006-2007, which required lower correction factors to estimate infant mortality rate. The risk of death of indigenous infant (31.3/1,000 live births) was higher than that noted for the other skin color or race groups, exceeding by 60% the infant mortality rate in Rondônia (19.9/1,000 live births). Black children had the highest neonatal infant mortality rate, while the indigenous had the highest post-neonatal infant mortality rate. Among the indigenous deaths, 15.2% were due to ill-defined causes, while the other groups did not exceed 5.4%. The proportional infant mortality due to infectious and parasitic diseases was higher among indigenous children (12.1%), while among black children it occurred due to external causes (8.7%). Expressive inequalities in infant mortality were noted between skin color or race categories, more unfavorable for indigenous infants. Correction factors proposed in the literature lack to consider differences in underreporting of deaths for skin color or race. The specific correction among the color or race categories would likely result in exacerbation of the observed inequalities. Analisar a qualidade dos registros de nascidos vivos e de óbitos infantis e estimar a taxa de mortalidade infantil segundo cor ou raça, a fim de explorar iniquidades étnico-raciais em saúde. Estudo descritivo que analisou a qualidade dos registros do Sistema de Informações sobre Nascidos Vivos e do Sistema de Informações sobre Mortalidade em Rondônia, Amazônia brasileira, entre 2006-2009. As taxas de mortalidade infantil foram estimadas nas categorias de cor ou raça, pelo método direto, e corrigidas por: (1) distribuição proporcional dos óbitos com cor ou raça ignorada; e (2) aplicação de fatores de correção. Efetuou-se também o cálculo da mortalidade proporcional por causas e grupos etários. Entre 2008-2009, a captação de nascimentos e óbitos melhorou em relação aos anos de 2006-2007, requerendo fatores de correção menores para estimar a taxa de mortalidade infantil. O risco de morte de crianças indígenas (31,3/1.000 nascidos vivos) foi maior que o registrado nos demais grupos de cor ou raça, excedendo em 60% a mortalidade infantil média no estado (19,9/1.000 nascidos vivos). As crianças pretas apresentaram as maiores taxas de mortalidade infantil neonatal, enquanto as indígenas apresentaram as maiores taxas de mortalidade infantil pós-neonatal. Observou-se que 15,2% dos óbitos indígenas foram por causas mal definidas, enquanto nos demais grupos não ultrapassaram 5,4%. A mortalidade infantil proporcional por doenças infecciosas e parasitárias foi maior entre indígenas, ao passo que entre crianças pretas, sobressaíram as causas externas (8,7%). Observaram-se expressivas iniquidades na mortalidade infantil entre as categorias de cor ou raça, com situação mais desfavorável às crianças indígenas. Os fatores de correção propostos na literatura não consideram diferenças na subenumeração de óbitos entre as categorias de cor ou raça. A correção específica entre as categorias de cor ou raça provavelmente resultaria em exacerbação das iniquidades observadas.
NASA Astrophysics Data System (ADS)
Albuquerque, Daniel Filipe
Esta tese apresenta um sistema de localizacao baseado exclusivamente em ultrassons, nao necessitando de recorrer a qualquer outra tecnologia. Este sistema de localizacao foi concebido para poder operar em ambientes onde qualquer outra tecnologia nao pode ser utilizada ou o seu uso esta condicionado, como sao exemplo aplicacoes subaquaticas ou ambientes hospitalares. O sistema de localizacao proposto faz uso de uma rede de farois fixos permitindo que estacoes moveis se localizem. Devido a necessidade de transmissao de dados e medicao de distancias foi desenvolvido um pulso de ultrassons robusto a ecos que permite realizar ambas as tarefas com sucesso. O sistema de localizacao permite que as estacoes moveis se localizem escutando apenas a informacao em pulsos de ultrassons enviados pelos farois usando para tal um algoritmo baseado em diferencas de tempo de chegada. Desta forma a privacidade dos utilizadores e garantida e o sistema torna-se completamente independente do numero de utilizadores. Por forma a facilitar a implementacao da rede de farois apenas sera necessario determinar manualmente a posicao de alguns dos farois, designados por farois ancora. Estes irao permitir que os restantes farois, completamente autonomos, se possam localizar atraves de um algoritmo iterativo de localizacao baseado na minimizacao de uma funcao de custo. Para que este sistema possa funcionar como previsto sera necessario que os farois possam sincronizar os seus relogios e medir a distancia entre eles. Para tal, esta tese propoe um protocolo de sincronizacao de relogio que permite tambem obter as medidas de distancia entre os farois trocando somente tres mensagens de ultrassons. Adicionalmente, o sistema de localizacao permite que farois danificados possam ser substituidos sem comprometer a operabilidade da rede reduzindo a complexidade na manutencao. Para alem do mencionado, foi igualmente implementado um simulador de ultrassons para ambientes fechados, o qual provou ser bastante preciso e uma ferramenta de elevado valor para simular o comportamento do sistema de localizacao sobre condicoes controladas.
Rinaldi, Mariano; Mezzano, Emilio; Berra, Matias S.; Parés, Herald R.; Olocco, Ricardo V.; Papalini, Francisco R.
2015-01-01
Objetivo: Describir nuestra experiencia en el manejo de las Mavs analizando las características clínicas de los pacientes y los resultados postoperatorios. Método de análisis: Realizamos un análisis retrospectivo de 52 pacientes admitidos en el Servicio de neurocirugía para manejo quirúrgico: La información de referencia incluyo síntomas al inicio, diagnostico de admisión, hallazgos neurológicos y hallazgos en estudio por imágenes tales como tomografía cerebral, IRM cerebral y angiografía por sustracción digital. Los hallazgos postoperatorios de interés fueron: Mortalidad, examen neurológico postoperatorio y complicaciones asociadas. Presentamos nuestro análisis estadístico. Resultados: Edad promedio: 37,7 años. Distribución: Hombres: 61,5%. Motivos de consulta más frecuentes: Cefalea 63,5%, evento hemorrágico 59,6%, convulsiones 26,9%. Localización: Supratentorial: 92,9%, Infratentorial: 7,2%. 30,8%, de las Mavs fueron grado 2 y grado 3 Cincuenta por ciento del total presentaron aneurismas, del total de la MAVs, 59,6% debutó con sangrado, 26,9% con Crisis Convulsivas y 13,5% con déficit neurológico. Recibieron tratamiento endovascular previo a cirugía 30,7%. Durante el postoperatorio 23,1% presentaron mejoría clínica, 57,7% no presento modificación, 19,2% empeoraron en el postoperatorio. La mortalidad fue 13,5%. Conclusión: Creemos que el subgrupo de Mavs grados III a V representan una entidad que requiere una compleja toma de decisiones dada la alta incidencia de aneurismas asociados que presentan y su asociación con eventos de sangrado. Nuestra mortalidad postoperatoria coincide con la bibliografía. Palabras clave, Mavs- aneurismas asociados- Acv hemorrágico- convulsiones. PMID:26600984
Factors associated with mortality in patients undergoing coronary artery bypass grafting.
Koerich, Cintia; Lanzoni, Gabriela Marcellino de Melo; Erdmann, Alacoque Lorenzini
2016-08-08
to investigate the factors associated with mortality in patients undergoing coronary artery bypass grafting in a cardiovascular referral hospital in Santa Catarina. quantitative, exploratory, descriptive and retrospective study. The medical records of 1447 patients, from 2005 to 2013, were analyzed for statistically related variables, these being: profile, hospitalization diagnosis, risk factors for coronary artery disease, complications recorded during the hospitalization, length of hospitalization and cause of death. the mortality rate was 5.3% during the study period. Death was more common in females and those of black skin color, with a mean age of 65 years. Acute myocardial infarction was the most common hospitalization diagnosis. The majority of the complications recorded during hospitalization were characterized by changes in the cardiovascular system, with longer hospitalization periods being directly related to death from septic shock. the data provide subsidies for nursing work with preventive measures and early detection of complications associated with coronary artery bypass grafting. This reinforces the importance of using the data as quality indicators, aiming to guarantee care guided by reliable information to guide managers in planning patient care and high complexity health services. conhecer os fatores associados à mortalidade de pacientes submetidos à cirurgia de revascularização do miocárdio em hospital referência cardiovascular em Santa Catarina. estudo quantitativo, exploratório, descritivo e retrospectivo. Foram analisados os prontuários de 1447 pacientes, entre 2005 e 2013, e as variáveis relacionadas estatisticamente, sendo estas: perfil, diagnóstico da internação, fatores de risco para doença arterial coronariana, intercorrências registradas na internação, tempo de internação e causa do óbito. a taxa de mortalidade foi de 5,3% no período do estudo. Os óbitos foram mais frequentes em negros, do sexo feminino e média de idade de 65 anos. O infarto agudo do miocárdio foi o diagnóstico de internação que apresentou maior representatividade. A maioria das intercorrências registradas durante a internação caracterizou-se por alterações do sistema cardiovascular e o maior tempo de internação teve relação direta com óbito por choque séptico. os dados fornecem subsídios para a enfermagem atuar com medidas preventivas e identificação precoce de intercorrências associadas à cirurgia de revascularização do miocárdio. Reforça-se a importância da utilização dos dados como indicadores de qualidade objetivando garantir um cuidado pautado em informações confiáveis que orientem gestores no planejamento da assistência ao paciente e dos serviços de saúde de alta complexidade. conocer los factores asociados a la mortalidad de pacientes sometidos a cirugía de revascularización del miocardio en un hospital de referencia cardiovascular en el estado de Santa Catarina. estudio cuantitativo, exploratorio, descriptivo y retrospectivo. Fueron analizados las fichas médicas de 1.447 pacientes, entre 2005 y 2013; las variables relacionadas estadísticamente fueron: perfil, diagnóstico de la internación, factores de riesgo para enfermedad arterial coronariana, complicaciones registradas en la internación, tiempo de internación y causa de la muerte. la tasa de mortalidad fue de 5,3%, en el período del estudio. Las muertes fueron más frecuentes en negros, sexo femenino y promedio de edad de 65 años. El infarto agudo del miocardio fue el diagnóstico de internación que presentó mayor representatividad. La mayoría de las complicaciones registradas durante la internación se caracterizó por alteraciones del sistema cardiovascular; el mayor tiempo de internación tuvo relación directa con muerte por choque séptico. los datos suministran informaciones para que la enfermería pueda actuar con medidas preventivas e identificar precozmente complicaciones asociadas a la cirugía de revascularización del miocardio. Se refuerza la importancia de la utilización de datos como indicadores de calidad, objetivando garantizar un cuidado guiado por informaciones confiables que orienten a los administradores en la planificación de la asistencia al paciente y en los servicios de salud de alta complejidad.
Management changes resulting from hospital accreditation.
Oliveira, João Lucas Campos de; Gabriel, Carmen Silvia; Fertonani, Hosanna Pattrig; Matsuda, Laura Misue
2017-03-02
to analyze managers and professionals' perceptions on the changes in hospital management deriving from accreditation. descriptive study with qualitative approach. The participants were five hospital quality managers and 91 other professionals from a wide range of professional categories, hierarchical levels and activity areas at four hospitals in the South of Brazil certified at different levels in the Brazilian accreditation system. They answered the question "Tell me about the management of this hospital before and after the Accreditation". The data were recorded, fully transcribed and transported to the software ATLAS.ti, version 7.1 for access and management. Then, thematic content analysis was applied within the reference framework of Avedis Donabedian's Evaluation in Health. one large family was apprehended, called "Management Changes Resulting from the Accreditation: perspectives of managers and professionals" and five codes, related to the management changes in the operational, structural, financial and cost; top hospital management and quality management domains. the management changes in the hospital organizations resulting from the Accreditation were broad, multifaceted and in line with the improvements of the service quality. analizar las percepciones de gestores y trabajadores sobre los cambios en la gestión hospitalaria resultantes de la Acreditación. estudio descriptivo con aproximación cualitativa. Participaron cinco gestores de calidad hospitalaria y otros 91 trabajadores de las más diversas categorías profesionales, niveles jerárquicos y áreas de actuación de cuatro hospitales del sur de Brasil certificados por la Acreditación nacional de diferentes niveles, que contestaron la pregunta "Cuéntame sobre la gestión de este hospital, antes y después de la Acreditación". Los datos fueron grabados, transcritos por completo y transportados para acceso y manoseo en el software ATLAS.ti, versión 7.1. A seguir, fue aplicado el análisis de contenido, modalidad temática, a la luz del referencial de la Evaluación en Salud de Avedis Donabedian. fue aprendida una gran categoría temática (family), llamada "Cambios Gerenciales Resultantes de la Acreditación: perspectivas de gestores y trabajadores" y cinco subcategorías (codes), relacionadas a los cambios gerenciales en las esferas operacional; estructural; financiera y de costo; en la alta gestión hospitalaria; y en la gestión de calidad. los cambios gerenciales en las organizaciones hospitalarias, resultantes de la Acreditación, fueron amplias, polifacéticas y coherentes con las mejoras en la calidad de los servicios. analisar as percepções de gestores e trabalhadores sobre as mudanças no gerenciamento hospitalar advindas da Acreditação. estudo descritivo com abordagem qualitativa. Participaram cinco gestores da qualidade hospitalar e outros 91 trabalhadores das mais diversas categorias profissionais, níveis hierárquicos e áreas de atuação de quatro hospitais do sul do Brasil certificados pela Acreditação nacional de diferentes níveis, que responderam à questão "Fale-me sobre o gerenciamento deste hospital, antes e depois da Acreditação". Os dados foram gravados, transcritos na íntegra e transportados para acesso e manejo no software ATLAS.ti, versão 7.1. Após isso, procedeu-se a análise de conteúdo, modalidade temática, sustentada à luz do referencial da Avaliação em Saúde de Avedis Donabedian. apreendeu-se uma grande categoria temática (family), denominada "Mudanças Gerenciais Advindas da Acreditação: perspectivas de gestores e trabalhadores" e cinco subcategorias (codes), relacionadas às mudanças gerenciais no âmbito operacional; estrutural; financeiro e de custo; na alta gestão hospitalar; e na gestão da qualidade. as mudanças gerenciais nas organizações hospitalares, advindas da Acreditação, se mostraram amplas, multifacetadas e coadunam às melhorais da qualidade nos serviços.
Torres Díaz, Cristina V; Martín Peña, Gonzalo; Ezquiaga, Elena; Navas García, Marta; García de Sola, Rafael
2016-07-19
Gracias a los avances técnicos en técnicas neuroquirúrgicas, y debido a que el diagnóstico y la clasificación de las enfermedades psiquiátricas han evolucionado significativamente a lo largo de las últimas décadas, se están desarrollando tratamientos a nivel experimental para aquellos pacientes resistentes al manejo conservador.La anorexia nerviosa es una enfermedad de prevalencia creciente, con la tasa de mortalidad más elevada dentro de los trastornos psiquiátricos, y con aproximadamente un 20% de pacientes que presentan una evolución tórpida. Para estos pacientes que no responden a manejo conservador, la estimulación cerebral profunda ha surgido como una alternativa terapéutica, si bien la literatura especializada al respecto es escasa.A continuación presentamos una revisión de la fisiopatología de la anorexia nerviosa, así como de los distintos tratamientos neuroquirúrgicos realizados a lo largo de la historia. Se detalla la perspectiva de tratamiento quirúrgico actual, así como los aspectos éticos que se han de considerar en relación con el surgimiento de estas nuevas terapias.
Costs of topical treatment of pressure ulcer patients.
Andrade, Cynthia Carolina Duarte; Almeida, Cláudia Fernanda Dos Santos Calixto de; Pereira, Walkíria Euzébio; Alemão, Márcia Mascarenhas; Brandão, Cristina Mariano Ruas; Borges, Eline Lima
2016-04-01
To evaluate the costs of a topical treatment of pressure ulcer (PU) patients in a hospital unit for treatment of chronic patients in 2014. This is an activity-based costing study. This method encompasses the identification, measurement and pricing of physical and human resources consumed for dressings. Procedure costs varied between BRL 16.41 and BRL 260.18. For PUs of the same category, of near areas and with the same type of barrier/adjuvant, the cost varied between 3.5% and 614.6%. For most dressings, the cost increased proportionally to the increase of the area and to the development of PU category. The primary barrier accounted for a high percentage of costs among all items required to the application of dressings (human and material resources). Dressings applied in sacral PUs had longer application times. This study allowed us to understand the costs involved in the treatment of PUs, and it may support decision-makers and other cost-effectiveness studies. Realizar uma avaliação do custo do tratamento tópico de pacientes com úlceras por pressão (UP), em uma unidade hospitalar de atendimento a pacientes crônicos no ano de 2014. Trata-se de um estudo de custos baseado no Sistema de custeio Baseado em Atividades. Este método contempla a identificação, mensuração e precificação dos recursos físicos e humanos consumidos para a realização de curativos. Os custos dos procedimentos variaram de R$16,41 a R$260,18. Para UP de mesma categoria, de áreas aproximadas e mesmo tipo de cobertura/adjuvante, a variação entre os custos foi de 3,5% a 614,6%. Para a maioria dos curativos, o custo aumentou proporcionalmente ao aumento da área e à progressão da categoria das UP. A cobertura primária representou elevado percentual nos custos entre todos os itens necessários para realizar os curativos (recursos humanos e materiais). Os curativos realizados nas UP sacrais foram os que apresentaram maiores tempos para execução. Este estudo permitiu conhecer os custos envolvidos no tratamento das UP e pode fornecer subsídios para os tomadores de decisão, assim como para a realização de estudos de custo-efetividade.
Cicero-Oneto, Carlo Egysto; Mata-Valderrama, Guadalupe; Valdez-Martínez, Edith
Describir los aspectos epidemiológicos, clínicos y éticos de la mortalidad de los adolescentes con cáncer en -México. Se revisaron 63 expedientes clínicos de adolescentes (de 14 a 18 años de edad) con cáncer, fallecidos entre 2011 y 2014, para obtener información clínica y epidemiológica de su muerte. Los sitios de estudio fueron tres hospitales de concentración en la Ciudad de México. De los 40 adolescentes con criterios de fase terminal, 16 (40%) continuaron recibiendo tratamiento con fines curativos. De los 51 cuyo lugar de muerte era conocido, 45 (88%) murieron en hospital. De los 41 que murieron dentro de los 30 días de su última hospitalización, las muertes fueron principalmente debidas a complicaciones (51%), a progresión de la enfermedad (41%) o bien fueron muertes en tratamiento paliativo (7%, 3/41). La práctica oncológica descansa en lo que es conocido como modelo biomédico. Los resultados del estudio sugieren y apoyan la urgente necesidad de implementar verdaderos servicios de cuidados paliativos, pero más importante que eso, está el ímpetu de poner la ética de la práctica clínica en acción, y de ese modo reforzar la buena práctica de la medicina. Copyright: © 2018 SecretarÍa de Salud
Gomes, Gustavo Gir; Gali, Wagner Luis; Sarabanda, Alvaro Valentim Lima; Cunha, Claudio Ribeiro da; Kessler, Iruena Moraes; Atik, Fernando Antibas
2017-07-01
Cox-Maze III procedure is one of the surgical techniques used in the surgical treatment of atrial fibrillation (AF). To determine late results of Cox-Maze III in terms of maintenance of sinus rhythm, and mortality and stroke rates. Between January 2006 and January 2013, 93 patients were submitted to the cut-and-sew Cox-Maze III procedure in combination with structural heart disease repair. Heart rhythm was determined by 24-hour Holter monitoring. Procedural success rates were determined by longitudinal methods and recurrence predictors by multivariate Cox regression models. Thirteen patients that obtained hospital discharge alive were excluded due to lost follow-up. The remaining 80 patients were aged 49.9 ± 12 years and 47 (58.7%) of them were female. Involvement of mitral valve and rheumatic heart disease were found in 67 (83.7%) and 63 (78.7%) patients, respectively. Seventy patients (87.5%) had persistent or long-standing persistent AF. Mean follow-up with Holter monitoring was 27.5 months. There were no hospital deaths. Sinus rhythm maintenance rates were 88%, 85.1% and 80.6% at 6 months, 24 months and 36 months, respectively. Predictors of late recurrence of AF were female gender (HR 3.52; 95% CI 1.21-10.25; p = 0.02), coronary artery disease (HR 4.73 95% CI 1.37-16.36; p = 0.01) and greater left atrium diameter (HR 1.05; 95% CI 1.01-1.09; p = 0.02). Actuarial survival was 98.5% at 12, 24 and 48 months and actuarial freedom from stroke was 100%, 100% and 97.5% in the same time frames. The Cox-Maze III procedure, in our experience, is efficacious for sinus rhythm maintenance, with very low late mortality and stroke rates. A operação de Cox-Maze III é uma das variantes técnicas no tratamento cirúrgico da fibrilação atrial (FA). Estudar os resultados tardios da operação de Cox-Maze III, quanto à eficácia na manutenção de ritmo sinusal e taxas de mortalidade e acidente vascular cerebral (AVC). Entre janeiro de 2006 a janeiro de 2013, 93 pacientes foram submetidos a operação de Cox-Maze III por corte e sutura associada a correção de cardiopatias estruturais. Avaliação do ritmo cardíaco ocorreu por Holter 24 horas. Taxas de sucesso da operação foram estudadas por métodos longitudinais e os preditores de recorrência por análise de regressão de Cox multivariada. Foram excluídos 13 pacientes sobreviventes ao período intra-hospitalar cujo seguimento tardio não foi possível. Os 80 pacientes restantes tinham idade média de 49,9 ± 12 anos e 47 (58,75%) eram do sexo feminino. Acometimento da valva mitral ocorreu em 67 pacientes (83,7%). Valvopatia reumática ocorreu em 63 (78,7%). Setenta pacientes (87,5%) tinham fibrilação atrial persistente ou persistente de longa duração. O tempo médio de seguimento clínico com avaliação de Holter foi de 27,5 meses. Não houve óbitos intra-hospitalares. As taxas de manutenção de ritmo sinusal foram 88%, 85,1% e 80,6% aos 6 meses, 24 meses e 36 meses, respectivamente. Os preditores de recorrência tardia foram sexo feminino (RR 3,52; IC 95% 1,21-10,25; p = 0,02), doença arterial coronária (RR 4,73; IC 95% 1,37-16,36; p = 0,01) e maior diâmetro de átrio esquerdo (RR 1,05; IC 95% 1,01-1,09; p = 0,02). A sobrevida atuarial aos 12, 24 e 48 meses foi de 98,5% e as taxas atuariais livres de AVC nos mesmos períodos de 100%, 100% e 97,5%. A operação de Cox-Maze III, na nossa experiência, é eficaz na manutenção do ritmo sinusal, com baixíssimos índices de mortalidade e de AVC tardios.
Zanchet, Marcos Vinícius; Silva, Larissa Luvison Gomes da; Matias, Jorge Eduardo Fouto; Coelho, Júlio Cezar Uili
2016-01-01
The outcome of the patients after liver transplant is complex and to characterize the risk for complications is not always easy. In this context, the hepatic post-reperfusion biopsy is capable of portraying alterations of prognostic importance. To compare the results of liver transplantation, correlating the different histologic features of the hepatic post-reperfusion biopsy with graft dysfunction, primary non-function and patient survival in the first year after transplantation. From the 377 transplants performed from 1996 to 2008, 164 patients were selected. Medical records were reviewed and the following clinical outcomes were registered: mortality in 1, 3, 6 and 12 months, graft dysfunction in varied degrees and primary graft non-function. The post-reperfusion biopsies had been examined by a blinded pathologist for the outcomes. The following histological variables had been evaluated: ischemic alterations, congestion, steatosis, neutrophilic exudate, monomorphonuclear infiltrate and necrosis. The variables associated with increased mortality were: steatosis (p=0.02209), monomorphonuclear infiltrate (p=0.03935) and necrosis (p<0.00001). The neutrophilic exudate reduced mortality in this study (p=0.00659). The primary non-function showed significant association (p<0.05) with the necrosis, steatosis and the monomorphonuclear infiltrate. Post-reperfusion biopsy is useful tool to foresee complications after liver transplant. A evolução dos pacientes após transplante hepático é complexa e caracterizar o risco para complicações nem sempre é fácil. Nesse contexto, a biópsia hepática pós-reperfusão é capaz de retratar alterações de importância prognóstica. Avaliar os resultados no primeiro ano após transplante hepático, correlacionando as alterações histológicas à biópsia hepática pós-reperfusão com a sobrevida, a disfunção e o não-funcionamento primário do enxerto. Dos 377 transplantes ocorridos de 1996 a 2008, 164 pacientes foram selecionados para estudo. Os seguintes desfechos clínicos foram registrados: mortalidade em 1, 3, 6 e 12 meses, disfunção do enxerto em graus variados e o não-funcionamento primário do enxerto. As biópsias pós-reperfusão foram examinadas por um patologista sem conhecimento dos resultados. As seguintes variáveis histológicas foram avaliadas: alterações isquêmicas, congestão, esteatose, exsudato neutrofílico, infiltrado monomorfonuclear e necrose. As variáveis associadas com aumento da mortalidade foram: esteatose (p=0.02209), infiltrado monomorfonuclear (p=0.03935) e necrose (p<0.00001). O infiltrado neutrofílico reduziu a mortalidade neste estudo (p=0.00659). O não-funcionamento primário do enxerto mostrou associação significativa (p<0.05) com a necrose, a esteatose e com o infiltrado monomorfonuclear. A biópsia hepática pós-reperfusão é ferramenta útil em prever complicações após o transplante hepático.
Coppola, Federico; Campbell, Juan Iaconis; Herrero, Juan Manuel; Volpe, Emilio; Cersosimo, Tito
2017-01-01
Resumen Introducción: Los meningiomas Grado II tienen un comportamiento biológico más agresivo que los Grado I. A partir del año 2007, con los nuevos criterios de clasificación, la incidencia de meningiomas atípicos reportada aumentó hasta un 35%. Objetivo: Establecer diferencias entre los Meningiomas Grado I y II de la clasificación de la OMS, en lo que respecta a: grados de resección de Simpson, localización tumoral, necesidad de reintervención, tratamiento adyuvante, evolución y mortalidad. Métodos: Estudio retrospectivo de 63 pacientes operados entre el periodo 2009-2015. Variables analizadas: sexo, edad, grado histológico, localización, grado de resección quirúrgica, radioterapia adyuvante, mortalidad y evolución. Resultados: Se analizaron 63 pacientes: 51 Grado I y 12 Grado II de la clasificación de la OMS. La distribución por sexo no mostró diferencias entre meningiomas benignos y atípicos. Tampoco el grupo etario de presentación; mediana de 57 años. Un 55% de los meningiomas benignos se localizaron fuera de la base del cráneo versus el 91,6% de los meningiomas atípicos (P = 0.02). En el 74,5% de los meningiomas benignos se logró una resección total (Simpson I-II-III) versus el 58.3% para los atípicos (P = 0.3). Se reintervinieron el 33,3% de meningiomas atípicos en comparación con el 9.8% de los benignos (P = 0.03). Tuvieron una buena evolución el 86,2% de los benignos vs el 53,8% de los GII (P = 0.01). Realizaron radioterapia adyuvante el 33,3% de los meningiomas Grado II vs el 1,9% de los Grado I. Conclusiones: Los meningiomas atípicos cerebrales tienen peor pronóstico evolutivo que los Grado I de la OMS. Presentan una mayor tasa de reintervención y se localizan más frecuentemente fuera de la base del cráneo. La localización pareciera ser un factor de riesgo para el desarrollo de meningiomas atípicos. PMID:29142779
Total number of planetary nebulae in different galaxies and the PN distance scale.
NASA Astrophysics Data System (ADS)
Peimbert, M.
1990-12-01
RESUMEN A partir de una muestra de quince galaxias se encuentra que la tasa de natalidad de nebulosas planetarias por unidad de luminosidad, , disminuye al aumentar la luminosidad y al aumentar (B - V)0. Se discuten posibles explicaciones para estos resultados. Se estima el valor de para la Galaxia y a partir de el se encuentra que el numero total de nebulosas planetarias en nuestra galaxia con R < 0.64 pc- es de 7200 j 1800. El valor galactico de implica que la mayorfa de las estrellas de masa intermedia pasa por la etapa de nebulosa planetaria. El valor galactico de , la tasa de mortalidad estelar por unidad de luminosidad y la tasa de natalidad de enanas blancas favorecen escalas de distancias largas para nebulosas planetarias, como la de Cudworth (1974) y la de Mallik y Peimbert (1988). ABSTRACT From a sample of fifteen galaxies it is found that the birth rate of PN per unit luminosity, , decreases with increasing luminosity and with increasing (B - V)0 possible reasons for these relationships are discussed. The value for the Galaxy is estimated and, from it, a total number of PN of 7200 # 1800 wid R < 0.64 pc is obtained. The galactic value implies that most of the intermediate mass stars go through the PN stage. The galactic value, the stellar death rate per unit luminosity and the white dwarf birth rate are in favor of long distance scales to PN like those of Cudworth (1974) and Mallik and (1988). Key wonis: NEBULAE.PLANETARY - STARS-EVOLUTION - STARS-SThLIAR STA. S
Intra-aortic balloon pump in cardiogenic shock: state of the art.
Thomaz, Petronio Generoso; Moura, Leonel Adelino; Muramoto, Giovana; Assad, Renato Samy
2017-01-01
The clinical definition of cardiogenic shock is that of a low cardiac output and evidence of tissue hypoxia in the presence of adequate blood volume. Cardiogenic shock is the main cause of death related to acute myocardial infarction (AMI), with a mortality rate of 45-70% in the absence of aggressive and highly specialized technical care. The intra-aortic balloon pump (IABP) is one of the most widely used mechanical assisting devices. During the last two decades, about 42% of patients with AMI who evolved with cardiogenic shock received mechanical circulatory assistance with IABP. Its clinical indication has been based on non-randomized studies and registry data. Recent studies have shown that the use of IABP did not reduce 30-day mortality in patients with AMI and cardiogenic shock treated with the strategy of early myocardial revascularization as the planned primary objective. The guidelines of the American Heart Association and of the European Society of Cardiology have reassessed their recommendations based on the results of meta-analyzes, including the IABP-SCHOCK II Trial study, which did not evidence an increase in survival of patients who received mechanical support with IABP. This review article addresses the clinical impact of IABP use in the cardiogenic shock caused by AMI. RESUMO A definição clínica de choque cardiogênico é a de um quadro de baixo débito cardíaco e evidência de hipóxia tecidual, na presença de volemia adequada. O choque cardiogênico representa a principal causa de óbito relacionada ao infarto agudo do miocárdio (IAM), com índice de mortalidade em torno de 45% a 70%, na ausência de cuidados técnicos agressivos e altamente especializados. O balão intra-aórtico (BIA) é um dos dispositivos de assistência mecânica mais utilizados no mundo. Nas duas últimas décadas, cerca de 42% dos pacientes com IAM, que evoluíram com choque cardiogênico, receberam assistência circulatória mecânica com BIA. Sua indicação clínica tem sido baseada em estudos não randomizados e dados de registro. Estudos recentes têm demonstrado que o uso do BIA não reduziu a mortalidade hospitalar (30 dias) em pacientes com IAM e choque cardiogênico, tratados com a estratégia de revascularização precoce do miocárdio como objetivo primário planejado. As diretrizes da Associação Americana de Cardiologia e da Sociedade Europeia de Cardiologia reavaliaram suas recomendações, baseadas nos resultados de metanálises, incluindo o estudo IABP-SCHOCK II Trial, que não evidenciou aumento na sobrevida de pacientes que receberam suporte mecânico com BIA. Este artigo de revisão aborda o impacto clínico do uso do BIA no choque cardiogênico ocasionado pelo IAM.
Profilaxia de tromboembolismo venoso na gestação
de Oliveira, André Luiz Malavasi Longo; Marques, Marcos Arêas
2016-01-01
Resumo O tromboembolismo venoso é importante causa de morbidade e mortalidade obstétrica. Durante a gestação, o risco de sua ocorrência aumenta entre cinco e dez vezes quando comparado ao de mulheres não gestantes de mesma idade. Associado a esse fato, a gestante apresenta algumas limitações para o diagnóstico clínico (alta frequência de dor e edema nos membros inferiores), ecográfico (menor sensibilidade e especificidade no diagnóstico de trombose venosa de ilíaca com a evolução da gestação) e laboratorial (o D-dímero apresenta aumento progressivo no decorrer da gravidez). Uma estratificação criteriosa de risco de tromboembolismo venoso de cada mulher antes da gestação pode diminuir a incidência dessa doença, frequente e de difícil diagnóstico na gravidez, e suas complicações. PMID:29930607
dos Santos, Reinaldo Benevides; Queiroz, André Brito; Fidelis, Ronald José Ribeiro; Lopes, Cicero Fidelis; de Araújo, José Siqueira
2017-01-01
Resumo A doença aterosclerótica das carótidas extracranianas pode resultar em complicações com alta morbidade e mortalidade. A avaliação pré-operatória com exames contrastados de imagem é associada a complicações como a parotidite, além das já bem conhecidas reações alérgicas e da disfunção renal. A bifurcação carotídea alta e a doença aterosclerótica de extensão cranial costumam ser fatores limitantes para o tratamento cirúrgico convencional. Entretanto, quando há contraindicação ao uso de contraste iodado ou impossibilidade do tratamento endovascular, há a necessidade do conhecimento de técnicas cirúrgicas que permitam a realização da endarterectomia com segurança. A subluxação da mandíbula se mostrou uma técnica adjuvante segura e efetiva, de fácil execução e reprodutibilidade, possibilitando o acesso a bifurcações carotídeas altas com boa exposição do campo cirúrgico e permitindo a realização da endarterectomia conforme a técnica padrão. Apresentamos o caso de uma paciente com bifurcação carotídea alta e com limitações para uso do contraste iodado que foi submetida a endarterectomia carotídea após subluxação de mandíbula. PMID:29930669
Simple motor tasks independently predict extubation failure in critically ill neurological patients.
Kutchak, Fernanda Machado; Rieder, Marcelo de Mello; Victorino, Josué Almeida; Meneguzzi, Carla; Poersch, Karla; Forgiarini, Luiz Alberto; Bianchin, Marino Muxfeldt
2017-01-01
To evaluate the usefulness of simple motor tasks such as hand grasping and tongue protrusion as predictors of extubation failure in critically ill neurological patients. This was a prospective cohort study conducted in the neurological ICU of a tertiary care hospital in the city of Porto Alegre, Brazil. Adult patients who had been intubated for neurological reasons and were eligible for weaning were included in the study. The ability of patients to perform simple motor tasks such as hand grasping and tongue protrusion was evaluated as a predictor of extubation failure. Data regarding duration of mechanical ventilation, length of ICU stay, length of hospital stay, mortality, and incidence of ventilator-associated pneumonia were collected. A total of 132 intubated patients who had been receiving mechanical ventilation for at least 24 h and who passed a spontaneous breathing trial were included in the analysis. Logistic regression showed that patient inability to grasp the hand of the examiner (relative risk = 1.57; 95% CI: 1.01-2.44; p < 0.045) and protrude the tongue (relative risk = 6.84; 95% CI: 2.49-18.8; p < 0.001) were independent risk factors for extubation failure. Acute Physiology and Chronic Health Evaluation II scores (p = 0.02), Glasgow Coma Scale scores at extubation (p < 0.001), eye opening response (p = 0.001), MIP (p < 0.001), MEP (p = 0.006), and the rapid shallow breathing index (p = 0.03) were significantly different between the failed extubation and successful extubation groups. The inability to follow simple motor commands is predictive of extubation failure in critically ill neurological patients. Hand grasping and tongue protrusion on command might be quick and easy bedside tests to identify neurocritical care patients who are candidates for extubation. Avaliar a utilidade de tarefas motoras simples, tais como preensão de mão e protrusão da língua, para predizer extubação malsucedida em pacientes neurológicos críticos. Estudo prospectivo de coorte realizado na UTI neurológica de um hospital terciário em Porto Alegre (RS). Pacientes adultos que haviam sido intubados por motivos neurológicos e que eram candidatos ao desmame foram incluídos no estudo. O estudo avaliou se a capacidade dos pacientes de realizar tarefas motoras simples como apertar as mãos do examinador e pôr a língua para fora seria um preditor de extubação malsucedida. Foram coletados dados referentes ao tempo de ventilação mecânica, tempo de internação na UTI, tempo de internação hospitalar, mortalidade e incidência de pneumonia associada à ventilação mecânica. Foram incluídos na análise 132 pacientes intubados que haviam recebido ventilação mecânica durante pelo menos 24 h e que passaram no teste de respiração espontânea. A regressão logística mostrou que a incapacidade dos pacientes de apertar a mão do examinador (risco relativo = 1,57; IC95%: 1,01-2,44; p < 0,045) e de pôr a língua para fora (risco relativo = 6,84; IC95%: 2,49-18,8; p < 0,001) foram fatores independentes de risco de extubação malsucedida. Houve diferenças significativas entre os pacientes nos quais a extubação foi malsucedida e aqueles nos quais a extubação foi bem-sucedida quanto à pontuação obtida no Acute Physiology and Chronic Health Evaluation II (p = 0,02), pontuação obtida na Escala de Coma de Glasgow no momento da extubação (p < 0,001), abertura dos olhos em resposta ao comando (p = 0,001), PImáx (p < 0,001), PEmáx (p = 0,006) e índice de respiração rápida e superficial (p = 0,03). A incapacidade de obedecer a comandos motores simples é preditora de extubação malsucedida em pacientes neurológicos críticos. Preensão de mão e protrusão da língua em resposta ao comando podem ser testes rápidos e fáceis realizados à beira do leito para identificar pacientes neurológicos críticos que sejam candidatos à extubação.
Nomura, Aline Tsuma Gaedke; Silva, Marcos Barragan da; Almeida, Miriam de Abreu
2016-11-21
to analyze the quality of nursing documentation by comparing the periods before and after the preparation for the hospital accreditation, using the Quality of Nursing Diagnoses, Interventions and Outcomes - Brazilian version (Q-DIO- Brazilian version). observational study of interventions conducted in a university hospital. Nursing documentation of 112 medical records for the period before and 112 for the period after the hospital accreditation were compared using the Q-DIO instrument - Brazilian version. Data were statistically analyzed. there was a significant improvement in the quality of nursing documentation. When the total score of the instrument was evaluated, a significant improvement was observed in 24 out of the 29 items (82.8%). there was commitment to the shift of culture by means of the interventions carried out, which resulted in the conquest of the quality seal ensured by the Joint Commission International. analisar a qualidade dos registros de enfermagem, comparando o período antes e depois do preparo para a acreditação hospitalar, fazendo uso do Quality of Nursing Diagnoses, Interventions and Outcomes - Versão brasileira (Q-DIO-Versão brasileira). estudo observacional de intervenções realizado em um hospital universitário. Comparados os registros de enfermagem em 112 prontuários referentes ao período anterior a acreditação hospitalar e 112 ao período posterior, por meio do instrumento Q-DIO - Versão brasileira. Os dados foram analisados estatisticamente. houve melhora significativa da qualidade dos registros de enfermagem. Quando avaliado o escore total do instrumento evidenciou melhora significativa em 24 dos 29 itens (82,8%). houve empenho à mudança de cultura por meio das intervenções realizadas, refletida na conquista do selo de qualidade da Joint Commission Internacional. analizar la calidad de los registros de enfermería, comparando los períodos antes y después de la preparación para la acreditación hospitalaria, haciendo uso del Quality of Nursing Diagnoses, Interventions and Outcomes - Versión brasileña (Q-DIO- Versión brasileña). estudio observacional de intervenciones realizado en un hospital universitario. Los registros de enfermería de 112 historias clínicas del período anterior y 112 historias clínicas del período posterior a la acreditación hospitalaria se compararon mediante el instrumento Q-DIO - Versión brasileña. Los datos fueron analizados estadísticamente. se observó una mejora significativa de la calidad de los registros de enfermería. Cuando se evaluó la puntuación total del instrumento, se observó una mejora significativa en 24 de los 29 ítenes (82,8%). hubo un compromiso con el cambio en la cultura por medio de las intervenciones realizadas, lo que resultó en la conquista del sello de calidad garantizado por la Joint Commission International.
Patient safety and nursing: interface with stress and Burnout Syndrome.
Rodrigues, Cláudia Cristiane Filgueira Martins; Santos, Viviane Euzébia Pereira; Sousa, Paulo
2017-01-01
To analyze studies on stress, Burnout Syndrome, and patient safety in the scope of nursing care in the hospital environment. This was an integrative literature review. Data collection was performed in February 2016 in the following databases: Medical Literature Analysis and Retrieval System Online - PubMed/MEDLINE, Latin American and Caribbean Literature in Health Sciences - LILACS. Ten scientific productions were selected, which listed that factors contributing to stress and Burnout Syndrome of nursing professionals are the work environment as a source of stress, and excessive workload as a source of failures. The analysis found that the stress and Burnout Syndrome experienced by these professionals lead to greater vulnerability and development of unsafe care, and factors such as lack of organizational support can contribute to prevent these failures. Analisar estudos que versam sobre o estresse e Síndrome de Burnout, bem como a segurança do paciente no âmbito da assistência de enfermagem no ambiente hospitalar. Tratou-se de uma revisão integrativa de literatura. O levantamento dos dados foi efetuado nas bases de dados Medical Literature Analysis and Retrieval System Online - PubMed / MEDLINE, Literatura Latino-Americana e do Caribe em Ciências da Saúde -LILACS em fevereiro de 2016. Foram selecionadas10 produções científicas que apontaram que os fatores que contribuem para o estresse e a Síndrome de Burnout dos profissionais de enfermagem são o ambiente de trabalho como fonte de estresse e a carga de trabalho excessiva como geradora de falhas. A análise apontou que o estresse e a Síndrome de Burnout vivenciada por esses profissionais acarretam maior vulnerabilidade ao desenvolvimento de uma assistência insegura e que fatores como a falta de apoio organizacional podem contribuir para dirimir essas falhas.
The culture of patient safety from the perspective of the pediatric emergency nursing team.
Macedo, Taise Rocha; Rocha, Patricia Kuerten; Tomazoni, Andreia; Souza, Sabrina de; Anders, Jane Cristina; Davis, Karri
2016-01-01
To identify the patient safety culture in pediatric emergencies from the perspective of the nursing team. A quantitative, cross-sectional survey research study with a sample composed of 75 professionals of the nursing team. Data was collected between September and November 2014 in three Pediatric Emergency units by applying the Hospital Survey on Patient Safety Culture instrument. Data were submitted to descriptive analysis. Strong areas for patient safety were not found, with areas identified having potential being: Expectations and actions from supervisors/management to promote patient safety and teamwork. Areas identified as critical were: Non-punitive response to error and support from hospital management for patient safety. The study found a gap between the safety culture and pediatric emergencies, but it found possibilities of transformation that will contribute to the safety of pediatric patients. Nursing professionals need to become protagonists in the process of replacing the current paradigm for a culture focused on safety. The replication of this study in other institutions is suggested in order to improve the current health care scenario. Identificar a cultura de segurança do paciente em emergências pediátricas, na perspectiva da equipe de enfermagem. Pesquisa quantitativa, tipo survey transversal. Amostra composta por 75 profissionais da equipe de enfermagem. Dados coletados entre setembro e novembro de 2014, em três Emergências Pediátricas, aplicando o instrumento Hospital Survey on Patient Safety Culture. Dados submetidos à análise descritiva. Não foram encontradas áreas de força para a segurança do paciente, sendo identificadas áreas com potencial de assim se tornarem: Expectativas e ações do supervisor/chefia para promoção da segurança do paciente e Trabalho em equipe. Como área crítica identificaram-se: Resposta não punitiva ao erro e Apoio da gestão hospitalar para segurança do paciente. O estudo apontou distanciamento entre a cultura de segurança e as emergências pediátricas, porém vislumbrou possibilidades de transformação, que contribuirão para segurança do paciente pediátrico. Os profissionais de enfermagem precisam se tornar protagonistas no processo de substituição do atual paradigma para uma cultura focada na segurança. Sugere-se replicação deste estudo em outras instituições a fim de aprimorar o atual cenário de assistência à saúde.
Prevalence and factors associated with minor psychiatric disorders in hospital housekeeping workers.
Marconato, Cintia da Silva; Magnago, Ana Carolina de Souza; Magnago, Tânia Solange Bosi de Souza; Dalmolin, Graziele de Lima; Andolhe, Rafaela; Tavares, Juliana Petri
2017-06-12
Investigating the prevalence and factors associated with minor psychiatric disorders (MPDs) in Hospital housekeeping workers. A cross-sectional study carried out in 2013 with workers from the cleaning service of a public university hospital in Rio Grande do Sul, Brazil. Data were collected through a form containing sociodemographic, occupational, habits and health variables. The Self-Reporting Questionnaire-20 was used in order to evaluate MPDs. The study population consisted of 161 workers. The overall prevalence of suspected MPD was 29.3%. The chances of suspected MPDs were higher in workers with Effort-Reward Imbalance, those who did not have time or who occasionally had time for leisure activities, and those taking medications. The prevalence of MPDs was similar to that found in the literature for health workers. Therefore, we consider it important to include these workers in institutional programs for continuing health education. Investigar a prevalência e os fatores associados aos Distúrbios Psíquicos Menores (DPMs) em trabalhadores do Serviço Hospitalar de Limpeza. Estudo transversal, realizado em 2013, com trabalhadores do serviço de limpeza de um hospital universitário público do Rio Grande do Sul, Brasil. Os dados foram coletados por meio de um formulário contendo variáveis sociodemográficas, laborais, hábitos e saúde. Para avaliação dos DPMs utilizou-se do Self-Reporting Questionnaire-20. A população do estudo foi composta pelos 161 trabalhadores. A prevalência global para suspeição de DPM foi de 29,3%. As chances de suspeição de DPMs foram maiores nos trabalhadores em Desequilíbrio Esforço-Recompensa, nos que não tinham ou às vezes tinham tempo para o lazer e naqueles que faziam uso de medicação. A prevalência de DPMs assemelhou-se à encontrada na literatura em trabalhadores da área saúde. Portanto, considera-se importante a inclusão desses trabalhadores em programas institucionais de educação permanente em saúde.
Salselas, Ana; Pestana, Inês; Bischoff, Francisco; Guimarães, Mariana; Andrade, Joaquim Aguiar
2015-01-01
Pregnant women with thromboembolic diseases, previous thrombotic episodes or thrombophilia family history were supervised in a multidisciplinary Obstetrics/ Hematology consultation in Centro Hospitalar São João EPE, Porto, Portugal. For the evaluation and medication of these women, a risk stratification scale was used. The aim of this study was to validate a Risk Stratification Scale and thromboprophylaxis protocol by means of comparing it with a similar scale, developed and published by Sarig. We have compared: The distribution, by risk groups, obtained through the application of the two scales on pregnant women followed at Centro Hospitalar São João, Porto, Portugal, consultation; the sensibility and specificity for each one of the scales (DeLong scale, applied to Receiver Operating Characteristic) curves; the outcomes in pregnancies followed in Hospital São João, Porto, PortugalResults: According to our Hema-Obs risk stratification scale, 29% were allocated to low-risk, 47% to high-risk and 24% to very-high-risk groups. According to Galit Sarig risk stratification scale, 24% were considered low-risk, 53% moderate, 16% high-risk and 7% as very high-risk group. In our study we observed 9% of spontaneous abortions, in comparison with 18% in the Galit Sarig cohort. From the application of Receiver Operating Characteristic curve to both risk stratification scales, the results of the calculated areas were 58,8% to our Hema-Obs risk stratification scale and 38,7% to Galit Sarig risk stratification scale, with a Delong test significancie of p = 0.0006. We concluded that Hema-Obs risk stratification scale is an effective support for clinical monitoring of therapeutic strategies.
Giner, Manel; Culebras, Jesús M; Meguid, Michael M
2016-03-01
En agosto de 1976, un joven llamado LeRoy cayó desde una cornisa fracturándose el fémur. Se sospechó una hemorragia interna importante. Durante una laparotomía se comprobó que todos los órganos internos estaban intactos y los cirujanos ortopédicos arreglaron la fractura. Treintadías después, LeRoy murió. Había comido poco; diariamente, tan solo había recibido tres litros de la glucosa, el equivalente a 510 calorías, por vía intravenosa. La glucosa fue insuficiente para satisfacer sus necesidades nutricionales, perdiendo más del 20% de su peso corporaldurante su estancia en el hospital. La causa de la muerte se debió a "desnutrición médicamente inducida". Mientras tanto, un artículo científico documentó que la prevalencia de desnutrición en los hospitales de Boston era del 44% y que la desnutrición en sí era un predictor de altas tasas de complicaciones y muerte.Como resultado, los médicos sensibilizados formaron una sociedad que creó programas de formación y alentó la formación de equipos de nutrición en los hospitales. La industria comercializó fórmulas de nutrición y catéteres. Las complicaciones en enfermos hospitalizados cayeron en picado, mientras que las tasas de supervivencia aumentaron. California aprobó una legislación para regular el soporte nutricional. Aunque la industria de la atención sanitaria reconoce la importancia de la nutrición en los cuidados al paciente, el Congreso no proporcionó apoyo fiscal para los equipos de nutrición. Como resultado, los hospitales disolvieron sus equipos de nutrición de reciente creación. La educación y las habilidades en nutrición disminuyeron, y las complicaciones hospitalarias y las tasas de mortalidad aumentaron de nuevo.
Santos, Talita Raquel Dos; Padoveze, Maria Clara; Nichiata, Lúcia Yasuko Izumi; Takahashi, Renata Ferreira; Ciosak, Suely Itsuko; Gryschek, Anna Luiza de Fátima Pinho Lins
2016-06-07
to analyze the feasibility of quality indicators for evaluation of hospital programs for preventing occupational tuberculosis. a descriptive cross-sectional study. We tested indicators for evaluating occupational tuberculosis prevention programs in six hospitals. The criterion to define feasibility was the time spent to calculate the indicators. time spent to evaluate the indicators ranged from 2h 52min to 15h11min 24sec. The indicator for structure evaluation required less time; the longest time was spent on process indicators, including the observation of healthcare workers' practices in relation to the use of N95 masks. There was an hindrance to test one of the indicators for tuberculosis outcomes in five situations, due to the lack of use of tuberculin skin test in these facilities. The time requires to calculate indicators in regarding to the outcomes for occupational tuberculosis largely depends upon the level of organizational administrative structure for gathering data. indicators to evaluate the structure for occupational tuberculosis prevention are highly feasible. Nevertheless, the feasibility of indicators for process and outcome is limited due to relevant variations in administrative issues at healthcare facilities. analisar a viabilidade de indicadores de qualidade para avaliação de programas hospitalares de prevenção de tuberculose ocupacional. estudo descritivo transversal. Testaram-se indicadores de avaliação de programas de prevenção de tuberculose ocupacional em seis hospitais. O critério para definir a viabilidade foi o tempo necessário para aplicar os indicadores. o tempo necessário para avaliar os indicadores variou de 02'52'' até 15h11'24''. O indicador para a avaliação da estrutura demandou menor tempo; o maior tempo foi utilizado com os indicadores de processo, incluindo a observação das práticas dos trabalhadores de saúde em relação ao uso de máscaras N95. Um dos indicadores de resultados de tuberculose deixou de ser testado em cinco situações devido à falta de uso do teste tuberculínico nessas instituições. O tempo necessário para aplicar indicadores em relação aos resultados de tuberculose ocupacional depende em grande parte do nível da organização da estrutura administrativa para a coleta de dados. os indicadores de avaliação da estrutura de prevenção de tuberculose ocupacional são altamente viáveis. No entanto, a viabilidade de aplicação dos indicadores de processo e de resultado é limitada devido a variações relevantes em questões administrativas nas instituições de saúde. analizar la viabilidad de los indicadores de calidad de la evaluación de los programas hospitalarios para la prevención de la tuberculosis en el trabajo. estudio descriptivo transversal. Se probaron los indicadores dirigidos a evaluar los programas para la prevención de la tuberculosis laboral en seis hospitales. El criterio para definir la viabilidad fue el tiempo para aplicar los indicadores. el tiempo empleado para la evaluación de los los indicadores varió desde 02'52 '' hasta 15h11'24 ''. El indicador para la evaluación de la estructura requiere menos tiempo; se invirtió más tiempo en los indicadores de proceso, lo que incluye la observación de las prácticas de los empleados del cuidado de salud en relación con el uso de máscaras N95. No se pudo probar uno de los indicadores de resultados de tuberculosis en cinco situaciones debido a la falta de uso de la prueba de la tuberculina en estas centros. El tiempo necesario para aplicar los indicadores en relación con los resultados por tuberculosis laboral depende en gran medida del nivel de organización de la estructura administrativa para la recopilación de datos. los indicadores para evaluar la estructura para la prevención de la tuberculosis laboral son altamente factibles. Sin embargo, la viabilidad de aplicación de los indicadores de proceso y el resultado es limitada debido a las variaciones relevantes en cuestiones administrativas en los centros sanitarios.
Quality of Life Score as a Predictor of Death in Dogs with Degenerative Mitral Valve Disease.
Strunz, Célia M C; Marcondes-Santos, Mário; Takada, Julio Yoshio; Fragata, Fernanda S; Mansur, Antônio de Pádua
2017-04-01
The knowledge of the variables predicting mortality is important in clinical practice and for therapeutic monitoring in mitral valve disease. To determine whether a quality of life score evaluated with the Functional Evaluation of Cardiac Health questionnaire would predict mortality in dogs with degenerative mitral valve disease (DMVD). Thirty-six client-owned dogs with mitral valve disease underwent clinical, laboratory, and echocardiographic evaluations at baseline and were monitored for 6 months. Cardiovascular death was the primary outcome. The 36 dogs were classified as survivors or nonsurvivors. Higher values of the following variables were obtained at baseline in the nonsurviving group (12 dogs): amino-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, plasma norepinephrine, heart rate, quality of life score, diastolic left ventricular internal dimension to aortic root ratio, systolic left ventricular internal dimension to aortic root ratio, and left atrium to aortic root ratio. NT-proBNP levels and quality life score were independently associated with death in the multivariable analysis. The quality life score was an independent variable for cardiac death in dogs with DMVD. This result is encouraging, as this score is easy to apply and does not require any technology, only a veterinarian and an observant owner. O conhecimento das variáveis preditoras de mortalidade é importante para a prática clínica e para o acompanhamento terapêutico na doença da valva mitral. Determinar se um escore de qualidade de vida avaliado com o Functional Evaluation of Cardiac Health poderia auxiliar na predição de mortalidade em cães com doença degenerativa da valva mitral (DDVM). Trinta e seis cães de estimação com doença valvar mitral foram submetidos a avaliação clínica, laboratorial e ecocardiográfica no início do estudo e monitorizados durante 6 meses. A morte cardiovascular foi o desfecho primário. Os 36 cães foram classificados como sobreviventes ou não sobreviventes. Os valores mais elevados das seguintes variáveis foram obtidos no início do estudo no grupo de não sobreviventes (12 cães): fragmento N-terminal do peptídeo natriurético tipo B (NT-proBNP), norepinefrina plasmática, frequência cardíaca, escore de qualidade de vida, razão da dimensão interna diastólica do ventrículo esquerdo e raiz aórtica, razão da dimensão interna sistólica do ventrículo esquerdo e raiz aórtica e a relação da dimensão do átrio esquerdo e a raiz aórtica. Concentrações de NT-proBNP e o escore de qualidade de vida foram independentemente associados com morte na análise multivariada. O escore de qualidade de vida foi uma variável independente para a morte por doença cardíaca em cães com DDVM. Este resultado é encorajador, pois este escore é de fácil aplicação e não requer o emprego de tecnologia, necessitando apenas de um veterinário e um dono observador.
Factors associated with disease-specific survival of patients with non-small cell lung cancer.
Souza, Mirian Carvalho de; Cruz, Oswaldo Gonçalves; Vasconcelos, Ana Glória Godoi
2016-01-01
Lung cancer is a global public health problem and is associated with high mortality. Lung cancer could be largely avoided by reducing the prevalence of smoking. The objective of this study was to analyze the effects of social, behavioral, and clinical factors on the survival time of patients with non-small cell lung cancer treated at Cancer Hospital I of the José Alencar Gomes da Silva National Cancer Institute, located in the city of Rio de Janeiro, Brazil, between 2000 and 2003. This was a retrospective hospital cohort study involving 1,194 patients. The 60-month disease-specific survival probabilities were calculated with the Kaplan-Meier method for three stage groups. The importance of the studied factors was assessed with a hierarchical theoretical model after adjustment by Cox multiple regression. The estimated 60-month specific-disease lethality rate was 86.0%. The 60-month disease-specific survival probability ranged from 25.0% (stages I/II) to 2.5% (stage IV). The performance status, the intention to treat, and the initial treatment modality were the major prognostic factors identified in the study population. In this cohort of patients, the disease-specific survival probabilities were extremely low. We identified no factors that could be modified after the diagnosis in order to improve survival. Primary prevention, such as reducing the prevalence of smoking, is still the best method to reduce the number of people who will suffer the consequences of lung cancer. O câncer de pulmão é um problema de saúde pública global e é associado a elevada mortalidade. Ele poderia ser evitado em grande parte com a redução da prevalência do tabagismo. O objetivo deste estudo foi analisar os efeitos de fatores sociais, comportamentais e clínicos sobre o tempo de sobrevida de pacientes com câncer de pulmão de células não pequenas atendidos, entre 2000 e 2003, no Hospital do Câncer I do Instituto Nacional de Câncer José Alencar Gomes da Silva, localizado na cidade do Rio de Janeiro. Estudo retrospectivo de coorte hospitalar com 1.194 pacientes. As probabilidades de sobrevida doença-específica em 60 meses foram calculadas com o método de Kaplan-Meier para três grupos de estadiamento. A importância dos fatores estudados foi avaliada por um modelo teórico hierarquizado após o ajuste de modelos de regressão múltipla de Cox. Foi estimada uma taxa de letalidade doença-específica em 60 meses de 86,0%. A probabilidade de sobrevida doença-específica em 60 meses variou de 25,0%, nos estádios iniciais, a 2,5%, no estádio IV. A situação funcional, a intenção e a modalidade do tratamento inicial foram os principais fatores prognósticos identificados na população estudada. As probabilidades de sobrevida doença-específica estimadas na amostra estudada foram muito baixas, e não foram identificados fatores que pudessem ser modificados após o diagnóstico visando uma melhora da sobrevida. A prevenção primária, como a redução da prevalência do tabagismo, ainda é a melhor forma de evitar que mais pessoas sofram as consequências do câncer de pulmão.
Enfermedad diarreica aguda por Escherichia coli patógenas en Colombia
Gómez-Duarte, Oscar G.
2014-01-01
Resumen Las cepas de E. coli patógenas intestinales son causas importantes de la enfermedad diarreica aguda (EDA) en niños menores de 5 años en América Latina, África y Asia y están asociadas a alta mortalidad en niños en las comunidades más pobres de África y el Sudeste Asiático. Estudios sobre el papel de las E. coli patógenas intestinales en la EDA infantil en Colombia y otros países de América Latina son limitados debido a la carencia de ensayos para detección de estos patógenos en los laboratorios clínicos de centros de salud. Estudios recientes han reportado la detección de E. coli patógenas intestinales en Colombia, siendo la E. coli enterotoxigénica la cepa más frecuentemente asociada a diarrea en niños menores de 5 años. Otros patógenos detectados en estos pacientes incluyen las E. coli enteroagregativa, enteropatógena, productora de toxina Shiga, y de adherencia difusa. Con base en estudios que reportan la presencia de E. coli productora de toxina Shiga y E. coli enteroagregativa en carnes y vegetales en supermercados, se cree que productos alimentarios contaminados contribuyen a la transmisión de estos patógenos y a la infección del huésped susceptible. Más estudios son necesarios para evaluar los mecanismos de transmisión, el impacto en la epidemiologia de la EDA, y las pautas de manejo y prevención de estos patógenos que afectan la población pediátrica en Colombia. PMID:25491457
Changes in frailty conditions and phenotype components in elderly after hospitalization.
Marchiori, Gianna Fiori; Tavares, Darlene Mara Dos Santos
2017-07-10
describing the changes in frailty conditions over the period of a year after hospital discharge, verifying predictive variables for changes in frailty conditions and frailty phenotype components according to worsening, improving and stable groups. a longitudinal survey carried out with 129 elderly. A structured form for socioeconomic and health data, scales (Geriatric Depression Scale - short form, Katz scale, Lawton and Brody scale) and frailty phenotype according to Fried were used. Descriptive analysis and multinomial logistic regression model (p<0.05) were performed. we found that 56.7% of older adults changed their condition from non-frail to pre-frail, with no changes from non-frail to frail. Deaths were found between frail and pre-frail elderly. In the worsening group, the increase in the number of morbidities was a predictor for exhaustion and/or fatigue, while in the improving group, increased dependence on instrumental activities of daily living was a predictor for weight loss, and reduced scores indicative of depression due to low level of physical activity. a greater percentage of changes from non-frail condition to pre-frail older adults were observed, and health variables were only predictive for frailty phenotype components. descrever as mudanças nas condições de fragilidade ao longo de um ano após a alta hospitalar, e verificar as variáveis preditoras da mudança das condições de fragilidade e dos componentes do fenótipo de fragilidade, segundo grupos de piora, melhora e estabilidade. inquérito longitudinal, realizado com 129 idosos. Utilizou-se formulário estruturado para dados socioeconômicos e saúde, escalas (Depressão Geriátrica Abreviada, Katz, Lawton e Brody) e fenótipo de fragilidade, segundo Fried. Procederam-se às análises descritiva e modelo de regressão logística multinomial (p<0,05). constatou-se que 56,7% dos idosos mudaram sua condição de não frágeis para pré-frágeis, não ocorrendo mudança dos não frágeis para frágeis. Observou-se o óbito entre idosos frágeis e pré-frágeis. No grupo de piora, o aumento do número de morbidades foi preditor para exaustão e/ou fadiga, enquanto que, no grupo de melhora, o aumento na dependência das atividades instrumentais de vida diária foi preditor para a perda de peso, e a diminuição dos escores do indicativo de depressão para o baixo nível de atividade física. houve maior percentual de mudança na condição de idosos não frágeis para pré-frágeis e as variáveis de saúde foram preditoras apenas para os componentes do fenótipo de fragilidade. describir los cambios en las condiciones de fragilidad a lo largo de un año después del alta hospitalaria, y verificar las variables predictoras del cambio de las condiciones de fragilidad y de los componentes del fenotipo de fragilidad, según grupos de empeoramiento, mejoría y estabilidad. encuesta longitudinal, realizada con 129 ancianos. Se utilizó formulario estructurado para recoger datos socioeconómicos y salud; se utilizaron las escalas Depresión Geriátrica Abreviada (GDS-15), Actividades Básicas de Vida Diaria de Katz, Actividades Instrumentales de Vida Diaria de Lawton y Brody, y Fenotipo de Fragilidad, según Fried. Se procedió al análisis descriptivo y modelo de regresión logística multinomial (p<0,05). se constató que 56,7% de los ancianos cambiaron su condición de no-frágiles para prefrágiles, no habiendo ocurriendo cambio de los no-frágiles para frágiles. Se observó muerte entre ancianos frágiles y prefrágiles. En el grupo de empeoramiento, el aumento del número de morbilidades fue predictor para agotamiento y/o fatiga, en cuanto en el grupo de mejoría, el aumento en la dependencia de las actividades instrumentales de vida diaria fue predictor para la pérdida de peso y la disminución de los puntajes del indicativo de depresión para el bajo nivel de actividad física. hubo mayor porcentaje de cambio en la condición de ancianos no-frágiles para prefrágiles y las variables de salud fueron predictoras apenas para los componentes del fenotipo de fragilidad.
Cholesterol and prevention of atherosclerotic events: limits of a new frontier.
Macedo, Luís Eduardo Teixeira de; E, Faerstein
2017-01-12
Control of atherosclerotic cardiovascular disease - a highly prevalent condition and one of the main causes of mortality in Brazil and worldwide - is a recurrent subject of great interest for public health. Recently, three new guidelines on dyslipidemia and atherosclerosis prevention have been published. The close release of these important publications is a good opportunity for comparison: the Brazilian model has greater sensitivity, the English model does not work with risk stratification, and the American model may be overestimating the risk. This will allow reflection on current progress and identification of controversial aspects which still require further research and debate. It is also an opportunity to discuss issues related to early diagnosis and its efficiency as a preventive strategy for atherosclerotic disease: the transformation of risk into disease, the gradual reduction of cut-off points, the limitations of the screening strategy, and the problem of overdiagnosis. RESUMO O controle da doença cardiovascular aterosclerótica - morbidade de alta prevalência e uma das principais causas de mortalidade no Brasil e no mundo - continua sendo tema de grande interesse para a Saúde Pública. Recentemente, três novas diretrizes sobre dislipidemia e prevenção da aterosclerose foram divulgadas. A convergência no tempo dessas importantes publicações constitui boa oportunidade para sua comparação: o modelo brasileiro tem maior sensibilidade, o inglês não trabalha com risco estratificado e o norte-americano parece estar superestimando o risco.Isso permitirá reflexões acerca dos avanços que já foram alcançados e identificação de aspectos ainda controversos, que seguem exigindo novas pesquisas e debates. É também uma oportunidade para discutir questões relacionadas ao diagnóstico precoce e sua eficiência como estratégia preventiva da doença aterosclerótica: as transformações do risco em doença, a diminuição progressiva de pontos de corte, as insuficiências da estratégia de rastreamento e o problema do sobrediagnóstico.
Tools For Interactive Learning And Self-Management Of Diabetes
NASA Astrophysics Data System (ADS)
Capelo, Rita; Baptista, Carla; Figueiredo, Júlia; Carrilho, Francisco; Furtado, Pedro
2015-05-01
Diabetes is a widespread disease and its control is dependent upon the patient. Although there is no permanent cure for diabetes, there are several available treatments which, when followed regularly, allow the patient to have a good quality of life. Patient education, especially about eating habits, is key to keep glucose levels stable both in the short and in the long term. This should include nutritional counselling, physical exercise, and the self monitoring of glucose levels. The University of Coimbra and the Serviço de Endocrinologia, Diabetes e Metabolismo of Centro Hospitalar e Universitário de Coimbra started a collaboration to develop interactive tools for the learning and improvement of carbohydrate counting by patients. The approach presented in this paper is an interactive multimedia tool, available to patients through either the web or a smartphone. It helps them to learn how to maintain a healthy diet and how to monitor their insulin levels correctly by measuring the carbo-hidrate “equivalents” in meals. This application will create a more dynamic and interactive way of educating patients, improving solutions currently used in the Serviço de Endocrinologia, Diabetes e Metabolismo of the Centro Hospitalar e Universitário de Coimbra.
Terapia fibrinolítica sistêmica no tromboembolismo pulmonar
Ceresetto, José Manuel; Marques, Marcos Arêas
2017-01-01
Resumo O tromboembolismo pulmonar permanece como um grande desafio terapêutico para os médicos especialistas, pois, apesar de todo investimento e desenvolvimento em seu diagnóstico, profilaxia e tratamento, essa condição continua sendo a principal causa de morte evitável em ambiente hospitalar. Ainda restam muitas dúvidas em relação a qual perfil de paciente vai se beneficiar de fato da terapia fibrinolítica sistêmica, sem ficar exposto a um grande risco de sangramento. A estratificação de risco e a avaliação do prognóstico do evento, através de escores clínicos de insuficiência ventricular direita, marcadores de dilatação e disfunção do ventrículo direito e avaliação da massa trombótica, associados ou de forma isolada, são ferramentas que podem auxiliar na identificação do paciente que irá se beneficiar dessa terapia. Os únicos consensos em relação à terapia fibrinolítica no tratamento do tromboembolismo pulmonar são: não deve ser indicada de forma rotineira; nenhum dos escores ou marcadores, isoladamente, devem justificar seu uso; e os pacientes com instabilidade hemodinâmica são os mais beneficiados. Além disto, deve-se avaliar cada caso em relação ao risco de sangramento, especialmente no sistema nervoso central. PMID:29930636
Factors associated with subendocardial ischemia risk in patients on hemodialysis.
Silva, Bruno Caldin da; Sanjuan, Adriano; Costa-Hong, Valéria; Reis, Luciene Dos; Graciolli, Fabiana; Consolim-Colombo, Fernanda; Bortolotto, Luiz Aparecido; Moyses, Rosa Maria Affonso; Elias, Rosilene Motta
2016-01-01
Bone metabolism disorder (BMD) and vascular dysfunction contribute to excess cardiovascular mortality observed in hemodialysis patients. Vascular dysfunction, a new marker of atherosclerosis, can play a role in this risk. Even though associated with higher mortality in the general population, such vascular evaluation in patients on hemodialysis has not been extensively studied. In this cross-sectional study, hemodialysis patients were submitted to flow-mediated dilation, subendocardial viability ratio (SEVR) and ejection duration index assessment, in order to estimate the impact of BMD markers on vascular dysfunction. A matched cohort of patients with (n = 16) and without (n = 11) severe secondary hyperparathyroidism (SHPT) was studied. Additionally, time spent under severe SHPT was also evaluated. Patients with severe SHPT had lower SEVR and higher ejection duration index, indicating higher cardiovascular risk. Lower SEVR was also associated to diastolic blood pressure (r = 0.435, p = 0.049), serum 25-Vitamin-D levels (r = 0.479, p = 0.028) and to more time spent under severe secondary hyperparathyroidism (SHPT), defined as time from PTH > 500pg/ml until parathyroidectomy surgery or end of the study (r = -0.642, p = 0.027). In stepwise multiple regression analysis between SEVR and independent variables, lower SEVR was independently associated to lower serum 25-Vitamin-D levels (p = 0.005), female sex (p = 0.012) and more time spent under severe SHPT (p = 0.001) in a model adjusted for age, serum cholesterol, and blood pressure (adjusted r² = 0.545, p = 0.001). Subendocardial perfusion was lower in patients with BMD, reflecting higher cardiovascular risk in this population. Whether early parathyroidectomy in the course of kidney disease could modify such results still deserves further investigation. Distúrbios do metabolismo ósseo (DMO) e alterações da função vascular contribuem para a elevada mortalidade de pacientes em hemodiálise. A disfunção vascular, um novo marcador de aterosclerose, pode contribuir para este risco. Apesar de associada a aumento de mortalidade na população geral, a avaliação de tal disfunção ainda não foi realizada de modo amplo em pacientes em hemodiálise. Neste estudo transversal, pacientes em hemodiálise foram submetidos à avaliação da vasodilatação mediada por fluxo, razão de viabilidade subendocárdica (RVSE) e índice de duração de ejeção, como estimativas de avaliação dos marcadores de DMO sobre disfunção vascular. Uma coorte pareada com (n = 16) e sem (n = 11) hiperparatireoidismo secundário (HPTS) grave foi estudada. Adicionalmente, o tempo transcorrido do diagnóstico de HPTS grave também foi avaliado. Pacientes com HPTS grave apresentaram menores valores de RVSE e maiores valores de índice de duração de ejeção, apontando maior risco cardiovascular. Baixa RVSE também foi associada à pressão arterial diastólica (r = 0,435, p = 0,049), níveis séricos de 25-Vitamina D (r = 0,479, p = 0,028) e maior tempo transcorrido desde diagnóstico de HPTS grave, definido como tempo em que o paciente permaneceu com valores de paratormônio superiores a 500 pg/ml até realização de cirurgia de paratireoidectomia ou término do estudo (r = -0,642, p = 0,027). Em regressão logística stepwise entre RVSE e variáveis independentes, menor RVSE foi independentemente associado a menores valores de 25-Vitamina D (p = 0,005), sexo feminino (p = 0,012) e maior tempo transcorrido desde diagnóstico de HPTS grave (p = 0,001) em um modelo ajustado para idade, colesterol sérico e pressão arterial (r2 ajustado = 0,545, p = 0,001). A perfusão subendocárdica foi menor em pacientes com DMO, refletindo o maior risco cardiovascular nesta população. Investigações adicionais são necessárias para definir se a paratireoidectomia precoce no curso da doença renal crônica poderia interferir neste risco.
Reis, Audrey Machado Dos; Kabke, Geórgia Brum; Fruchtenicht, Ana Valéria Gonçalves; Barreiro, Taiane Dias; Moreira, Luis Fernando
2016-01-01
Costs, length of hospital staying and morbidity are frequently and significantly increased as a result of infections and other complications following surgical procedure for gastrointestinal tract cancer. Recently, improving host defence mechanisms have become a target of interest. Immunonutrition aims at improving immunity, most likely providing key nutrients to maintain T-lymphocyte and other host defence. To evaluate the immunonutrition in cancer patients who are operated by digestive diseases and assess the cost-effectiveness of this supplementation. This study consisted of a systematic review of the literature based on reference analyses retrieved from current databases such as PubMed, Lilacs and SciELO. The search strategy was defined by terms related to immunonutrition [immunonutrition, arginine, omega-3 and nucleotides] in combination with [costs, cost-effective and cost-effectiveness] as well as [gastrointestinal cancer surgery, oesophageal, gastric or pancreatic surgery] in English, Portuguese or Spanish language. For cost analyses, currencies used in the manuscripts were all converted to American dollars (US$) in order to uniform and facilitate comparison. Six prospective randomized studies were included in this review. The cost-effectiveness was positive in most of studies, demonstrating that this diet can significantly reduce hospital costs in the North hemisphere. However, similar studies needed to be carried to determine such results among us. Custos, tempo de hospitalização e morbidade estão frequentemente aumentados na presença de infecções e outras complicações decorrentes de procedimentos cirúrgicos para o câncer gastrointestinal. Recentemente, a melhora de mecanismos de defesa do hospedeiro tem se tornado um alvo de interesse. Nutrição adequada está fortemente relacionada com competência imune e redução de infeções. Imunonutrição objetiva a melhora da imunidade, principalmente para manutenção de linfócitos-T e outras defesas. Avaliar a imunonutrição em pacientes oncológicos que são operados por doenças do aparelho digestivo e avaliar a relação custo-eficácia desta suplementação. Revisão sistemática da literatura baseada nas bases de dados PubMed, Lilacs e SciELO. A busca foi realizada com combinação de descritores em inglês e português relacionados ao tema da revisão: [immunonutrition, arginine, omega-3, nucleotides] combinado com [costs, cost-effective, cost-effectiveness] e [gastrointestinal cancer surgery, oesophageal, gastric or pancreatic surgery]. Para análise de custos, moedas usadas nos artigos foram todas convertidas para dólar americano. Seis estudos randomizados prospectivos foram incluídos nesta revisão. O custo-benefício foi positivo na maioria dos estudos, sugerindo que este tipo de dieta reduz significativamente os custos hospitalares nos países do hemisfério norte. Contudo, estudos similares de custo-benefício devem ser realizados para definir o real custo-benefício em nosso meio.
Silva, Natasha Dejigov Monteiro da; Barbosa, Antonio Pires; Padilha, Kátia Grillo; Malik, Ana Maria
2016-01-01
To identify the perceptions of leaderships toward patient safety culture dimensions in the routine of hospitals with different administrative profiles: government, social and private organizations, and make correlations among participating institutions regarding dimensions of patient safety culture used. A quantitative cross-sectional study that used the Self Assessment Questionnaire 30 translated into Portuguese. The data were processed by analysis of variance (ANOVA) in addition to descriptive statistics, with statistical significance set at p-value ≤ 0.05. According to the participants' perceptions, the significant dimensions of patient safety culture were 'patient safety climate' and 'organizational learning', with 81% explanatory power. Mean scores showed that among private organizations, higher values were attributed to statements; however, the correlation between dimensions was stronger among government hospitals. Different hospital organizations present distinct values for each dimension of patient safety culture and their investigation enables professionals to identify which dimensions need to be introduced or improved to increase patient safety. Identificar percepções das lideranças sobre as dimensões da cultura de segurança do paciente no cotidiano de hospitais de diferentes perfis administrativos: públicos, organizações sociais e privados, e realizar correlação entre as instituições participantes, de acordo com as dimensões da cultura de segurança do paciente utilizadas. Estudo transversal de aspecto quantitativo obtido por meio da aplicação do instrumento Self Assessment Questionnaire 30, traduzido para a língua portuguesa. Os dados foram tratados com análise de variância (ANOVA), além das estatísticas descritivas, considerando como de significância estatística valores de p-valor ≤ 0,05. Segundo a percepção dos participantes do estudo, as dimensões significativas para a cultura de segurança do paciente foram Ambiente de Segurança do Paciente e Aprendizado Organizacional, com poder explicativo de 81%. A média de respostas obtidas evidenciou que nas organizações privadas houve maiores valores atribuídos às questões, porém a correlação entre as dimensões foi mais forte nas organizações públicas. As dimensões da cultura de segurança do paciente têm valores distintos nas diferentes organizações hospitalares e a sua investigação possibilita identificar quais necessitam ser introduzidas ou aprimoradas para maior segurança do paciente.
Terrorist bombings: foreign bodies from the Boston Marathon bombing.
Brunner, John; Singh, Ajay K; Rocha, Tatiana; Havens, Joaquim; Goralnick, Eric; Sodickson, Aaron
2015-02-01
On April 15, 2013, 2 improvised explosive devices detonated at the 117th Boston Marathon, killing 3 people and injuring 264 others. In this article, the foreign bodies and injuries that presented at 2 of the responding level 1 trauma hospitals in Boston-Brigham and Women׳s Hospital and Massachusetts General Hospital--are reviewed with a broader discussion of blast injuries and imaging strategies. Copyright © 2014 Elsevier Inc. All rights reserved.
Valero Chávez, Francisco Javier; Luengo Pérez, Luis Miguel; Cubero Juánez, Javier
2016-09-20
Introducción: ante las nuevas implicaciones atribuidas a la vitamina D y la asociación con enfermedades tales como el cáncer, diabetes, enfermedades cardiovasculares, autoinmunes y mortalidad, no es de extrañar que se haya defendido la medición de los niveles de vitamina D en la población general. Sin embargo, no existen datos experimentales que demuestren la viabilidad y rentabilidad de la estrategia de cribado en la población y tampoco se ha comprobado la existencia de beneficios para la salud, por lo que en la actualidad solo es aconsejable la medida de 25 (OH) vitamina D en los grupos de personas de alto riesgo como indican las guías clínicas internacionales.Objetivos: analizar las peticiones de vitamina D comprobando si se adecuan a las guías clínicas.Métodos: realizamos un estudio descriptivo transversal en el Área de Salud de Badajoz (España) estudiando las peticiones de determinación de vitamina D durante 12 meses consecutivos (n = 3.907). En dicho estudio revisamos el diagnóstico de petición y la historia clínica del paciente para discriminar entre peticiones que se adecuaban a las guías clínicas y peticiones injustificadas. Por último, realizamos el estudio económico.Resultados: en nuestros resultados encontramos que casi un tercio de peticiones no se adecuaban a las guías clínicas, en patologías tales como diabetes, dislipemias e hipertensión en las que no está recomendada la medición de los niveles de vitamina D, por lo que suponía un exceso de gasto para el sistema sanitario. Gasto que se incrementa cada año, tanto es así que se ha producido un aumento en las peticiones de más del 1.000% en los últimos 6 años.Conclusiones: concluimos la necesidad de crear protocolos de petición de vitamina D que se ajusten a las guías clínicas hasta que existan más estudios experimentales sobre las nuevas implicaciones de la vitamina D y así conseguir una correcta utilización de los recursos económicos del hospital.
Dipierri, José Edgardo; Bronberg, Rubén Adrian
2017-09-08
Debido al incremento de casos de microcefalia por virus Zika en Brasil el Ministerio de Salud de Argentina recomienda incrementar la vigilancia de esta malformación. A fin de profundizar el conocimiento del comportamiento epidemiológico de microcefalia en el país se analiza la mortalidad infantil por microcefalia entre 1998-2012. Los datos proceden de la Dirección de Estadísticas e Información de Salud (DEIS). Se calculó por provincias y regiones la tasa de mortalidad infantil por microcefalia (TMI-M) y se realizó un análisis de agrupamiento a nivel departamental. Las tasas más elevadas se observaron en las regiones y provincias del norte del país. La distribución espacial de la TMI-M guarda relación con las prevalencias de microcefalia en recién nacidos. Esta distribución se relaciona con la mayor pobreza y consanguinidad del norte de la Argentina, factores sinérgicos predisponentes de la ocurrencia de malformaciones congénitas en general y de microcefalia en particular.
DO PROXIMAL AND DISTAL GASTRIC TUMOURS BEHAVE DIFFERENTLY?
Costa, Laurence Bedin da; Toneto, Marcelo Garcia; Moreira, Luis Fernando
2016-01-01
Although the incidence of gastric (adenocarcinoma) cancer has been decreasing over time, it is still one of the most common malignancies worldwide, and proximal tumours tend to have a worse prognosis. To compare surgical outcomes and prognosis between proximal - excluding tumours of the cardia - and distal gastric cancer. Out of 293 cases reviewed - 209 with distal and 69 with proximal gastric cancer - were compared for clinical and pathological features, stage, surgical outcome, mortality and survival. Statistically, there was no significant difference between patients in both groups regarding mortality (p=0.661), adjuvant chemotherapy (p 0.661), and radiation (p=1.000). However, there was significant difference in the degree of lymph node dissection employed (p=0.002) and the number of positive lymph nodes resected (p=0.038) between the two groups. The odds of death at five years for patients who had a D0 dissection was three times greater (odds ratio 2.78; (95%CI 1.33-5.82) than that for patients who had a D2 dissection, while for patients who had a D1 dissection the odds ratio was only 1.41 (95%CI 0.71-2.83) compared to D2-dissected patients. Although no significant differences were found between proximal and distal gastric cancer, the increased risk of death in D0- and D1-dissected patients clearly suggests an important role of radical D2 lymph node dissection in survival. Embora a incidência do câncer gástrico esteja diminuindo nas últimas décadas, ele ainda aparece como uma das neoplasias malignas mais comuns, e tumores proximais tendem a ter pior prognóstico. Comparar os resultados cirúrgicos e o prognóstico entre o câncer gástrico proximal, excluindo os tumores da cárdia e junção esofagogástrica, e o distal. De 293 casos revistos - 209 distais e 69 proximais - foram comparados quanto aos achados clínicos e patológicos, estágio, resultados cirúrgicos, mortalidade e sobrevida. Estatisticamente não houve diferença entre pacientes em ambos os grupos quanto à mortalidade (p=0.661), emprego de quimioterapia adjuvante (p=0.661) e de radioterapia (p=1.000). Entretanto, houve diferença significativa no grau de dissecção linfonodal empregada (p=0.002) e no número de linfonodos positivos ressecados (p=0.038) entre os dois grupos. A razão de chances para morte em cinco anos nos casos de dissecção D0 foi três vezes maior (2,78; IC95% de 1,33 a 5,82) do que a D2, enquanto que para dissecção D1, ela foi apenas 1,41 vezes maior (95%CI 0.71-2.83) quando comparado à D2. Ainda que não se tenha observado diferenças significativas entre o câncer gástrico proximal e o distal, o risco de morte aumentado nos casos de D0 e D1, claramente demonstra o papel preponderante da linfadenectomia radical D2 no tratamento dessa doença.
Stocco, Janislei Gislei Dorociaki; Hoers, Hellen; Pott, Franciele Soares; Crozeta, Karla; Barbosa, Dulce Aparecida; Meier, Marineli Joaquim
2016-08-08
to evaluate the effectiveness and safety in the use of second-generation central venous catheters impregnated in clorhexidine and silver sulfadiazine when compared with other catheters, being them impregnated or not, in order to prevent the bloodstream infection prevention. systematic review with meta-analysis. Databases searched: MEDLINE, EMBASE, CINAHL, LILACS/SciELO, Cochrane CENTRAL; search in Congress Proceedings and records from Clinical Trials. 1.235 studies were identified, 97 were pre-selected and 4 were included. In catheter-related bloodstream infection, there was no statistical significance between second-generation impregnated catheter compared with the non-impregnated ones, absolute relative risk 1,5% confidence interval 95% (3%-1%), relative risk 0,68 (confidence interval 95%, 0,40-1,15) and number needed to treat 66. In the sensitivity analysis, there was less bloodstream infection in impregnated catheters (relative risk 0,50, confidence interval 95%, 0,26-0,96). Lower colonization, absolute relative risk 9,6% (confidence interval 95%, 10% to 4%), relative risk 0,51 (confidence interval 95% from 0,38-0,85) and number needed to treat 5. the use of second-generation catheters was effective in reducing the catheter colonization and infection when a sensitivity analysis is performed. Future clinical trials are suggested to evaluate sepsis rates, mortality and adverse effects. evaluar la efectividad y seguridad del uso de catéteres venosos centrales de segunda generación, impregnados en clorhexidina y sulfadiazina de plata, comparados con otros catéteres impregnados o no impregnados, para prevención de infección de la corriente sanguínea. revisión sistemática con metaanálisis. La búsqueda fue realizada en las bases: MEDLINE, EMBASE, CINAHL, LILACS/SciELO, Cochrane CENTRAL; fueron consultados anales de congresos y registros de ensayos clínicos. fueron identificados 1.235 estudios, 97 preseleccionados y cuatro incluidos. En la infección de la corriente sanguínea, relacionada al catéter, no hubo significación estadística entre catéter de segunda generación impregnado en comparación a los no impregnados, riesgo relativo absoluto 1,5%, intervalo de confianza 95% (3%-1%), riesgo relativo 0,68 (intervalo de confianza 95%, 0,40-1,15) y número necesario para tratar 66. En el análisis de sensibilidad, hubo disminución de la infección de la corriente sanguínea en los catéteres impregnados (riesgo relativo 0,50, intervalo de confianza 95%, 0,26-0,96). Reducción de la colonización, riesgo relativo absoluto de 9,6% (intervalo de confianza 95%, 10% a 4%), riesgo relativo 0,51 (intervalo de confianza 95% de 0,38-0,85) y número necesario para tratar 5. el uso de los catéteres de segunda generación fue efectivo en la reducción de la colonización del catéter y de infección cuando realizado análisis de sensibilidad. Se sugirieron ensayos clínicos futuros que evalúen tasas de sepsis, mortalidad y efectos adversos. avaliar a efetividade e segurança do uso de cateteres venosos centrais de segunda geração, impregnados em clorexidina e sulfadiazina de prata, comparados com outros cateteres impregnados ou não, na prevenção de infecção de corrente sanguínea. revisão sistemática com metanálise. Busca realizada nas bases: MEDLINE, EMBASE, CINAHL, LILACS/SciELO, Cochrane CENTRAL; consulta em anais de congresso e registro de ensaios clínicos. foram identificados 1.235 estudos, 97 pré-selecionados e quatro incluídos. Na infecção de corrente sanguínea, relacionada ao cateter, não houve significância estatística entre cateter de segunda geração impregnado em comparação aos não impregnados risco relativo absoluto 1,5%, intervalo de confiança 95% (3%-1%), risco relativo 0,68 (intervalo de confiança 95%, 0,40-1,15) e número necessário para tratar 66. Na análise de sensibilidade, houve diminuição da infecção de corrente sanguínea nos cateteres impregnados (risco relativo 0,50, intervalo de confiança 95%, 0,26-0,96). Redução da colonização, risco relativo absoluto de 9,6% (intervalo de confiança 95%, 10% a 4%), risco relativo 0,51 (intervalo de confiança 95% de 0,38-0,85) e número necessário para tratar 5. o uso dos cateteres de segunda geração foi efetivo na redução de colonização do cateter e de infecção quando realizada análise de sensibilidade. Sugerem-se ensaios clínicos futuros que avaliem taxas de sepse, mortalidade e efeitos adversos.
ROBOTIC SURGERY: BIOETHICAL ASPECTS.
Siqueira-Batista, Rodrigo; Souza, Camila Ribeiro; Maia, Polyana Mendes; Siqueira, Sávio Lana
2016-01-01
The use of robots in surgery has been increasingly common today, allowing the emergence of numerous bioethical issues in this area. To present review of the ethical aspects of robot use in surgery. Search in Pubmed, SciELO and Lilacs crossing the headings "bioethics", "surgery", "ethics", "laparoscopy" and "robotic". Of the citations obtained, were selected 17 articles, which were used for the preparation of the article. It contains brief presentation on robotics, its inclusion in health and bioethical aspects, and the use of robots in surgery. Robotic surgery is a reality today in many hospitals, which makes essential bioethical reflection on the relationship between health professionals, automata and patients. A utilização de robôs em procedimentos cirúrgicos tem sido cada vez mais frequente na atualidade, o que permite a emergência de inúmeras questões bioéticas nesse âmbito. Apresentar revisão sobre os aspectos éticos dos usos de robôs em cirurgia. Realizou-se revisão nas bases de dados Pubmed, SciELO e Lilacs cruzando-se os descritores "bioética", "cirurgia", "ética", "laparoscopia" e "robótica". Do total de citações obtidas, selecionou-se 17 artigos, os quais foram utilizados para a elaboração do artigo. Ele contém breve apresentação sobre a robótica, sua inserção na saúde e os aspectos bioéticos da utilização dos robôs em procedimentos cirúrgicos. A cirurgia robótica é uma realidade, hoje, em muitas unidades hospitalares, o que torna essencial a reflexão bioética sobre as relações entre profissionais da saúde, autômatos e pacientes.
Martínez-Lozano Aranaga, Fátima; Palacios Vales, Paula; Serrano Navarro, Juana María; Caballero Requejo, Carmen; Gómez Ramos, María Jesús; Sánchez Álvarez, Carmen
2016-06-30
Introducción: la composición lipídica de las fórmulas de nutrición parenteral (NP) se postula como posible factor de evolución clínica.Objetivo: evaluar las diferencias en eficacia y seguridad de dos emulsiones lipídicas en NP.Material y métodos: estudio clínico prospectivo de pacientes posquirúrgicos sometidos a NP durante más de 7 días en un periodo de 2 años. Se administraron de forma indistinta 2 tipos de emulsiones lipídicas: enriquecida con ácidos grasos omega 3 (SMOFlipid Fresenius Kabi®) o con ácido oleico omega 9 (Clinoleic Baxter®). Se analizaron variables epidemiológicas, analíticas, complicaciones infecciosas y mortalidad.Resultados: se estudió un total de 154 pacientes con edad media de 64,36 ± 13,73 años, de los que 95 eran hombres (61%), 78 (51%) recibieron SMOFlipid® y 76 (49%) Clinoleic®. La estancia media fue de 16,91 ± 4,23 días, la duración de la NP 9,68 ± 3,25 días y la mortalidad del 11%. Se diagnosticaron 58 (37%) infecciones. No existieron diferencias significativas en cuanto a los parámetros analíticos lipídicos, hepáticos o nutricionales (medidos al inicio y al 7.º día) ni en su evolución (estancia media, complicaciones infecciosas ni mortalidad) entre los dos grupos de pacientes.Conclusión: los pacientes sometidos a NP presentan similares características evolutivas con independencia de la emulsión lipídica utilizada. La bibliografía actual apunta a un beneficio de la disminución del aporte de ácidos grasos omega 9, pero no se han encontrado diferencias significativas entre las fórmulas comparadas.
Inequalities in healthy life expectancy by Federated States.
Szwarcwald, Célia Landmann; Montilla, Dália Elena Romero; Marques, Aline Pinto; Damacena, Giseli Nogueira; Almeida, Wanessa da Silva de; Malta, Deborah Carvalho
2017-06-01
To estimate the healthy life expectancy at 60 years by sex and Federated States and to investigate geographical inequalities by socioeconomic status. Healthy life expectancy was estimated by the Sullivan method, based on the information of the National Survey on Health, 2013. Three criteria were adopted for the definition of "unhealthy state": self-assessment of bad health, functionality for performing the activities of daily living, and the presence of noncommunicable disease with intense degree of limitation. The indicator of socioeconomic status was built based on the number of goods at household and educational level of the head of household. To analyze the geographical inequalities and socioeconomic level, inequality measures were calculated, such as the ratio, the difference, and the angular coefficient. Healthy life expectancy among men ranged from 13.8 (Alagoas) to 20.9 (Espírito Santo) for the self-assessment criterion of bad health. Among women, the corresponding estimates were always higher and ranged from 14.9 (Maranhão) to 22.2 (São Paulo). As to the ratio of inequality by Federated State, the medians were always higher for healthy life expectancy than for life expectancy, regardless of the definition adopted for healthy state. Regarding the differences per Federated State, the healthy life expectancy was seven years higher in one state than in another. By socioeconomic status, differences of three and four years were found, approximately, between the last and first fifth, for men and women, respectively. Despite the association of the mortality indicators with living conditions, the inequalities are even more pronounced when the welfare and the limitations in usual activities are considered, showing the necessity to promote actions and programs to reduce the socio-spatial gradient. Estimar a esperança de vida saudável aos 60 anos por sexo e Unidade da Federação e investigar as desigualdades geográficas e por nível socioeconômico. A esperança de vida saudável foi estimada pelo método de Sullivan, com base nas informações da Pesquisa Nacional de Saúde, 2013. Foram adotados três critérios para definição de estado "não saudável": autoavaliação de saúde ruim, funcionalidade para realização das atividades da vida diária, e presença de doença crônica não transmissível com grau intenso de limitação. O indicador de nível socioeconômico foi construído com base no número de bens no domicílio e grau de escolaridade do responsável. Para analisar as desigualdades geográficas e por nível socioeconômico, foram calculadas medidas de desigualdade, como a razão, a diferença e o coeficiente angular. A esperança de vida saudável entre os homens variou de 13,8 (Alagoas) a 20,9 (Espírito Santo) para o critério de autoavaliação de saúde ruim. Entre as mulheres, as estimativas correspondentes foram sempre mais altas e variaram de 14,9 (Maranhão) a 22,2 (São Paulo). Quanto à razão de desigualdades por Unidade da Federação, as medianas foram sempre maiores para a esperança de vida saudável do que para a esperança de vida, independentemente da definição adotada para estado saudável. Quanto às diferenças por Unidade da Federação, a esperança de vida saudável chegou a ser sete anos maior em um estado do que em outro. Por nível socioeconômico, foram encontradas diferenças de três e quatro anos, aproximadamente, entre os últimos e primeiro quintos, para homens e mulheres, respectivamente. Além de os indicadores de mortalidade estarem associados às condições de vida, as desigualdades são ainda mais pronunciadas quando o bem-estar e as limitações nas atividades habituais são levados em consideração, mostrando a necessidade de promover ações e programas para diminuir o gradiente socioespacial.
Mortalidade em florestas de Pinus palustris causada por tempestade de raios
Kenneth W. Outcalt; Jorge Paladino Corrêa de Lima; Jose Américo de Mello Filho
2002-01-01
The importance of lightning as an ignition source for the fire driven Pinus palustris ecosystem is widely recognized. Lightning also impacts this system on a smaller scale by causing individual tree mortality. The objective of this study was to determine the level of mortality due to lightning activity at the Department of Energy's Savannah...
Nurses' knowledge to identify early acute kidney injury.
Nascimento, Roseli Aparecida Matheus do; Assunção, Murillo Santucci Cesar; Silva, João Manoel; Amendola, Cristina Prata; Carvalho, Taysa Martindo de; Lima, Emerson Quintino; Lobo, Suzana Margareth Ajeje
2016-01-01
To evaluate the knowledgeof nurses on early identification of acute kidney injury (AKI) in intensive care, emergency and hospitalization units. A prospective multi-center study was conducted with 216 nurses, using a questionnaire with 10 questions related to AKI prevention, diagnosis, and treatment. 57.2% of nurses were unable to identify AKI clinical manifestations, 54.6% did not have knowledge of AKI incidence in patients admitted to the ICU, 87.0% of the nurses did not know how to answer as regards the AKI mortality rate in patients admitted to the ICU, 67.1% answered incorrectly that slight increases in serum creatinine do not have an impact on mortality, 66.8% answered incorrectly to the question on AKI prevention measures, 60.4% answered correctly that loop diuretics for preventing AKI is not recommended, 77.6% answered correctly that AKI does not characterize the need for hemodialysis, and 92.5% said they had no knowledge of the Acute Kidney Injury Networkclassification. Nurses do not have enough knowledge to identify early AKI, demonstrating the importance of qualification programs in this field of knowledge. Avaliar o conhecimento do enfermeiro na identificação precoce da Injúria Renal Aguda (IRA) em Unidade de Terapia Intensiva, Unidade de Internação e Emergência. Estudo multicêntrico, prospectivo.Participaram do estudo 216 enfermeiros,por meio de questionário com 10 questões relacionadas à prevenção, ao diagnóstico e ao tratamento da IRA. 57,2% não souberam identificar as manifestações clínicas da IRA, 54,6% não têm conhecimento da incidência de IRA em pacientes internados na UTI, 87,0% dos enfermeiros não souberam responder ao índice de mortalidade de IRA em pacientes internados na UTI, 67,1% responderam incorretamente que aumentos discretos da creatinina sérica não têm impacto na mortalidade, 66,8% responderam incorretamente à questão sobre as medidas de prevenção da IRA, 60,4% acertaram quando responderam que não é recomendada a utilização de diuréticos de alça na prevenção da IRA, 77,6% acertaram ao responder que IRA não caracteriza necessidade de hemodiálise e 92,5% disseram não conhecer a classificação AKIN. Enfermeiros não têm conhecimento suficiente para a identificação precoce da IRA, mostrando a importância de programas de capacitação nesta área do conhecimento.
[Etiology of urinary tract infections and antimicrobial susceptibility of urinary pathogens].
Correia, Carlos; Costa, Elísio; Peres, António; Alves, Madalena; Pombo, Graça; Estevinho, Letícia
2007-01-01
With the objective of knowing the common etiological agents in urinary infection and comparing its antimicrobial susceptibility in nosocomial and community-acquired urinary infections, we analyse all the urine bacteriological exams from the Serviço de Patologia Clínica do Centro Hospitalar do Nordeste, EPE - Unidade Hospitalar de Bragança, during a two years period (April 2004 to March 2006). During this period, 4018 urine bacteriological exams were made. The cultural exam was positive in 572 samples (144 from nosocomial infections and 428 from community-acquired urinary infections). The Escherichia coli was the more isolated strain (68,4 %), followed by Klebsiella spp (7,9%), Pseudomonas aeruginosa (6,1%) and Proteus mirabilis (5,2%). Concerning to antimicrobial susceptibility, Escherichia coli and Klebsiella spp showed a high resistance to the antimicrobials Amoxicillin, Piperacillin, Cephalothin, Ceftazidim and Quinolones. For Enterobacteriaceae Imipenem, Amikacin and Netilmicin were the antimicrobials with more level of susceptibility. Imipenem and Amikacin were the more efficient antimicrobials against Pseudomonas aeruginosa. Concerning to the susceptibility for the same etiological agent, in nosocomial and community-acquired urinary infections, we founded statistical significant differences in the antimicrobials Ticarcillin-clavulanic acid and Collistin for Pseudomonas aeruginosa and in the group of antimicrobials from Quinolones for the Proteus mirabilis. In the other identified agents there were no statistical significant differences for antimicrobials. This study it allows making use of data necessary for the knowledge of etiologic urinary infection agents in Bragança and provides the information about the antimicrobials resistance, which were necessary to initiate an adequate empirical treatment and to elaborate treatment guides.
The situation of nursing education in Latin America and the Caribbean towards universal health.
Cassiani, Silvia Helena De Bortoli; Wilson, Lynda Law; Mikael, Sabrina de Souza Elias; Peña, Laura Morán; Grajales, Rosa Amarilis Zarate; McCreary, Linda L; Theus, Lisa; Agudelo, Maria Del Carmen Gutierrez; Felix, Adriana da Silva; Uriza, Jacqueline Molina de; Gutierrez, Nathaly Rozo
2017-05-11
to assess the situation of nursing education and to analyze the extent to which baccalaureate level nursing education programs in Latin America and the Caribbean are preparing graduates to contribute to the achievement of Universal Health. quantitative, descriptive/exploratory, cross-sectional study carried out in 25 countries. a total of 246 nursing schools participated in the study. Faculty with doctoral level degrees totaled 31.3%, without Brazil this is reduced to 8.3%. The ratio of clinical experiences in primary health care services to hospital-based services was 0.63, indicating that students receive more clinical experiences in hospital settings. The results suggested a need for improvement in internet access; information technology; accessibility for the disabled; program, faculty and student evaluation; and teaching/learning methods. there is heterogeneity in nursing education in Latin America and the Caribbean. The nursing curricula generally includes the principles and values of Universal Health and primary health care, as well as those principles underpinning transformative education modalities such as critical and complex thinking development, problem-solving, evidence-based clinical decision-making, and lifelong learning. However, there is a need to promote a paradigm shift in nursing education to include more training in primary health care. avaliar a situação da educação em enfermagem e analisar o quanto os programas de educação em enfermagem, no nível de Bacharelado na América Latina e no Caribe, estão preparando graduados a contribuir para o alcance da Saúde Universal. estudo quantitativo, descritivo/exploratório, transversal, realizado em 25 países. um total de 246 escolas de enfermagem participaram do estudo. O corpo docente com nível de Doutorado totalizou 31,3%; sem o Brasil o número fica reduzido a 8,3%. A razão entre experiências clínicas nos serviços de atenção primária à saúde e nos serviços hospitalares foi de 0,63, indicando que os estudantes têm mais experiências clínicas nos cenários hospitalares. Os resultados sugeriram necessidade de aprimoramento relacionada ao acesso à Internet; tecnologia da informação; acesso para portadores de deficiências; avaliação do programa, do corpo docente e dos estudantes; e aos métodos de ensino/aprendizagem. há heterogeneidade na educação em enfermagem na América Latina e no Caribe. Os currículos de enfermagem incluem, geralmente, os princípios e valores da Saúde Universal e da atenção primária à saúde, bem como aqueles princípios subjacentes às modalidades de educação transformativa, como o desenvolvimento de pensamento crítico e complexo, a solução de problemas, a tomada de decisão clínica baseada em evidências, e aprendizagem contínua. No entanto, é preciso promover uma mudança de paradigma na educação em enfermagem que inclua mais treinamento na atenção primária à saúde. evaluar la situación de la educación en enfermería y analizar en qué grado los programas de educación de enfermería a nivel de grado en América Latina y el Caribe están preparando a los graduados para contribuir al logro de la Salud Universal. se llevó a cabo un estudio transversal, cuantitativo, descriptivo y exploratorio en 25 países. participaron en el estudio 246 escuelas de enfermería. El porcentaje de profesores con títulos de doctorado fue de 31,3%; pero, si se excluye a Brasil esta cifra se reduce a 8,3%. La proporción de la experiencia clínica adquirida en los servicios de atención primaria de salud en relación con la adquirida en servicios hospitalarios fue de 0,63, lo que indica que los estudiantes adquieren la mayor parte de su experiencia clínica en entornos hospitalarios. Los resultados mostraron una necesidad de mejorar el acceso a internet; la tecnología de la información; la accesibilidad para las personas discapacitadas; la evaluación de los programas, de los profesores y de los estudiantes; y los métodos de enseñanza y aprendizaje. hay heterogeneidad en la educación en enfermería en América Latina y el Caribe. En general, los programas de estudios de enfermería han adoptado los principios y los valores de la Salud Universal y la atención primaria de salud, así como los principios que sustentan las modalidades de educación transformadora, como son el desarrollo del pensamiento crítico y complejo, la solución de problemas, la toma de decisiones clínicas basadas en la evidencia y el aprendizaje a lo largo de toda la vida. Sin embargo, hay necesidad de promover un cambio en el paradigma de la educación en enfermería, a fin de que abarque más capacitación en la atención primaria de salud.
Indicators of health and safety among institutionalized older adults.
Cavalcante, Maria Lígia Silva Nunes; Borges, Cíntia Lira; Moura, Acácia Maria Figueiredo Torres de Melo; Carvalho, Rhanna Emanuela Fontenele Lima de
2016-01-01
To identify the incidence of mortality, diarrheal diseases, scabies and falls; and the prevalence of pressure ulcers - all of which are related to the safety ofinstitutionalized older adults. This was a documentary retrospective study developed in a long-term residential careinstitution for older adults in the Northeast region of Brazil. The data were gathered from records of health assessment indicators filed between January 2008 and December 2015. Analysis included absolute case frequency; the sum of monthly prevalence and incidence rates; mean values of cases; and mean annual incidence and prevalence rates. The incidence of mortality over these nine years ranged from 9% to 13%; of acute diarrheic disease from 13% to 45%; and scabies from 21% to 63%. The prevalence of pressure ulcers ranged from 8% to 23%. Between 2012 and 2015, the incidence rate of falls without injury varied from 38% to 83%, and with injury from12% to 20%. Analysis of the health indicators revealeda high incidence of scabies and falls and a high prevalence of pressure ulcers. The identification of less than optimal rates for performance indicators canhelp improve the quality of nursing care. Identificar a incidência de mortalidade, doenças diarreicas, escabiose e quedas, e a prevalência de lesões por pressão para a segurança do idoso institucionalizado. Estudo documental, retrospectivo desenvolvido em uma Instituição de Longa Permanência para Idosos, localizada no nordeste do Brasil. Os dados foram coletados por meio dos registros dos indicadores de avaliação de saúde, arquivados de janeiro de 2008 a dezembro de 2015. A análise incluiu a frequência absoluta dos casos; o somatório das taxas de prevalência e incidência mensais; a média de casos e das taxas de incidência e prevalência anuais. Observa-se que a incidência de óbitos nos nove anos considerados variou de 9 a 13%; de doenças diarreicas agudas, de 13 a 45%; e de escabiose, de 21 a 63%. A prevalência de lesão por pressão oscilou de 8 a 23%. Entre os anos de 2012 a 2015, a taxa de incidência de quedas sem lesão variou em torno de 38 a 83%, e com lesão, de 12 a 20%. A análise da amplitude dos indicadores de saúde permitiu identificar a alta incidência de escabiose e de quedas e a elevada prevalência de lesões por pressão. A identificação do comprometimento dos indicadores contribui para otimização da qualidade da assistência de enfermagem.
Nunes, Sheila Elke Araujo; Minamisava, Ruth; Vieira, Maria Aparecida da Silva; Itria, Alexander; Pessoa, Vicente Porfirio; Andrade, Ana Lúcia Sampaio Sgambatti de; Toscano, Cristiana Maria
2017-01-01
To determine and compare hospitalization costs of bacterial community-acquired pneumonia cases via different costing methods under the Brazilian Public Unified Health System perspective. Cost-of-illness study based on primary data collected from a sample of 59 children aged between 28 days and 35 months and hospitalized due to bacterial pneumonia. Direct medical and non-medical costs were considered and three costing methods employed: micro-costing based on medical record review, micro-costing based on therapeutic guidelines and gross-costing based on the Brazilian Public Unified Health System reimbursement rates. Costs estimates obtained via different methods were compared using the Friedman test. Cost estimates of inpatient cases of severe pneumonia amounted to R$ 780,70/$Int. 858.7 (medical record review), R$ 641,90/$Int. 706.90 (therapeutic guidelines) and R$ 594,80/$Int. 654.28 (Brazilian Public Unified Health System reimbursement rates). Costs estimated via micro-costing (medical record review or therapeutic guidelines) did not differ significantly (p=0.405), while estimates based on reimbursement rates were significantly lower compared to estimates based on therapeutic guidelines (p<0.001) or record review (p=0.006). Brazilian Public Unified Health System costs estimated via different costing methods differ significantly, with gross-costing yielding lower cost estimates. Given costs estimated by different micro-costing methods are similar and costing methods based on therapeutic guidelines are easier to apply and less expensive, this method may be a valuable alternative for estimation of hospitalization costs of bacterial community-acquired pneumonia in children. Determinar e comparar custos hospitalares no tratamento da pneumonia bacteriana adquirida na comunidade por diferentes metodologias de custeio, na perspectiva do Sistema Único de Saúde. Estudo de custo, com coleta de dados primários de uma amostra de 59 crianças com 28 dias a 35 meses de idade hospitalizadas por pneumonia bacteriana. Foram considerados custos diretos médicos e não médicos. Três metodologias de custeio foram utilizadas: microcusteio por revisão de prontuários, microcusteio considerando diretriz terapêutica e macrocusteio por ressarcimento do Sistema Único de Saúde. Os custos estimados pelas diferentes metodologias foram comparados utilizando o teste de Friedman. Os custos hospitalares de crianças com pneumonia grave foram R$ 780,70 ($Int. 858.7) por revisão de prontuários, R$ 641,90 ($Int. 706.90) por diretriz terapêutica e R$ 594,80 ($Int. 654.28) por ressarcimento do Sistema Único de Saúde, respectivamente. A utilização de metodologias de microcusteio (revisão de prontuários e diretriz) resultou em estimativas de custos equivalentes (p=0,405), enquanto o custo estimado por ressarcimento foi significativamente menor do que aqueles estimados por diretriz (p<0,001) e por revisão de prontuário (p=0,006), sendo, assim, significativamente diferentes. Na perspectiva do Sistema Único de Saúde, existe diferença significativa nos custos estimados quando se utilizam diferentes metodologias, sendo a estimativa por ressarcimento a que resulta em valores menores. Considerando que não há diferença nos valores de custos estimados por diferentes metodologias de microcusteio, a metodologia de custeio por diretriz, de mais fácil e rápida execução, é uma alternativa válida para estimativa de custos de hospitalização por pneumonias bacterianas em crianças.
Visceral leishmaniasis in the state of Sao Paulo, Brazil: spatial and space-time analysis.
Cardim, Marisa Furtado Mozini; Guirado, Marluci Monteiro; Dibo, Margareth Regina; Chiaravalloti, Francisco
2016-08-11
To perform both space and space-time evaluations of visceral leishmaniasis in humans in the state of Sao Paulo, Brazil. The population considered in the study comprised autochthonous cases of visceral leishmaniasis and deaths resulting from it in Sao Paulo, between 1999 and 2013. The analysis considered the western region of the state as its studied area. Thematic maps were created to show visceral leishmaniasis dissemination in humans in the municipality. Spatial analysis tools Kernel and Kernel ratio were used to respectively obtain the distribution of cases and deaths and the distribution of incidence and mortality. Scan statistics were used in order to identify spatial and space-time clusters of cases and deaths. The visceral leishmaniasis cases in humans, during the studied period, were observed to occur in the western portion of Sao Paulo, and their territorial extension mainly followed the eastbound course of the Marechal Rondon highway. The incidences were characterized as two sequences of concentric ellipses of decreasing intensities. The first and more intense one was found to have its epicenter in the municipality of Castilho (where the Marechal Rondon highway crosses the border of the state of Mato Grosso do Sul) and the second one in Bauru. Mortality was found to have a similar behavior to incidence. The spatial and space-time clusters of cases were observed to coincide with the two areas of highest incidence. Both the space-time clusters identified, even without coinciding in time, were started three years after the human cases were detected and had the same duration, that is, six years. The expansion of visceral leishmaniasis in Sao Paulo has been taking place in an eastbound direction, focusing on the role of highways, especially Marechal Rondon, in this process. The space-time analysis detected the disease occurred in cycles, in different spaces and time periods. These meetings, if considered, may contribute to the adoption of actions that aim to prevent the disease from spreading throughout the whole territory of São Paulo or to at least reducing its expansion speed. Avaliar, no espaço e espaço-tempo, a ocorrência da leishmaniose visceral em humanos no estado de São Paulo, Brasil. Considerou-se como população de estudo os casos autóctones e óbitos por leishmaniose visceral em humanos ocorridos em São Paulo entre 1999 e 2013 e, como área de estudo, a região oeste do estado. Construíram-se mapas temáticos que mostraram a disseminação da leishmaniose visceral em humanos nos municípios. Ferramentas de análise espacial Kernel e razão Kernel foram utilizadas para obter, respectivamente, a distribuição dos casos e óbitos e a distribuição da incidência e mortalidade. Utilizaram-se estatísticas de varredura para identificar aglomerados espaciais e espaço-temporais de casos e óbitos. Os casos de leishmaniose visceral em humanos, no período de estudo, ocorreram na parte ocidental de São Paulo e sua expansão territorial seguiu principalmente o curso da rodovia Marechal Rondon, no sentido oeste-leste. As incidências foram caracterizadas como duas sequências de elipses concêntricas com intensidade decrescente. A primeira, com maior intensidade, teve epicentro no município de Castilho (cruzamento da rodovia Marechal Rondon com a divisa com o estado de Mato Grosso do Sul) e a segunda, em Bauru. A mortalidade apresentou comportamento similar ao da incidência. Os aglomerados espaciais e espaço-temporais de casos coincidiram com as duas áreas de maiores incidências. Ambos os aglomerados espaço-temporais identificados, mesmo sem coincidirem temporalmente, tiveram início após três anos da detecção dos casos humanos e tiveram a mesma duração, seis anos. A expansão da leishmaniose visceral em São Paulo vem ocorrendo no sentido oeste-leste, com destaque ao papel das rodovias, especialmente a Marechal Rondon, neste processo. A análise espaço-temporal detectou, em diferentes espaços e períodos de tempo, ciclicidade na ocorrência da doença. Esses encontros, se considerados, podem colaborar para a adoção de ações que visem a evitar que a doença se espalhe por todo o território paulista ou, no mínimo, diminuir sua velocidade de expansão.
Passos, Silvia da Silva Santos; Pereira, Álvaro; Nitschke, Rosane Gonçalves
2016-01-01
Compreender o relacionamento no quotidiano dos familiares acompanhantes nos cenários de cuidado que se aproximam da metáfora da tribo no ambiente hospitalar. Estudo qualitativo com dados coletados a partir de entrevistas semiestruturadas e observação com 16 familiares acompanhantes de pessoas hospitalizadas com dependência para o autocuidado. Os dados foram submetidos à análise temática e analisados através da metáfora da tribo proposta pela sociologia compreensiva. Os familiares formam um agrupamento social em torno do cuidado onde encontramos as características das tribos: a ambiência emocional; a solidariedade baseada nos vínculos de simpatia e ajuda mútua; a nebulosa afetual no processo interacional; a lógica da fusão nas relações tácteis e a comunhão/religiosidade no processo de ligação numa identidade coletiva. Os familiares na presença do trágico criam agrupamentos sociais que se assemelham a tribos cujo totem é o cuidado. Understand the quotidian relationships of accompanying family members in an environment of care, which are close to the metaphor of a tribe in hospital environment. METHODQualitative study with data gathered from semi-structured interviews and observations with 16 family members accompanying hospitalized individuals with dependence on self-care. Data were submitted to thematic analysis, and analyzed through the metaphor of "tribe" proposed by comprehensive sociology. Family members build up social clusters around caring, where we find traits typical of tribes: emotional ambience; solidarity based on links of sympathy and mutual assistance; an affectual nebula in the process of interaction; a logic of fusion in tactile relations; and communion/religiosity in the process of connecting in a collective identity. In the presence of tragedy, families build social clusters similar to tribes having care as a totem.
Nascimento, Antônio Paula; Santos, Jane Meri; Mill, José Geraldo; Souza, Juliana Bottoni de; Reis, Neyval Costa; Reisen, Valdério Anselmo
2017-01-12
To analyze the association between fine particulate matter concentration in the atmosphere and hospital care by acute respiratory diseases in children. Ecological study, carried out in the region of Grande Vitória, Espírito Santo, in the winter (June 21 to September 21, 2013) and summer (December 21, 2013 to March 19, 2014). We assessed data of daily count for outpatient care and hospitalization by respiratory diseases (ICD-10) in children from zero to 12 years in three hospitals in the Region of Grande Vitória. For collecting fine particulate matter, we used portable samplers of particles installed in six locations in the studied region. The Generalized Additive Model with Poisson distribution, fitted for the effects of predictor covariates, was used to evaluate the relationship between respiratory outcomes and concentration of fine particulate matter. The increase of 4.2 µg/m3 (interquartile range) in the concentration of fine particulate matter increased in 3.8% and 5.6% the risk of medical care or hospitalization, respectively, on the same day and with six-day lag from the exposure. We identified positive association between outpatient care and hospitalizations of children under 12 years due to acute respiratory diseases and the concentration of fine particulate matter in the atmosphere. Analisar a associação entre a concentração de material particulado fino na atmosfera e atendimento hospitalar por doenças respiratórias agudas em crianças. Estudo ecológico, realizado na Região da Grande Vitória, ES, no inverno (21 de junho a 21 de setembro de 2013) e no verão (21 de dezembro de 2013 a 19 de março de 2014). Foram avaliados dados de contagem diária de atendimentos ambulatoriais e hospitalizações por doenças respiratórias (CID-10) em crianças de zero a 12 anos em três hospitais da Região da Grande Vitoria. Para a coleta de material particulado fino foram utilizados amostradores portáteis de partículas instalados em seis locais na região estudada. O Modelo Aditivo Generalizado com distribuição de Poisson, ajustado para efeitos das covariáveis preditoras, foi utilizado para avaliar a relação entre os desfechos respiratórios e a concentração de material particulado fino. O incremento de 4,2 µg/m3 (intervalo interquartílico) na concentração de material particulado fino aumentou em 3,8% e 5,6% o risco de atendimento ou internação, respectivamente, no mesmo dia e com seis dias de defasagem da exposição. Foi identificada associação positiva entre atendimentos ambulatoriais e hospitalizações de crianças com até 12 anos devido a doenças respiratórias agudas e a concentração de material particulado fino na atmosfera.
Violent Crime: A Comparative Study of Honduras and Nicaragua
2009-03-01
Preventiva and the Ministerio Público, Observatorio de la Violencia : Mortalidad y Otros, Universidad Nacional Autónoma de Honduras, Edición No. 10...be the worst.”57 The “Observatorio de la Violencia ,” a report from the Honduran Police and Public Ministry contradicts the rationale that they are...Ibid. 62 Ibid. 63 Roberto Solis, “ Violencia en Nicaragua a Paso de Gigante.” La Prensa, 2005, www.laprensa.com.ni/archivo/2008/diciembre/13/noticias
Use of comorbidity measures to predict the risk of death in Brazilian in-patients.
Martins, Monica
2010-06-01
To assess the use of comorbidity measures to predict the risk of death in Brazilian in-patients. Data from the Sistema de Informações Hospitalares do Sistema Unico de Saúde (Unified Health System Hospital Information System) were used, which enables only one secondary diagnosis to be recorded. A total of 1,607,697 hospitalizations were selected, all of which occurred in Brazil, between 2003 and 2004, and whose main diagnoses were: ischemic heart disease, congestive cardiac failure, stroke and pneumonia. Charlson Index and Elixhauser comorbidities were the comorbidity measures used. In addition, the simple record of a certain secondary diagnosis was also used. Logistic regression was applied to assess the impact of comorbidity measures on the estimate of risk of death. The baseline model included the following variables: age, sex and main diagnosis. Models to predict death were assessed, based on C-statistic and Hosmer-Lemeshow test. Hospital mortality rate was 10.4% and mean length of stay was 5.7 days. The majority (52%) of hospitalizations occurred among men and mean age was 62.6 years. Of all hospitalizations, 5.4% included a recorded secondary diagnosis, although the odds ratio between death and presence of comorbidity was 1.93. The baseline model showed a discriminatory capacity (C-statistic) of 0.685. The improvement in the models, attributed to the introduction of comorbidity indices, was poor, equivalent to zero when C-statistic with only two digits was considered. Although the introduction of three comorbidity measures in distinct models to predict death improved the predictive capacity of the baseline model, the values obtained are still considered insufficient. The accuracy of this type of measure is influenced by the completeness of the source of information. In this sense, high underreporting of secondary diagnosis, in addition to the well-known lack of space to note down this type of information in the Sistema de Informações Hospitalares, are the main explanatory factors for the results found.
Hyeda, Adriano; Costa, Élide Sbardellotto Mariano da
2017-01-01
To conduct an economic analysis of enteral and parenteral diet costs according to the type of disease and outcome (survivors versus deaths). It is a cross-sectional, observational, retrospective study with a qualitative and quantitative design, based on analysis of hospital accounts from a healthcare insurance provider in the Southern region of Brazil. We analyzed 301 hospital accounts of individuals who used enteral and parenteral diets. The total cost of the diet was 35.4% of hospital account total costs. The enteral modality accounted for 59.8% of total dietary costs. The major costs with diets were observed in hospitalizations related to infections, cancers and cerebro-cardiovascular diseases. The major costs with parenteral diet were with admissions related by cancers (64.52%) and dementia syndromes (46.17%). The highest ratio between total diet costs with the total of hospital account costs was in dementia syndromes (46.32%) and in cancers (41.2%). The individuals who died spent 51.26% of total of hospital account costs, being 32.81% in diet (47.45% of total diet value and 58.81% in parenteral modality). Enteral and parenteral nutritional therapies account for a significant part of the costs with hospitalized individuals, especially in cases of cancers and dementia syndromes. The costs of parenteral diets were higher in the group of patients who died. Realizar uma análise econômica de custos da terapia nutricional enteral e parenteral, conforme o tipo de doença e o desfecho (sobreviventes versus óbitos). Estudo transversal, observacional, retrospectivo, com estratégia qualitativa e quantitativa, a partir da análise de contas hospitalares de uma operadora de saúde da Região Sul do Brasil. Foram analisadas 301 contas hospitalares de usuários que utilizaram dieta enteral e parenteral. O custo total com dieta foi de 35,4% do custo total das contas hospitalares. A modalidade enteral representou 59,8% do custo total em dieta. Os maiores custos com dieta foram observados em internações relacionadas a infecções, cânceres e doenças cérebro-cardiovasculares. Os maiores custos com dieta parenteral foram observados nas internações relacionadas aos cânceres (64,52%) e às síndromes demenciais (46,17%). A maior relação entre o custo total com dieta e o custo total da conta foi na síndrome demencial (46,32%) e no câncer (41,2%). Os usuários que foram a óbito consumiram 51,26% dos custos totais das contas, sendo 32,81% com dieta (47,45% do valor total com dieta e 58,81% do custo na modalidade parenteral). As terapias nutricionais enteral e parenteral representaram uma parte importante dos custos no tratamento de indivíduos hospitalizados, principalmente nos casos dos cânceres e nas síndromes demenciais. O custo com dieta parenteral foi maior no grupo de usuários que foram a óbito.
Analysis of the Economic Impact of Cardiovascular Diseases in the Last Five Years in Brazil.
Siqueira, Alessandra de Sá Earp; Siqueira-Filho, Aristarco Gonçalves de; Land, Marcelo Gerardin Poirot
2017-07-01
There is growing concern about the economic impact of cardiovascular diseases (CVD) in Brazil and worldwide. To estimate the economic impact of CVD in Brazil in the last five years. The information to estimate CVD costs was taken from national databases, adding the direct costs with hospitalizations, outpatient visits and benefits granted by social security. Indirect costs were added to the calculation, such as loss of income caused by CVD morbidity or mortality. CVD mortality accounts for 28% of all deaths in Brazil in the last five years and for 38% of deaths in the productive age range (18 to 65 years). The estimated costs of CVD were R$ 37.1 billion in 2015, a 17% increase in the period from 2010 to 2015. The estimated costs of premature death due to CVD represent 61% of the total cost of CVD, Direct costs with hospitalizations and consultations were 22%, and costs related to the loss of productivity related to the disease were 15% of the total. Health expenditures in Brazil are estimated at 9.5% of GDP and the average cost of CVD was estimated at 0.7% of GDP. CVD costs have increased significantly in the last five years. It is estimated that CVD costs increase as the Brazilian population ages and the prevalence of CVD increases. Existe uma preocupação crescente com o impacto econômico das doenças cardiovasculares (DCV) no Brasil e no mundo. Estimar o impacto econômico das DCV no Brasil nos últimos cinco anos. As informações para estimar os custos em DCV foram retiradas de bancos de dados nacionais, somando os custos diretos com hospitalizações, atendimentos ambulatoriais e benefícios concedidos pela previdência. Custos indiretos foram acrescidos ao cálculo, como a perda de renda causada pela morbidade ou pela mortalidade da DCV. A mortalidade por DCV representa 28% do total de óbitos ocorridos no Brasil nos últimos cinco anos e atinge 38% dos óbitos na faixa etária produtiva (18 a 65 anos). Os custos estimados por DCV foram de R$ 37,1 bilhões de reais no ano de 2015, um aumento percentual de 17% no período de 2010 a 2015. Os custos estimados pela morte prematura por DCV representam 61% do total de custo por DCV, os custos diretos com internações e consultas foram de 22% e os custos pela perda da produtividade relacionados à doença foram de 15% do total. Os gastos com saúde no Brasil são estimados em 9,5% do PIB e o custo médio das DCV foi estimado em 0,7% do PIB. Os custos com DCV vêm aumentando significativamente nos últimos cinco anos. Estima-se que os custos por DCV aumentem à medida que a população brasileira envelhece e que a prevalência de DCV aumenta.
Bellido, Diego; Bellido, Virginia
2016-09-20
El sobrepeso y la obesidad se definen como un depósito anormal o excesivo de grasa corporal. El aumento de su prevalencia en las últimas décadas lo convierte en uno de los principales problemas de salud pública que afecta a 42 millones de niños menores de 5 años en el mundo. Su presencia durante la infancia puede ser causa de enfermedades metabólicas hasta ahora consideradas típicas del adulto y mortalidad prematura, por lo que su correcto diagnóstico y tratamiento son fundamentales.
Novello, Mayra Faria; Rosa, Maria Luiza Garcia; Ferreira, Ranier Tagarro; Nunes, Icaro Gusmão; Jorge, Antonio José Lagoeiro; Correia, Dayse Mary da Silva; Martins, Wolney de Andrade; Mesquita, Evandro Tinoco
2017-02-01
Hypertension is the most prevalent risk factor for cardiovascular disease, and its proper control can prevent the high morbidity and mortality associated with this disease. To assess the degree of compliance of antihypertensive prescriptions with the VI Brazilian Guidelines on Hypertension and the blood pressure control rate in primary care. Cross-sectional study conducted between August 2011 and November 2012, including 332 adults ≥ 45 years registered in the Family Doctor Program in Niteroi and selected randomly. The analysis included the prescribed antihypertensive classes, doses, and frequencies, as well as the blood pressure (BP) of the individuals. The rate of prescription compliance was 80%. Diuretics were the most prescribed medications, and dual therapy was the most used treatment. The most common non-compliances were underdosing and underfrequencies. The BP goal in all cases was < 140/90 mmHg, except for diabetic patients, in whom the goal was set at < 130/80 mmHg. Control rates according to these goals were 44.9% and 38.6%, respectively. There was no correlation between prescription compliance and BP control. The degree of compliance was considered satisfactory. The achievement of the targets was consistent with national and international studies, suggesting that the family health model is effective in BP management, although it still needs improvement. A hipertensão arterial é o fator de risco mais prevalente para a doença cardiovascular e seu controle adequado pode prevenir a elevada morbi-mortalidade associada a esta doença. Avaliar o grau de conformidade das prescrições de anti-hipertensivos com as VI Diretrizes Brasileiras de Hipertensão e a taxa de controle pressórico na atenção básica. Estudo transversal conduzido entre agosto de 2011 e novembro de 2012, incluindo 332 adultos ≥ 45 anos cadastrados no Programa Médico de Família de Niterói e selecionados aleatoriamente. Foram analisadas as classes de anti-hipertensivos prescritos, suas doses e frequências, bem como a pressão arterial (PA) dos indivíduos. A taxa de conformidade das prescrições foi de 80%. Diuréticos foram as medicações mais prescritas e a terapia dupla foi o tratamento mais utilizado. As não conformidades mais comuns foram subdoses e subfrequências. A meta de PA para todos os casos foi < 140/90 mmHg, exceto para diabéticos, que foi < 130/80 mmHg. As taxas de controle de acordo com essas metas foram de 44,9% e 38,6%, respectivamente. Não houve correlação entre conformidade da prescrição e controle pressórico. O grau de conformidade foi considerado satisfatório. O alcance das metas foi compatível com estudos nacionais e internacionais, sugerindo que o modelo de saúde da família é efetivo no manejo da PA, embora ainda necessite aprimoramento. (Arq Bras Cardiol. 2017; [online].ahead print, PP.0-0).
Como Lo Hago Yo: Mielomeningocele En Bolivia
Dabdoub, Carlos F.; Dabdoub, Carlos B.; Villavicencio, Ramiro; Quevedo, Germán
2014-01-01
Introducción: Las malformaciones del tubo neural (MTN) representan la segunda causa más frecuente de anomalías congénitas, luego de las cardiopatías. En este grupo se destaca el mielomeningocele (MMC) por su mayor incidencia, y por ser la más incapacitante y la más compleja entre todas las demás malformaciones del sistema nervioso c`entral (SNC). En Bolivia, como en muchos países de Sudamérica, los bajos niveles socio-culturales y la debilidad en el sistema sanitario, hacen que su incidencia y su morbilidad, sean mayores que en las naciones más desarrolladas. Material y Métodos: Se realizó un estudio retrospectivo y descriptivo de 70 casos de MMC, atendidos por un equipo multidisciplinario en el Hospital Universitario Japonés (HUJ) de Santa Cruz de la Sierra, entre 2008-2011. De ellos, 60 fueron intervenidos quirúrgicamente. Resultados: Se realizaron controles prenatales sólo en 27 mujeres (38.6%), diagnosticándose una disrafia espinal en apenas dos casos (7.4%). La edad de ingreso del MMC en su mayoría fue después de las 24 horas (65.6%), predominando su localización en la región lumbosacra (64.3%). De ellos, 67.2% eran abiertos, presentando un 32.9% un daño neurológico motor parcial mientras que 47.1% tenían paraplejia por debajo de la lesión. De los 70 casos, tres (4.3%) no fueron intervenidos, por presentar defectos congénitos severos o estado general grave. Las principales complicaciones posoperatorias inmediatas fueron: dehiscencia de sutura y/o infección de la herida (16.6%), fístula de líquido cefalorraquídeo (LCR) (10%) e infección del SNC (11.7%). La mortalidad general y postoperatoria fue de 7.1% y 3.3%, respectivamente. Al mes de vida presentaban hidrocefalia un 80% de los pacientes operados, colocándose una derivación ventriculoperitoneal (DVP) de presión media. De 9 pacientes que tuvieron un acompanamiento de dos o más años, seis presentaron una médula anclada, que fueron intervenidas quirúrgicamente. Conclusión: En esta serie, el diagnóstico prenatal del MMC fue ocasional y la derivación al HUJ de los recién nacidos con esta malformación fue generalmente tardía. No hubo predominio de género y la mayoría de los casos presentaron sus lesiones en la región lumbar y lumbosacra. La mortalidad general y postoperatoria fue similar a la reportada en la literatura. Pocos enfermos realizaron controles posteriores al alta hospitalaria. Igual que otros países de Sudamérica, las falencias en el sistema público de salud y el nivel sociocultural, son factores determinantes para un mal pronóstico en estos niños. Por sus múltiples complicaciones, el MMC requiere de una especial atención gubernamental, sobre todo de carácter preventivo mediante el uso de ácido fólico en mujeres fértiles, como también de un equipo profesional multidisciplinario, a fin de realizar un tratamiento adecuado y oportuno. Al mismo tiempo, trabajos multicéntricos en hospitales de América Latina, ayudarán al mejor manejo de estos pacientes. PMID:24791220
Fumis, María Agustina; Bidabehere, María Belén; Moyano, Yohana; Sardoy, Agustina; Gubiani, María Laura; Boldrini, María Pía; Pinardi, Beatriz Alicia
2017-09-08
La fascitis necrotizante por estrepotococo del grupo A es una infección infrecuente del tejido subcutáneo y de la fascia, con una tasa de mortalidad elevada debido a su rápida progresión a shock y fallo multiorgánico. Se desarrolla generalmente en extremidades tras un traumatismo o lesión previa. El diagnóstico temprano es esencial así como también el manejo rápido y agresivo. Presentamos un caso de fascitis necrotizante de evolución rápida a pesar del diagnóstico precoz y tratamiento específico instaurado.
Severe maternal morbidity: a case-control study in Maranhao, Brazil
2013-01-01
Background Maternal mortality and morbidity are among the top public health priorities in Brazil, being quite high, especially among the most disadvantage women. A case control study was developed to identify risk factors for severe maternal morbidity in Sao Luis, one of the poorest Brazilian State Capitals. Methods The case–control study was carried out between 01/03/2009 and 28/02/2010 in two public high-risk maternities facilities and in two intensive care units (ICUs) for referral of obstetric cases. All cases hospitalized due to complications during gestation period, childbirth or up to 42 days of puerperium and who fulfilled any of Mantel's and/or Waterstone's criteria were identified. Two controls per case were randomly selected among patients of the same clinics discharged for other reasons. Data were obtained through a structured interview as well as from medical charts and prenatal cards and included sociodemographic variables, clinical and obstetric histories, behavioral factors and exposure to stress factors during pregnancy, pre-natal assistance and obstetric complication and childbirth care. Results In the final model of the unconditional logistic regression analysis, being older than 35 years (OR=3.11; 95% CI:1.53-6.31), previous hypertension (OR=2.52; 95% CI:1.09-5.80), history of abortion (OR=1.61; 95% CI:0.97-2.68), 4–5 pre-natal consultations (OR=1.78; 95% CI:1.05-3.01) and 1–3 pre-natal consultations (OR=1.89; 95% CI:1.03-3.49) were independently associated with severe maternal morbidity. Conclusions The results corroborate the importance of reproductive healthcare, of identifying a high-risk pregnancy and of a qualified and complete prenatal care to prevent severe morbid events. Resumo Introdução A mortalidade e morbidade maternas estão entre os tópicos prioritários da Saúde Pública brasileira, especialmente na população de menor nível socioeconômico. Um estudo caso-controle foi desenvolvido para identificar os fatores de risco para morbidade materna grave em São Luís, capital de um dos estados mais pobres do Brasil. Método Estudo caso-controle realizado em duas maternidades públicas de alto risco e duas UTIs de referência aos casos obstétricos entre 01/03/2009 e 28/02/2010. Foram incluídas todas as pacientes internadas por complicação do período grávido-puerperal e que preenchiam os critérios de Waterstone e/ou Mantel para morbidade materna grave. Foram selecionados para cada caso, dois controles por sorteio aleatório dentre as pacientes internadas no mesmo período e mesma maternidade que o caso. As informações de domínio sociodemográfico, clínico, obstétrico, comportamental, exposição a eventos estressores na gestação, assistência ao pré-natal, intercorrências obstétricas e atenção ao parto, foram obtidas por meio de entrevista estruturada. As variáveis foram analisadas por modelo de regressão logística múltipla não condicional, baseado em modelo hierarquizado a priori. Resultados Foram identificados como fatores de risco para morbidade materna grave: idade >35 anos (OR=3,11; IC 95%:1,53-6,31), hipertensão prévia à gestação (OR=2,52; IC 95%:1,09-5,80), antecedente de aborto (OR=1,61; IC 95%:0,97-2,68), ter realizado 4–5 consultas pré-natais (OR=1,78; IC 95%:1,05-3,01) ou 1–3 consultas (OR=1,89; IC 95%:1,03-3,49). Conclusão Os resultados do estudo corroboram a importância da assistência à saúde reprodutiva e o pré-natal completo e qualificado na prevenção de eventos mórbidos graves durante o ciclo grávido-puerperal. PMID:23399443
Relationship between Resting Heart Rate, Blood Pressure and Pulse Pressure in Adolescents.
Christofaro, Diego Giulliano Destro; Casonatto, Juliano; Vanderlei, Luiz Carlos Marques; Cucato, Gabriel Grizzo; Dias, Raphael Mendes Ritti
2017-05-01
High resting heart rate is considered an important factor for increasing mortality chance in adults. However, it remains unclear whether the observed associations would remain after adjustment for confounders in adolescents. To analyze the relationship between resting heart rate, blood pressure and pulse pressure in adolescents of both sexes. A cross-sectional study with 1231 adolescents (716 girls and 515 boys) aged 14-17 years. Heart rate, blood pressure and pulse pressure were evaluated using an oscillometric blood pressure device, validated for this population. Weight and height were measured with an electronic scale and a stadiometer, respectively, and waist circumference with a non-elastic tape. Multivariate analysis using linear regression investigated the relationship between resting heart rate and blood pressure and pulse pressure in boys and girls, controlling for general and abdominal obesity. Higher resting heart rate values were observed in girls (80.1 ± 11.0 beats/min) compared to boys (75.9 ± 12.7 beats/min) (p ≤ 0.001). Resting heart rate was associated with systolic blood pressure in boys (Beta = 0.15 [0.04; 0.26]) and girls (Beta = 0.24 [0.16; 0.33]), with diastolic blood pressure in boys (Beta = 0.50 [0.37; 0.64]) and girls (Beta = 0.41 [0.30; 0.53]), and with pulse pressure in boys (Beta = -0.16 [-0.27; -0.04]). This study demonstrated a relationship between elevated resting heart rate and increased systolic and diastolic blood pressure in both sexes and pulse pressure in boys even after controlling for potential confounders, such as general and abdominal obesity. A frequência cardíaca de repouso é considerada um importante fator de aumento de mortalidade em adultos. Entretanto, ainda é incerto se as associações observadas permanecem após ajuste para fatores de confusão em adolescentes. Analisar a relação entre frequência cardíaca de repouso, pressão arterial e pressão de pulso em adolescentes dos dois sexos. Estudo transversal com 1231 adolescentes (716 meninas e 515 meninos, idade de 14-17 anos). Frequência cardíaca, pressão arterial e pressão de pulso foram avaliadas com esfigmomanômetro oscilométrico validado para essa população. Peso e altura foram medidos com balança eletrônica e estadiômetro, respectivamente, e a circunferência abdominal, com uma fita inextensível. Análise multivariada com regressão linear investigou a relação entre frequência cardíaca de repouso, pressão arterial e pressão de pulso em meninos e meninas, controlando para obesidade geral e abdominal. Valores maiores de frequência cardíaca de repouso foram observados em meninas (80,1 ± 11,0 bpm) em comparação a meninos (75,9 ± 12,7 bpm) (p ≤ 0,001). Frequência cardíaca de repouso associou-se com pressão arterial sistólica em meninos [Beta = 0,15 (0,04; 0,26)] e meninas [Beta = 0,24 (0,16; 0,33)], com pressão arterial diastólica em meninos [Beta = 0,50 (0,37; 0,64)] e meninas [Beta = 0,41 (0,30; 0,53)], e com pressão de pulso apenas em meninos [Beta = -0,16 (-0,27; -0,04)]. Este estudo demonstrou a relação da frequência cardíaca de repouso elevada com aumento das pressões arteriais sistólica e diastólica em ambos os sexos e com pressão de pulso em meninos, mesmo após controle para potenciais fatores de confusão, como obesidade geral e abdominal.
Burgos, Rosa
2016-03-25
La desnutrición relacionada con la enfermedad (DRE) es un problema sanitario de elevada índole que impacta fuertemente en la morbilidad, mortalidad y calidad de vida de los pacientes ancianos ingresados en el hospital. Además, incrementa enormemente el gasto sanitario, sobre todo a través del aumento de la estancia hospitalaria, incremento de las complicaciones y necesidad de centro de convalecencia u otros recursos sanitarios al alta hospitalaria. Conjuntamente con la osteoporosis y la sarcopenia, contribuye de forma directa a la discapacidad y a la pérdida de autonomía del anciano, con las repercusiones familiares y sociales que ello implica.
Prevalence of hypoalbuminemia and nutritional issues in hospitalized elders.
Brock, Felipe; Bettinelli, Luiz Antonio; Dobner, Taise; Stobbe, Júlio César; Pomatti, Gabriela; Telles, Cristina Trevizan
2016-08-08
to estimate the prevalence of hypoalbuminemia in hospitalized elders, related to socio-demographic variables, nutritional status and length of stay. crosscutting study with 200 patients hospitalized in a large hospital in the South of Brazil during three months. Evaluations, lab tests and interviews through questionnaires were performed. the average albuminemia was 2,9 ± 0,5g/dL. Hypoalbuminemia was diagnosed in 173 subjects (87%) and was absent in 27 (13%) that have normal albuminemia (p=0,000). After six days of hospitalization, the prevalence of low levels grew significantly to 90% (p=0,002), average 2,7 ± 0,5g/dL. Using the Mini Nutritional Assessment, it was observed that 41 patients were malnourished and from those, 40 had hypoalbuminemia. the prevalence of hypoalbuminemia proved to be high, in approx. nine in ten elders, and the nutritional status and the length of stay proved to be related to the decrease of serum albumin levels. Thus, it is suggested that monitoring albumin levels should be done to evaluate the risk that the patient has to develop malnutrition and other complications during hospital stays. estimar a prevalência de hipoalbuminemia em idosos hospitalizados, em relação às variáveis sociodemográficas, estado nutricional e tempo de internação. estudo transversal, com 200 pacientes internados em hospital de grande porte do sul do Brasil, durante o período de três meses. Foram realizadas avaliações, análise de exames laboratoriais e entrevista através de questionário. a média de albuminemia foi 2,9 ± 0,5g/dL. O diagnóstico de hipoalbuminemia, foi encontrado em 173 sujeitos (87%), e não revelado em 27 (13%), que apresentaram albuminemia normal (p=0,000). Constatou-se que após seis dias de internação a prevalência de níveis baixos aumentou significativamente para 90% (p=0,002), com média de 2,7 ± 0,5g/dL. Utilizando-se a Mini Avaliação Nutricional, observou-se que 41 pacientes estavam desnutridos, e que destes, 40 apresentavam hipoalbuminemia. a prevalência de hipoalbuminemia mostrou-se elevada, acometendo aproximadamente nove entre dez idosos, sendo que o estado nutricional, da mesma maneira que o tempo de internação , está relacionado à diminuição dos níveis de albumina sérica. Assim, sugere-se monitorar os níveis de albuminemia para avaliar o risco que o paciente tem de desenvolver desnutrição e demais complicações durante a internação hospitalar. estimar la prevalencia de hipoalbuminemia en ancianos hospitalizados, considerando las variables sociodemográficas, estado nutricional y tiempo de internación. estudio transversal, en 200 pacientes internados en hospital de gran porte del sur de Brasil, durante un período de tres meses. Fueron realizadas evaluaciones, análisis de exámenes de laboratorio y se realizó una entrevista usando un cuestionario. el promedio de albuminemia fue 2,9 ± 0,5g/dL. El diagnóstico de hipoalbuminemia, fue encontrado en 173 sujetos (87%), y no revelado en 27 (13%), que presentaron albuminemia normal (p=0,000). Se constató que después de seis días de internación la prevalencia de niveles bajos aumentó significativamente para 90% (p=0,002), con promedio de 2,7 ± 0,5g/dL. Utilizando la Mini Evaluación Nutricional, se observó que 41 pacientes estaban desnutridos, y que de estos, 40 presentaban hipoalbuminemia. la prevalencia de hipoalbuminemia se mostró elevada, afectando aproximadamente nueve entre diez ancianos, siendo que el estado nutricional, de la misma manera que el tiempo de internación, está relacionado a la disminución de los niveles de albúmina sérica. Así, se sugiere monitorizar los niveles de albuminemia para evaluar el riesgo que el paciente tiene de desarrollar desnutrición y demás complicaciones durante la internación hospitalaria.
Taking a look to promoting health and complications' prevention: differences by context.
Freire, Rosa Maria de Albuquerque; Landeiro, Maria José Lumini; Martins, Maria Manuela Ferreira Pereira da Silva; Martins, Teresa; Peres, Heloísa Helena Ciqueto
2016-08-08
to acknowledge and compare the health promotion and complications' prevention practices performed by nurses working in hospital and primary health care contexts. descriptive, exploratory and crosscutting study, performed with 474 nurses selected by convenience sampling. It was used a form that encompassed two categories of descriptive statements about quality in the professional exercise of nurses. This study had ethical committee approval. the nurses' population was mainly women (87,3%) with an average age of 35,5 years. There was more practices of the hospital's nurses related to the identification of potential problems of the patient (p=0.001) and supervision of the activities that put in place the nursing interventions and the activities that they delegate (p=0.003). the nurses perform health promotion and complications' prevention activities, however not in a systematic fashion and professional practices differ by context. This study is relevant as it may promote the critical consciousness of the nurses about the need of stressing quality practices. conhecer e comparar as práticas de promoção da saúde e prevenção de complicações de enfermeiros que exercem em contexto hospitalar e em cuidados de atenção básica à saúde. estudo descritivo, exploratório e transversal desenvolvido com 474 enfermeiros, selecionados por meio de amostragem por conveniência. Foi utilizado questionário que integrou duas categorias de enunciados descritivos de qualidade do exercício profissional dos enfermeiros. O estudo foi aprovado em comitê de ética. a maioria dos enfermeiros era do sexo feminino (87,3%), com idade média de 35,5 anos. Houve mais práticas dos enfermeiros dos cuidados básicos à saúde relativamente a promoção de estilos de vida saudável (<0.001) e encaminhamento de situações problemáticas identificadas, para outros profissionais (p=0.039). Houve mais práticas dos enfermeiros do hospital relativamente a identificação dos problemas potenciais do paciente (p=0.001) e supervisão das atividades que concretizam as intervenções de enfermagem e as atividades que delegam (p=0.003). os enfermeiros realizam atividades de promoção da saúde e prevenção de complicações, porém, não de forma sistemática e as práticas profissionais diferem com relação ao contexto. Este estudo é relevante na medida em que pode promover a conscientização dos enfermeiros para a necessidade de reforçar práticas de qualidade. conocer y comparar las practicas de promoción de la salud y prevención de complicaciones, de los enfermeros que ejercen en el contexto de hospitales y en cuidados de atención primaria de salud. estudio descriptivo, exploratorio y transversal, desarrollado con 474 enfermeros, seleccionados por muestreo de conveniencia. Se utilizó un cuestionario que integra dos categorías de enunciados descriptivos de la calidad del ejercicio profesional de los enfermeros. El estudio fue aprobado en comité de ética. la mayoría de los enfermeros eran del sexo femenino (87,3%) con una edad promedio de 35,5 años. Se encontraron mayor cantidad de prácticas de estos enfermeros en cuidados primarios en relación a la promoción de estilos de vida saludable (<0.001) y referencia de situaciones problemáticas para otros profesionales (p=0.039). También se encontraron más prácticas de los enfermeros de hospital en relación a identificación de problemas potenciales del paciente (p=0.001) y supervisión de las actividades que concretan las intervenciones de enfermería y las actividades que delegan (p=0.003). los enfermeros realizan actividades de promoción de salud y prevención de complicaciones, sin embargo, no en forma sistemática, y las prácticas varían en relación al contexto. Este estudio es relevante en la medida que puede promover la concientización de los enfermeros para la necesidad de reforzar prácticas de calidad.
Effective Universal Coverage of Diabetes Mellitus Type 2 in Chile.
Guerrero-Núñez, Sara; Valenzuela-Suazo, Sandra; Cid-Henríquez, Patricia
2017-04-06
determine the prevalence of Effective Universal Coverage of Diabetes Mellitus Type 2 in Chile and its relation with the variables: Health Care Coverage of Diabetes Mellitus Type 2; Average of diabetics with metabolic control in 2011-2013; Mortality Rate for Diabetes Mellitus; and Percentage of nurses participating in the Cardiovascular Health Program. cross-sectional descriptive study with ecological components that uses documentary sources of the Ministry of Health. It was established that there is correlation between the Universal Effective Coverage of Diabetes Mellitus Type 2 and the independent variables; it was applied the Pearson Coefficient, being significant at the 0.05 level. in Chile Universal Health Care Coverage of Diabetes Mellitus Type 2 (HbA1c<7% estimated population) is less than 20%; this is related with Mortality Rate for Diabetes Mellitus and Percentage of nurses participating in the Cardiovascular Health Program, being significant at the 0.01 level. effective prevalence of Universal Health Coverage of Diabetes Mellitus Type 2 is low, even though some regions stand out in this research and in the metabolic control of patients who participate in health control program; its relation with percentage of nurses participating in the Cardiovascular Health Program represents a challenge and an opportunity for the health system. determinar a prevalência de Cobertura Universal Efetiva da Diabetes Mellitus tipo 2 em Chile e sua relação com as variáveis; Cobertura da Diabetes Mellitus tipo 2, Média de diabéticos com controle metabólico em 2011-2013, Taxa de Mortalidade por Diabetes Mellitus e Percentagem de participação de enfermeiras no Programa de Saúde Cardiovascular. estudo descritivo transversal com componentes ecológicos, utilizando fontes documentais do Ministério da Saúde. Foi estabelecida correlação entre Cobertura Universal Efetiva da Diabetes Mellitus tipo 2 e as variáveis independentes, aplicando o Coeficiente de Pearson, sendo significante ao 0,05. no Chile a Cobertura Universal Efetiva da Diabetes Mellitus tipo 2 (HbA1c<7% em população estimada) é menor que 20%. Esta se relaciona com uma Taxa de Mortalidade por Diabetes Mellitus e Percentagem de participação de enfermeiras no Programa de Saúde Cardiovascular, que ademais é significativa ao 0,01. a prevalência de Cobertura Universal Efetiva da Diabetes Mellitus tipo 2 é baixa, mesmo quando algumas regiões se destacam nas pesquisas e no controle metabólico de pacientes assistentes ao controle. Sua relação com a Percentagem de participação de enfermeiras no Programa de Saúde Cardiovascular se constitui em um desafio e oportunidade em saúde. determinar la prevalencia de la Cobertura Universal Efectiva de la diabetes mellitus tipo 2 en Chile y su relación con las variables: Cobertura de Diabetes Mellitus tipo 2, Promedio de diabéticos con control metabólico en 2011-2013, Tasa de Mortalidad por Diabetes Mellitus y Porcentaje de participación de enfermeros en el Programa de Salud Cardiovascular. estudio descriptivo transversal con componentes ecológicos, utilizando fuentes documentales del Ministerio de Salud. Se estableció que existe correlación entre la Cobertura Universal Efectiva de la Diabetes Mellitus tipo 2 y las variables independientes, aplicando el Coeficiente de Pearson, siendo significativa al nivel 0,05. en Chile la Cobertura Universal Efectiva de Diabetes Mellitus tipo 2 (HbA1c<7% en población estimada) es menor que 20%; esta se relaciona con la Tasa de Mortalidad por Diabetes Mellitus y con el Porcentaje de participación de enfermeras en el Programa de Salud Cardiovascular, que es significativa al nivel 0,01. la prevalencia de Cobertura Universal Efectiva de la Diabetes Mellitus tipo 2 es baja; sin embargo algunas regiones se destacan en la cobertura y en el control metabólico de pacientes que participan del control de salud. La relación de la cobertura con el porcentaje de participación de enfermeras en el Programa de Salud Cardiovascular es un desafío y una oportunidad en salud.
Machado, Aline Dos Santos; Pires-Neto, Ruy Camargo; Carvalho, Maurício Tatsch Ximenes; Soares, Janice Cristina; Cardoso, Dannuey Machado; Albuquerque, Isabella Martins de
2017-01-01
To evaluate the effects that passive cycling exercise, in combination with conventional physical therapy, have on peripheral muscle strength, duration of mechanical ventilation, and length of hospital stay in critically ill patients admitted to the ICU of a tertiary care university hospital. This was a randomized clinical trial involving 38 patients (≥ 18 years of age) on mechanical ventilation who were randomly divided into two groups: control (n = 16), receiving conventional physical therapy; and intervention (n = 22), receiving conventional physical therapy and engaging in passive cycling exercise five days per week. The mean age of the patients was 46.42 ± 16.25 years, and 23 were male. The outcomes studied were peripheral muscle strength, as measured by the Medical Research Council scale, duration of mechanical ventilation, and length of hospital stay. There was a significant increase in peripheral muscle strength (baseline vs. final) in both groups (control: 40.81 ± 7.68 vs. 45.00 ± 6.89; and intervention: 38.73 ± 11.11 vs. 47.18 ± 8.75; p < 0.001 for both). However, the range of increase in strength was higher in the intervention group than in the control group (8.45 ± 5.20 vs. 4.18 ± 2.63; p = 0.005). There were no significant differences between the groups in terms of duration of mechanical ventilation or length of hospital stay. The results suggest that the performance of continuous passive mobilization on a cyclical basis helps to recover peripheral muscle strength in ICU patients. (ClinicalTrials.gov Identifier: NCT01769846 [http://www.clinicaltrials.gov/]). Avaliar os efeitos da realização de exercícios passivos com um cicloergômetro, associada à fisioterapia convencional, na força muscular periférica, no tempo de ventilação mecânica e no tempo de internação hospitalar em pacientes críticos internados em UTI de um hospital universitário terciário. Ensaio clínico randomizado envolvendo 38 pacientes (idade > 18 anos) em ventilação mecânica e divididos aleatoriamente em grupo controle (n = 16), que realizou fisioterapia convencional, e grupo intervenção (n = 22) submetidos a fisioterapia convencional e exercícios passivos em cicloergômetro cinco vezes por semana. A média de idade dos pacientes foi de 46,42 ± 16,25 anos, e 23 eram homens. Os desfechos analisados foram força muscular periférica, mensurada pela escala Medical Research Council, tempo de ventilação mecânica e tempo de internação hospitalar. Houve um aumento significativo da força muscular periférica (basal vs. final) tanto no grupo controle (40,81 ± 7,68 vs. 45,00 ± 6,89; p < 0,001) quanto no grupo intervenção (38,73 ± 11,11 vs. 47,18 ± 8,75; p < 0,001). Entretanto, a variação do aumento da força foi maior no grupo intervenção que no controle (8,45 ± 5,20 vs. 4,18 ± 2,63; p = 0,005). Não foram observadas diferenças significativas entre os grupos quanto ao tempo de ventilação mecânica e tempo de internação hospitalar. Os resultados sugerem que a realização de mobilização passiva contínua de forma cíclica auxilia na recuperação da força muscular periférica de pacientes internados em UTI. (ClinicalTrials.gov Identifier: NCT01769846 [http://www.clinicaltrials.gov/]).
Analyzing the concept of disruptive behavior in healthcare work: an integrative review.
Oliveira, Roberta Meneses; Silva, Lucilane Maria Sales da; Guedes, Maria Vilani Cavalcante; Oliveira, Adriana Catarina de Souza; Sánchez, Rosario Gómez; Torres, Raimundo Augusto Martins
2016-01-01
To analyze the concept of disruptive behavior in healthcare work. An integrative review carried out in the theoretical phase of a qualitative research substantiated by the theoretical framework of the Hybrid Model of Concept Development. The search for articles was conducted in the CINAHL, LILACS, PsycINFO, PubMed and SciVerse Scopus databases in 2013. 70 scientific articles answered the guiding question and lead to attributes of disruptive behavior, being: incivility, psychological violence and physical/sexual violence; with their main antecedents (intrapersonal, interpersonal and organizational) being: personality characteristics, stress and work overload; and consequences of: workers' moral/mental distress, compromised patient safety, labor loss, and disruption of communication, collaboration and teamwork. Analysis of the disruptive behavior concept in healthcare work showed a construct in its theoretical stage that encompasses different disrespectful conduct adopted by health workers in the hospital context, which deserve the attention of leadership for better recognition and proper handling of cases and their consequences. Analisar o conceito comportamento destrutivo no trabalho em saúde. Revisão integrativa realizada na fase teórica de pesquisa qualitativa fundamentada pelo referencial teórico-metodológico do Modelo Híbrido de Análise de Conceitos. A busca dos artigos foi realizada nas bases de dados CINAHL, LILACS, PsycINFO, PubMed e SciVerse Scopus, em 2013. 70 artigos científicos responderam à questão norteadora e atenderam aos critérios de inclusão, permitindo evidenciar os atributos do comportamento destrutivo: incivilidade, violência psicológica e violência física/sexual; seus principais antecedentes (intrapessoais, interpessoais e organizacionais): características de personalidade, estresse e sobrecarga de trabalho; e consequentes: sofrimento moral/psíquico dos trabalhadores, comprometimento da segurança do paciente, prejuízos laborais, rompimento da comunicação, da colaboração e do trabalho em equipe. A análise do conceito comportamento destrutivo no trabalho em saúde evidenciou, em sua fase teórica, um constructo que abrange diferentes condutas desrespeitosas adotadas por trabalhadores de saúde no contexto hospitalar, merecendo atenção de lideranças da área para maior reconhecimento e manejo adequado dos casos e suas consequências.
Safe surgery: validation of pre and postoperative checklists.
Alpendre, Francine Taporosky; Cruz, Elaine Drehmer de Almeida; Dyniewicz, Ana Maria; Mantovani, Maria de Fátima; Silva, Ana Elisa Bauer de Camargo E; Santos, Gabriela de Souza Dos
2017-07-10
to develop, evaluate and validate a surgical safety checklist for patients in the pre and postoperative periods in surgical hospitalization units. methodological research carried out in a large public teaching hospital in the South of Brazil, with application of the principles of the Safe Surgery Saves Lives Programme of the World Health Organization. The checklist was applied to 16 nurses of 8 surgical units and submitted for validation by a group of eight experts using the Delphi method online. the instrument was validated and it was achieved a mean score ≥1, level of agreement ≥75% and Cronbach's alpha >0.90. The final version included 97 safety indicators organized into six categories: identification, preoperative, immediate postoperative, immediate postoperative, other surgical complications, and hospital discharge. the Surgical Safety Checklist in the Pre and Postoperative periods is another strategy to promote patient safety, as it allows the monitoring of predictive signs and symptoms of surgical complications and the early detection of adverse events. elaborar, avaliar e validar um checklist de segurança cirúrgica para os períodos pré e pós-operatório de unidades de internação cirúrgica. pesquisa metodológica, realizada em hospital de ensino público de grande porte do Sul do Brasil, com aplicação dos fundamentos do Programa Cirurgias Seguras Salvam Vidas da Organização Mundial da Saúde. O checklist foi aplicado a 16 enfermeiros de oito unidades cirúrgicas, e submetido à validação por meio da técnica Delphi on-line com oito especialistas. o instrumento foi validado, obtendo-se ranking médio ≥1, grau de concordância ≥75% e Alfa de Cronbach >0,90. A versão final contemplou 97 indicadores de segurança organizados em seis categorias: identificação, pré-operatório, pós-operatório imediato, pós-operatório mediato, outras complicações cirúrgicas, e alta hospitalar. o Checklist de Segurança Cirúrgica Pré e Pós-Operatório é mais uma estratégia na promoção da segurança do paciente, pois possibilita monitorar sinais e sintomas preditivos de complicações cirúrgicas e detecção precoce de eventos adversos. desarrollar, evaluar y validar un checklist de seguridad quirúrgica para los períodos pre y postoperatorio de unidades de hospitalización quirúrgica.. investigación metodológica llevada a cabo en un amplio hospital público de enseñanza del Sur de Brasil, con aplicación de los principios del Programa de Cirugía Segura Salva Vidas de la Organización Mundial de la Salud. El checklist se aplicó a 16 enfermeros de 8 unidades quirúrgicas y fue sometida a validación por ocho expertos utilizando el método Delphi en línea. el instrumento fue validado y se logró una puntuación media ≥1, grado de acuerdo ≥75% y alfa de Cronbach >0.90. La versión final incluyó 97 indicadores de seguridad organizados en seis categorías: identificación, preoperatorio, postoperatorio inmediato, postoperatorio inmediato, otras complicaciones quirúrgicas y alta hospitalaria. el Checklist de Seguridad Quirúrgica en el Período Pre y Postoperatorio es otra estrategia más para promover la seguridad del paciente, ya que permite monitorear los signos y síntomas predictivos de las complicaciones quirúrgicas y la detección temprana de eventos adversos.
Ranzani, Otavio Tavares; Forte, Daniel Neves; Forte, Antonio Carlos; Mimica, Igor; Forte, Wilma Carvalho Neves
2016-01-01
Ventilator-associated pneumonia (VAP) is the leading type of hospital-acquired infection in ICU patients. The diagnosis of VAP is challenging, mostly due to limitations of the diagnostic methods available. The aim of this study was to determine whether antibody-coated bacteria (ACB) evaluation can improve the specificity of endotracheal aspirate (EA) culture in VAP diagnosis. We conducted a diagnostic case-control study, enrolling 45 patients undergoing mechanical ventilation. Samples of EA were obtained from patients with and without VAP (cases and controls, respectively), and we assessed the number of bacteria coated with FITC-conjugated monoclonal antibodies (IgA, IgM, or IgG) or an FITC-conjugated polyvalent antibody. Using immunofluorescence microscopy, we determined the proportion of ACB among a fixed number of 80 bacteria. The median proportions of ACB were significantly higher among the cases (n = 22) than among the controls (n = 23)-IgA (60.6% vs. 22.5%), IgM (42.5% vs. 12.5%), IgG (50.6% vs. 17.5%), and polyvalent (75.6% vs. 33.8%)-p < 0.001 for all. The accuracy of the best cut-off points for VAP diagnosis regarding monoclonal and polyvalent ACBs was greater than 95.0% and 93.3%, respectively. The numbers of ACB in EA samples were higher among cases than among controls. Our findings indicate that evaluating ACB in EA is a promising tool to improve the specificity of VAP diagnosis. The technique could be cost-effective and therefore useful in low-resource settings, with the advantages of minimizing false-positive results and avoiding overtreatment. A pneumonia associada à ventilação mecânica (PAVM) é o principal tipo de infecção adquirida no ambiente hospitalar em pacientes em UTIs. O diagnóstico de PAVM é desafiador, principalmente devido a limitações dos métodos diagnósticos disponíveis. O objetivo deste estudo foi determinar se a avaliação de bactérias revestidas por anticorpos (BRA) pode melhorar a especificidade de culturas de aspirado traqueal (AT) no diagnóstico de PAVM. Estudo diagnóstico caso-controle envolvendo 45 pacientes sob ventilação mecânica. Amostras de AT foram obtidas de pacientes com e sem PAVM (casos e controles, respectivamente), e verificamos o número de bactérias revestidas com anticorpos monoclonais conjugados com FITC (IgA, IgM ou IgG) ou anticorpo polivalente conjugado com FITC. Utilizando microscopia de imunofluorescência, foi determinada a proporção de BRA em um número fixo de 80 bactérias. A mediana das proporções de BRA foi significativamente maior nos casos (n = 22) que nos controles (n = 23) - IgA (60,6% vs. 22,5%), IgM (42,5% vs. 12,5%), IgG (50,6% vs. 17,5%) e polivalente (75,6% vs. 33,8%) - p < 0,001 para todos. A acurácia dos melhores pontos de corte para o diagnostico de PAVM em relação aos BRA monoclonais e polivalentes foi > 95,0% e > 93,3%, respectivamente. O número de BRA em amostras de AT foi maior nos casos que nos controles. Nossos achados indicam que a avaliação de BRA no AT é uma ferramenta promissora para aumentar a especificidade do diagnóstico de PAVM. A técnica pode ser custo-efetiva e, portanto, útil em locais com poucos recursos, com as vantagens de minimizar resultados falso-positivos e evitar o tratamento excessivo.
Arboviruses emerging in Brazil: challenges for clinic and implications for public health.
Donalisio, Maria Rita; Freitas, André Ricardo Ribas; Zuben, Andrea Paula Bruno Von
2017-04-10
Arboviruses have been emerging in different parts of the world due to genetic changes in the virus, alteration of the host and vector population dynamics, or because of anthropogenic environmental factors. These viruses' capacity for adaptation is notable, as well as the likelihood of their emergence and establishment in new geographic areas. In Brazilian epidemiologic scenario, the most common arboviruses are DENV, CHIKV, and ZIKV, although others may spread in the country. Little is yet known of the impact of viral co-circulation, which would theoretically result in more intense viremia or other immunological alterations that could trigger autoimmune diseases, such as Guillain-Barré syndrome. The impact on morbidity and mortality intensifies as extensive epidemics lead to a high number of affected individuals, severe cases, and implications for health services, mainly due to the absence of treatment, vaccines, and effective prevention and control measures. RESUMO Notifica-se a emergência de arboviroses em diferentes regiões do planeta em decorrência de mudanças genéticas no vírus, alteração da dinâmica populacional de hospedeiros e vetores ou por fatores ambientais de origem antropogênica. É notável a capacidade de adaptação desses vírus e a possibilidade de emergirem e se estabelecerem em novas áreas geográficas. No contexto epidemiológico brasileiro, os arbovírus de maior circulação são DENV, CHIKV e ZIKV, embora existam outros com potencial de disseminação no País. O impacto da cocirculação viral ainda é pouco conhecido, a qual teoricamente resultaria em viremias mais intensas ou outras alterações imunológicas que poderiam ser o gatilho para doenças autoimunes, como a síndrome de Guillain-Barré. O impacto na morbidade e mortalidade se intensifica à medida que extensas epidemias pressupõem grande número de indivíduos acometidos, casos graves e implicações sobre os serviços de saúde, principalmente diante da ausência de tratamento, vacinas e medidas efetivas de prevenção e controle.
Urinary tract infection: a cohort of older people with urinary incontinence.
Melo, Laís Samara de; Ercole, Flávia Falci; Oliveira, Danilo Ulisses de; Pinto, Tatiana Saraiva; Victoriano, Mariana Avendanha; Alcoforado, Carla Lúcia Goulart Constant
2017-01-01
To evaluate epidemiological aspects of urinary tract infection in older patients with urinary incontinence living in long-term care institutions in Belo Horizonte. Method: Concurrent cohort held from April 1st to October 1st, 2015. The study was conducted in two long-term care institutions in the city of Belo Horizonte, Minas Gerais, with 84 incontinent older people. Cumulative incidence of urinary tract infection was 19% (95% CI: 7.83-23.19) and the incidence density was 3.6 cases/100 people-month of follow-up period. The variables Bacteriuria and Institution presented statistical association with the occurrence of urinary tract infection. It is observed that the incidence of urinary tract infection in the study was smaller than in other similar international and national studies, however this is an important world health problem for the older population, with impact on mortality of these individuals. Avaliar aspectos epidemiológicos da infecção do trato urinário em pacientes idosos com incontinência urinária, residentes em instituições de longa permanência, de Belo Horizonte. Coorte concorrente realizada no período de 01 de abril a 01 de outubro de 2015. O estudo foi realizado em duas instituições de longa permanência, na cidade de Belo Horizonte, MG, com 84 idosos incontinentes. A incidência acumulada de infecção do trato urinário foi de 19% (IC 95%: 7,83-23,19) e a densidade de incidência foi de 3,6 casos/100 pessoas-mês de seguimento. As variáveis Bacteriúria e Instituição apresentaram associação estatística com a ocorrência de infecção do trato urinário. Observa-se que a incidência de infecção do trato urinário no estudo foi menor que em outros estudos nacionais e internacionais semelhantes, no entanto trata-se de um importante problema de saúde mundial para os idosos, com impacto na mortalidade desses indivíduos.
Terra, Ricardo Mingarini; Araujo, Pedro Henrique Xavier Nabuco de; Lauricella, Leticia Leone; Campos, José Ribas Milanez de; Costa, Herbert Felix; Pego-Fernandes, Paulo Manuel
2016-01-01
To describe the implementation of a robotic thoracic surgery program at a public tertiary teaching hospital and to analyze its initial results. This was a planned interim analysis of a randomized clinical trial aimed at comparing video-assisted thoracoscopic surgery and robotic surgery in terms of the results obtained after pulmonary lobectomy. The robotic surgery program developed at the Instituto do Câncer do Estado de São Paulo, in the city of São Paulo, Brazil, is a multidisciplinary initiative involving various surgical specialties, as well as anesthesiology, nursing, and clinical engineering teams. In this analysis, we evaluated the patients included in the robotic lobectomy arm of the trial during its first three months (from April to June of 2015). Ten patients were included in this analysis. There were eight women and two men. The mean age was 65.1 years. All of the patients presented with peripheral tumors. We performed right upper lobectomy in four patients, right lower lobectomy in four, and left upper lobectomy in two. Surgical time varied considerably (range, 135-435 min). Conversion to open surgery or video-assisted thoracoscopic surgery was not necessary in any of the cases. Intraoperative complications were not found. Only the first patient required postoperative transfer to the ICU. There were no deaths or readmissions within the first 30 days after discharge. The only postoperative complication was chest pain (grade 3), in two patients. Pathological examination revealed complete tumor resection in all cases. When there is integration and proper training of all of the teams involved, the implementation of a robotic thoracic surgery program is feasible and can reduce morbidity and mortality. Descrever a implantação de um programa de cirurgia torácica robótica em um hospital terciário público universitário e analisar seus resultados iniciais. Este estudo é uma análise interina planejada de um ensaio clínico aleatorizado cujo objetivo é comparar resultados da lobectomia pulmonar por videotoracoscopia com a robótica. O programa de cirurgia robótica do Instituto do Câncer do Estado de São Paulo, localizado na cidade de São Paulo (SP), foi uma iniciativa multidisciplinar que envolveu diversas especialidades cirúrgicas e equipes de anestesia, enfermagem e engenharia clínica. Nesta análise, avaliamos os pacientes incluídos no braço lobectomia robótica durante os primeiros três meses do estudo (de abril a junho de 2015). Dez pacientes foram incluídos nesta análise. Eram oito mulheres e dois homens. A média de idade foi de 65,1 anos. Todos apresentavam tumores periféricos. Foram realizadas lobectomia superior direita, em quatro pacientes; lobectomia inferior direita, em quatro; e lobectomia superior esquerda, em dois. Os tempos cirúrgicos variaram bastante (variação, 135-435 min). Não foi necessária a conversão para técnica aberta ou videotoracoscópica em nenhum paciente. Não foram observadas complicações intraoperatórias. Apenas o primeiro paciente foi encaminhado à UTI no pós-operatório. Não houve mortalidade nem reinternações em 30 dias após a alta. A única complicação pós-operatória observada foi dor torácica (grau 3), em dois pacientes. O exame anatomopatológico revelou a ressecção completa do tumor em todos os casos. A implantação de um programa de cirurgia torácica robótica, quando há integração e treinamento adequado de todas as equipes envolvidas, é factível e pode reduzir a morbidade e a mortalidade.
Costa, Mario Augusto Cray da; Lirani, Wesley; Wippich, Ana Caroline; Lopes, Luana; Tolentino, Eduardo de Souza; Zampar, Beatriz; Schafranski, Marcelo Derbli
2017-04-01
Atrial fibrillation (AF) takes place in 10-40% of patients undergoing coronary artery bypass grafting (CABG), and increases cardiovascular mortality. Enlargement of atrial chambers is associated with increased AF incidence, so patients with higher central venous pressure (CVP) are expected to have larger atrial distension, which increases AF incidence. To compare post-CABG AF incidence, following two CVP control strategies. Interventional, randomized, controlled clinical study. The sample comprised 140 patients undergoing CABG between 2011 and 2015. They were randomized into two groups, G15 and G20, with CVP maintained ≤ 15 cmH2O and ≤ 20 cmH2O, respectively. 70 patients were included in each group. The AF incidence in G15 was 8.57%, and in G20, 22.86%, with absolute risk reduction of 14.28%, and number needed to treat (NNT) of 7 (p = 0.03). Mortality (G15 = 5.71%; G20 = 11.42%; p = 0.07), hospital length of stay (G15 = 7.14 days; G20 = 8.21 days; p = 0.36), number of grafts (median: G15 = 3, G2 = 2; p = 0.22) and cardiopulmonary bypass use (G15 = 67.10%; G20 = 55.70%; p = 0.22) were statistically similar. Age (p = 0.04) and hospital length of stay (p = 0.001) were significantly higher in patients who developed AF in both groups. Keeping CVP low in the first 72 post-CABG hours reduces the relative risk of AF, and may be useful to prevent AF after CABG. A fibrilação atrial (FA) ocorre em 10-40% dos pacientes submetidos a cirurgia de revascularização miocárdica (RM), e eleva a mortalidade cardiovascular. Como o aumento dos átrios está associado ao aumento da incidência de FA, espera-se que pacientes com pressão venosa central (PVC) mais alta tenham maior distensão atrial, o que eleva a incidência dessa arritmia. Comparar a incidência de FA em pós-operatório de RM, seguindo duas estratégias de controle de PVC. Estudo clínico randomizado controlado intervencionista. A amostra foi composta por 140 pacientes submetidos a RM entre 2011 e 2015. Os pacientes foram randomizados em dois grupos, G15 e G20, mantidos com PVC máxima de 15 cmH2O e 20 cmH2O, respectivamente. Foram incluídos 70 pacientes em cada grupo. A incidência da arritmia em G15 foi de 8,57% e, no G20, de 22,86%, com redução de risco absoluto de 14,28% e número necessário para tratar (NNT) de 7 (p = 0,03). Mortalidade (G15 = 5,71%; G20 = 11,42%; p = 0,07), tempo de internamento (G15 = 7,14 dias; G20 = 8,21 dias; p = 0,36), número de enxertos (medianas: G15 = 3, G2 = 2; p = 0,22) e uso de circulação extracorpórea (G15 = 67,10%; G20 = 55,70%; p = 0,22) mostraram-se estatisticamente semelhantes. A idade (p = 0,04) e o tempo de internamento (p = 0,001) foram significativamente maiores nos pacientes que desenvolveram FA nos dois grupos. Manter a PVC com valores mais baixos nas primeiras 72h após a cirurgia de RM reduz o risco relativo de FA e pode ser uma ferramenta útil na prevenção da FA após RM.
The Next Generation of Interoperability Agents in Healthcare
Cardoso, Luciana; Marins, Fernando; Portela, Filipe; Santos, Manuel ; Abelha, António; Machado, José
2014-01-01
Interoperability in health information systems is increasingly a requirement rather than an option. Standards and technologies, such as multi-agent systems, have proven to be powerful tools in interoperability issues. In the last few years, the authors have worked on developing the Agency for Integration, Diffusion and Archive of Medical Information (AIDA), which is an intelligent, agent-based platform to ensure interoperability in healthcare units. It is increasingly important to ensure the high availability and reliability of systems. The functions provided by the systems that treat interoperability cannot fail. This paper shows the importance of monitoring and controlling intelligent agents as a tool to anticipate problems in health information systems. The interaction between humans and agents through an interface that allows the user to create new agents easily and to monitor their activities in real time is also an important feature, as health systems evolve by adopting more features and solving new problems. A module was installed in Centro Hospitalar do Porto, increasing the functionality and the overall usability of AIDA. PMID:24840351
National Workshop on Astrobiology: The Life Science Involvement of AAS I Laben
NASA Astrophysics Data System (ADS)
Adami, Giorgio
2006-12-01
The search for traces of past and present life is a complex and multidisciplinary research activity involving several scientific heritages and a specific industrial ability for planetary exploration. Laben was established in 1958 to design and manufacture electronic instruments for research in nuclear physics. In the mid 2004 the company was merged with Alenia Spazio. It is now part of Alcatel Alenia Space, a French Italian joint venture. Alcatel Alenia Space Italia SpA is a Finmeccanica Company. Currently the plant of Vimodrone provides a wide heritage in life science oriented to space application. The experience in Space Life Science is consolidated in the following research areas:
Care management: agreement between nursing prescriptions and patients' care needs.
Faeda, Marília Silveira; Perroca, Márcia Galan
2016-08-08
analyze agreement between nursing prescriptions recorded in medical files and patients' care needs; investigate the correlation between the nurses' professional background and agreement of prescriptions. descriptive study with quantitative and documentary approach conducted in the medical clinic, surgical, and specialized units of a university hospital in the interior of São Paulo, Brazil. The new validated version of a Patient Classification Instrument was used and 380 nursing prescriptions written at the times of hospital admission and discharge were assessed. 75% of the nursing prescriptions items were compatible with the patients' care needs. Only low correlation between nursing prescription agreement and professional background was found. the nursing prescriptions did not fully meet the care needs of patients. The care context and work process should be analyzed to enable more effective prescriptions, while strategies to assess the care needs of patients are recommended. analisar a concordância entre prescrições de enfermagem, registradas nos prontuários, e as necessidades de cuidados dos pacientes; investigar a correlação entre o perfil profissional dos enfermeiros e a concordância das prescrições. estudo descritivo com abordagem quantitativa e documental, realizado em unidades de clínica médica, cirúrgica e especializada de um hospital de ensino, no interior do Estado de São Paulo. Foi aplicada a nova versão validada do Instrumento de Classificação de Pacientes e, posteriormente, investigadas 380 prescrições de enfermagem no momento da admissão e alta hospitalar. foi identificado que 75% dos itens das prescrições de enfermagem estavam compatíveis com as necessidades cuidativas dos pacientes. Encontrou-se baixa correlação entre a concordância da prescrição de enfermagem e o perfil profissional. as prescrições de enfermagem não estão sendo realizadas, em sua totalidade, em consonância com as necessidades dos pacientes. Para possibilitar prescrições mais efetivas, recomenda-se análise do contexto assistencial e processo de trabalho e o uso de estratégias avaliativas das necessida¬des de cuidados dos pacientes. analizar la concordancia entre prescripciones de enfermería, registradas en las fichas médicas, y las necesidades de cuidados de los pacientes; investigar la correlación entre el perfil profesional de los enfermeros y la concordancia de las prescripciones. estudio descriptivo con abordaje cuantitativo y documental, realizado en unidades de clínica médica, quirúrgica y especializada de un hospital de enseñanza, en el interior del Estado de Sao Paulo. Fue aplicada la nueva versión validada del Instrumento de Clasificación de Pacientes y, posteriormente, investigadas 380 prescripciones de enfermería en el momento de la admisión y alta hospitalaria. fue identificado que 75% de los ítems de las prescripciones de enfermería eran compatibles con las necesidades de cuidados de los pacientes. Se encontró baja correlación entre la concordancia de la prescripción de enfermería y el perfil profesional. las prescripciones de enfermería no están siendo realizadas, en su totalidad, en consonancia con las necesidades de los pacientes. Para posibilitar prescripciones más efectivas, se recomienda analizar el contexto asistencial y el proceso de trabajo y el uso de estrategias de evaluación de las necesidades de cuidados de los pacientes.
Is there any link between accreditation programs and the models of organizational excellence?
Berssaneti, Fernando Tobal; Saut, Ana Maria; Barakat, Májida Farid; Calarge, Felipe Araujo
2016-01-01
To evaluate whether accredited health organizations perform better management practices than non-accredited ones. The study was developed in two stages: a literature review, and a study of multiple cases in 12 healthcare organizations in the state of São Paulo, Brazil. It surveyed articles comparing hospital accreditation with the EFQM (European Foundation for Quality Management) model of excellence in management. According to the pertinent literature, the accreditation model and the EFQM model are convergent and supplementary in some aspects. With 99% confidence, one can say that there is evidence that accredited organizations scored better in the evaluation based on the EFQM model in comparison to non-accredited organizations. This result was also confirmed in the comparison of results between the categories Facilitators and Results in the EFQM model. There is convergence between the accreditation model and the EFQM excellence model, suggesting that accreditation helps the healthcare sector to implement the best management practices already used by other business sectors. Avaliar se as organizações de saúde acreditadas possuem melhores práticas de gestão do que as não acreditadas. A pesquisa foi dividida em duas etapas: revisão da literatura e estudo de casos múltiplos com 12 organizações de saúde, localizadas no estado de São Paulo ‒ Brasil. Foram pesquisados artigos que comparavam a acreditação hospitalar com o modelo de excelência em gestão da EFQM (European Foundation for Quality Management), sendo que a literatura pertinente considera que o modelo de acreditação e o modelo da EFQM são convergentes e, ao mesmo tempo, complementares em determinados aspectos. Com 99% de confiança, pode-se afirmar que há evidência de que as organizações com acreditação obtiveram uma pontuação maior na avaliação baseada no modelo EFQM comparativamente às organizações não acreditadas. Este resultado também se confirmou na comparação dos resultados das categorias Facilitadores e Resultados do modelo EFQM. Há uma convergência entre o modelo de acreditação e o modelo de excelência da EFQM, sugerindo que a acreditação contribui para o setor de saúde implementar as melhores práticas de gestão já difundidas em outros setores de negócio.
Alvarado score in the diagnostic of pain in the right lower quadrant.
Lada, Paul Eduardo
2017-09-08
Acute appendicitis neither suspected nor diagnosed could develop a perforation or otherwise it would take to removing of a normal appendix. Utilization of a clinical score system for aided diagnosis of this pathology and can reduce a negative appendicitis. National Clinicas Hospital. Córdoba. Argentina. Prospective and protocolized study. 594 patients were studied between October 2002 and December 2013. 312 males and 282 females their age average was 26.2 years. Alvarado score was realized in all patients when they entered. According clinic and second valoration with the score surgical exploration was decided in 574 patients. The remaining 20 were excluded due to other pathology. The diagnosis in acute appendicitis was confirmed by surgical finding and histopathologic studies. In surgical finding we showed 594 patients (91,28 %) had acute appendicitis. There was no operative mortality. Respects morbidity there was 1,74 % of medical and 13,93 % of surgical complications. The anatomo-pathologic report showed a normal cecal appendix in 50. The incidence of negative appendicectomy was about 8.71 %. The utilization of score related to the surgical and anatomo-pathologic finding confirmed it was appreciable from 6 points to acute appendicitis diagnosis. RESUMENAntecedentes: La apendicitis aguda no sospechada y diagnosticada puede evolucionar hacia la perforación, ó por el contrario conduce a la remoción de un apéndice normal. Objetivo: La utilización de un sistema de Score, desde un punto de vista clínico, para el diagnóstico de esta patología y lograr disminuir las apendicetomías negativas.Lugar de Aplicación: Hospital Nacional de Clínicas. Córdoba. (Argentina)Diseño: Estudio prospectivo y protocolizado.Material y Métodos: Comprende a 594 pacientes estudiados entre octubre de 2002 y diciembre del 2013. De ellos, 312 eran del sexo masculino y 282 del femenino, con una edad promedio de 26,2 años de edad. A todos los pacientes se les realizo al ingreso el Score de Alvarado. En base a la clínica y a una segunda valoración con el Score se decidió la exploración quirúrgica en 574 pacientes. De los 20 restantes, fueron excluidos por otra patología. El diagnóstico de apendicitis aguda fue confirmado por los hallazgos quirúrgicos y la anatomía patológica.Resultados: En los hallazgos operatorios se encontró en 524 pacientes (91,28%) que tenían una apendicitis aguda. No hubo mortalidad postoperatoria. En relación a la morbilidad hubo un 1,74 % de complicaciones médicas y un 13,93 % de las quirúrgicas. El informe anatomopatológico mostró en 50 pacientes un apéndice cecal normal. Por lo tanto la incidencia de las apendicetomías negativas fue del 8,71%. Conclusiones: La utilización del Score en relación a los hallazgos quirúrgicos y anatomopatológicos confirma que fue sensible a partir de 6 puntos para el diagnóstico de apendicitis aguda.
Braga, Sonia Faria Mendes; Souza, Mirian Carvalho de; Oliveira, Raphael Romie de; Andrade, Eli Iola Gurgel; Acurcio, Francisco de Assis; Cherchiglia, Mariangela Leal
2017-05-15
Analyze the probability of specific survival and factors associated with the risk of death of patients with prostate cancer who received outpatient cancer treatment in the Brazilian Unified Health System, Brazil. Retrospective cohort study using the National Database of Oncology, developed through the deterministic-probabilistic pairing of health information systems: outpatient (SIA), hospital (SIH) and mortality (SIM). The probability of overall and specific survival was estimated by the time elapsed between the date of the first ambulatory treatment, from 2002 to 2003, until the patient's death or the end of the study. Fine and Gray's model of competing-risks regression was adjusted according to the variables: age of diagnostic, region of residence, tumor clinical staging, type of outpatient cancer treatment and hospitalization in the assessment of factors associated with risk of patient death. Of 16,280 patients studied, the average age was 70 years, approximately 25% died due to prostate cancer and 20% for other causes. The probability of overall survival was 0.50 (95%CI 0.49-0.52) and the specific was 0.70 (95%CI 0.69-0.71). The factors associated with the risk of patient death were: stage III (HR = 1.66; 95%CI 1.39-1.99) and stage IV (HR = 3.49; 95%CI 2.91-4.18), chemotherapy (HR = 2.34; 95%CI 1.76-3.11) and hospitalization (HR = 1.6; 95%CI 1.55-1.79). The late diagnosis of the tumor, palliative treatments, and worse medical condition were factors related to the worst survival and increased risk of death from prostate cancer patients in Brazil. Analisar a probabilidade de sobrevida específica e os fatores associados ao risco de óbito dos pacientes com câncer de próstata, que receberam tratamento oncológico ambulatorial no SUS, Brasil. Estudo de coorte retrospectivo utilizando a Base Nacional em Oncologia, desenvolvida por meio de pareamento determinístico-probabilístico dos sistemas de informação de saúde: ambulatorial (SIA), hospitalar (SIH) e de mortalidade (SIM). A probabilidade de sobrevida global e específica foi estimada pelo tempo decorrido entre a data do primeiro tratamento ambulatorial, entre 2002 e 2003, até o óbito dos pacientes ou fim do estudo. O modelo de regressão de riscos competitivos de Fine e Gray foi ajustado segundo as variáveis: idade ao diagnóstico, região de residência, estadiamento clínico do tumor, tipo de tratamento oncológico ambulatorial e internação na avaliação dos fatores associados ao risco de óbito dos pacientes. Dos 16.280 pacientes estudados, a idade média foi de 70 anos, cerca de 25% foi a óbito devido ao câncer de próstata e 20% por outras causas. A probabilidade de sobrevida global foi de 0,50 (IC95% 0,49-0,52) e a específica 0,70 (IC95% 0,69-0,71) . Os fatores associados ao risco de óbito dos pacientes foram: estádio III (HR = 1,66; IC95% 1,39-1,99) e estágio IV (HR = 3,49; IC95% 2,91-4,18), tratamento quimioterápico (HR = 2,34; IC95% 1,76-3,11) e internação (HR = 1,6; IC95% 1,55-1,79). O diagnóstico tardio do tumor, tratamentos não curativos e pior condição clínica foram fatores relacionados à pior sobrevida e ao maior risco de óbito dos pacientes com câncer próstata no Brasil.
Silva, Vangie Dias da; Mello, Fernanda Carvalho de Queiroz; Figueiredo, Sonia Catarina de Abreu
2017-01-01
To estimate the rates of recurrence, cure, and treatment abandonment in patients with pulmonary tuberculosis treated with a four-drug fixed-dose combination (FDC) regimen, as well as to evaluate possible associated factors. This was a retrospective observational study involving 208 patients with a confirmed diagnosis of pulmonary tuberculosis enrolled in the Hospital Tuberculosis Control Program at the Institute for Thoracic Diseases, located in the city of Rio de Janeiro, Brazil. Between January of 2007 and October of 2010, the patients were treated with the rifampin-isoniazid-pyrazinamide (RHZ) regimen, whereas, between November of 2010 and June of 2013, the patients were treated with the rifampin-isoniazid-pyrazinamide-ethambutol FDC (RHZE/FDC) regimen. Data regarding tuberculosis recurrence and mortality in the patients studied were retrieved from the Brazilian Case Registry Database and the Brazilian Mortality Database, respectively. The follow-up period comprised two years after treatment completion. The rates of cure, treatment abandonment, and death were 90.4%, 4.8%, and 4.8%, respectively. There were 7 cases of recurrence during the follow-up period. No significant differences in the recurrence rate were found between the RHZ and RHZE/FDC regimen groups (p = 0.13). We identified no factors associated with the occurrence of recurrence; nor were there any statistically significant differences between the treatment groups regarding adverse effects or rates of cure, treatment abandonment, or death. The adoption of the RHZE/FDC regimen produced no statistically significant differences in the rates of recurrence, cure, or treatment abandonment; nor did it have any effect on the occurrence of adverse effects, in comparison with the use of the RHZ regimen. Estimar as taxas de recidiva, cura e abandono de tratamento em pacientes com tuberculose pulmonar tratados com o esquema de dose fixa combinada (DFC) de quatro drogas e avaliar possíveis fatores associados. Estudo observacional retrospectivo com 208 pacientes com diagnóstico confirmado de tuberculose pulmonar registrados no Programa de Controle da Tuberculose Hospitalar do Instituto de Doenças do Tórax, localizado na cidade do Rio de Janeiro. Os pacientes tratados entre janeiro de 2007 e outubro de 2010 receberam o esquema rifampicina-isoniazida-pirazinamida (RHZ), e aqueles tratados entre novembro de 2010 e junho de 2013 receberam o esquema rifampicina-isoniazida-pirazinamida-etambutol em DFC (RHZE/DFC). Os dados dos pacientes sobre recidiva e óbito foram obtidos no Sistema de Informação de Agravos de Notificação e no Sistema de Informação de Mortalidade, respectivamente. O período de acompanhamento foi de dois anos após o encerramento do tratamento. As taxas de cura, abandono e óbito foram de 90,4%, 4,8% e 4,8%, respectivamente. Houve 7 casos de recidivas durante o período de acompanhamento. Não houve diferenças significativas na taxa de recidiva entre os grupos de tratamento RHZ e RHZE/DFC (p = 0,13). Não foram identificados fatores associados com a ocorrência de recidiva, nem houve diferenças estatisticamente significativas na ocorrência dos efeitos adversos ou nas taxas de cura, abandono e óbito entre os grupos de tratamento. A adoção do esquema de tratamento RHZE/DFC não produziu diferenças estatisticamente significativas nas taxas de recidiva, cura e abandono nem na ocorrência de efeitos adversos em comparação com o esquema RHZ.
Rodríguez-Hidalgo, Antonio; Saladié, Palmira; Ollé, Andreu; Arsuaga, Juan Luis; Bermúdez de Castro, José María; Carbonell, Eudald
2017-04-01
Zooarcheological research is an important tool in reconstructing subsistence, as well as for inferring relevant aspects regarding social behavior in the past. The organization of hunting parties, forms of predation (number and rate of animals slaughtered), and the technology used (tactics and tools) must be taken into account in the identification and classification of hunting methods in prehistory. The archeological recognition of communal hunting reflects an interest in evolutionary terms and their inherent implications for anticipatory capacities, social complexity, and the development of cognitive tools, such as articulated language. Late and Middle Paleolithic faunal assemblages in Europe have produced convincing evidence of communal hunting of large ungulates allowing for the formation of hypotheses concerning the skills of Neanderthals anatomically modern humans as social predators. However, the emergence of this cooperative behavior is not currently understood. Here, faunal analysis, based on traditional/long-established zooarcheological methods, of nearly 25,000 faunal remains from the "bison bone bed" layer of the TD10.2 sub-unit at Gran Dolina, Atapuerca (Spain) is presented. In addition, other datasets related to the archeo-stratigraphy, paleo-landscape, paleo-environmental proxies, lithic assemblage, and ethno-archeological information of communal hunting have been considered in order to adopt a holistic approach to an investigation of the subsistence strategies developed during deposition of the archeological remains. The results indicate a monospecific assemblage heavily dominated by axial bison elements. The abundance of anthropogenic modifications and the anatomical profile are in concordance with early primary access to carcasses and the development of systematic butchering focused on the exploitation of meat and fat for transportation of high-yield elements to somewhere out of the cave. Together with a catastrophic and seasonal mortality pattern, the results indicate the procurement of bison by communal hunting as early as circa 400 kyr. This suggests that the cognitive, social, and technological capabilities required for successful communal hunting were at least fully developed among the pre-Neanderthal paleodeme of Atapuerca during the Lower Paleolithic. Similarly, the early existence of mass communal hunting as a predation technique informs our understanding of the early emergence of predatory skills similar to those exhibited by modern communal hunters. La zooarqueología es una importante herramienta para la reconstrucción de la subsistencia y también para inferir aspectos relevantes del comportamiento social en el pasado. En este trabajo presentamos el análisis faunístico del llamado "lecho de huesos de bisonte", contenido en la subunidad TD10.2 del yacimiento Gran Dolina (Atapuerca, España). La composición taxonómica y perfil anatómico indican un conjunto monoespecífico fuertemente dominado por elementos del esqueleto axial de bisonte (Bison sp.). Las características y abundancia de las modificaciones antrópicas revelan un acceso primario e inmediato a las carcasas, así como el desarrollo de un procesado carnicero sistemático dirigido a la explotación de la carne y grasa, y a la preparación para el transporte de elementos de alto rendimiento hacia algún lugar fuera de la cavidad. Esas características unidas a un perfil de mortalidad catastrófico y estacional, sugieren la obtención de los bisontes mediante caza comunal. La frecuencia, localización e intensidad de las mordeduras de carnívoro en los restos indica un fuerte saqueo de las carcasas de bisonte una vez abandonadas éstas por los homininos en el yacimiento. La suma de decisiones antrópicas sobre el transporte y el posterior saqueo por carnívoros de los despojos abandonados resulta en un conjunto interpretado como lugar de matanza y procesamiento carnicero de bisontes carroñeados posteriormente por las fieras. Las analogías etnográficas, etnohistóricas y arqueológicas nos han permitido interpretar el "lecho de huesos de bisonte" como cazadero utilizado durante varios eventos estacionales de caza comunal en los que rebaños completos de bisontes fueron sacrificados para ser explotados intensamente por los homininos que ocuparon la cueva. El repetido uso estacional de un punto en el territorio para el desarrollo de tareas específicas muestra ciertas similitudes con el patrón logístico de gestión de los recursos. En el mismo sentido, la existencia temprana de la caza comunal como táctica depredatoria nos informa sobre la emergencia de habilidades cognitivas, tecnológicas y sociales similares a aquellas exhibidas por otros cazadores comunales modernos en un momento tan temprano como el Pleistoceno medio. Copyright © 2017 Elsevier Ltd. All rights reserved.
Simulating Asymmetric Top Impurities in Superfluid Clusters: A para-Water Dopant in para-Hydrogen.
Zeng, Tao; Li, Hui; Roy, Pierre-Nicholas
2013-01-03
We present the first simulation study of bosonic clusters doped with an asymmetric top molecule. The path-integral Monte Carlo method with the latest methodological advance in treating rigid-body rotation [Noya, E. G.; Vega, C.; McBride, C. J. Chem. Phys.2011, 134, 054117] is employed to study a para-water impurity in para-hydrogen clusters with up to 20 para-hydrogen molecules. The growth pattern of the doped clusters is similar in nature to that of pure clusters. The para-water molecule appears to rotate freely in the cluster. The presence of para-water substantially quenches the superfluid response of para-hydrogen with respect to the space-fixed frame.
A Comparative Usage-Based Approach to the Reduction of the Spanish and Portuguese Preposition "Para"
ERIC Educational Resources Information Center
Gradoville, Michael Stephen
2013-01-01
This study examines the frequency effect of two-word collocations involving "para" "to," "for" (e.g. "fui para," "para que") on the reduction of "para" to "pa" (in Spanish) and "pra" (in Portuguese). Collocation frequency effects demonstrate that language speakers…
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ORTHO-PARA SELECTION RULES IN THE GAS-PHASE CHEMISTRY OF INTERSTELLAR AMMONIA
DOE Office of Scientific and Technical Information (OSTI.GOV)
Faure, A.; Hily-Blant, P.; Le Gal, R.
The ortho-para chemistry of ammonia in the cold interstellar medium is investigated using a gas-phase chemical network. Branching ratios for the primary reaction chain involved in the formation and destruction of ortho- and para-NH{sub 3} were derived using angular momentum rules based on the conservation of the nuclear spin. We show that the 'anomalous' ortho-to-para ratio of ammonia ({approx}0.7) observed in various interstellar regions is in fact consistent with nuclear spin selection rules in a para-enriched H{sub 2} gas. This ratio is found to be independent of temperature in the range 5-30 K. We also predict an ortho-to-para ratio ofmore » {approx}2.3 for NH{sub 2}. We conclude that a low ortho-to-para ratio of H{sub 2} naturally drives the ortho-to-para ratios of nitrogen hydrides below the statistical values.« less
Para-nitrobenzyl esterases with enhanced activity in aqueous and nonaqueous media
Arnold, Frances H.; Moore, Jeffrey C.
1998-01-01
A method for isolating and identifying modified para-nitrobenzyl esterases which exhibit improved stability and/or esterase hydrolysis activity toward selected substrates and under selected reaction conditions relative to the unmodified para-nitrobenzyl esterase. The method involves preparing a library of modified para-nitrobenzyl esterase nucleic acid segments (genes) which have nucleotide sequences that differ from the nucleic acid segment which encodes for unmodified para-nitrobenzyl esterase. The library of modified para-nitrobenzyl nucleic acid segments is expressed to provide a plurality of modified enzymes. The clones expressing modified enzymes are then screened to identify which enzymes have improved esterase activity by measuring the ability of the enzymes to hydrolyze the selected substrate under the selected reaction conditions. Specific modified para-nitrobenzyl esterases are disclosed which have improved stability and/or ester hydrolysis activity in aqueous or aqueous-organic media relative to the stability and/or ester hydrolysis activity of unmodified naturally occurring para-nitrobenzyl esterase.
Para-nitrobenzyl esterases with enhanced activity in aqueous and nonaqueous media
Arnold, Frances H.; Moore, Jeffrey C.
1999-01-01
A method for isolating and identifying modified para-nitrobenzyl esterases which exhibit improved stability and/or esterase hydrolysis activity toward selected substrates and under selected reaction conditions relative to the unmodified para-nitrobenzyl esterase. The method involves preparing a library of modified para-nitrobenzyl esterase nucleic acid segments (genes) which have nucleotide sequences that differ from the nucleic acid segment which encodes for unmodified para-nitrobenzyl esterase. The library of modified para-nitrobenzyl nucleic acid segments is expressed to provide a plurality of modified enzymes. The clones expressing modified enzymes are then screened to identify which enzymes have improved esterase activity by measuring the ability of the enzymes to hydrolyze the selected substrate under the selected reaction conditions. Specific modified para-nitrobenzyl esterases are disclosed which have improved stability and/or ester hydrolysis activity in aqueous or aqueous-organic media relative to the stability and/or ester hydrolysis activity of unmodified naturally occurring para-nitrobenzyl esterase.
Leadership Practices in Hospital Nursing: A Self of Manager Nurses.
Silva, Vânea Lúcia Dos Santos; Camelo, Silvia Helena Henriques; Soares, Mirelle Inácio; Resck, Zélia Marilda Rodrigues; Chaves, Lucieli Dias Pedreschi; Santos, Fabiana Cristina Dos; Leal, Laura Andrian
2017-04-03
To assess the frequency of the leadership practices performed by the manager nurses of hospital institutions and their association with the variables of the socioprofessional profile. Cross-sectional, descriptive, correlational study conducted in four hospitals in a city of the state of São Paulo. A sociodemographic questionnaire and the instrument Leadership Practices Inventory were used. Data collection and analysis were based on an exemplary Leadership Practices Model. Eighty-four manager nurses participated in the study. The mean values of the leadership practices used by the nurses were: enable others to act (50.6); encourage the heart (48.2); model the way (46.7); challenge the process (43.3); and inspire a shared vision (43.1). Data analysis also evidenced a correlation between the practice encourage the heart and the variables time of care and employment relationship. The study evidenced the presence of manager nurses exercising moderate leadership, and promoting teamwork, an environment of trust, and a horizontal vision. However, moderate values also reveal managerial aspects to be improved by the leaders by means of organizational strategies and/or tools aimed at best leadership practices. Avaliar a frequência das práticas de liderança executadas pelos enfermeiros gerentes de instituições hospitalares e sua associação às variáveis do perfil socioprofissional. Estudo transversal, descritivo e correlacional, realizado em quatro hospitaisde um município do interior paulista. Utilizou-se de questionário sociodemográfico e do instrumento Leadership Practices Inventory. A coleta e a análise de dados foram fundamentadas em um Modelo de Práticas para Liderança exemplar. Participaram 84 enfermeiros gerentes. As médias das práticas de liderança utilizadas pelos enfermeiros foram: capacitar os outros a agir (50,6), encorajar o coração (48,2), traçar o caminho (46,7), desafiar o processo (43,3) e inspirar uma visão compartilhada (43,1). Na análise dos dados também se constatou correlação entre a prática encoraje o coração e as variáveis tempo de assistência e vínculo empregatício. O estudo constatou a presença de enfermeiros gerentes exercendo liderança moderada, promovendo o trabalho em equipe, propiciando um clima de confiança e visão horizontalizada. No entanto, os valores moderados também revelam aspectos gerenciais a serem aprimorados pelos líderes, por meio de ferramentas e/ou estratégias organizacionais em busca de melhores práticas de liderança.
The Ratio of Ortho- to Para-H2 in Photodissociation Regions
NASA Technical Reports Server (NTRS)
Sternberg, Amiel; Neufeld, David A.
1999-01-01
We discuss the ratio of ortho- to para-H2 in photodissociation regions (PDRs). We draw attention to an apparent confusion in the literature between the ortho-to-para ratio of molecules in FUV-pumped vibrationally excited states and the total H2 ortho-to-para abundance ratio. These ratios are not the same because the process of FUV pumping of fluorescent H2 emission in PDRs occurs via optically thick absorption lines. Thus gas with an equilibrium ratio of ortho- to para-H2 equal to 3 will yield FUV-pumped vibrationally excited ortho-to-para ratios smaller than 3, because the ortho-H2 pumping rates are preferentially reduced by optical depth effects. Indeed, if the ortho and para pumping lines are on the "square root" part of the curve of growth, then the expected ratio of ortho and para vibrational line strengths is 3(sup 1/2) approximately 1.7, close to the typically observed value. Thus, contrary to what has sometimes been stated in the literature, most previous measurements of the ratio of ortho- to para-H2 in vibrationally excited states are entirely consistent with a total ortho-to-para ratio of 3, the equilibrium value for temperatures greater than 200 K. We present an analysis and several detailed models that illustrate the relationship between the total ratios of ortho- to para-H2 and the vibrationally excited ortho-to-para ratios in PDRs. Recent Infrared Space Observatory measurements of pure rotational and vibrational H2 emissions from the PDR in the star-forming region S140 provide strong observational support for our conclusions.
Para-nitrobenzyl esterases with enhanced activity in aqueous and nonaqueous media
Arnold, F.H.; Moore, J.C.
1999-05-25
A method is disclosed for isolating and identifying modified para-nitrobenzyl esterases which exhibit improved stability and/or esterase hydrolysis activity toward selected substrates and under selected reaction conditions relative to the unmodified para-nitrobenzyl esterase. The method involves preparing a library of modified para-nitrobenzyl esterase nucleic acid segments (genes) which have nucleotide sequences that differ from the nucleic acid segment which encodes for unmodified para-nitrobenzyl esterase. The library of modified para-nitrobenzyl nucleic acid segments is expressed to provide a plurality of modified enzymes. The clones expressing modified enzymes are then screened to identify which enzymes have improved esterase activity by measuring the ability of the enzymes to hydrolyze the selected substrate under the selected reaction conditions. Specific modified para-nitrobenzyl esterases are disclosed which have improved stability and/or ester hydrolysis activity in aqueous or aqueous-organic media relative to the stability and/or ester hydrolysis activity of unmodified naturally occurring para-nitrobenzyl esterase. 43 figs.
Para-nitrobenzyl esterases with enhanced activity in aqueous and nonaqueous media
Arnold, F.H.; Moore, J.C.
1998-04-21
A method is disclosed for isolating and identifying modified para-nitrobenzyl esterases. These enzymes exhibit improved stability and/or esterase hydrolysis activity toward selected substrates and under selected reaction conditions relative to the unmodified para-nitrobenzyl esterase. The method involves preparing a library of modified para-nitrobenzyl esterase nucleic acid segments (genes) which have nucleotide sequences that differ from the nucleic acid segment which encodes for unmodified para-nitrobenzyl esterase. The library of modified para-nitrobenzyl nucleic acid segments is expressed to provide a plurality of modified enzymes. The clones expressing modified enzymes are then screened to identify which enzymes have improved esterase activity by measuring the ability of the enzymes to hydrolyze the selected substrate under the selected reaction conditions. Specific modified para-nitrobenzyl esterases are disclosed which have improved stability and/or ester hydrolysis activity in aqueous or aqueous-organic media relative to the stability and/or ester hydrolysis activity of unmodified naturally occurring para-nitrobenzyl esterase. 43 figs.
Producing and quantifying enriched para-H2.
Tom, Brian A; Bhasker, Siddhartha; Miyamoto, Yuki; Momose, Takamasa; McCall, Benjamin J
2009-01-01
The production of enriched para-H(2) is useful for many scientific applications, but the technology for producing and measuring para-H(2) is not yet widespread. In this note and in the accompanying auxiliary material, we describe the design, construction, and use of a versatile standalone converter that is capable of producing para-H(2) enrichments of up to > or = 99.99% at continuous flow rates of up to 0.4 SLM. We also discuss para-H(2) storage and back conversion rates, and improvements to three techniques (thermal conductance, NMR, and solid hydrogen impurity spectroscopy) used to quantify the para-H(2) enrichment.
Kilgore, Matthew B.; Augustin, Megan M.; May, Gregory D.; Crow, John A.; Kutchan, Toni M.
2016-01-01
The Amaryllidaceae alkaloids are a family of amino acid derived alkaloids with many biological activities; examples include haemanthamine, haemanthidine, galanthamine, lycorine, and maritidine. Central to the biosynthesis of the majority of these alkaloids is a C-C phenol-coupling reaction that can have para-para', para-ortho', or ortho-para' regiospecificity. Through comparative transcriptomics of Narcissus sp. aff. pseudonarcissus, Galanthus sp., and Galanthus elwesii we have identified a para-para' C-C phenol coupling cytochrome P450, CYP96T1, capable of forming the products (10bR,4aS)-noroxomaritidine and (10bS,4aR)-noroxomaritidine from 4′-O-methylnorbelladine. CYP96T1 was also shown to catalyzed formation of the para-ortho' phenol coupled product, N-demethylnarwedine, as less than 1% of the total product. CYP96T1 co-expresses with the previously characterized norbelladine 4′-O-methyltransferase. The discovery of CYP96T1 is of special interest because it catalyzes the first major branch in Amaryllidaceae alkaloid biosynthesis. CYP96T1 is also the first phenol-coupling enzyme characterized from a monocot. PMID:26941773
DOE Office of Scientific and Technical Information (OSTI.GOV)
Persad, A.B.; Hoy, M.A.; Ru Nguyen
The parasitoid Lipolexis oregmae Gahan (introduced as L. scutellaris Mackauer) was imported from Guam, evaluated in quarantine, mass reared, and released into citrus groves in Florida in a classical biological control program directed against the brown citrus aphid, Toxoptera citricida Kirkaldy. Releases of 20,200, 12,100, and 1,260 adults of L. oregmae were made throughout Florida during 2000, 2001, and 2002, respectively. To determine if L. oregmae had successfully established, surveys were conducted throughout the state beginning in the summer of 2001 and continuing through the summer of 2003. Parasitism during 2001 and 2002 was evaluated by holding brown citrus aphidsmore » in the laboratory until parasitoid adults emerged. Lipolexis oregmae was found in 10 sites in 7 counties and 4 sites in 3 counties with parasitism rates ranging from 0.7 to 3.3% in 2001 and 2002, respectively. Laboratory tests indicated that high rates of mortality occurred if field-collected parasitized aphids were held in plastic bags, so a molecular assay was used that allowed immature L. oregmae to be detected within aphid hosts immediately after collection. The molecular assay was used in 2003 with the brown citrus aphids and with other aphid species collected from citrus, weeds, and vegetables near former release sites; immatures of L. oregmae were detected in black citrus aphids, cowpea aphids, spirea aphids, and melon aphids, as well as in the brown citrus aphid, in 4 of 8 counties sampled, with parasitism ranging from 2.0 to 12.9%, indicating that L. oregmae is established and widely distributed. Samples taken in Polk County during Oct 2005 indicated that L. oregmae has persisted. The ability of L. oregmae to parasitize other aphid species on citrus, and aphids on other host plants, enhances the ability of L. oregmae to persist when brown citrus aphid populations are low. (author) [Spanish] El parasitoide Lipolexis oregmae Gahan (introducido como L. scutellaris Mackauer) fue importado de Guam, evaluado en cuarentena, criado en masa y liberado en huertos de citricos en un programa de control biologico clasico dirigido contra el afido pardo de citricos, Toxoptera citricida Kirkaldy. Se hicieron liberaciones de 20,200, 12,100, y 1,260 adultos de L. oregmae a traves de la Florida durante los anos de 2000, 2001, y 2002, respectivamente. Para determinar si L. oregmae ha logrado en establecer, se realizaron sondeos a traves del estado empezando en el verano del 2001 y continuando hasta el final del verano del 2003. El parasitismo durante 2001 y 2002 fue evaluado con el mantenimiento de individuos del afido pardo de los citricos en el laboratorio hasta que los adultos emergieron. Lipolexis oregmae fue encontrado en 10 sitios en 7 condados y con tasas de parasitismo en 4 sitios en 3 condados entre 0.7 a 3.3% en el 2001 y 2002, respectivamente. Las pruebas del laboratorio indicaron que las tasas altas de mortalidad fueron posibles si los afidos con parasitos recolectados en el campo fueron mantenidos en bolsas plasticas, entonces un ensayo molecular fue usado con lo que permitio la deteccion de inmaduros de L. oregmae dentro de los hospederos de afidos inmediatamente despues de la recoleccion. El ensayo molecular fue usado en el 2003 con individuos del afido pardo de los citricos y con otras especies de afidos recolectados sobre citricos, malezas y hortalizas cerca de los sitios donde los parasitoides fueron liberados anteriormente; inmaduros de L. oregmae fueron detectados en individuos del afido negro de los citricos, el afido del caupi, el afido spirea y el afido del melon, ademas del afido pardo de los citricos en 4 de los 8 condados muestreados, con la tasa del parasitismo entre 2.0 a12.9%, indicando que L. oregmae estaba estabecido y ampliamente distribuido. Las muestras tomadas en el Condado de Polk durante octobre del 2005 indicaron que L. oregmae ha persistido. La capacidad de L. oregmae para parasitar otras especies de afidos sobre citricos y otros afidos sobre otras plantas hospederas, incrementa la capacidad de L. oregmae para persistir cuando las poblaciones del afido pardo de los citricos estan bajas. (author)« less
Probing the Superfluid Response of para-Hydrogen with a Sulfur Dioxide Dopant.
Zeng, Tao; Guillon, Grégoire; Cantin, Joshua T; Roy, Pierre-Nicholas
2013-07-18
We recently presented the first attempt at using an asymmetric top molecule (para-water) to probe the superfluidity of nanoclusters (of para-hydrogen) [ Zeng , T. ; Li , H. ; Roy , P.-N. J. Phys. Chem. Lett. 2013 , 4 , 18 - 22 ]. Unfortunately, para-water could not be used to probe the para-hydrogen superfluid response. We now report a theoretical simulation of sulfur dioxide rotating in para-hydrogen clusters and show that this asymmetric top can serve as a genuine probe of superfluidity. With this probe, we predict that as few as four para-hydrogen molecules are enough to form a superfluid cluster, the smallest superfluid system to date. We also propose the concept of "exchange superfluid fraction" as a more precise measurement. New superfluid scenarios brought about by an asymmetric top dopant and potential experimental measurements are discussed.
Guerrero, Michelle; Martin, Jeffrey
2018-05-01
The primary purpose of this article is to review the literature on para sport athletic identity and provide avenues for future research direction. First, the authors briefly describe the existing quantitative and qualitative research on para sport athletic identity and, thereby, illustrate the complexities para sport athletes experience regarding the way they describe their participation in competitive sport. Next, the authors describe how para sport athletes with acquired permanent disabilities and congenital disabilities face similar, yet unique, identity-related challenges. Finally, the authors argue that future researchers should consider examining para sport athletes' identity through narrative identity. Copyright © 2018 Elsevier Inc. All rights reserved.
Smoking among female sex workers: prevalence and associated variables.
Devóglio, Ligia Lopes; Corrente, José Eduardo; Borgato, Maria Helena; Godoy, Ilda de
2017-01-01
To assess the prevalence of smoking and associated variables in female sex workers (FSWs). This was a quantitative cross-sectional study involving FSWs in the city of Botucatu, Brazil, who completed a sociodemographic questionnaire, including data regarding smoking status, motivational stage of change, and degree of nicotine dependence, as well as the Perceived Stress Scale and the Hospital Anxiety and Depression Scale. We included 83 FSWs. The mean age was 26.8 years. Among the participants, 58 (69.8%) had at least a high school education, only 26 (31.3%) resided in the city of Botucatu, 59 (71.1%) were smokers, 5 (6.0%) were former smokers, 74 (89.2%) regularly consumed alcohol, and 43 (51.8%) used illicit drugs. The majority of the women were classified as having an intermediate stress level, and 51 (61.4%) were classified as having possible or probable anxiety, whereas depression was found to be improbable in 57 (68.7%). The level of nicotine dependence was high among the smokers, the majority of whom showed no intention to quit smoking. Smoking was associated with illicit drug use (p = 0.0271) and with alcohol consumption (p = 0.0001), although not with the levels of stress, anxiety, or depression; nor was the age at smoking initiation associated with the length of time as an FSW (p = 0.4651). The prevalence of smoking among the FSWs evaluated here was much higher than the 8.3% reported for the overall female population of Brazil. Our findings show that FSWs are exposed to various risk factors inherent to their profession. Therefore, harm reduction is an important strategy to be adopted. Avaliar a prevalência de tabagismo e variáveis associadas em mulheres profissionais do sexo (MPS). Estudo de corte transversal quantitativo com MPS na cidade de Botucatu (SP), as quais completaram um questionário sociodemográfico, incluindo informações sobre tabagismo, estágio motivacional para cessação do tabagismo e grau de dependência da nicotina, assim como a Escala de Estresse Percebido e a Escala Hospitalar de Ansiedade e Depressão. Foram incluídas 83 MPS. A média de idade foi de 26,8 anos. Entre as participantes, 58 (69,8%) possuíam pelo menos o ensino médio, apenas 26 (31,3%) residiam em Botucatu, 59 (71,1%) eram fumantes, 5 (6,0%) eram ex-fumantes, 74 (89,2%) faziam uso de bebidas alcoólicas e 43 (51,8%) faziam uso de algum tipo de drogas. A maioria foi classificada com grau de estresse médio, 51 (61,4%) apresentaram nível de ansiedade possível ou provável, e 57 (68,7%) tiveram resultado improvável para depressão. O nível de dependência da nicotina foi elevado entre as fumantes. Dessas, a maioria não tinha intenção de parar de fumar. Houve associações do tabagismo com o consumo de drogas ilícitas (p = 0,0271) e com o uso de bebidas alcoólicas (p < 0,0001); porém, não houve associações do tabagismo com as questões de humor e nem da idade da iniciação tabágica com o tempo que trabalhavam como MPS (p = 0,4651). A prevalência de tabagismo entre as MPS estudadas se mostrou muito elevada quando comparada à da média nacional de mulheres (8,3%). Evidenciou-se que MPS estão expostas a diversos fatores de risco inerentes da própria profissão, sendo a redução de danos uma estratégia importante a ser trabalhada.
El contexto de la familia y el vecindario en la salud de los ancianos del estudio EPESE hispano
Reyes-Ortiz, Carlos A.; Camacho, María E.; Eschbach, Karl; Markides, Kyriakos S.
2014-01-01
RESUMEN En este artículo se discute el papel de la familia y el vecindario en la salud de los ancianos méjico-americanos del estudio EPESE (Established Populations for Epidemiologic Studies of the Elderly) hispano. La paradoja epidemiológica consiste en que, a pesar de estar en desventaja socioeconómica, los ancianos hispanos tienen mortalidad relativamente menor que los ancianos de raza blanca. Esto es especialmente cierto cuando el anciano vive en los vecindarios donde hay un porcentaje alto de méjico-americanos. La familia también juega un papel importante en estos ancianos al disminuir el riesgo de institucionalización o de morbilidad. Asimismo, el estrés originado en problemas económicos o al depender económicamente de la familia, habiendo inmigrado en edades tardías, puede sobrepasar la capacidad de amortiguamiento del estrés y afectar la salud del anciano méjico-americano. PMID:25190897
Amthauer, Camila; Cunha, Maria Luzia Chollopetz da
2016-08-29
to characterize the care services performed through risk rating by the Manchester Triage System, identifying demographics (age, gender), main flowcharts, discriminators and outcomes in pediatric emergency. cross-sectional quantitative study. Data on risk classification were obtained through a search of computerized registration data from medical records of patients treated in the pediatric emergency within one year. Descriptive statistics with absolute and relative frequencies was used for the analysis. 10,921 visits were conducted in the pediatric emergency, mostly male (54.4%), aged between 29 days and two years (44.5%). There was a prevalence of the urgent risk category (43.6%). The main flowchart used in the care was worried parents (22.4%) and the most prevalent discriminator was recent event (15.3%). The hospitalization outcome occurred in 10.4% of care performed in the pediatric emergency, however 61.8% of care needed to stay under observation and / or being under the health team care in the pediatric emergency. worried parents was the main flowchart used and recent events the most prevalent discriminator, comprising the hospitalization outcomes and permanency in observation in the pediatric emergency before discharge from the hospital. caracterizar os atendimentos realizados por meio da classificação de risco pelo Sistema de Triagem de Manchester, identificando dados demográficos (idade, sexo), principais fluxogramas, discriminadores e desfechos na emergência pediátrica. estudo quantitativo transversal. Os dados referentes à classificação de risco foram obtidos por meio de uma pesquisa ao registro informatizado de dados dos prontuários dos pacientes atendidos na emergência pediátrica no período de um ano. Para análise foi utilizada estatística descritiva com frequências absolutas e relativas. foram realizados 10.921 atendimentos na emergência pediátrica, em sua maioria do sexo masculino (54,4%), com idade entre 29 dias e dois anos (44,5%). Houve prevalência da categoria de risco urgente (43,6%). O principal fluxograma utilizado nos atendimentos foi pais preocupados (22,4%) e o discriminador mais prevalente foi evento recente (15,3%). O desfecho de internação hospitalar ocorreu em 10,4% dos atendimentos realizados na emergência pediátrica, entretanto 61,8% dos atendimentos necessitaram permanecer em observação e/ou ficar sob os cuidados da equipe de saúde na emergência pediátrica. pais preocupados foi o principal fluxograma utilizado e evento recente o discriminador mais prevalente, constando-se os desfechos de hospitalização e de permanencia em observação na emergência pediátrica, antes da alta para o domicílio. caracterizar la atención recibida por calificación de riesgo por el sistema de triaje de Manchester, identificando los datos demográficos (edad, sexo), principales organigramas, discriminadores y los resultados en la emergencia pediátrica. estudio cuantitativo transversal. Los datos sobre la clasificación de riesgo se obtuvieron a través de una búsqueda de los datos de registro informático de los registros médicos de los pacientes tratados en la emergencia pediátrica en el período de un año. Para el análisis se utilizó la estadística descriptiva con frecuencias absolutas y relativas. se llevaron a cabo 10.921 consultas en urgencias pediátricas, en su mayoría hombres (54,4%), con edades comprendidas entre 29 días y dos años (44,5%). Hubo una prevalencia de la categoría de riesgo urgente (43,6%). El diagrama de flujo principal utilizado en los cuidados fue padres preocupados (22,4%) y el discriminador más prevalente fue el evento reciente (15,3%). El resultado de internación se produjo en el 10,4% de los casos realizados en la emergencia pediátrica, sin embargo el 61,8% de las visitas precisaron permanecer en observación y/o estar bajo el cuidado del equipo de atención médica en la emergencia pediátrica. padres preocupados fue el diagrama de flujo principal utilizado y los eventos recientes el discriminador más frecuente, constatando los resultados de hospitalización y permanencia en la observación en la emergencia pediátrica antes del alta a la casa.
ERIC Educational Resources Information Center
Raval, Harini; McKenney, Susan; Pieters, Jules
2012-01-01
The appointment of para-professionals to overcome skill shortages and/or make efficient use of expensive resources is well established in both developing and developed countries. The present research concerns para-teachers in India. The literature on para-teachers is dominated by training for special needs settings, largely in developed societies.…
Sudan azo dyes and Para Red degradation by prevalent bacteria of the human gastrointestinal tract☆
Xu, Haiyan; Heinze, Thomas M.; Paine, Donald D.; Cerniglia, Carl E.; Chen, Huizhong
2018-01-01
Sudan azo dyes have genotoxic effects and ingestion of food products contaminated with Sudan I, II, III, IV, and Para Red could lead to exposure in the human gastrointestinal tract. In this study, we examined thirty-five prevalent species of human intestinal bacteria to evaluate their capacity to degrade Sudan dyes and Para Red. Among these tested bacterial strains, 23, 13, 33, 30, and 29 out of 35 species tested were able to reduce Sudan I, II, III, IV, and Para Red, respectively, to some extent. Bifidobacterium infantis, Clostridium indolis, Enterococcus faecalis, Lactobacillus rhamnosus, and Ruminococcus obeum were able to reduce completely all four tested Sudan dyes and Para Red. Escherichia coli and Peptostreptococcus magnus were the only two strains that were not able to reduce any of the tested Sudan dyes and Para Red to any significant extent. Metabolites of the reduction of the tested Sudan dyes and Para Red by E. faecalis were isolated and identified by HPLC and LC/ESI-MS analyses and compared with authentic standards. Thus it appears that the ability to reduce Sudan dyes and Para Red except Sudan II is common among bacteria in the human colon. PMID:19580882
Preparation of ortho-para ratio controlled D2 gas for muon-catalyzed fusion.
Imao, H; Ishida, K; Kawamura, N; Matsuzaki, T; Matsuda, Y; Toyoda, A; Strasser, P; Iwasaki, M; Nagamine, K
2008-05-01
A negative muon in hydrogen targets, e.g., D2 or D-T mixture, can catalyze nuclear fusions following a series of atomic processes involving muonic hydrogen molecular formation (muon-catalyzed fusion, muCF). The ortho-para state of D2 is a crucial parameter not only for enhancing the fusion rate but also to precisely investigate various muonic atom processes. We have developed a system for controlling and measuring the ortho-para ratio of D2 gas for muCF experiments. We successfully collected para-enriched D2 without using liquid-hydrogen coolant. Ortho-enriched D2 was also obtained by using a catalytic conversion method with a mixture of chromium oxide and alumina. The ortho-para ratio of D2 gas was measured with a compact Raman spectroscopy system. We produced large volume (5-30 l at STP), high-purity (less than ppm high-Z contaminant) D2 targets with a wide range of ortho-para ratios (ortho 20%-99%). By using the ortho-para controlled D2 in muCF experiments, we observed the dependence of muCF phenomena on the ortho-para ratio.
Preparation of ortho-para ratio controlled D{sub 2} gas for muon-catalyzed fusion
DOE Office of Scientific and Technical Information (OSTI.GOV)
Imao, H.; Ishida, K.; Matsuzaki, T.
2008-05-15
A negative muon in hydrogen targets, e.g., D{sub 2} or D-T mixture, can catalyze nuclear fusions following a series of atomic processes involving muonic hydrogen molecular formation (muon-catalyzed fusion, {mu}CF). The ortho-para state of D{sub 2} is a crucial parameter not only for enhancing the fusion rate but also to precisely investigate various muonic atom processes. We have developed a system for controlling and measuring the ortho-para ratio of D{sub 2} gas for {mu}CF experiments. We successfully collected para-enriched D{sub 2} without using liquid-hydrogen coolant. Ortho-enriched D{sub 2} was also obtained by using a catalytic conversion method with a mixturemore » of chromium oxide and alumina. The ortho-para ratio of D{sub 2} gas was measured with a compact Raman spectroscopy system. We produced large volume (5-30 l at STP), high-purity (less than ppm high-Z contaminant) D{sub 2} targets with a wide range of ortho-para ratios (ortho 20%-99%). By using the ortho-para controlled D{sub 2} in {mu}CF experiments, we observed the dependence of {mu}CF phenomena on the ortho-para ratio.« less
Para hydrogen equilibration in the atmospheres of the outer planets
NASA Technical Reports Server (NTRS)
Conrath, Barney J.
1986-01-01
The thermodynamic behavior of the atmospheres of the Jovian planets is strongly dependent on the extent to which local thermal equilibration of the ortho and para states of molecular hydrogen is achieved. Voyager IRIS data from Jupiter imply substantial departures of the para hydrogen fraction from equilibrium in the upper troposphere at low latitudes, but with values approaching equilibrium at higher latitudes. Data from Saturn are less sensitive to the orth-para ratio, but suggest para hydrogen fractions near the equilibrium value. Above approximately the 200 K temperature level, para hydrogen conversion can enhance the efficiency of convection, resulting in a substantial increase in overturning times on all of the outer planets. Currently available data cannot definitively establish the ortho-para ratios in the atmospheres of Uranus and Neptune, but suggest values closer to local equilibrium than to the 3.1 normal ratio. Modeling of sub-millimeter wavelength measurements of these planets suggest thermal structures with frozen equilibrium lapse rates in their convective regions.
Generating para-water from para-hydrogen: A Gedankenexperiment.
Ivanov, Konstantin L; Bodenhausen, Geoffrey
2018-07-01
A novel conceptual approach is described that is based on the transfer of hyperpolarization from para-hydrogen in view of generating a population imbalance between the two spin isomers of H 2 O. The approach is analogous to SABRE (Signal Amplification By Reversible Exchange) and makes use of the transfer of spin order from para-hydrogen to H 2 O in a hypothetical organometallic complex. The spin order transfer is expected to be most efficient at avoided level crossings. The highest achievable enrichment levels of para- and ortho-water are discussed. Copyright © 2018 Elsevier Inc. All rights reserved.
2013-01-01
Background ParaHox and Hox genes are thought to have evolved from a common ancestral ProtoHox cluster or from tandem duplication prior to the divergence of cnidarians and bilaterians. Similar to Hox clusters, chordate ParaHox genes including Gsx, Xlox, and Cdx, are clustered and their expression exhibits temporal and spatial colinearity. In non-chordate animals, however, studies on the genomic organization of ParaHox genes are limited to only a few animal taxa. Hemichordates, such as the Enteropneust acorn worms, have been used to gain insights into the origins of chordate characters. In this study, we investigated the genomic organization and expression of ParaHox genes in the indirect developing hemichordate acorn worm Ptychodera flava. Results We found that P. flava contains an intact ParaHox cluster with a similar arrangement to that of chordates. The temporal expression order of the P. flava ParaHox genes is the same as that of the chordate ParaHox genes. During embryogenesis, the spatial expression pattern of PfCdx in the posterior endoderm represents a conserved feature similar to the expression of its orthologs in other animals. On the other hand, PfXlox and PfGsx show a novel expression pattern in the blastopore. Nevertheless, during metamorphosis, PfXlox and PfCdx are expressed in the endoderm in a spatially staggered pattern similar to the situation in chordates. Conclusions Our study shows that P. flava ParaHox genes, despite forming an intact cluster, exhibit temporal colinearity but lose spatial colinearity during embryogenesis. During metamorphosis, partial spatial colinearity is retained in the transforming larva. These results strongly suggest that intact ParaHox gene clustering was retained in the deuterostome ancestor and is correlated with temporal colinearity. PMID:23802544
SADI-S WITH RIGHT GASTRIC ARTERY LIGATION: TECHNICAL SYSTEMATIZATION AND EARLY RESULTS.
Gebelli, Jordi Pujol; Gordejuela, Amador Garcia Ruiz de; Ramos, Almino Cardoso; Nora, Mario; Pereira, Ana Marta; Campos, Josemberg Marins; Ramos, Manoela Galvão; Bastos, Eduardo Lemos de Souza; Marchesini, João Batista
Bariatric surgery is performed all over the world with close to 500.000 procedures per year. The most performed techniques are Roux-en-Y gastric bypass and sleeve gastrectomy. Despite this data, the most effective procedure, biliopancreatic diversion with or without duodenal switch, represents only no more than 1.5% of the procedures. Technical complexity, morbidity, mortality, and severe nutritional adverse effects related to the procedure are the main fears that prevent most universal acceptance. To explain the technical aspects and the benefits of the SADI-S with right gastric artery ligation as an effective simplification from the original duodenal switch. Were included all patients undergoing this procedure from the November 2014 to May 2016, describing and analysing aspects of this technique, the systematization and early complications associated with the procedure. A series of 67 patients were operated; 46 were women (68.7%); mean age of the group was 44 years old (33-56); and an average BMI of 53.5 kg/m2 (50-63.5). Surgical time was 115 min (80-180). A total of five patients (7.5%) had any complication and two (2.9%) had to be reoperated. There were two patients with leak, one at the duodenal stump and other at the esophagogastric angle. There was no mortality. Patients stayed at the hospital a median of 2.5 days (1-25). SADI-S with right gastric artery ligation is a safe procedure with few preliminary complications. The technical variations introduced to the classical duodenal switch are reproducible and may allow this procedure to be more popular. All the complications in this series were not related to the ligation of the right gastric artery. Cerca de 500.000 cirurgias bariátricas são realizadas a cada ano em todo o mundo. As técnicas mais realizadas são o bypass gástrico em Y-de-Roux e a gastrectomia vertical. A derivação biliopancreática, com ou sem duodenal switch, é considerada técnica mais eficaz no tratamento cirúrgico do paciente obeso mórbido; entretanto, representa não mais do que 1,5% dos procedimentos na atualidade, pois sua complexidade técnica, morbimortalidade e graves efeitos adversos nutricionais impedem aceitação mais universal. Descrever os aspectos técnicos e os benefícios do SADI-S com ligadura da artéria gástrica direita como um modo simplificado do duodenal switch original. Foram incluídos todos os pacientes submetidos a este procedimento entre novembro 2014 e maio de 2016. Além da descrição da sistematização da técnica operatória, foram analisadas as complicações precoces associadas ao procedimento. Uma série de 67 pacientes foi operada no período analisado; 46 eram mulheres (68,7%) e a média de idade foi de 44 anos (33-56). O IMC médio foi de 53,5 kg/m2 (50-63,5). O tempo cirúrgico médio foi de 115 min (80-180) e a permanência hospitalar média foi de 2,5 dias (1-25). Complicações foram observadas em cinco pacientes (7,5%) e dois (2,9%) tiveram de ser reoperados. Duas pacientes evoluíram com fístula, uma no coto duodenal e outra na junção esofagogástrica. Não houve mortalidade. SADI-S com ligadura da artéria gástrica direita é procedimento seguro com poucas complicações precoces. A simplificação técnica em relação ao duodenal switch clássico pode permitir que este procedimento se torne mais popular. Todas as complicações observadas nesta série não estavam relacionadas com a ligadura da artéria gástrica direita.
Oliveira, Frederico Michelino de; Carvalho, Marcus Vinícius H de; Marchi, Evaldo; Pinto, Clóvis Antônio Lopes
2016-01-01
to evaluate the effectiveness of an collagen-based adhesive associated with fibrinogen and thrombin in experimental liver injuries in rats. we randomly divided 30 Wistar rats into three groups: A, B and C. All underwent a standard liver traumatic injury. In group A, the lesion was treated with the adhesive; in group B, with conventional, absorbable suture; group C received no treatment. We analyzed the time of hemostasis, mortality, occurrence of adhesions and any histological changes. there was no statistical difference in relation to mortality (p=0.5820). The adhesive treated group showed the lowest hemostasis times (p=0.0573, odds ratio 13.5) and lower incidence of adhesions (p=0.0119). The histological alterations of the Groups A and B were similar, with foreign body granuloma formation separating the adhesive material and the hepatic stroma suture. the collagen adhesive associated with fibrinogen and thrombin was effective in treating experimental hepatic injury, providing a lower incidence of adhesions between the liver and surrounding structures. avaliar a eficácia de um adesivo a base de colágeno associado ao fibrinogênio e trombina, no trauma hepático experimental em ratos. toram incluídos no estudo 30 ratos Wistar, igualmente divididos aleatoriamente em três grupos: A, B e C. Todos foram submetidos à lesão traumática hepática padronizada. No grupo A, a lesão foi tratada com o adesivo, no grupo B, com sutura convencional com fio absorvível, e no grupo C, não houve tratamento da lesão. Foram analisados o tempo de hemostasia, mortalidade, ocorrência de aderências e eventuais alterações histológicas. os resultados mostraram que não houve diferença estatística em relação à mortalidade (p=0,5820). O grupo tratado com adesivo apresentou os menores tempos de hemostasia (p=0,0573 e odds ratio 13,5) e menor ocorrência de aderências (p=0,0119). Microscopicamente as alterações histológicas dos grupos A e B foram semelhantes, com a formação de granuloma de corpo estranho separando o material do adesivo e do fio de sutura do estroma hepático. o adesivo de colágeno associado ao fibrinogênio e trombina foi eficaz no tratamento do trauma hepático experimental, proporcionado menor ocorrência de aderências entre o fígado e as estruturas vizinhas.
Wagner, Shawn
2014-06-01
To determine the storability of para-hydrogen before reestablishment of the room temperature thermal equilibrium mixture. Para-hydrogen was produced at near 100% purity and mixed with different oxygen quantities to determine the rate of conversion to the thermal equilibrium mixture of 75: 25% (ortho: para) by detecting the ortho-hydrogen (1)H nuclear magnetic resonance using a 9.4 T imager. The para-hydrogen to ortho-hydrogen velocity constant, k, near room temperature (292 K) was determined to be 8.27 ± 1.30 L/mol · min(-1). This value was calculated utilizing four different oxygen fractions. Para-hydrogen conversion to ortho-hydrogen by oxygen can be minimized for long term storage with judicious removal of oxygen contamination. Prior calculated velocity rates were confirmed demonstrating a dependence on only the oxygen concentration.
EPA News Release: MAÑANA: U.S. EPA, National Econ Corporation demostrarán prácticas seguras de trabajo con plomo para contratistas, se anunciará compromiso para reducir la exposición al plomo en la región
Osborne, Peter W; Benoit, Gérard; Laudet, Vincent; Schubert, Michael; Ferrier, David E K
2009-03-01
The ParaHox cluster is the evolutionary sister to the Hox cluster. Like the Hox cluster, the ParaHox cluster displays spatial and temporal regulation of the component genes along the anterior/posterior axis in a manner that correlates with the gene positions within the cluster (a feature called collinearity). The ParaHox cluster is however a simpler system to study because it is composed of only three genes. We provide a detailed analysis of the amphioxus ParaHox cluster and, for the first time in a single species, examine the regulation of the cluster in response to a single developmental signalling molecule, retinoic acid (RA). Embryos treated with either RA or RA antagonist display altered ParaHox gene expression: AmphiGsx expression shifts in the neural tube, and the endodermal boundary between AmphiXlox and AmphiCdx shifts its anterior/posterior position. We identified several putative retinoic acid response elements and in vitro assays suggest some may participate in RA regulation of the ParaHox genes. By comparison to vertebrate ParaHox gene regulation we explore the evolutionary implications. This work highlights how insights into the regulation and evolution of more complex vertebrate arrangements can be obtained through studies of a simpler, unduplicated amphioxus gene cluster.
Donczew, Magdalena; Mackiewicz, Paweł; Wróbel, Agnieszka; Flärdh, Klas; Zakrzewska-Czerwińska, Jolanta
2016-01-01
In unicellular bacteria, the ParA and ParB proteins segregate chromosomes and coordinate this process with cell division and chromosome replication. During sporulation of mycelial Streptomyces, ParA and ParB uniformly distribute multiple chromosomes along the filamentous sporogenic hyphal compartment, which then differentiates into a chain of unigenomic spores. However, chromosome segregation must be coordinated with cell elongation and multiple divisions. Here, we addressed the question of whether ParA and ParB are involved in the synchronization of cell-cycle processes during sporulation in Streptomyces. To answer this question, we used time-lapse microscopy, which allows the monitoring of growth and division of single sporogenic hyphae. We showed that sporogenic hyphae stop extending at the time of ParA accumulation and Z-ring formation. We demonstrated that both ParA and ParB affect the rate of hyphal extension. Additionally, we showed that ParA promotes the formation of massive nucleoprotein complexes by ParB. We also showed that FtsZ ring assembly is affected by the ParB protein and/or unsegregated DNA. Our results indicate the existence of a checkpoint between the extension and septation of sporogenic hyphae that involves the ParA and ParB proteins. PMID:27248800
Quantum fluctuations increase the self-diffusive motion of para-hydrogen in narrow carbon nanotubes.
Kowalczyk, Piotr; Gauden, Piotr A; Terzyk, Artur P; Furmaniak, Sylwester
2011-05-28
Quantum fluctuations significantly increase the self-diffusive motion of para-hydrogen adsorbed in narrow carbon nanotubes at 30 K comparing to its classical counterpart. Rigorous Feynman's path integral calculations reveal that self-diffusive motion of para-hydrogen in a narrow (6,6) carbon nanotube at 30 K and pore densities below ∼29 mmol cm(-3) is one order of magnitude faster than the classical counterpart. We find that the zero-point energy and tunneling significantly smoothed out the free energy landscape of para-hydrogen molecules adsorbed in a narrow (6,6) carbon nanotube. This promotes a delocalization of the confined para-hydrogen at 30 K (i.e., population of unclassical paths due to quantum effects). Contrary the self-diffusive motion of classical para-hydrogen molecules in a narrow (6,6) carbon nanotube at 30 K is very slow. This is because classical para-hydrogen molecules undergo highly correlated movement when their collision diameter approached the carbon nanotube size (i.e., anomalous diffusion in quasi-one dimensional pores). On the basis of current results we predict that narrow single-walled carbon nanotubes are promising nanoporous molecular sieves being able to separate para-hydrogen molecules from mixtures of classical particles at cryogenic temperatures. This journal is © the Owner Societies 2011
Ortho- and para-hydrogen in dense clouds, protoplanets, and planetary atmospheres
NASA Technical Reports Server (NTRS)
Decampli, W. M.; Cameron, A. G. W.; Bodenheimer, P.; Black, D. C.
1978-01-01
If ortho- and para-hydrogen achieve a thermal ratio on dynamical time scales in a molecular hydrogen cloud, then the specific heat is high enough in the temperature range 35-70 K to possibly induce hydrodynamic collapse. The ortho-para ratio in many interstellar cloud fragments is expected to meet this condition. The same may have been true for the primitive solar nebula. Detailed hydrodynamic and hydrostatic calculations are presented that show the effects of the assumed ortho-para ratio on the evolution of Jupiter during its protoplanetary phase. Some possible consequences of a thermalized ortho-para ratio in the atmospheres of the giant planets are also discussed.
Whitham, Martin; Laing, Stewart J; Dorrington, Melanie; Walters, Robert; Dunklin, Steve; Bland, Duncan; Bilzon, James L J; Walsh, Neil P
2006-08-01
The effects of the first 19 weeks of U.K. Parachute Regiment (PARA) training on upper respiratory tract infection (URTI) incidence and immune function (circulating leukocyte counts, lymphocyte subsets, lipopolysaccharide-stimulated neutrophil degranulation, and salivary immunoglobulin A concentrations) were investigated for 14 PARA recruits and 12 control subjects. No significant differences were reported between groups for the number or duration of URTIs, lymphocyte subsets, or salivary immunoglobulin A concentrations during training. URTI incidence was greater in the PARA group at weeks 2 and 3 (p < 0.05), coinciding with a decrease in circulating leukocyte and lymphocyte counts (p < 0.05). Neutrophil degranulation was similar in the PARA and control groups at weeks 0 and 19. Decreases in saliva flow rate occurred in the PARA group at week 15 and weeks 18 to 20 (p < 0.05). These results show a limited effect of PARA training on URTI incidence and immune function. The progressive decrease in saliva flow rate during PARA training may indicate an ensuing state of hypohydration.
Military Objective and Collateral Damage: Their Dynamics and Relationship
2002-04-01
LOAN DOCUMENT___ PHOTOGRAPH 1113SMWr DOCUMENTWIENTIMCATION A DISTRIBUTION STATEMENT A N Approved for Public Release Distribution Unlimited D...16, paras. 1951, 2017 . 39 Id. para. 2020. 40 Id. para. 2021. ൱ OFFICE OF THE JUDGE ADVOCATE GENERAL, CANADIAN FORCES, THE LAW OF ARMED CONFLICT AT...27-10, THE LAW OF LAND WARFARE Change 1 para. 40 (c) ( July 1956 with 15 July 1976 Change No. 1). 75 Michael J. Matheson, Session One: The United
Aguilar, Juan A; Adams, Ralph W; Duckett, Simon B; Green, Gary G R; Kandiah, Rathika
2011-01-01
A new family of NMR pulse sequences is reported for the recording of para-hydrogen enhanced NMR spectra. This Only Para-hydrogen SpectroscopY (OPSY) approach uses coherence selection to separate hyperpolarized signals from those of fully relaxed and thermally equilibrated protons. Sequence design, performance, practical aspects and applicability to other hyperpolarization techniques are discussed. Copyright © 2010 Elsevier Inc. All rights reserved.
Laboratory Graduate Fellowship Program, 1989. Appendix D, Part 1. Certifications and Concurrence
1989-01-01
takes place in nitric acid/sulfuric acid at degrees C for 3 hours. Nitration occurs both ortho and para the acetanilide (NHAc) moiety. This was...unexpected as acetanilide is usually a strong para director. Currently we preparing bulkier diamides using isobutyric anhydride and trimethylacetic...C for 3 hours. Nitration occurs both ortho and para t the acetanilide (NHAc) moiety. This was unexpected as acetanilide is usually a strong para
DOE Office of Scientific and Technical Information (OSTI.GOV)
Chu, C.C.
A process is described of dehydrogenating para-ethyltoluene to selectively form para-methylstyrene comprising contacting to para-ethyltoluene under dehydrogenation reaction conditions with a catalyst composition comprising: (a) from about 30% to 60% by weight of iron oxide, calculated as ferric oxide; (b) from about 13% to 48% by weight of a potassium compound, calculated as potassium oxide; and (c) from about 0% to 5% by weight of a chromium compound, calculated as chromic oxide. The improvement is described comprising dehydrogenating the para-ethyltoluene with a catalyst composition comprising, in addition to the components (a), (b) and (c), a modifying component (d) capable ofmore » rendering the para-methylstyrene-containing dehydrogenation reaction effluent especially resistant to the subsequent formation of popcorn polymers when the dehydrogenation of para-ethyltoluene is conducted over the modified catalyst, the modifying component (d) being a bismuth compound present to the extent of from about 1% to 20% by weight of the catalyst composition, calculated as bismuth trioxide.« less
Towards a double field theory on para-Hermitian manifolds
DOE Office of Scientific and Technical Information (OSTI.GOV)
Vaisman, Izu
In a previous paper, we have shown that the geometry of double field theory has a natural interpretation on flat para-Kähler manifolds. In this paper, we show that the same geometric constructions can be made on any para-Hermitian manifold. The field is interpreted as a compatible (pseudo-)Riemannian metric. The tangent bundle of the manifold has a natural, metric-compatible bracket that extends the C-bracket of double field theory. In the para-Kähler case, this bracket is equal to the sum of the Courant brackets of the two Lagrangian foliations of the manifold. Then, we define a canonical connection and an action ofmore » the field that correspond to similar objects of double field theory. Another section is devoted to the Marsden-Weinstein reduction in double field theory on para-Hermitian manifolds. Finally, we give examples of fields on some well-known para-Hermitian manifolds.« less
Ortho-para-hydrogen equilibration on Jupiter
NASA Technical Reports Server (NTRS)
Carlson, Barbara E.; Lacis, Andrew A.; Rossow, William B.
1992-01-01
Voyager IRIS observations reveal that the Jovian para-hydrogen fraction is not in thermodynamic equilibrium near the NH3 cloud top, implying that a vertical gradient exists between the high-temperature equilibrium value of 0.25 at depth and the cloud top values. The height-dependent para-hydrogen profile is obtained using an anisotropic multiple-scattering radiative transfer model. A vertical correlation is found to exist between the location of the para-hydrogen gradient and the NH3 cloud, strongly suggesting that paramagnetic conversion on NH3 cloud particle surfaces is the dominant equilibration mechanism. Below the NH3 cloud layer, the para fraction is constant with depth and equal to the high-temperature equilibrium value of 0.25. The degree of cloud-top equilibration appears to depend on the optical depth of the NH3 cloud layer. Belt-zone variations in the para-hydrogen profile seem to be due to differences in the strength of the vertical mixing.
Möller, Matías N; Hatch, Duane M; Kim, Hye-Young H; Porter, Ned A
2012-10-10
Tyrosine-derived hydroperoxides are formed in peptides and proteins exposed to enzymatic or cellular sources of superoxide and oxidizing species as a result of the nearly diffusion-limited reaction between tyrosyl radical and superoxide. However, the structure of these products, which informs their reactivity in biology, has not been unequivocally established. We report here the complete characterization of the products formed in the addition of superoxide, generated from xanthine oxidase, to several peptide-derived tyrosyl radicals, formed from horseradish peroxidase. RP-HPLC, LC-MS, and NMR experiments indicate that the primary stable products of superoxide addition to tyrosyl radical are para-hydroperoxide derivatives (para relative to the position of the OH in tyrosine) that can be reduced to the corresponding para-alcohol. In the case of glycyl-tyrosine, a stable 3-(1-hydroperoxy-4-oxocyclohexa-2,5-dien-1-yl)-L-alanine was formed. In tyrosyl-glycine and Leu-enkephalin, which have N-terminal tyrosines, bicyclic indolic para-hydroperoxide derivatives were formed ((2S,3aR,7aR)-3a-hydroperoxy-6-oxo-2,3,3a,6,7,7a-hexahydro-1H-indole-2-carboxylic acid) by the conjugate addition of the free amine to the cyclohexadienone. It was also found that significant amounts of the para-OH derivative were generated from the hydroxyl radical, formed on exposure of tyrosine-containing peptides to Fenton conditions. The para-OOH and para-OH derivatives are much more reactive than other tyrosine oxidation products and may play important roles in physiology and disease.
Kit para aplicar la metodología de Lean en el gobierno
Este Kit para comenzar a aplicar la metodología Lean (Gobierno optimizado) ofrece información para ayudar a las agencias de protección ambiental a planificar e implementar iniciativas Lean exitosas.
Rohanova, Miroslava; Balikova, Marie
2009-04-01
para-Methoxymethamphetamine (PMMA) is an abused psychedelic compound with reports of several intoxications and deaths after ingestion. However, its pharmacokinetics based on a controlled study is unknown and only partial information on its biotransformation is available. Our experimental study was designed for the time disposition profile of PMMA and its metabolites para-methoxyamphetamine (PMA), para-hydroxymethamphetamine (OH-MAM) and para-hydroxyamphetamine (OH-AM) in blood and biological tissues in rats after the bolus subcutaneous dose 40 mg/kg using a validated GC-MS method. The experimental results ascertained could be useful for subsequent evaluation of PMMA psychotropic or neurotoxic effects and the diagnostic concern of intoxication.
DOE Office of Scientific and Technical Information (OSTI.GOV)
None
Por encargo del Secretario Abraham, la Oficina de Eficiencia Energética y Energía Renovable suministra el liderazgo a nivel nacional para impulsar las tecnologías de eficiencia energética y energía renovables, para saltar por encima de las limitaciones del status quo, y para alcanzar beneficios ambientales notables. El Programa de Tecnologías Geotérmicas, parte crítica de nuestro esfuerzo conjunto, está avanzando a grandes zancadas para aumentar la viabilidad y el despliegue de electricidad ...
Los plaguicidas y la contaminacion del medio ambiente Venezolano
Stickel, L.F.; Stickel, W.H.
1972-01-01
RESUMEN DE RECOMENDACIONES Recomendaciones para el Programa de Investigacion: 1. Establecer un sistema de muestreo biologico para detectar los niveles tendencias de los productos quimicos toxicos en un peque?o numero de si tios representativos. 2. Mantener continua vigilancia de la contaminacion ambiental, mediante la seleccion acertadamente dirigida de las zonas afectadas y de las fuentes de contaminacion. 3. Realizar estudios acerca de las poblaciones de animales silvestres, y del exito de los procesos reproductivos de las especies o grupos clayes de animales que se consideran mas gravemente afectados. 4. Preparar recomendaciones para una accion gubernamental de proteccion al hombre, a la fauna silvestre y al medio ambiente. Recomendaciones para la Accion Administrativa: 1. Establecer limites a la tolerancia de los residuos de plaguicidas en los alimentos. Constituye una medida clave para disminuir la contaminacion ambiental. 2. Establecer normas de calidad del agua para las corrientes, represas, la gos y otros cuerpos. Es la segunda medida clave para reducir la contaminacion del ambiente 3. Exigir un tratamiento adecuado de los efluentes industriales, especialmente antes de que se construyan las nuevas plantas. 4. Exigir a los agricultores que en el uso de plaguicidas sigan los consejos tecnicos autorizados y negar a los vendedores el derecho a recomendar productos por su cuenta. 5. Tomar medidas para recoger y eliminar los recipientes y sobrantes de los plaguicidas.
NASA Astrophysics Data System (ADS)
Rosado Olivieri, Wilda Y.
Gran parte de la investigacion acerca de la ensenanza de las ciencias se dedica a estudiar la forma o manera en que los estudiantes visualizan los conceptos cientificos. Para Driver (1983) esas ideas o concepciones se conocen como concepciones alternativas; las cuales pueden ocasionar dificultad para comprender los conceptos de las diferentes areas del conocimiento. El proposito de este estudio fue: (a) indagar como las distintas etapas del ABP permiten explorar las concepciones alternativas que poseen los estudiantes de nivel elemental acerca de los estados de agregacion de la materia y, (b) explorar en que medida el ABP permite identificar e incorporar las concepciones alternativas que poseen los estudiantes de nivel elemental con relacion al concepto de estados de agregacion de la materia para facilitar su aprendizaje. Con el fin de explorar las concepciones alternativas en el tema de los estados agregados de la materia se implanto la estrategia de Aprendizaje Basado en Problemas (ABP) con estudiantes de quinto grado de nivel elemental. Se utilizo la metodologia mixta con varias estrategias de recopilacion de datos, como una pre y pos prueba para elucidar el conocimiento previo y al mismo tiempo las concepciones alternativas sobre el tema bajo estudio y luego verificar el aprendizaje en los estudiantes. Asimismo, el uso de mapas conceptuales para determinar la profundidad del tema estudiado y el entrelazamiento de los conceptos Una tercera estrategia fue el grupo focal para tomar en cuenta la impresion de los estudiantes acerca del proyecto ABP. El aspecto colaborativo y cooperativo fue un factor fundamental, ya que el aprendizaje ocurrio en ese contexto educativo. Para los hallazgos de esta investigacion fue tan importante el conocimiento previo como los procesos que se generaban para que la adquisicion del mismo fuera de forma significativa y funcional (Escribano & Del Valle, 2010). La estrategia de ABP constituyo en este estudio una forma para indagar las concepciones alternativas que poseian los estudiantes y a su vez, determinar como el estudiante manejaba dichas concepciones a situaciones que requeririan aplicar su conocimiento para luego modificar las estructuras conceptuales hacia el conocimiento cientifico.
NASA Astrophysics Data System (ADS)
Ballesteros Benavides, Maria Elvira
Para este trabajo utilizamos el estudio de casos cualitativo que se llevo a cabo en una universidad privada de Puerto Rico. Empleamos como unidad de analisis el concepto de enlace quimico, ionico y covalente. Los participantes fueron los estudiantes de la seccion nocturna del curso de Quimica General I. La investigacion se desarrollo por medio de dos entrevistas de persona a persona, observaciones de las expresiones no verbales y la hoja de identificacion de conceptos. Para la triangulacion tomamos en consideracion las preconcepciones erroneas, las concepciones alternativas y el mapa de conceptos de cada participante. Preparamos un mapa de conceptos para el enlace quimico validado por un comite de expertos. Tambien, elaboramos los mapas de conceptos de los participantes que sirvieron para varios propositos: conocer la estructura conceptual, expresar los logros, hacer comparaciones e identificar la presencia de concepciones alternativas. Entre los hallazgos encontramos que todos los participantes poseen conocimiento previo de los enlaces quimicos ionico y covalente y dentro de ese conocimiento existen preconcepciones erroneas mas numerosas para el enlace ionico. Al principio del semestre el 50% de los participantes demostraron tener "carencia fuerte de conceptos" tanto para el enlace ionico como para el covalente. Al finalizar el semestre encontramos en el 40% de los participantes concepciones alternativas tanto para el enlace ionico como para el covalente y el 90% no lograron distinguir un enlace del otro. Nuestras conclusiones fueron que los participantes sin distincion del aprovechamiento academico demostraron tener la tendencia de "carencia fuerte de conceptos" tanto para el enlace ionico como para el covalente, presentaron dificultad al integrar los conceptos de los enlaces quimicos ionico y covalente que se pusieron de manifiesto al dar los ejemplos. Las preconcepciones erroneas contribuyen en el desarrollo de las concepciones alternativas. Ademas, los participantes no lograron diferenciar los dos enlaces quimicos. Esto implica que reflexionemos sobre la necesidad de revisar tanto las competencias cognoscitivas como la forma de ensenar quimica en el salon de clase. Recomendamos indagar y dar importancia al conocimiento previo de los estudiantes, enfatizar la ensenanza de los conceptos y propiciar el aprendizaje con significado.
A new version of Scilab software package for the study of dynamical systems
NASA Astrophysics Data System (ADS)
Bordeianu, C. C.; Felea, D.; Beşliu, C.; Jipa, Al.; Grossu, I. V.
2009-11-01
This work presents a new version of a software package for the study of chaotic flows, maps and fractals [1]. The codes were written using Scilab, a software package for numerical computations providing a powerful open computing environment for engineering and scientific applications. It was found that Scilab provides various functions for ordinary differential equation solving, Fast Fourier Transform, autocorrelation, and excellent 2D and 3D graphical capabilities. The chaotic behaviors of the nonlinear dynamics systems were analyzed using phase-space maps, autocorrelation functions, power spectra, Lyapunov exponents and Kolmogorov-Sinai entropy. Various well-known examples are implemented, with the capability of the users inserting their own ODE or iterative equations. New version program summaryProgram title: Chaos v2.0 Catalogue identifier: AEAP_v2_0 Program summary URL:
Primary Health Care: care coordinator in regionalized networks?
Almeida, Patty Fidelis de; Santos, Adriano Maia Dos
2016-12-22
To analyze the breadth of care coordination by Primary Health Care in three health regions. This is a quantitative and qualitative case study. Thirty-one semi-structured interviews with municipal, regional and state managers were carried out, besides a cross-sectional survey with the administration of questionnaires to physicians (74), nurses (127), and a representative sample of users (1,590) of Estratégia Saúde da Família (Family Health Strategy) in three municipal centers of health regions in the state of Bahia. Primary Health Care as first contact of preference faced strong competition from hospital outpatient and emergency services outside the network. Issues related to access to and provision of specialized care were aggravated by dependence on the private sector in the regions, despite progress observed in institutionalizing flows starting out from Primary Health Care. The counter-referral system was deficient and interprofessional communication was scarce, especially concerning services provided by the contracted network. Coordination capacity is affected both by the fragmentation of the regional network and intrinsic problems in Primary Health Care, which poorly supported in its essential attributes. Although the health regions have common problems, Primary Health Care remains a subject confined to municipal boundaries. Analisar o alcance da coordenação do cuidado pela Atenção Primária à Saúde em três regiões de saúde. Trata-se de estudo de caso, com abordagem quantitativa e qualitativa. Foram realizadas 31 entrevistas semiestruturadas com gestores municipais, regionais e estaduais e estudo transversal com aplicação de questionários para médicos (74), enfermeiros (127) e amostra representativa de usuários (1.590) da Estratégia Saúde da Família em três municípios-sede de regiões de saúde do estado da Bahia. A função de porta de entrada preferencial pela Atenção Primária à Saúde deparava-se com forte concorrência de serviços ambulatoriais hospitalares e de pronto-atendimento, desarticulados da rede. Problemas de acesso e oferta de atenção especializada eram agravados pela dependência do setor privado nas regiões, ainda que tenham sido observados avanços na institucionalização de fluxos desde a Atenção Primária à Saúde. A contrarreferência era deficiente e a comunicação interprofissional escassa, principalmente quando o usuário era atendido na rede contratada ou conveniada. A capacidade de coordenação mostra-se afetada tanto pela fragmentação da rede regional, quanto por problemas intrínsecos à Atenção Primária à Saúde, pouco fortalecida em seus atributos essenciais. Apesar de as regiões de saúde apresentarem problemas em comum, a Atenção Primária à Saúde continua sendo um tema circunscrito aos limites municipais.
NASA Astrophysics Data System (ADS)
Mishra, Piyush; Hewett, Daniel M.; Zwier, Timothy S.
2018-05-01
The single-conformation ultraviolet and infrared spectroscopy of three short-chain para-dialkylbenzenes (para-diethylbenzene, para-dipropylbenzene, and para-dibutylbenzene) is reported for the jet-cooled, isolated molecules. The present study builds off previous work on single-chain n-alkylbenzenes, where an anharmonic local mode Hamiltonian method was developed to account for stretch-bend Fermi resonance in the alkyl CH stretch region [D. P. Tabor et al., J. Chem. Phys. 144, 224310 (2016)]. The jet-cooled molecules are interrogated using laser-induced fluorescence (LIF) excitation, fluorescence dip infrared spectroscopy, and dispersed fluorescence. The LIF spectra in the S1 ← S0 origin region show a dramatic increase in the number of resolved transitions with increasing length of the alkyl chains, reflecting an explosion in the number of unique low-energy conformations formed when two independent alkyl chains are present. Since the barriers to isomerization of the alkyl chain are similar in size, this results in an "egg carton" shaped potential energy surface. A combination of electronic frequency shift and alkyl CH stretch infrared spectra is used to generate a consistent set of conformational assignments. Using these experimental techniques in conjunction with computational methods, subsets of origin transitions in the LIF excitation spectrum can be classified into different conformational families. Two conformations are resolved in para-diethylbenzene, seven in para-dipropylbenzene, and about nineteen in para-dibutylbenzene. These chains are largely independent of each other as there are no new single-chain conformations induced by the presence of a second chain. A cursory LIF excitation scan of para-dioctylbenzene shows a broad congested spectrum at frequencies consistent with interactions of alkyl chains with the phenyl π cloud.
NASA Astrophysics Data System (ADS)
Kundu, Anu; Anthony, Savarimuthu Philip
2018-01-01
Triphenyl amine based chemosensors, (2-(((2-(9H-carbazol-9-yl)phenyl)imino)methyl)-5-(diphenylamino)phenol (ortho-CPDP) and 2-(((4-(9H-carbazol-9-yl)phenyl)imino)methyl)-5-(diphenylamino)phenol (para-CPDP), showed solvent and isomerism dependent selective coloro/fluorometric sensing of multiple metal ions (Fe3 +, Al3 + and Zn2 +) with distinguishable responses. In CH3CN, ortho and para-CPDP selectively produced yellow color upon addition of Al3 + and Fe3 + that was slowly disappeared. The yellow color of ortho and para-CPDP in DMF was decolourised selectively by adding Al3 + and Fe3 +. Both ortho and para-CPDP in CH3CN showed nearly similar rate of decolourization for Fe3 + and Al3 +. However, the rate of decolourization of ortho and para-CPDP in DMF was different for Fe3 + (10 μM, 8 min) and Al3 + (5 × 10- 4 M, 40 min) ions. The limit of detection of para-CPDP for Fe3 + is 10 μM and Al3 + 500 μM. The mechanistic studies revealed the imine hydrolysis of ortho and para-CPDP in presence of Lewis acidic Fe3 + and Al3 +. The reactivity based sensing lead to high selectivity for Al3 + and Fe3 + ions. Further, para-CPDP exhibited selective fluorescence turn-on for Zn2 + in DMF (λmax = 513 nm) and detection limit of 6.0 μM. Thus, reactive chemosensors, ortho and para-CPDP, exhibited selective and distinguishable colorimetric sensing of Fe3 + and Al3 + ions and isomerism and solvent dependent fluorescence sensing of Zn2 +.
Mishra, Piyush; Hewett, Daniel M; Zwier, Timothy S
2018-05-14
The single-conformation ultraviolet and infrared spectroscopy of three short-chain para-dialkylbenzenes (para-diethylbenzene, para-dipropylbenzene, and para-dibutylbenzene) is reported for the jet-cooled, isolated molecules. The present study builds off previous work on single-chain n-alkylbenzenes, where an anharmonic local mode Hamiltonian method was developed to account for stretch-bend Fermi resonance in the alkyl CH stretch region [D. P. Tabor et al., J. Chem. Phys. 144, 224310 (2016)]. The jet-cooled molecules are interrogated using laser-induced fluorescence (LIF) excitation, fluorescence dip infrared spectroscopy, and dispersed fluorescence. The LIF spectra in the S 1 ← S 0 origin region show a dramatic increase in the number of resolved transitions with increasing length of the alkyl chains, reflecting an explosion in the number of unique low-energy conformations formed when two independent alkyl chains are present. Since the barriers to isomerization of the alkyl chain are similar in size, this results in an "egg carton" shaped potential energy surface. A combination of electronic frequency shift and alkyl CH stretch infrared spectra is used to generate a consistent set of conformational assignments. Using these experimental techniques in conjunction with computational methods, subsets of origin transitions in the LIF excitation spectrum can be classified into different conformational families. Two conformations are resolved in para-diethylbenzene, seven in para-dipropylbenzene, and about nineteen in para-dibutylbenzene. These chains are largely independent of each other as there are no new single-chain conformations induced by the presence of a second chain. A cursory LIF excitation scan of para-dioctylbenzene shows a broad congested spectrum at frequencies consistent with interactions of alkyl chains with the phenyl π cloud.
Lampreys, the jawless vertebrates, contain only two ParaHox gene clusters.
Zhang, Huixian; Ravi, Vydianathan; Tay, Boon-Hui; Tohari, Sumanty; Pillai, Nisha E; Prasad, Aravind; Lin, Qiang; Brenner, Sydney; Venkatesh, Byrappa
2017-08-22
ParaHox genes ( Gsx , Pdx , and Cdx ) are an ancient family of developmental genes closely related to the Hox genes. They play critical roles in the patterning of brain and gut. The basal chordate, amphioxus, contains a single ParaHox cluster comprising one member of each family, whereas nonteleost jawed vertebrates contain four ParaHox genomic loci with six or seven ParaHox genes. Teleosts, which have experienced an additional whole-genome duplication, contain six ParaHox genomic loci with six ParaHox genes. Jawless vertebrates, represented by lampreys and hagfish, are the most ancient group of vertebrates and are crucial for understanding the origin and evolution of vertebrate gene families. We have previously shown that lampreys contain six Hox gene loci. Here we report that lampreys contain only two ParaHox gene clusters (designated as α- and β-clusters) bearing five ParaHox genes ( Gsxα , Pdxα , Cdxα , Gsxβ , and Cdxβ ). The order and orientation of the three genes in the α-cluster are identical to that of the single cluster in amphioxus. However, the orientation of Gsxβ in the β-cluster is inverted. Interestingly, Gsxβ is expressed in the eye, unlike its homologs in jawed vertebrates, which are expressed mainly in the brain. The lamprey Pdxα is expressed in the pancreas similar to jawed vertebrate Pdx genes, indicating that the pancreatic expression of Pdx was acquired before the divergence of jawless and jawed vertebrate lineages. It is likely that the lamprey Pdxα plays a crucial role in pancreas specification and insulin production similar to the Pdx of jawed vertebrates.
Nonclassical and semiclassical para-Bose states
NASA Astrophysics Data System (ADS)
Huerta Alderete, C.; Villanueva Vergara, Liliana; Rodríguez-Lara, B. M.
2017-04-01
Motivated by the proposal to simulate para-Bose oscillators in a trapped-ion setup [C. Huerta Alderete and B. M. Rodríguez-Lara, Phys. Rev. A 95, 013820 (2017), 10.1103/PhysRevA.95.013820], we introduce an overcomplete, nonorthogonal basis for para-Bose Hilbert spaces. The states spanning these bases can be experimentally realized in the trapped-ion simulation via time evolution. The para-Bose states show both nonclassical and semiclassical statistics on their Fock state distribution, asymmetric field quadrature variances, and do not minimize the uncertainty relation for the field quadratures. These properties are analytically controlled by the para-Bose order and the evolution time; both parameters might be feasible for fine tuning in the trapped-ion quantum simulation.
Influence of Molecular Oxygen on Ortho-Para Conversion of Water Molecules
NASA Astrophysics Data System (ADS)
Valiev, R. R.; Minaev, B. F.
2017-07-01
The mechanism of influence of molecular oxygen on the probability of ortho-para conversion of water molecules and its relation to water magnetization are considered within the framework of the concept of paramagnetic spin catalysis. Matrix elements of the hyperfine ortho-para interaction via the Fermi contact mechanism are calculated, as well as the Maliken spin densities on water protons in H2O and O2 collisional complexes. The mechanism of penetration of the electron spin density into the water molecule due to partial spin transfer from paramagnetic oxygen is considered. The probability of ortho-para conversion of the water molecules is estimated by the quantum chemistry methods. The results obtained show that effective ortho-para conversion of the water molecules is possible during the existence of water-oxygen dimers. An external magnetic field affects the ortho-para conversion rate given that the wave functions of nuclear spin sublevels of the water protons are mixed in the complex with oxygen.
NASA Astrophysics Data System (ADS)
Panei, J. A.; Althaus, L. G.; Benvenuto, O. G.
Recientes mediciones de la masa y el radio hechas por Hipparcos de las estrellas enanas blancas 40 Eri B y Procyon B (Shipman, H. & Provencal, J. - ApJ. 1998, 494, 759), sugieren un núcleo compuesto de hierro para dichas estrellas, en lugar de carbono y oxígeno como predice la teoría standard de evolución estelar. Para interpretar estas observaciones, presentamos aquí, relaciones masa-radio para configuraciones degeneradas a temperatura finita para distintas composiciones químicas centrales. Para tal fin hemos calculado secuencias evolutivas de enanas blancas utilizando el código de evolución estelar, desarrollado en el Observatorio de La Plata. Dicho código resuelve las ecuaciones de estructura y evolución estelar mediante la técnica de relajación de Henyey, y esta basado en una descripción física muy detallada y actualizada.
NASA Astrophysics Data System (ADS)
Romanelli, Giovanni; Rudić, Svemir; Zanetti, Matteo; Andreani, Carla; Fernandez-Alonso, Felix; Gorini, Giuseppe; Krzystyniak, Maciej; Škoro, Goran
2018-04-01
We present an experimental study to determine the para-hydrogen concentration in the hydrogen moderators at the ISIS pulsed neutron and muon source. The experimental characterisation is based on neutron transmission experiments performed on the VESUVIO spectrometer, and thermal conductivity measurements using the TOSCA para-hydrogen rig. A reliable estimation of the level of para-hydrogen concentration in the hydrogen moderators is of crucial importance in the framework of a current project to completely refurbish the first target station at ISIS. Moreover, we report a new measurement of the total neutron cross section for normal hydrogen at 15 K on the broad energy range 3 meV -10 eV suggesting a revision of the most recent nuclear libraries for incident neutron energies lower than 10 meV. Finally, we characterise systematic errors affecting the para-hydrogen level estimation due to conversion from para to ortho hydrogen, as a function of the time a batch of gas spends in every component of our gas panel and apparatus.
USDA-ARS?s Scientific Manuscript database
En este articulo se reporta por primera vez para el Peru una especies del genero Nielsonia Young, 1977, de material procedente del Departamento de Tumbes. El genero ha sido reportada anteriormente de Ecuador, como unico registro para Sudamerica, y America Central. El unico especimen hembra encontra...
Cooling by Para-to-Ortho-Hydrogen Conversion
NASA Technical Reports Server (NTRS)
Sherman, A.; Nast, T.
1983-01-01
Catalyst speeds conversion, increasing capacity of solid hydrogen cooling system. In radial-flow catalytic converter, para-hydrogen is converted to equilibrium mixture of para-hydrogen and ortho-hydrogen as it passes through porous cylinder of catalyst. Addition of catalyst increases capacity of hydrogen sublimation cooling systems for radiation detectors.
Calidad del aire interior en las escuelas
EPA ha desarrollado el Programa de Herramientas de Calidad del Aire Interior para las Escuelas para reducir la exposición a los contaminantes ambientales en las mismas a través de la adopción voluntaria de las prácticas para manejar la calidad del aire int
... finalizado el examen, el radiólogo, médico entrenado para la lectura de imágenes para diagnóstico, examina las películas. El radiólogo dicta un informe que describe las técnicas utilizadas para adquirir la imagen, el motivo del examen, antecedentes relevantes del ...
Norma para la Certificación de Aplicadores de Plaguicidas Revisada
La EPA emitió una propuesta para la revisión de la norma para la Certificación de Aplicadores de Plaguicidas. La norma ayudará a mantener nuestras comunidades seguras, salvaguardar el medio ambiente y reducir el riesgo a los que aplican los plaguicidas.
Polymorphism and Modulation of Para-Substituted l-Phenylalanine.
Sögütoglu, Leyla-Cann; Lutz, Martin; Meekes, Hugo; de Gelder, René; Vlieg, Elias
2017-12-06
The crystal structure of para -methyl-l-phenylalanine at 230 K resembles that of the para-fluorinated analogue from the literature but is commensurately modulated with seven molecules in the asymmetric unit ( Z ' = 7). At 100 K, the superstructure loses its modulation, leading to a unit cell with Z ' = 1, with clear disorder in the phenyl ring orientations. The methyl-substituent in para -methyl-l-phenylalanine has, in contrast to fluorine, no polar interactions with protons of neighboring molecules, which might allow for the well-defined modulation of the crystal structure at 230 K.
Ro-vibrational Spectra of (para-H2 )N -CH4 in He Droplets.
Hoshina, Hiromichi; Sliter, Russell; Ravi, Aakash; Kuma, Susumu; Momose, Takamasa; Vilesov, Andrey F
2016-11-18
In this work, we report on the infrared spectroscopic study of clusters of CH 4 molecules with up to N=80 para-hydrogen molecules assembled inside He droplets. Upon increase of the number of the added para-hydrogen molecules up to about N=12, both the rotational constant, B, and the origin frequency of the υ 3 band of CH 4 decrease gradually. In the range of 6 ≤N≤12, the spectra indicate some abrupt changes of B and υ 3 with both values being approximately constant at N≥12. The origin of this effect is discussed. Comparison of the spectra of methane molecules in para-hydrogen clusters to that in solid para-hydrogen is also presented. © 2016 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.
Um enfoque antropológico para o ensino de astronomia no nível médio
NASA Astrophysics Data System (ADS)
Costa, G. B.; Jafelice, L. C.
2003-08-01
Há uma enorme carência de materiais didático-pedagógicos em astronomia para professores do ensino médio, sobretudo materiais que explorem também aspectos humanísticos. A origem do Universo é um bom exemplo desta constatação central. Embora tal origem teve explicações culturais diversas, os professores não têm informações sobre isso e muito menos material que trabalhe diferentes visões de mundo e treinamento que os capacite a abordá-las devidamente. Conseqüentemente o ensino de astronomia costuma ser tecnicista e dissociado do aspecto humano que alimenta o grande interesse e curiosidade que esses temas despertam. Aqui apresentamos propostas visando contribuir para reverter esse quadro e trabalhamos distintas visões de Universo: espontâneas, autóctones e científicas. Desenvolvemos práticas, materiais instrucionais e textos para viabilizar a adoção de um enfoque antropológico para o ensino de astronomia no nível médio, no qual as culturas humanística e científica sejam integradas de uma maneira contextualizada e eficaz para aquele ensino. Estas propostas foram aplicadas em um curso de treinamento para professores da rede pública de diferentes disciplinas. A receptividade dos professores à abordagem proposta e os resultados alcançados foram muito estimulantes. Destes, destacamos: produção de roteiros de atividades; desenvolvimento de práticas didático-pedagógicas específicas (e.g., encenação de mitos; dança primordial guarani; "criação" de constelações e interpretações pluriculturais; etc.); e sugestões concretas para a efetiva realização de um ensino interdisciplinar contextualizado, onde questões cosmogônicas servem de mote para iniciar tal ensino. Discutimos estes resultados e como o enfoque adotado pode instrumentalizar os professores para leituras de mundo que incluem naturalmente aspectos culturais, sociais e históricos associados aos temas estudados. (PPGECNM/UFRN; PRONEX/FINEP; NUPA/USP; Temáticos/FAPESP)
[General Practitioners and Physical Activity Counselling: from Evidence to Practice Contingencies].
Bloy, Géraldine; Moussard Philippon, Laetitia; Rigal, Laurent
2016-06-08
Desigualdad social y tendencias de mortalidad por diabetes.
Medina-Gómez, Oswaldo; Medina-Reyes, E Ismael Seth
2017-01-01
To identify the trend of national diabetes mortality by level of marginality at the state and municipal levels. A descriptive study was conducted with records of deaths from diabetes in over 20 years from 1990 to 2013. The national mortality rate was calculated standardized by age according to the 2000 world population and the state level 2013 saw the projected naational population by join point analysis for trend analysis was performed. For the general population, the annual percentage change between 1990 and 1996 was 2.2, from 1996 to 2005 was 4.3, and from 2005 to 2013 was 0.1. The largest increase among women occurred between 1998 and 2005 while among men occurred between 1995 and 2006. At the state level was found higher annual percentage change between the towns with the highest degree of marginalization. The mortality of diabetes in women shows a significant decrease since 2004, among men, the mortality with a continuous upward trend, consistent with the trend that the disease has had in recent years. Copyright: © 2017 SecretarÍa de Salud
Guía para la evaluación del riesgo de los polinizadores
La Guía para la evaluación del riesgo de los polinizadores de la EPA es parte de una estrategia de la evaluación de los riesgos que presentan los pesticidas para las abejas a fin de mejorar la protección de los polinizadores.
Infrastructure Suitability Assessment Modeling for Cloud Computing Solutions
2011-09-01
Virtualization vs . Para-Virtualization .......................................................10 Figure 4. Modeling alternatives in relation to model...the conceptual difference between full virtualization and para-virtualization. Figure 3. Full Virtualization vs . Para-Virtualization 2. XEN...Besides Microsoft’s own client implementations, dubbed “Remote Desktop Con- nection Client” for Windows® and Apple ® operating systems, various open
On harmonic oscillators and their Kemmer relativistic forms
NASA Technical Reports Server (NTRS)
Debergh, Nathalie; Beckers, Jules
1993-01-01
It is shown that Dirac (Kemmer) equations are intimately connected with (para)supercharges coming from (para)supersymmetric quantum mechanics, a nonrelativistic theory. The dimensions of the irreducible representations of Clifford (Kemmer) algebras play a fundamental role in such an analysis. These considerations are illustrated through oscillator like interactions, leading to (para)relativistic oscillators.
Study on cross-reactivity to the para group.
Picardo, M; Cannistraci, C; Cristaudo, A; De Luca, C; Santucci, B
1990-01-01
In 80 patients, positive to at least one hapten of the para group (para-phenylenediamine, diaminodiphenylmethane, benzocaine, PPD mix), patch tests were carried out with freshly prepared solutions of para-phenylenediamine (PPD) and of 3 selected aromatic compounds related structurally to PPD (para-aminophenol, ortho-aminophenol, hydroquinone). The number of positive reactions correlated with the rate of decomposition of the substances as evaluated by high-pressure liquid chromatography. PPD, which was almost decomposed after 24 h, gave the highest number of positive reactions, followed by ortho-aminophenol and by para-aminophenol, while hydroquinone, which was oxidized to the extent of 35%, did not give any reactions. To evaluate if a different rate of oxidation can modify the patch test response, in the same patients and in 10 normal volunteers, tests were carried out with PPD solutions containing the oxidizing agent silver oxide (0.1%). By this procedure a significant increase in the number of positive responses was observed. The results suggest that the rate of decomposition and therefore the amount of quinone(s) generated, might be the key to eliciting patch test responses to oxidizable aromatic haptens.
Previdi, Irene Lafarga; Guzzi Vasques, Ana C.; Varas-Díaz, Nelson; Albizu García, Carmen E.
2017-01-01
Resumen La población carcelaria de Puerto Rico en 2013 se compone de aproximadamente 13,000 personas. En la literatura no se encuentran documentos que describan los facilitadores y las limitaciones para realizar estudios relacionados con la salud mental en las cárceles. El artículo es una reflexión en torno a situaciones que facilitan o retan la investigación en cárceles según identificaron los/las miembros del equipo de investigación de un proyecto cuyo objetivo era validar una escala para medir estrés en los confinados. En este artículo presentamos elementos facilitadores y retantes del trabajo investigativo en prisión, que sirven para afrontar los retos que presenta este escenario particular. Estas verbalizaciones pueden servir de guía para futuras investigaciones con la población penal. Los hallazgos y recomendaciones preparan al grupo de investigación para afrontar los retos que presenta este escenario particular y a saber cómo maximizar los facilitadores para obtener productos satisfactorios. PMID:28316510
Determination of the ortho to para ratio of H2Cl+ and H2O+ from submillimeter observations.
Gerin, Maryvonne; de Luca, Massimo; Lis, Dariusz C; Kramer, Carsten; Navarro, Santiago; Neufeld, David; Indriolo, Nick; Godard, Benjamin; Le Petit, Franck; Peng, Ruisheng; Phillips, Thomas G; Roueff, Evelyne
2013-10-03
The opening of the submillimeter sky with the Herschel Space Observatory has led to the detection of new interstellar molecular ions, H2O(+), H2Cl(+), and HCl(+), which are important intermediates in the synthesis of water vapor and hydrogen chloride. In this paper, we report new observations of H2O(+) and H2Cl(+) performed with both Herschel and ground-based telescopes, to determine the abundances of their ortho and para forms separately and derive the ortho-to-para ratio. At the achieved signal-to-noise ratio, the observations are consistent with an ortho-to-para ratios of 3 for both H2O(+) and H2Cl(+), in all velocity components detected along the lines-of-sight to the massive star-forming regions W31C and W49N. We discuss the mechanisms that contribute to establishing the observed ortho-to-para ratio and point to the need for a better understanding of chemical reactions, which are important for establishing the H2O(+) and H2Cl(+) ortho-to-para ratios.
Terenzi, Camilla; Bouguet-Bonnet, Sabine; Canet, Daniel
2015-05-07
We report that at ambient temperature and with 100% enriched para-hydrogen (p-H2) dissolved in organic solvents, paramagnetic spin catalysis of para → ortho hydrogen conversion is accompanied at the onset by a negative ortho-hydrogen (o-H2) proton NMR signal. This novel finding indicates an electron spin polarization transfer, and we show here that this can only occur if the H2 molecule is dissociated upon its transient adsorption by the paramagnetic catalyst. Following desorption, o-H2 is created until the thermodynamic equilibrium is reached. A simple theory confirms that in the presence of a static magnetic field, the hyperfine coupling between unpaired electrons and nuclear spins is responsible for the observed polarization transfer. Owing to the negative electron gyromagnetic ratio, this explains the experimental results and ascertains an as yet unexplored mechanism for para → ortho conversion. Finally, we show that the recovery of o-H2 magnetization toward equilibrium can be simply modeled, leading to the para → ortho conversion rate.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ombaka, L.M.; Ndungu, P.G.; Department of Applied Chemistry, Doornfontein Campus, University of Johannesburg, P.O. Box 17011, Johannesburg 2028
Nitrogen-doped carbon nanotubes (N-CNTs) have been synthesized at 850 °C via a CVD deposition technique by use of three ferrocenyl derivative catalysts, i.e. para-CN, -CF{sub 3} and -Cl substituted-phenyl rings. The synthesized catalysts have been characterized by NMR, IR, HR-MS and XRD. The XRD analysis of the para-CF{sub 3} catalyst indicates that steric factors influence the X-ray structure of 1,1′-ferrocenylphenyldiacrylonitriles. Acetonitrile or pyridine was used as carbon and nitrogen sources to yield mixtures of N-CNTs and carbon spheres (CS). The N-CNTs obtained from the para-CF{sub 3} catalysts, in pyridine, have the highest nitrogen-doping level, show a helical morphology and aremore » less thermally stable compared with those synthesized by use of the para-CN and -Cl as catalyst. This suggests that fluorine heteroatoms enhance nitrogen-doping in N-CNTs and formation of helical-N-CNTs (H-N-CNTs). The para-CF{sub 3} and para-Cl catalysts in acetonitrile yielded iron-filled N-CNTs, indicating that halogens promote encapsulation of iron into the cavity of N-CNT. The use of acetonitrile, as carbon and nitrogen source, with the para-CN and -Cl as catalysts also yielded a mixture of N-CNTs and carbon nanofibres (CNFs), with less abundance of CNFs in the products obtained using para-Cl catalysts. However, para-CF{sub 3} catalyst in acetonitrile gave N-CNTs as the only shaped carbon nanomaterials. - Graphical abstract: Graphical abstract showing the synthesis of N-CNTs using halogenated-ferrocenyl derivatives as catalyst with pyridine or acetonitrile as nitrogen and carbon sources via the chemical vapour deposition technique. - Highlights: • N-CNTs were synthesized from halogenated ferrocenyl catalysts. • Halogenated catalysts promote nitrogen-doping and pyridinic nitrogen in N-CNTs. • Halogenated catalysts facilitate iron filling of N-CNTs.« less
Uellendahl, Marly; Siqueira, Maria Eduarda Menezes de; Calado, Eveline Barros; Kalil-Filho, Roberto; Sobral, Dário; Ribeiro, Clébia; Oliveira, Wilson; Martins, Silvia; Narula, Jagat; Rochitte, Carlos Eduardo
2016-11-01
Chagas disease (CD) is an important cause of heart failure and mortality, mainly in Latin America. This study evaluated the morphological and functional characteristics of the heart as well the extent of myocardial fibrosis (MF) in patients with CD by cardiac magnetic resonance (CMR). The prognostic value of MF evaluated by myocardial-delayed enhancement (MDE) was compared with that via Rassi score. This study assessed 39 patients divided into 2 groups: 28 asymptomatic patients as indeterminate form group (IND); and symptomatic patients as Chagas Heart Disease (CHD) group. All patients underwent CMR using the techniques of cine-MRI and MDE, and the amount of MF was compared with the Rassi score. Regarding the morphological and functional analysis, significant differences were observed between both groups (p < 0.001). Furthermore, there was a strong correlation between the extent of MF and the Rassi score (r = 0.76). CMR is an important technique for evaluating patients with CD, stressing morphological and functional differences in all clinical presentations. The strong correlation with the Rassi score and the extent of MF detected by CMR emphasizes its role in the prognostic stratification of patients with CD. A doença de Chagas (DC) é importante causa de insuficiência cardíaca e mortalidade, principalmente na América Latina. Este estudo avaliou as características morfológicas e funcionais do coração, assim como a extensão da fibrose miocárdica (FM) em pacientes com DC através de ressonância magnética cardíaca (RMC). O valor prognóstico da FM avaliada por realce tardio miocárdico (RTM) foi comparado àquele do escore de Rassi. Avaliação de 39 pacientes divididos em 2 grupos: grupo 'forma indeterminada' (IND), 28 pacientes assintomáticos; e grupo 'cardiopatia chagásica' (CC), pacientes sintomáticos. Todos os pacientes foram submetidos a RMC com as técnicas de cine-RM e RTM, sendo a quantidade de FM evidenciada ao exame comparada ao escore de Rassi. As análises morfológica e funcional mostraram significativas diferenças entre os 2 grupos (p < 0,001). Houve ainda uma forte correlação entre a extensão da FM e o escore de Rassi (r = 0,76). A RMC é uma importante técnica para avaliar pacientes com DC, ressaltando as diferenças morfológicas e funcionais em todas as apresentações clínicas. A forte correlação entre o escore de Rassi e a extensão da FM detectada por RMC enfatiza seu papel na estratificação prognóstica de pacientes com DC.
Key Nutritional Strategies to Optimize Performance in Para Athletes.
Scaramella, Jacque; Kirihennedige, Nuwanee; Broad, Elizabeth
2018-05-01
Para athletes are a high-risk population for inadequate dietary intake leading to insufficiencies in nutrients important to athletic performance. This is partly due to minimal support and resources, especially in sport nutrition education, combined with limited prior nutrition knowledge and risks associated with different impairment types. Inadequate energy, carbohydrate, protein, iron, and vitamin D status are of particular concern in Para athletes. Assessment of these key nutrients, along with sport nutrition education, is needed to empower Para athletes with the knowledge to understand their individual nutrition needs and maximize athletic performance. Copyright © 2018 Elsevier Inc. All rights reserved.
Ellena, Silvano; Viale, Alessandra; Gobetto, Roberto; Aime, Silvio
2012-08-01
Para-hydrogen-induced polarization effects have been observed in the (29)Si NMR spectra of trimethylsilyl para-hydrogenated molecules. The high signal enhancements and the long T(1) values observed for the (29)Si hyperpolarized resonances point toward the possibility of using (29)Si for hyperpolarization applications. A method for the discrimination of multiple compounds and/or complex mixtures of hydroxylic compounds (such as steroids), consisting of the silylization of alcoholic functionalities with an unsaturated silylalkyl moiety and subsequent reaction with para-H(2), is proposed. Copyright © 2012 John Wiley & Sons, Ltd.
ERIC Educational Resources Information Center
Pell, Elena; And Others
This guide, in Spanish, offers practical advice to Latino parents on how to help their children succeed academically. Chapter 1, "About This Booklet," discusses the importance of parent involvement in a child's education and development and reviews the format of the five other chapters. Chapter 2, "What Is Parent Involvement, and…
se cuenta con los fondos necesarios para efectuar el Programa PIA para el 2018. We do, on occasion Observatorio Inter-Americano de Cerro Tololo es el centro nacional de los Estados Unidos para el desarrollo de unos 400 kms al norte de Santiago. Los telescopios se ubican en la cima de Cerro Tololo, a 90 kms al
NASA Astrophysics Data System (ADS)
Dyckmanns, Malte; Vaughan, Owen
2017-06-01
We generalise the hyper-Kähler/quaternionic Kähler (HK/QK) correspondence to include para-geometries, and present a new concise proof that the target manifold of the HK/QK correspondence is quaternionic Kähler. As an application, we construct one-parameter deformations of the temporal and Euclidean supergravity c-map metrics and show that they are para-quaternionic Kähler.
Programa de conservacion para aves migratorias neotropicales
Deborah Finch; Marcia Wilson; Roberto Roca
1992-01-01
Mas de 250 especies de aves terrestres migran a Norte America durante la epoca reproductiva para aprovechar los sistemas templados. No obstante, las aves migratorias neotropicales pasan la mayor parte de su ciclo de vida en los habitat tropicales y subtropicales de paises latinoamericanos y caribefios donde viven en una asociacion cercana con las aves residentes. Para...
La EPA propone normas más rigurosas para las personas que aplican los plaguicidas de más alto riesgo
La EPA emitió una propuesta para la revisión de la norma para la Certificación de Aplicadores de Plaguicidas. La norma ayudará a mantener nuestras comunidades seguras, salvaguardar el medio ambiente y reducir el riesgo a los que aplican los plaguicidas.
La EPA publicó su Informe de Progreso en Justicia Ambiental AF2017 destacando los continuos logros en crear ambientes más limpios, más seguros y más saludables para comunidades minoritarias, de bajos ingresos, tribales e indígenas.
Role of Tyrosine Isomers in Acute and Chronic Diseases Leading to Oxidative Stress - A Review.
Molnár, Gergő A; Kun, Szilárd; Sélley, Eszter; Kertész, Melinda; Szélig, Lívia; Csontos, Csaba; Böddi, Katalin; Bogár, Lajos; Miseta, Attila; Wittmann, István
2016-01-01
Oxidative stress plays a major role in the pathogenesis of a variety of acute and chronic diseases. Measurement of the oxidative stress-related end products may be performed, e.g. that of structural isomers of the physiological para-tyrosine, namely meta- and ortho-tyrosine, that are oxidized derivatives of phenylalanine. Recent data suggest that in sepsis, serum level of meta-tyrosine increases, which peaks on the 2(nd) and 3(rd) days (p<0.05 vs. controls), and the kinetics follows the intensity of the systemic inflammation correlating with serum procalcitonin levels. In a similar study subset, urinary meta-tyrosine excretion correlated with both need of daily insulin dose and the insulin-glucose product in non-diabetic septic cases (p<0.01 for both). Using linear regression model, meta-tyrosine excretion, urinary meta-tyrosine/para-tyrosine, urinary ortho-tyrosine/para-tyrosine and urinary (meta- + orthotyrosine)/ para-tyrosine proved to be markers of carbohydrate homeostasis. In a chronic rodent model, we tried to compensate the abnormal tyrosine isomers using para-tyrosine, the physiological amino acid. Rats were fed a standard high cholesterol-diet, and were given para-tyrosine or vehicle orally. High-cholesterol feeding lead to a significant increase in aortic wall meta-tyrosine content and a decreased vasorelaxation of the aorta to insulin and the glucagon-like peptide-1 analogue, liraglutide, that both could be prevented by administration of para-tyrosine. Concluding, these data suggest that meta- and ortho-tyrosine are potential markers of oxidative stress in acute diseases related to oxidative stress, and may also interfere with insulin action in septic humans. Competition of meta- and ortho-tyrosine by supplementation of para-tyrosine may exert a protective role in oxidative stress-related diseases.
Varas-Díaz, Nelson; Neilands, Torsten B.; Guilamo-Ramos, Vincent; Cintrón Bou, Francheska N.
2009-01-01
El estigma relacionado con el VIH/SIDA continúa siendo un obstáculo para la prevención primaria y secundaria del VIH. Las consecuencias para las personas que viven con la enfermedad han sido muy documentadas y continúan siendo una gran preocupación para las personas que proveen servicios de salud y para aquellas que investigan el tema. Estas consecuencias son preocupantes cuando el estigma emana de profesionales de la salud porque se puede limitar el acceso a los servicios. Uno de los principales obstáculos para la investigación del estigma relacionado con el VIH en Puerto Rico es la falta de instrumentos cuantitativos para evaluar las manifestaciones del estigma entre profesionales de la salud. El objetivo principal de este estudio fue desarrollar y probar las propiedades psicométricas de una escala sobre el estigma relacionado con el VIH/SIDA culturalmente apropiada para personas que proveen servicios de salud puertorriqueñas y desarrollar una versión corta de la escala que pudiera usarse en escenarios clínicos con tiempo limitado. El instrumento desarrollado estuvo basado en evidencia cualitativa recopilada entre profesionales y estudiantes de profesiones de la salud puertorriqueños/as (n=80) y administrado a una muestra de 421 profesionales de la salud en adiestramiento. La escala contenía 12 dimensiones del estigma relacionado con el VIH/SIDA. El análisis cuantitativo corroboró 11 de ellas, teniendo como resultado un instrumento con validez y confiabilidad satisfactoria. Estas dimensiones, a su vez, fueron subcomponentes de un factor de estigma general superior. PMID:20333258
DOE Office of Scientific and Technical Information (OSTI.GOV)
Liu, Shubin, E-mail: shubin@email.unc.edu
Electrophilic aromatic substitution as one of the most fundamental chemical processes is affected by atoms or groups already attached to the aromatic ring. The groups that promote substitution at the ortho/para or meta positions are, respectively, called ortho/para and meta directing groups, which are often characterized by their capability to donate electrons to or withdraw electrons from the ring. Though resonance and inductive effects have been employed in textbooks to explain this phenomenon, no satisfactory quantitative interpretation is available in the literature. Here, based on the theoretical framework we recently established in density functional reactivity theory (DFRT), where electrophilicity andmore » nucleophilicity are simultaneously quantified by the Hirshfeld charge, the nature of ortho/para and meta group directing is systematically investigated for a total of 85 systems. We find that regioselectivity of electrophilic attacks is determined by the Hirshfeld charge distribution on the aromatic ring. Ortho/para directing groups have most negative charges on the ortho/para positions, while meta directing groups often possess the largest negative charge on the meta position. Our results do not support that ortho/para directing groups are electron donors and meta directing groups are electron acceptors. Most neutral species we studied here are electron withdrawal in nature. Anionic systems are always electron donors. There are also electron donors serving as meta directing groups. We predicted ortho/para and meta group directing behaviors for a list of groups whose regioselectivity is previously unknown. In addition, strong linear correlations between the Hirshfeld charge and the highest occupied molecular orbital have been observed, providing the first link between the frontier molecular orbital theory and DFRT.« less
NASA Astrophysics Data System (ADS)
Gumbau, Manuel Forner
2010-11-01
Uno de los problemas que aborda la Mecánica Celeste es la determinación de las figuras de equilibrio de los cuerpos celestes. Para investigar su solución mediante métodos directos, se precisa evaluar el potencial generado por su autogravitación, el generado por su fuerza centríÂfuga y el generado por la fuerza de atracción entre los cuerpos. Los métodos clásicos de Finlay y Kopal que afrontan estos problemas, para determinar el potencial autogravitatorio en las configuraciones de equilibrio, emplean desarrollos en serie de los potenciales interior y exterior del potencial autogravitatorio. Estos métodos incurren en el error de suponer la convergencia en capas donde resulta cuestionable dicha convergencia para estos desarrollos en serie. En este trabajo se han elaborado unos algoritmos que contemplan toda la casuí&stica y que permiten una manipulación efic iente del producto de polinomios de Legendre, del producto de funciones asociada s de Legendre y del producto de armónicos esféricos como combinacióon lineal de ellos mismos, respectivamente. Se han obtenido, para primer y segundo orden en las amplitudes, los desarrollos correctos para los potencial es interior y exterior del potencial autogravitatorio para configuraciones de equilibrio aisladas, y , en primer orden de amplitudes, los mismos potenciales para los sistemas binarios próximos. Se ha elaborado un método analítico, en primer orden respecto de las amplitudes, para la determinación del potencial de marea en sistemas binarios próximos en el cual se manifiesta la forma de la componente secundaria del sistema
Alexandre Teixeira, César; Direito, Bruno; Bandarabadi, Mojtaba; Le Van Quyen, Michel; Valderrama, Mario; Schelter, Bjoern; Schulze-Bonhage, Andreas; Navarro, Vincent; Sales, Francisco; Dourado, António
2014-05-01
The ability of computational intelligence methods to predict epileptic seizures is evaluated in long-term EEG recordings of 278 patients suffering from pharmaco-resistant partial epilepsy, also known as refractory epilepsy. This extensive study in seizure prediction considers the 278 patients from the European Epilepsy Database, collected in three epilepsy centres: Hôpital Pitié-là-Salpêtrière, Paris, France; Universitätsklinikum Freiburg, Germany; Centro Hospitalar e Universitário de Coimbra, Portugal. For a considerable number of patients it was possible to find a patient specific predictor with an acceptable performance, as for example predictors that anticipate at least half of the seizures with a rate of false alarms of no more than 1 in 6 h (0.15 h⁻¹). We observed that the epileptic focus localization, data sampling frequency, testing duration, number of seizures in testing, type of machine learning, and preictal time influence significantly the prediction performance. The results allow to face optimistically the feasibility of a patient specific prospective alarming system, based on machine learning techniques by considering the combination of several univariate (single-channel) electroencephalogram features. We envisage that this work will serve as benchmark data that will be of valuable importance for future studies based on the European Epilepsy Database. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
NASA Astrophysics Data System (ADS)
Lyon, A. L.; Kowalkowski, J. B.; Jones, C. D.
2017-10-01
ParaView is a high performance visualization application not widely used in High Energy Physics (HEP). It is a long standing open source project led by Kitware and involves several Department of Energy (DOE) and Department of Defense (DOD) laboratories. Futhermore, it has been adopted by many DOE supercomputing centers and other sites. ParaView is unique in speed and efficiency by using state-of-the-art techniques developed by the academic visualization community that are often not found in applications written by the HEP community. In-situ visualization of events, where event details are visualized during processing/analysis, is a common task for experiment software frameworks. Kitware supplies Catalyst, a library that enables scientific software to serve visualization objects to client ParaView viewers yielding a real-time event display. Connecting ParaView to the Fermilab art framework will be described and the capabilities it brings discussed.
Tom, Brian A; Mills, Andrew A; Wiczer, Michael B; Crabtree, Kyle N; McCall, Benjamin J
2010-02-28
In an effort to develop a source of H(3)(+) that is almost entirely in a single quantum state (J=K=1), we have successfully generated a plasma that is enriched to approximately 83% in para-H(3)(+) at a rotational temperature of 80 K. This enrichment is a result of the nuclear spin selection rules at work in hydrogenic plasmas, which dictate that only para-H(3)(+) will form from para-H(2), and that para-H(3)(+) can be converted to ortho-H(3)(+) by subsequent reaction with H(2). This is the first experimental study in which the H(2) and H(3) (+) nuclear spin selection rules have been observed at cold temperatures. The ions were produced from a pulsed solenoid valve source, cooled by supersonic expansion, and interrogated via continuous-wave cavity ringdown spectroscopy.
Effect of Lactation on myocardial vulnerability to ischemic insult in rats.
Askari, Sahar; Imani, Alireza; Sadeghipour, Hamidreza; Faghihi, Mahdieh; Edalatyzadeh, Zohreh; Choopani, Samira; Karimi, Nasser; Fatima, Sulail
2017-05-01
Cardiovascular diseases are the leading cause of mortality and long-term disability worldwide. Various studies have suggested a protective effect of lactation in reducing the risk of cardiovascular diseases. This study was designed to assess the effects of pregnancy and lactation on the vulnerability of the myocardium to an ischemic insult. Eighteen female rats were randomly divided into three groups: ischemia-reperfusion (IR), in which the hearts of virgin rats underwent IR (n = 6); lactating, in which the rats nursed their pups for 3 weeks and the maternal hearts were then submitted to IR (n = 6); and non-lactating, in which the pups were separated after birth and the maternal hearts were submitted to IR (n = 6). Outcome measures included heart rate (HR), left ventricular developed pressure (LVDP), rate pressure product (RPP), ratio of the infarct size to the area at risk (IS/AAR %), and ventricular arrhythmias - premature ventricular contraction (PVC) and ventricular tachycardia (VT). The IS/AAR was markedly decreased in the lactating group when compared with the non-lactating group (13.2 ± 2.5 versus 39.7 ± 3.5, p < 0.001) and the IR group (13.2 ± 2.5 versus 34.0 ± 4.7, p < 0.05). The evaluation of IR-induced ventricular arrhythmias indicated that the number of compound PVCs during ischemia, and the number and duration of VTs during ischemia and in the first 5 minutes of reperfusion in the non-lactating group were significantly (p < 0.05) higher than those in the lactating and IR groups. Lactation induced early-onset cardioprotective effects, while rats that were not allowed to nurse their pups were more susceptible to myocardial IR injury. As doenças cardiovasculares são a principal causa de mortalidade e invalidez a longo prazo a nível mundial. Diversos estudos têm sugerido um efeito protetor da lactação na redução do risco para doenças cardiovasculares. Este estudo foi desenvolvido para avaliar os efeitos da gestação e da lactação sobre a vulnerabilidade do miocárdio ao insulto isquêmico. Dezoito ratas foram divididas aleatoriamente em três grupos: isquemia-reperfusão (IR), no qual os corações de ratas virgens foram submetidos à IR (n = 6); lactantes, no qual as ratas amamentaram seus filhotes por 3 semanas e os corações maternos foram, em seguida, submetidos à IR (n = 6); e não lactantes, no qual os filhotes foram separados após o nascimento e os corações maternos foram submetidos à IR (n = 6). As medidas de desfecho incluíram frequência cardíaca (FC), pressão desenvolvida no ventrículo esquerdo (PDVE), duplo produto (DP), razão do tamanho do infarto sobre a área sob risco (TI/ASR %) e arritmias ventriculares - contração ventricular prematura (CVP) e taquicardia ventricular (TV). O TI/ASR foi substancialmente menor no grupo de lactantes quando comparado ao grupo de não lactantes (13,2 ± 2,5 versus 39,7 ± 3,5, p < 0,001) e ao grupo IR (13,2 ± 2,5 versus 34,0 ± 4,7, p < 0,05). A avaliação das arritmias ventriculares induzidas pela IR indicou que o número de CVPs compostas na isquemia, e o número e a duração das TVs na isquemia e nos primeiros 5 minutos de reperfusão no grupo de não lactantes foram significativamente (p < 0,05) mais elevados do que os encontrados nos grupos IR e de lactantes. A lactação induziu o aparecimento precoce de efeitos cardioprotetores, enquanto ratas que não foram permitidas a amamentar seus filhotes se mostraram mais suscetíveis à lesão miocárdica por IR.
Oliveira, Frederico Michelino DE; Carvalho, Marcus Vinícius H DE; Marchi, Evaldo; Pinto, Clóvis Antônio Lopes
2016-01-01
: to evaluate the effectiveness of a collagen-based adhesive associated with fibrinogen and thrombin in experimental liver injury in rats. : the study included 30 Wistar rats randomly divided into three groups: A, B and C. All underwent standard liver traumatic injury. In group A the lesion was treated with the adhesive; in group B, with conventional absorbable suture; and in group C, there was no treatment. We analyzed the time of hemostasis, mortality, occurrence of adhesions and any histological changes. : there was no statistical difference in relation to mortality (p = 0.5820). The group treated with the adhesive showed the lowest hemostasis times (p = 0.0573, odds ratio 13.5) and lower incidence of adhesions (p = 0.0119). Microscopic histological alterations of Groups A and B were similar, with foreign body granuloma formation separating the adhesive material or the suture from the hepatic stroma. : the adhesive of collagen associated with fibrinogen and thrombin was effective in the treatment of experimental hepatic injury, providing a lower incidence of adhesions between the liver and surrounding structures. avaliar a eficácia de um adesivo à base de colágeno associado a fibrinogênio e trombina, no trauma hepático experimental em ratos. foram incluídos no estudo 30 ratos Wistar, igualmente divididos aleatoriamente em três grupos: A, B e C. Todos foram submetidos à lesão traumática hepática padronizada. No grupo A a lesão foi tratada com o adesivo, no grupo B com sutura convencional com fio absorvível e no grupo C não houve tratamento da lesão. Foram analisados o tempo de hemostasia, mortalidade, ocorrência de aderências e eventuais alterações histológicas. os resultados mostraram que não houve diferença estatística em relação à mortalidade (p=0,5820). O grupo tratado com adesivo apresentou os menores tempos de hemostasia (p=0,0573 e odds ratio 13,5) e menor ocorrência de aderências (p=0,0119). Microscopicamente, as alterações histológicas dos grupos A e B foram semelhantes, com a formação de granuloma de corpo estranho separando o material do adesivo e do fio de sutura do estroma hepático. o estudo concluiu que o adesivo de colágeno associado a fibrinogênio e trombina foi eficaz no tratamento do trauma hepático experimental, proporcionado menor ocorrência de aderências entre o fígado e as estruturas vizinhas.
Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-21
... needed for national defense purposes. Another respondent notes that DuPont is in the process of building.... Domestic Para-Aramid Sewing Thread May Be of Lower Quality One respondent fully supported the interim rule... specification to use para-aramid thread that was heavier and weaker than the commercial thread that was used in...
Aplicación del Teorema de Nekhorochev para tiempos de estabilidad en Mecánica Celeste
NASA Astrophysics Data System (ADS)
Miloni, O.; Núñez, J.; Brunini, A.
En Mecánica Celeste, uno de los problemas centrales consiste en la determinación de los tiempos de estabilidad. El teorema de Nekhorochev proporciona un método para dicho estudio, para un sistema determinado por un hamiltoniano descripto en las variables acción-ángulo. El trabajo consiste en la acotación tanto del potencial perturbador y de la matriz hessiana del hamiltoniano integrable para determinar luego el tiempo de estabilidad de dicho sistema, donde por estabilidad se entiende la separación en norma infinito en el espacio de las acciones.
Ustynyuk, Yuri A; Gavrikov, Alexei V; Sergeyev, Nikolay M
2006-11-28
The quantum-chemical simulation (DFT, PBE, TZ2p basis set) of the mechanism of catalytic hydrogenation of compounds containing R(n)X --> O semipolar bonds (R(n)X = N(2), Me(2)S, C(5)H(5)N, Ph(3)P) on the Wilkinson catalyst (Ph(3)P)(3)RhCl with para-hydrogen showed that this process proceeds with retention of proton nuclear spin correlation, which enables a principal possibility to synthesize para-H(2)O, i.e. the nuclear spin isomer of water with antiparallel proton spins, using this route.
Parainflammation, chronic inflammation and age-related macular degeneration
Chen, Mei; Xu, Heping
2016-01-01
Inflammation is an adaptive response of the immune system to noxious insults to maintain homeostasis and restore functionality. The retina is considered an immune privileged tissue due to its unique anatomical and physiological properties. During aging, the retina suffers from a low-grade chronic oxidative insult, which sustains for decades and increases in level with advancing age. As a result, the retinal innate immune system, particularly microglia and the complement system, undergo low levels of activation (para-inflammation). In many cases, this para-inflammatory response can maintain homeostasis in the healthy aging eye. However, in patients with age-related macular degeneration (AMD), this para-inflammatory response becomes dysregulated and contributes to macular damage. Factors contributing to the dysregulation of age-related retinal para-inflammation include genetic predisposition, environmental risk factors and old age. Dysregulated para-inflammation (chronic inflammation) in AMD damages the blood retina barrier (BRB), resulting in the breach of retinal immune privilege leading to the development of retinal lesions. This review discusses the basic principles of retinal innate immune responses to endogenous chronic insults in normal aging and in AMD, and explores the difference between beneficial para-inflammation and the detrimental chronic inflammation in the context of AMD. PMID:26292978
NASA Astrophysics Data System (ADS)
Carlos, I. M.; Lépine, J. R. D.
2003-08-01
Os aglomerados abertos são objetos de grande valor para o estudo da dinâmica da Galáxia devido esses objetos terem uma faixa de idade relativamente ampla. O trabalho visa estudar a dinâmica da estrutura espiral da Galáxia principalmente através do uso desses aglomerados, uma vez que o estudo da cinemática desses objetos é fundamental para esse objetivo. Nosso grupo trabalha no sentido de construir uma base de dados de aglomerados abertos contendo coordenadas, distância, idade, movimentos próprios e velocidades radiais e já disponibiliza uma nova versão do catálogo de aglomerados abertos o qual é uma compilação de edições anteriores, principalmente Lynga (1987), Mermilliod (1995) e ESO-B (Lauberts 1982). Nossa amostra possui cerca de 1630 aglomerados, mas nem todos os parâmetros acima citados foram determinados em sua totalidade. Para determinarmos esses parâmetros, derivamos as cores intrínsecas das estrelas membro de cada aglomerado a partir de seus tipos espectrais (busca feita no SIMBAD) obtendo assim o excesso de cor individual. A distribuição dos excessos de cor foi então utilizada para derivarmos o avermelhamento médio para cada aglomerado. De maneira similar, os tipos espectrais foram usados para estimar as magnitudes absolutas, e com as magnitudes absolutas e aparentes determinamos a respectiva distribuição do módulo de distância e finalmente a distância. Para determinar as idades foram confeccionados os diagramas cor-magnitude das estrelas de cada aglomerado onde foram superpostas a Seqüência Principal de Idade Zero (ZAMS). Superpomos a ZAMS de Schmidt-Kaler e isócronas de composição solar. Essas isócronas foram usadas para determinação das idades dos aglomerados. Uma vez que não temos ainda resultados finais, apresentamos então alguns diagramas cor-magnitude os quais foram usados para determinação, principalmente, da distância e idade dos aglomerados.
New tools for subsurface imaging of 3D seismic Node data in hydrocarbon exploration =
NASA Astrophysics Data System (ADS)
Benazzouz, Omar
A aquisicao de dados sismicos de reflexao multicanal 3D/4D usando Ocean Bottom NODES de 4 componentes constitui atualmente um sector de importancia crescente no mercado da aquisicao de dados reflexao sismica marinha na industria petrolifera. Este tipo de dados permite obter imagens de sub-superficie de alta qualidade, com baixos niveis de ruido, banda larga, boa iluminacao azimutal, offsets longos, elevada resolucao e aquisicao de tanto ondas P como S. A aquisicao de dados e altamente repetitiva e portanto ideal para campanhas 4D. No entanto, existem diferencas significativas na geometria de aquisicao e amostragem do campo de ondas relativamente aos metodos convencionais com streamers rebocados a superficie, pelo que e necessario desenvolver de novas ferramentas para o processamento deste tipo de dados. Esta tese investiga tres aspectos do processamento de dados de OBSs/NODES ainda nao totalmente resolvidos de forma satisfatoria: a deriva aleatoria dos relogios internos, o posicionamento de precisao dos OBSs e a implementacao de algoritmos de migracao prestack 3D em profundidade eficientes para obtencao de imagens precisas de subsuperficie. Foram desenvolvidos novos procedimentos para resolver estas situacoes, que foram aplicados a dados sinteticos e a dados reais. Foi desenvolvido um novo metodo para deteccao e correccao de deriva aleatoria dos relogios internos, usando derivadas de ordem elevada. Foi ainda desenvolvido um novo metodo de posicionamento de precisao de OBSs usando multilateracao e foram criadas ferramentas de interpolacao/extrapolacao dos modelos de velocidades 3D de forma a cobrirem a extensao total area de aquisicao. Foram implementados algoritmos robustos de filtragem para preparar o campo de velocidades para o tracado de raios e minimizar os artefactos na migracao Krichhoff pre-stack 3D em profundidade. Os resultados obtidos mostram um melhoramento significativo em todas as situacoes analisadas. Foi desenvolvido o software necessario para o efeito e criadas solucoes computacionais eficientes. As solucoes computacionais desenvolvidas foram integradas num software standard de processamento de sismica (SPW) utilizado na industria, de forma a criar, conjuntamente com as ferramentas ja existentes, um workflow de processamento integrado para dados de OBS/NODES, desde a aquisicao e controle de qualidade a producao dos volumes sismicos migrados pre-stack em profundidade.
Construction and validation of nursing diagnoses for people in palliative care.
Silva, Rudval Souza da; Pereira, Álvaro; Nóbrega, Maria Miriam Lima da; Mussi, Fernanda Carneiro
2017-08-03
to construct and validate nursing diagnoses for people in palliative care based on the Dignity-Conserving Care Model and the International Classification for Nursing Practice. a two-stage methodological study: 1) construction of the database of clinically and culturally relevant terms for the nursing care for people in palliative care and 2) construction of nursing diagnoses from the database of terms, based on the guidelines of the International Council of Nurses. the 262 terms validated constituted a database of terms from which 56 nursing diagnoses were developed. Of these, 33 were validated by a group of 26 experts, and classified in the three categories of the Dignity-Conserving Care Model: illness-related concerns (21); dignity-conserving repertoire (9); and social dignity inventory (3). of the 33 validated diagnoses, 18 of them could be included in the update of the Catalog of the International Classification for Nursing Practice - palliative care for a dignified death. The study contributes to support the clinical reasoning and decision making of the nurse. construir e validar diagnósticos de enfermagem para pessoas em cuidados paliativos, fundamentados no Modelo de Cuidados para Preservação da Dignidade e na Classificação Internacional para a Prática de Enfermagem. estudo metodológico operacionalizado em duas etapas: 1) construção do banco de termos relevantes, clínica e culturalmente, para a assistência de enfermagem à pessoa em cuidados paliativos e 2) construção de diagnósticos de enfermagem a partir do banco de termos, com base nas diretrizes do Conselho Internacional de Enfermeiros. os 262 termos validados constituíram um banco de termos a partir do qual foram desenvolvidos 56 diagnósticos de enfermagem. Desses, 33 foram validados por um grupo de 26 peritos, e classificados nas três categorias do Modelo de Cuidados para Preservação da Dignidade: preocupações relacionadas com a doença (21); repertório de conservação da dignidade (9); inventário da dignidade social (3). dos 33 diagnósticos validados, 18 deles poderão ser incluídos na atualização do Catálogo da Classificação Internacional para a Prática de Enfermagem - cuidados paliativos para uma morte digna. O estudo contribui para subsidiar o enfermeiro no raciocínio clínico e na tomada de decisão. construir y validar diagnósticos de enfermería para personas en cuidados paliativos, fundamentados en el Modelo de Cuidados para Preservación de la Dignidad y en la Clasificación Internacional para la Práctica de Enfermería. estudio metodológico operacionalizado en dos etapas: 1) construcción del banco de términos relevantes, clínicamente y culturalmente, para la asistencia de enfermería a la persona en cuidados paliativos y 2) construcción de diagnósticos de enfermería a partir del banco de términos, con base en las directrices del Consejo Internacional de Enfermeros. los 262 términos validados constituyeron un banco de términos a partir del cual fueron desarrollados 56 diagnósticos de enfermería. De esos, 33 fueron validados por un grupo de 26 peritos, y clasificados en las tres categorías del Modelo de Cuidados para Preservación de la Dignidad: preocupaciones relacionadas con la enfermedad (21); repertorio de conservación de la dignidad (9); inventario de la dignidad social (3). de los 33 diagnósticos validados, 18 de ellos podrán ser incluidos en la actualización del Catálogo de la Clasificación Internacional para la Práctica de Enfermería - cuidados paliativos para una muerte digna. El estudio contribuye para auxiliar al enfermero en el raciocinio clínico y en la toma de decisiones.
NASA Astrophysics Data System (ADS)
Medina-Barrios, M.; Conde-Alvarez, C.; Gay-Garcia, C.
2007-05-01
El impacto de la variabilidad y cambio climáticos, afectan el potencial agrícola de la Región Sur de Tamaulipas. Además de los cambios estacionales, bajos rendimientos agrícolas, el manejo de los cultivos y las políticas locales de producción, existe la incertidumbre del mercado regional para los pequeños y grandes productores. La diversificación agrícola ha sido una alternativa para enfrentar las condiciones imperantes en esta región. Pero ésta ha provocado la fragmentación territorial, por lo que sólo algunos productores logran competir en un mercado nacional. Existe una preocupación generalizada por buscar soluciones que permitan que la población que es afectada por la inseguridad de la producción agrícola y económica, pueda adaptarse a las variaciones climáticas que afectan el proceso productivo. La seguridad alimentaría queda sujeta a la fluctuación de las importaciones para los sectores básicos y a las estrategias mercantiles de empresas trasnacionales. La percepción local sugiere un número creciente de eventos climatológicos extremos, constantes y severos en los últimos 20 años, con el aumento creciente de pérdidas económicas. El análisis se centra en la disponibilidad de agua, agregándose un aspecto de capital importancia como es la variabilidad interanual de la lluvia, que condiciona muy fuertemente el riesgo agrícola en el trópico seco, siendo ésta la que determina el momento de inicio de la estación favorable para el crecimiento y su duración. En este trabajo se han obtenido modelos de la distribución espacial de la precipitación y temperaturas, para el escenario base 1961-1990, el escenario actual 1971-2000, para algunos años El Niño y La Niña, así como para los escenarios de Cambio Climático HADLEY, ECHAM y GFDL, con escenarios A2 y B2, para las décadas de los 20s y 50s, para establecer el inicio y duración de la Estación de Crecimiento, utilizando Sistemas de Información Geográfica (ArcView). Estos resultados serán utilizados por los administradores de las decisiones locales, para estrategias de manejo y para la difusión entre los habitantes, de tal manera que esto les permita establecer prioridades en las medidas de mitigación, y formular las posibilidades de adaptación.
An "adiabatic-hindered-rotor" treatment allows para-H(2) to be treated as if it were spherical.
Li, Hui; Roy, Pierre-Nicholas; Le Roy, Robert J
2010-09-14
In para-H(2)-{molecule} interactions, the common assumption that para-H(2) may be treated as a spherical particle is often substantially in error. For example, quantum mechanical eigenvalues on a full four-dimensional (4D) potential energy surface for para H(2)-{linear molecule} species often differ substantially from those calculated from the corresponding two-dimensional (2D) surface obtained by performing a simple spherical average over the relative orientations of the H(2) moiety. However, use of an "adiabatic-hindered-rotor" approximation can yield an effective 2D surface whose spectroscopic properties are an order of magnitude closer to those yielded by a full 4D treatment.
The Douro estuarine plume: Detection, processes and dynamics =
NASA Astrophysics Data System (ADS)
Mendes, Renato Paulo dos Santos
O Douro e um dos maiores rios da Peninsula Iberica, constituindo a maior descarga de agua doce para o Oceano Atlântico na costa noroeste portuguesa. A sua pluma estuarina tem particular relevância na dinâmica costeira e na modulacao de fenomenos biogeoquimicos. Sao objetivos desta dissertacao contribuir para a compreensao dos processos fisicos associados a geracao e propagacao da pluma estuarina do Rio Douro no oceano, assim como para o conhecimento dos seus padroes de dispersao e da forma como estes alteram a hidrologia e a circulacao costeira, considerando os agentes forcadores tipicos deste fenomeno (caudal fluvial, vento e mare) e indices climaticos relevantes. Para concretizacao destes objetivos foram desenvolvidas e aplicadas metodologias inovadoras de processamento de dados de detecao remota, assim como novas implementacoes estuarinas e costeiras de modelos numericos. Atraves de imagens MODIS, otimizadas para o estudo de fenomenos costeiros, efetuou-se uma detecao rigorosa da pluma. Identificou-se uma relacao entre o sinal turbido nLw555 e o caudal, demonstrando-se este produto como um bom proxy para a observacao da pluma no oceano. As escalas temporais e espaciais da pluma foram caraterizadas atraves destas imagens, combinadas com dados de caudal fluvial, mare, vento e precipitacao, e tambem com indices climaticos relevantes. Para compreender a propagacao da pluma e caracterizar a sua dinâmica e impacto na circulacao costeira, foi desenvolvida uma aplicacao 3D de modelos estuarinos e costeiros com malhas aninhadas de resolucao variavel. Definiramse e analisaram-se diferentes cenarios de vento e descarga fluvial. A interacao da pluma do Rio Douro e do Minho foi ainda analisada atraves dos resultados de simulacoes baseadas num evento de inverno. Os compositos turbidos mostraram que a pluma e facilmente detetada quando o caudal e maior que 500 m3 s??1. A descarga fluvial e o vento sao os principais forcadores da sua propagacao, enquanto a mare e apenas importante na regiao proxima a embocadura do estuario. Observaram-se relacoes a uma escala interanual entre a turbidez da pluma e os indices climaticos East Atlantic e NAO, com uma correlacao maxima identificada com 1 e 3 meses de desfasamento, respetivamente. Com base nos resultados das simulacoes efetuadas, a pluma e classificada como de larga escala e de advecao superficial, apresentando caracteristicas de uma pluma prototipica. Em condicoes de caudal moderado a elevado, a descarga estuarina e suficiente para gerar uma corrente costeira para norte sem acao do vento. Em eventos de ventos leste, a propagacao da pluma e similar ao caso sem vento, com um aumento da velocidade da corrente. Uma corrente costeira para sul e unicamente identificada sob condicoes de forte vento de oeste. Ventos de norte tendem a estender a pluma para o largo, com uma inclinacao na direcao sudoeste, enquanto ventos de sul intensificam a corrente para norte, sendo a mistura das plumas do Douro e do Minho uma consequencia possivel. A analise desta interacao apontou a contribuicao do Douro como importante na estabilizacao da WIBP e nas trocas de agua entre o oceano e as Rias Baixas. A interacao da pluma do Douro com estuarios localizados a sul da sua foz e a confirmacao in situ da recirculacao observada nos resultados numericos afiguram-se como temas relevantes para investigacoes futuras. None
DOE Office of Scientific and Technical Information (OSTI.GOV)
Lyon, A. L.; Kowalkowski, J. B.; Jones, C. D.
ParaView is a high performance visualization application not widely used in High Energy Physics (HEP). It is a long standing open source project led by Kitware and involves several Department of Energy (DOE) and Department of Defense (DOD) laboratories. Futhermore, it has been adopted by many DOE supercomputing centers and other sites. ParaView is unique in speed and efficiency by using state-of-the-art techniques developed by the academic visualization community that are often not found in applications written by the HEP community. In-situ visualization of events, where event details are visualized during processing/analysis, is a common task for experiment software frameworks.more » Kitware supplies Catalyst, a library that enables scientific software to serve visualization objects to client ParaView viewers yielding a real-time event display. Connecting ParaView to the Fermilab art framework will be described and the capabilities it brings discussed.« less
Infrared spectra of seeded hydrogen clusters: (para-H2)N-N2O and (ortho-H2)N-N2O, N = 2-13.
Tang, Jian; McKellar, A R W
2005-09-15
High-resolution infrared spectra of clusters containing para-H2 and/or ortho-H2 and a single nitrous oxide molecule are studied in the 2225-cm(-1) region of the upsilon1 fundamental band of N2O. The clusters are formed in pulsed supersonic jet expansions from a cooled nozzle and probed using a tunable infrared diode laser spectrometer. The simple symmetric rotor-type spectra generally show no resolved K structure, with prominent Q-branch features for ortho-H2 but not para-H2 clusters. The observed vibrational shifts and rotational constants are reported. There is no obvious indication of superfluid effects for para-H2 clusters up to N=13. Sharp transitions due to even larger clusters are observed, but no definite assignments are possible. Mixed (para-H2)N-(ortho-H2)M-N2O cluster line positions can be well predicted by linear interpolation between the corresponding transitions of the pure clusters.
NASA Technical Reports Server (NTRS)
Conrath, B. J.; Gierasch, P. J.
1984-01-01
A detailed analysis of the Voyager infrared spectrometer measurements on Jupiter's atmosphere is presented, and possible implications of para hydrogen disequilibrium for the energetics and dynamics of that atmosphere are examined. The method of data analysis is described, and results for the large scale latitude variation of the para hydrogen fraction are presented. The Jovian results show pronounced latitude variation, and are compared with other parameters including wind fields, thermal structure, and various indicators of atmospheric clouds. The problem of equilibration rate is reexamined, and it is concluded that on Jupiter the equilibration time is longer than the radiative time constant at the level of emission to space, but that this inequality reverses at greater depths. A model for the interaction of fluid motions with the ortho-para conversion process is presented, and a consistent mixing length theory for the reacting ortho-para mixture is developed. Several implications of the Jovian data for atmospheric energetics and stability on the outer planets are presented.
Smith, Kyle K G; Poulsen, Jens Aage; Cunsolo, A; Rossky, Peter J
2014-01-21
The dynamic structure factor of liquid para-hydrogen and ortho-deuterium in corresponding thermodynamic states (T = 20.0 K, n = 21.24 nm(-3)) and (T = 23.0 K, n = 24.61 nm(-3)), respectively, has been computed by both the Feynman-Kleinert linearized path-integral (FK-LPI) and Ring-Polymer Molecular Dynamics (RPMD) methods and compared with Inelastic X Ray Scattering spectra. The combined use of computational and experimental methods enabled us to reduce experimental uncertainties in the determination of the true sample spectrum. Furthermore, the refined experimental spectrum of para-hydrogen and ortho-deuterium is consistently reproduced by both FK-LPI and RPMD results at momentum transfers lower than 12.8 nm(-1). At larger momentum transfers the FK-LPI results agree with experiment much better for ortho-deuterium than for para-hydrogen. More specifically we found that for k ∼ 20.0 nm(-1) para-hydrogen provides a test case for improved approximations to quantum dynamics.
Cooling by conversion of para to ortho-hydrogen
NASA Technical Reports Server (NTRS)
Sherman, A. (Inventor)
1983-01-01
The cooling capacity of a solid hydrogen cooling system is significantly increased by exposing vapor created during evaporation of a solid hydrogen mass to a catalyst and thereby accelerating the endothermic para-to-ortho transition of the vapor to equilibrium hydrogen. Catalyst such as nickel, copper, iron or metal hydride gels of films in a low pressure drop catalytic reactor are suitable for accelerating the endothermic para-to-ortho conversion.
Detection of the MW Transition Between Ortho and Para States
NASA Astrophysics Data System (ADS)
Kanamori, Hideto; Dehghani, Zeinab Tafti; Mizoguchi, Asao; Endo, Yasuki
2017-06-01
Thorough the detailed analysis of the hyperfine resolved rotational transitions, we have been pointed out that there exists not a little interaction between ortho and para states in the molecular Hamiltonian of S_2Cl_2. Using the ortho-para mixed molecular wavefunctions derived from the Hamiltonian, we calculated the transition moment and frequency of the ortho-para forbidden transitions in the cm- and mm-wave region, and picked up some promising candidate transitions for the spectroscopic detection. In the experiment, the S_2Cl_2 vapor with Ar buffer gas in a supersonic jet condition was used with FTMW spectrometer at National Chiao Tung University. As a result, seven hyperfine resolved rotational transitions in the cm-wave region were detected as the ortho-para transition at the predicted frequency within the experimental error range. The observed intensity was 10^{-3} smaller than that of an allowed transition, which is also consistent with the prediction. This is the first time the electric dipole transition between ortho and para states has been detected in a free isolated molecule. A. Mizoguchi, S. Ota, H. Kanamori, Y. Sumiyoshi, and Y. Endo, J. Mol. Spectrosc, 250, 86 (2008) Z. T. Dehghani, S. Ota, A. Mizoguchi and H. Kanamori, J. Phys. Chem. A, 117(39), 10041, (2013)
Bonano, J S; Banks, M L; Kolanos, R; Sakloth, F; Barnier, M L; Glennon, R A; Cozzi, N V; Partilla, J S; Baumann, M H; Negus, S S
2015-05-01
Methcathinone (MCAT) is a potent monoamine releaser and parent compound to emerging drugs of abuse including mephedrone (4-CH3 MCAT), the para-methyl analogue of MCAT. This study examined quantitative structure-activity relationships (QSAR) for MCAT and six para-substituted MCAT analogues on (a) in vitro potency to promote monoamine release via dopamine and serotonin transporters (DAT and SERT, respectively), and (b) in vivo modulation of intracranial self-stimulation (ICSS), a behavioural procedure used to evaluate abuse potential. Neurochemical and behavioural effects were correlated with steric (Es ), electronic (σp ) and lipophilic (πp ) parameters of the para substituents. For neurochemical studies, drug effects on monoamine release through DAT and SERT were evaluated in rat brain synaptosomes. For behavioural studies, drug effects were tested in male Sprague-Dawley rats implanted with electrodes targeting the medial forebrain bundle and trained to lever-press for electrical brain stimulation. MCAT and all six para-substituted analogues increased monoamine release via DAT and SERT and dose- and time-dependently modulated ICSS. In vitro selectivity for DAT versus SERT correlated with in vivo efficacy to produce abuse-related ICSS facilitation. In addition, the Es values of the para substituents correlated with both selectivity for DAT versus SERT and magnitude of ICSS facilitation. Selectivity for DAT versus SERT in vitro is a key determinant of abuse-related ICSS facilitation by these MCAT analogues, and steric aspects of the para substituent of the MCAT scaffold (indicated by Es ) are key determinants of this selectivity. © 2014 The British Pharmacological Society.
A novel method to guide classification of para swimmers with limb deficiency.
Hogarth, Luke; Payton, Carl; Van de Vliet, Peter; Connick, Mark; Burkett, Brendan
2018-05-30
The International Paralympic Committee has directed International Federations that govern Para sports to develop evidence-based classification systems. This study defined the impact of limb deficiency impairment on 100 m freestyle performance to guide an evidence-based classification system in Para Swimming, which will be implemented following the 2020 Tokyo Paralympic games. Impairment data and competitive race performances of 90 international swimmers with limb deficiency were collected. Ensemble partial least squares regression established the relationship between relative limb length measures and competitive 100 m freestyle performance. The model explained 80% of the variance in 100 m freestyle performance, and found hand length and forearm length to be the most important predictors of performance. Based on the results of this model, Para swimmers were clustered into four-, five-, six- and seven-class structures using nonparametric kernel density estimations. The validity of these classification structures, and effectiveness against the current classification system, were examined by establishing within-class variations in 100 m freestyle performance and differences between adjacent classes. The derived classification structures were found to be more effective than current classification based on these criteria. This study provides a novel method that can be used to improve the objectivity and transparency of decision-making in Para sport classification. Expert consensus from experienced coaches, Para swimmers, classifiers and sport science and medicine personnel will benefit the translation of these findings into a revised classification system that is accepted by the Para swimming community. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Bonano, J S; Banks, M L; Kolanos, R; Sakloth, F; Barnier, M L; Glennon, R A; Cozzi, N V; Partilla, J S; Baumann, M H; Negus, S S
2015-01-01
Background and Purpose Methcathinone (MCAT) is a potent monoamine releaser and parent compound to emerging drugs of abuse including mephedrone (4-CH3 MCAT), the para-methyl analogue of MCAT. This study examined quantitative structure–activity relationships (QSAR) for MCAT and six para-substituted MCAT analogues on (a) in vitro potency to promote monoamine release via dopamine and serotonin transporters (DAT and SERT, respectively), and (b) in vivo modulation of intracranial self-stimulation (ICSS), a behavioural procedure used to evaluate abuse potential. Neurochemical and behavioural effects were correlated with steric (Es), electronic (σp) and lipophilic (πp) parameters of the para substituents. Experimental Approach For neurochemical studies, drug effects on monoamine release through DAT and SERT were evaluated in rat brain synaptosomes. For behavioural studies, drug effects were tested in male Sprague-Dawley rats implanted with electrodes targeting the medial forebrain bundle and trained to lever-press for electrical brain stimulation. Key Results MCAT and all six para-substituted analogues increased monoamine release via DAT and SERT and dose- and time-dependently modulated ICSS. In vitro selectivity for DAT versus SERT correlated with in vivo efficacy to produce abuse-related ICSS facilitation. In addition, the Es values of the para substituents correlated with both selectivity for DAT versus SERT and magnitude of ICSS facilitation. Conclusions and Implications Selectivity for DAT versus SERT in vitro is a key determinant of abuse-related ICSS facilitation by these MCAT analogues, and steric aspects of the para substituent of the MCAT scaffold (indicated by Es) are key determinants of this selectivity. PMID:25438806
Bioavailability of paracetamol with/without caffeine in Egyptian patients with hepatitis C virus.
El-Lakkany, Naglaa M; Hendawy, Ahmed S; Seif El-Din, Sayed H; Ashour, Ahmed A; Atta, Raafat; Abdel-Aziz, Abdel-Aziz H; Mansour, Ahmed M; Botros, Sanaa S
2016-05-01
This study investigates the involvement of liver dysfunction in the modulation of paracetamol pharmacokinetic profile in genotype-4 HCV patients treated with either paracetamol alone (Para) or in combination with caffeine (Para-Caf). Twenty healthy volunteers and 20 Child-Pugh B HCV patients, each divided into two equal subgroups, were examined, whose liver/kidney functions were correlated with their main clinical manifestation. After an overnight fasting, healthy and hepatic subjects received either a single dose of Para (1000 mg paracetamol) or Para-Caf (1000 mg paracetamol/130 mg caffeine). Two milliliters of saliva samples were collected prior to and at different time-intervals after drug administration and analyzed using HPLC. There was a noticeable increase in the mean concentration time profile of salivary paracetamol concentrations in hepatic patients, with concomitant decrease in paracetamol clearance (CLT), along with induction in the primary pharmacokinetic (PK) parameters, C max, AUC(0-8 h) and AUC(0-∞) (by about 95, 82, and 64 %, respectively, after treatment with Para, and 98, 96, and 101 %, respectively, after treatment with Para-Caf), when compared with the corresponding parameters in healthy subjects. Additionally, the healthy subjects treated with Para-Caf exhibited bioinequivalent increase in C max, K a, and t 1/2 with decrease in T max when compared with the healthy individuals treated with Para alone. A similar pattern was recorded in hepatic patients after addition of caffeine to paracetamol, with even augmented significant increase in K a and t 1/2 (by 100 and 32 %, respectively). Liver dysfunction modified the PK of paracetamol expressed as earlier effective paracetamol concentration, with obvious decrease in its clearance. Caffeine induced faster absorption (evidenced by shorter T max and higher K a) and prolonged t 1/2 of paracetamol, the effects that were more profound in hepatic patients. Further studies are needed to evaluate the influence of liver damage on paracetamol pharmacokinetics whenever repeated dosing is applied, to avoid possible drug accumulation.
Gehrke, Iris; Razavi, Regina; Poll-Wolbeck, Simon Jonas; Berkessel, Albrecht; Hallek, Michael; Kreuzer, Karl-Anton
2011-10-01
Chronic Lymphocytic Leukemia (CLL) is not curable in patients that are not eligible for allogeneic stem cell transplantation. Therefore, new treatment options are highly desirable. Chemically modified nonsteroidal anti-inflammatory drugs (NSAIDs), such as nitric-oxide-donating acetylsalicylic acid (NO-ASA), have been described to possess antineoplastic capacity. Recently, we could demonstrate a potent apoptosis induction in primary CLL cells in vitro and tumor growth inhibition by para-NO-ASA in a xenograft mouse model. However, little is known about the impact of positional isomerism of NO-ASA on its antineoplastic capacity in CLL. Primary CLL cells were treated with the meta-or para-isomer of NO-ASA at varying concentrations and durations. Viability was assessed flow cytometrically by annexin V-FITC/PI staining and by CellTiter-Glo luminescence cell viability assay. Caspase and PARP cleavage as well as involvement of β-catenin/Lef-1 signaling was determined by immunoblotting. For caspase inhibition, BD™ ApoBlock was used. Nude mice were xenografted with JVM3 cells and treated with meta-NO-ASA, para-NO-ASA or vehicle control. The meta-isomer was entirely ineffective in inducing CLL cell apoptosis in concentrations up to 100 μM, while para-NO-ASA acted in the low micromolar range. meta-NO-ASA, in contrast to para-NO-ASA, did not alter caspase activity. While para-NO-ASA action involved inhibition of β-catenin/Lef-1 signaling, meta-NO-ASA did not show any impact on this signaling pathway. Further, meta-NO-ASA did not significantly reduce tumor growth in a CLL xenograft mouse model, while para-NO-ASA was highly potent. We conclude that positional isomerism is crucial for the antineoplastic effect of NO-ASA in CLL. It can be suggested that the para-isomer, but not the meta-isomer, generates a chemical structure which is essential for the neoplastic effect of NO-ASA.
Gehrke, Iris; Razavi, Regina; Poll-Wolbeck, Simon Jonas; Berkessel, Albrecht; Hallek, Michael; Kreuzer, Karl-Anton
2011-01-01
Background: Chronic Lymphocytic Leukemia (CLL) is not curable in patients that are not eligible for allogeneic stem cell transplantation. Therefore, new treatment options are highly desirable. Chemically modified nonsteroidal anti-inflammatory drugs (NSAIDs), such as nitric-oxide-donating acetylsalicylic acid (NO-ASA), have been described to possess antineoplastic capacity. Recently, we could demonstrate a potent apoptosis induction in primary CLL cells in vitro and tumor growth inhibition by para-NO-ASA in a xenograft mouse model. However, little is known about the impact of positional isomerism of NO-ASA on its antineoplastic capacity in CLL. Methods: Primary CLL cells were treated with the meta-or para-isomer of NO-ASA at varying concentrations and durations. Viability was assessed flow cytometrically by annexin V-FITC/PI staining and by CellTiter-Glo luminescence cell viability assay. Caspase and PARP cleavage as well as involvement of β-catenin/Lef-1 signaling was determined by immunoblotting. For caspase inhibition, BD™ ApoBlock was used. Nude mice were xenografted with JVM3 cells and treated with meta-NO-ASA, para-NO-ASA or vehicle control. Results: The meta-isomer was entirely ineffective in inducing CLL cell apoptosis in concentrations up to 100 μM, while para-NO-ASA acted in the low micromolar range. meta-NO-ASA, in contrast to para-NO-ASA, did not alter caspase activity. While para-NO-ASA action involved inhibition of β-catenin/Lef-1 signaling, meta-NO-ASA did not show any impact on this signaling pathway. Further, meta-NO-ASA did not significantly reduce tumor growth in a CLL xenograft mouse model, while para-NO-ASA was highly potent. Conclusion: We conclude that positional isomerism is crucial for the antineoplastic effect of NO-ASA in CLL. It can be suggested that the para-isomer, but not the meta-isomer, generates a chemical structure which is essential for the neoplastic effect of NO-ASA. PMID:23556096
Landeiro, Maria José Lumini; Peres, Heloísa Helena Ciqueto; Martins, Teresa Vieira
2016-08-18
to assess the contributions of interactive educational technology "Caring for Dependent People" in the development of knowledge to family caregivers of dependent people in a household context and their satisfaction in its use. quasi-experimental study, not randomized, of the before and after type, with a convenience sample of 65 family caregivers, from two Medicine services of a hospital in Porto, Portugal. The Control Group consisted of 33 family caregivers and the Experimental Group of 32, identified by consecutive sampling. The experimental group had access to educational technology at home. Data were collected by socio-demographic, satisfaction and evaluation of knowledge questionnaire, about how to feed by nasogastric tube, positioning and transferring the dependent person. The assessment in both groups had two moments: initial, during hospitalization and one month after discharge. the experimental group had a larger increase in knowledge related to the use of the educational technology. In the control group the knowledge did not differ in the two evaluation time points. these results confirm the improvement of interactive educational technologies and in the training of family caregivers to care for dependents. This technology successfully met the technical quality and learning needs of caregivers, and was considered easy and stimulating. avaliar os contributos da tecnologia educacional interativa "Cuidar de Pessoas Dependentes" no desenvolvimento de conhecimentos aos familiares cuidadores de pessoas dependentes, no contexto domiciliário e a satisfação no seu uso. estudo quasi-experimental, não randomizado, do tipo antes e depois, com amostra de conveniência constituída por 65 familiares cuidadores, de dois Serviços de Medicina de um hospital do Porto, Portugal. O Grupo Controle foi constituído por 33 familiares cuidadores e o Grupo Experimental por 32, identificados por amostragem consecutiva. O grupo experimental teve Acesso à tecnologia educacional no domicílio. Os dados foram colhidos por questionário sociodemográfico de satisfação e avaliação de conhecimentos sobre como alimentar por sonda nasogástrica, posicionar e transferir a pessoa dependente. A avaliação nos dois grupos teve dois momentos: inicial, no internamento e um mês após alta hospitalar. registou-se no grupo experimental um ganho maior de conhecimentos relacionado com a utilização da tecnologia educacional. No grupo controle os conhecimentos não variaram nos dois momentos de avaliação. esses resultados corroboraram na melhoria das tecnologias educacionais interativas e na capacitação dos familiares cuidadores para cuidar de pessoas dependentes. Essa tecnologia atendeu satisfatoriamente as necessidades de qualidade técnica e de aprendizagem dos cuidadores, sendo considerada fácil e estimulante. evaluar las contribuciones de la tecnología educativa interactiva "Cuidar de personas dependientes" en el desarrollo de conocimiento de los familiares cuidadores de personas dependientes en el contexto domiciliario y la satisfacción en su uso. estudio cuasi-experimental, no aleatorizado, de tipo antes-después, con una muestra de 65 familiares cuidadores, de dos servicios de Medicina de un hospital en Oporto, Portugal. El grupo control consistió en 33 familiares cuidadores y el grupo experimental en 32, identificados por muestreo consecutivo. El grupo experimental tuvo acceso a la tecnología de la educación en el hogar. Los datos fueron recolectados por cuestionario sociodemográfico de satisfacción y evaluación de los conocimientos sobre cómo alimentar por sonda nasogástrica, posicionar y transferir a la persona dependiente. La evaluación en ambos grupos tuvo dos etapas: inicial, durante la hospitalización y un mes después del alta. se registraron en el grupo experimental aumentos del conocimiento relacionado con el uso de la tecnología educativa. En el grupo control el conocimiento no difirió en los dos puntos en el tiempo. estos resultados confirmaron el beneficio de las tecnologías interactivas educativas y la formación de los familiares cuidadores para el cuidado de personas dependientes. Esta tecnología cumplió con éxito con las necesidades técnicas y de calidad de aprendizaje de los cuidadores, siendo considerada fácil y estimulante.
Correlation between classification in risk categories and clinical aspects and outcomes.
Oliveira, Gabriella Novelli; Vancini-Campanharo, Cássia Regina; Lopes, Maria Carolina Barbosa Teixeira; Barbosa, Dulce Aparecida; Okuno, Meiry Fernanda Pinto; Batista, Ruth Ester Assayag
2016-12-08
to correlate classification in risk categories with the clinical profiles, outcomes and origins of patients. analytical cross-sectional study conducted with 697 medical forms of adult patients. The variables included: age, sex, origin, signs and symptoms, exams, personal antecedents, classification in risk categories, medical specialties, and outcome. The Chi-square and likelihood ratio tests were used to associate classifications in risk categories with origin, signs and symptoms, exams, personal antecedents, medical specialty, and outcome. most patients were women with an average age of 44.5 years. Pain and dyspnea were the symptoms most frequently reported while hypertension and diabetes mellitus were the most common comorbidities. Classifications in the green and yellow categories were the most frequent and hospital discharge the most common outcome. Patients classified in the red category presented the highest percentage of ambulance origin due to surgical reasons. Those classified in the orange and red categories also presented the highest percentage of hospitalization and death. correlation between clinical aspects and outcomes indicate there is a relationship between the complexity of components in the categories with greater severity, evidenced by the highest percentage of hospitalization and death. correlacionar as categorias de classificação de risco com perfil clínico, desfechos e procedência. estudo transversal analítico realizado com 697 fichas de atendimento de pacientes adultos. Variáveis estudadas: idade, sexo, procedência, sinais e sintomas, exames, antecedentes pessoais, categorias da classificação de risco, especialidade médica de atendimento e desfecho. Para associar as categorias de classificação de risco com procedência, sinais e sintomas, exames, antecedentes pessoais, especialidade médica e desfecho, utilizaram-se o teste qui-quadrado e a razão de verossimilhança. pacientes do sexo feminino foram a maioria e com média de idade 44,5 anos. Dor e dispneia foram os sintomas mais relatados e hipertensão arterial e diabetes mellitus foram as comorbidades. As categorias de classificação verde e amarela foram as mais frequentes, e a alta hospitalar foi o desfecho mais observado. Pacientes classificados na categoria vermelha apresentaram maior porcentual de procedência de ambulância, por motivos cirúrgicos. Os classificados nas categorias laranja e vermelha apresentaram maior porcentual de internação e óbito. a correlação entre os aspectos clínicos e desfechos permitiu inferir que existe uma relação entre a complexidade dos componentes estudados nas categorias de maior gravidade, evidenciado pelo maior porcentual de internação e óbito. correlacionar las categorías de clasificación de riesgo con perfil clínico, resultados y procedencia. estudio transversal analítico, realizado con 697 fichas de atención de pacientes adultos. Variables estudiadas: edad, sexo, procedencia, señales y síntomas, exámenes, antecedentes personales, categorías de la clasificación de riesgo, especialidad médica de atención y resultado. Para asociar las categorías de clasificación de riesgo con procedencia, señales y síntomas, exámenes, antecedentes personales, especialidad médica y resultado, se utilizaron el test chi-cuadrado y la razón de verosimilitud. pacientes del sexo femenino fueron la mayoría, con promedio de edad 44,5 años. El dolor y disnea fueron los síntomas más relatados e la hipertensión arterial y diabetes mellitus fueron las comorbilidades. Las categorías de clasificación verde y amarillo fueron las más frecuentes, y el alta hospitalaria fue el resultado más observado. Pacientes clasificados en la categoría roja presentaron mayor porcentaje de procedencia por ambulancia, por motivos quirúrgicos. Los clasificados en las categorías naranja y roja presentaron mayor porcentaje de internación y muerte. la correlación entre los aspectos clínicos y resultados permitió inferir que existe una relación entre la complejidad de los componentes estudiados en las categorías de mayor gravedad, evidenciado por el mayor porcentaje de internación y muerte.
USE OF TRANEXAMIC ACID IN TRAUMA PATIENTS: AN ANALYSIS OF COST-EFFECTIVENESS FOR USE IN BRAZIL.
Pinto, Marcelo A; Silva, Jair G da; Chedid, Aljamir D; Chedid, Marcio F
2016-01-01
Use of tranexamic acid (TXA) in trauma has been the subject of growing interest by researchers and health professionals. However, there are still several open questions regarding its use. In some aspects medical literature is controversial. The points of disagreement among experts include questions such as: Which patients should receive TXA in trauma? Should treatment be performed in the pre-hospital environment? Is there any need for laboratory parameters before starting TXA treatment? What is the drug safety profile? The main issue on which there is still no basis in literature is: What is the indication for treatment within massive transfusion protocols? Answer the questions proposed based on critical evaluation of the evidence gathered so far and carry out a study of cost-effectiveness of TXA use in trauma adapted to the Brazilian reality. A literature review was performed through searching Pubmed.com, Embase and Cab Abstract by headings "tranexamic AND trauma", in all languages, yielding 426 articles. Manuscripts reporting on TXA utilization for elective procedures were excluded, remaining 79 articles. Fifty-five articles were selected, and critically evaluated in order to answer study questions. The evaluation of cost effectiveness was performed using CRASH-2 trial data and Brazilian official population data. TXA is effective and efficient, and should be administered to a wide range of patients, including those with indication evaluated in research protocols and current indication criteria for TXA should be expanded. As for the cost-effectiveness, the TXA proved to be cost-effective with an average cost of R$ 61.35 (currently US$16) per year of life saved. The use of TXA in trauma setting seems to be effective, efficient and cost-effective in the various groups of polytrauma patients. Its use in massive transfusion protocols should be the subject of further investigations. O uso do ácido tranexâmico (TXA) no trauma tem sido alvo de interesse crescente por parte de pesquisadores e profissionais de saúde. No entanto, seus benefícios ainda não foram completamente definidos. Os pontos de divergência entre especialistas incluem questões como: quais pacientes devem receber TXA no trauma? O tratamento deve ser realizado em ambiente pré-hospitalar? Há necessidade de exames laboratoriais para indicar o tratamento? Qual o perfil de segurança da droga? A principal questão para a qual ainda não existe qualquer embasamento na literatura é: qual a indicação do tratamento dentro de protocolos de transfusão maciça? Responder às questões propostas, com base em avaliação crítica da evidência reunida até o momento e realizar estudo de custo-efetividade do uso do TXA no trauma adaptado à realidade brasileira. Foi realizada revisão da literatura através de estratégia de busca: PubMed.com, Embase e no Cab Abstract pelos descritores "tranexamic AND trauma", em todos idiomas, resultando em 426 artigos. Foram excluídos aqueles relativos às operações eletivas, restando 79 artigos. Cinquenta e cinco foram selecionados e avaliados criticamente com vistas a responder às questões em estudo. A avaliação de custo-efetividade foi realizada utilizando dados do estudo CRASH-2 e populacionais oficiais brasileiros. Através da análise da evidência disponível chegou-se à conclusão de que o ácido tranexâmico é tratamento eficaz e efetivo, devendo ser administrado à ampla gama de pacientes, incluindo todos aqueles com indicação já avaliada nos protocolos de pesquisa publicados e provavelmente devam-se expandir os critérios de indicação. Quanto à avaliação de custo-efetividade, o TXA mostrou-se bastante custo-eficaz com gasto médio de R$ 61,35 por ano de vida salvo. O uso do ácido tranexâmico no trauma parece ser eficaz, efetivo e custo-eficaz nos diversos grupos de pacientes politraumatizados. Seu uso em protocolos de transfusão maciça ainda deve ser objeto de futuras investigações.
Accuracy of a pediatric early warning score in the recognition of clinical deterioration.
Miranda, Juliana de Oliveira Freitas; Camargo, Climene Laura de; Nascimento, Carlito Lopes; Portela, Daniel Sales; Monaghan, Alan
2017-07-10
to evaluate the accuracy of the version of the Brighton Pediatric Early Warning Score translated and adapted for the Brazilian context, in the recognition of clinical deterioration. a diagnostic test study to measure the accuracy of the Brighton Pediatric Early Warning Score for the Brazilian context, in relation to a reference standard. The sample consisted of 271 children, aged 0 to 10 years, blindly evaluated by a nurse and a physician, specialists in pediatrics, with interval of 5 to 10 minutes between the evaluations, for the application of the Brighton Pediatric Early Warning Score for the Brazilian context and of the reference standard. The data were processed and analyzed using the Statistical Package for the Social Sciences and VassarStats.net programs. The performance of the Brighton Pediatric Early Warning Score for the Brazilian context was evaluated through the indicators of sensitivity, specificity, predictive values, area under the ROC curve, likelihood ratios and post-test probability. the Brighton Pediatric Early Warning Score for the Brazilian context showed sensitivity of 73.9%, specificity of 95.5%, positive predictive value of 73.3%, negative predictive value of 94.7%, area under Receiver Operating Characteristic Curve of 91.9% and the positive post-test probability was 80%. the Brighton Pediatric Early Warning Score for the Brazilian context, presented good performance, considered valid for the recognition of clinical deterioration warning signs of the children studied. avaliar a acurácia da versão traduzida e adaptada do Brighton Paediatric Early Warning Score para o contexto brasileiro, no reconhecimento da deterioração clínica. estudo de teste diagnóstico para medir a acurácia do Brighton Paediatric Early Warning Score, para o contexto brasileiro, em relação a um padrão de referência. A amostra foi composta por 271 crianças de 0 a 10 anos, avaliadas de forma cega por uma enfermeira e um médico, especialistas em pediatria, com intervalo de 5 a 10 minutos entre as avaliações, para aplicação do Brighton Paediatric Early Warning Score, para o contexto brasileiro e do padrão de referência. Os dados foram processados e analisados nos programas Statistical Package for the Social Sciences e VassarStats.net. O desempenho do Brighton Paediatric Early Warning Score para o contexto brasileiro foi avaliado por meio dos indicadores de sensibilidade, especificidade, valores preditivos, área sob a curva ROC, razões de probabilidades e probabilidade pós-teste. o Brighton Paediatric Early Warning Score para o contexto brasileiro apresentou sensibilidade de 73,9%, especificidade de 95,5%, valor preditivo positivo de 73,3%, valor preditivo negativo de 94,7%, área sob a Receiver Operating Characteristic Curve de 91,9% e a probabilidade pós-teste positivo foi de 80%. o Brighton Paediatric Early Warning Score, para o contexto brasileiro, apresentou bom desempenho, considerado válido para o reconhecimento de sinais de alerta de deterioração clínica das crianças estudadas. evaluar la precisión de la versión traducida y adaptada del Brighton Paediatric Early Warning Score para el contexto brasileño, en el reconocimiento de la deterioración clínica. estudio de test diagnóstico para medir la precisión del Brighton Paediatric Early Warning Score para el contexto brasileño, en relación a un estándar de referencia. La muestra estuvo compuesta por 271 niños de 0 a 10 años, evaluadas de forma ciega por especialistas en pediatría, una enfermera y un médico, con intervalo de 5 a 10 minutos entre las evaluaciones, para aplicación del Brighton Paediatric Early Warning Score para el contexto brasileño. Los datos fueron procesados y analizados en los programas Statistical Package for the Social Sciences y VassarStats.net. El desempeño del Brighton Paediatric Early Warning Score para el contexto brasileño fue evaluado por medio de los indicadores de sensibilidad, especificidad, valores predictivos, área debajo de la curva ROC, razones de probabilidades y probabilidad postest. el Brighton Paediatric Early Warning Score para el contexto brasileño presentó sensibilidad de 73,9%, especificidad de 95,5%, valor predictivo positivo de 73,3%, valor predictivo negativo de 94,7%, área bajo la Receiver Operating Characteristic Curve de 91,9% y la probabilidad postest positivo fue de 80%. el Brighton Paediatric Early Warning Score para el contexto brasileño, presentó buen desempeño, considerado válido para el reconocimiento de señales de alerta de deterioración clínica de los niños estudiados.
Cuauhtemoc Saenz-Romero; Gerald E. Rehfeldt; Nicholas L. Crookston; Pierre Duval; Jean Beaulieu
2009-01-01
El cambio climatico, conocido comunmente como calentamiento global, es el incremento de la temperatura a nivel mundial y los cambios que de ello derivan, causados por el "efecto invernadero" del bioxido de carbono (CO2) y otros gases emitidos a la atmosfera. El uso de combustibles fosiles (carbon y derivados del petroleo, como gasolina, diesel, combustoleo y...
U.S. Department of the Interior Bureau of Land Management
2008-01-01
La posibilidad de perdidas humanas y de propiedad en Nuevo Mexico debido a un incendio forestal ha ido incrementando. Para responder a este peligro, entidades locales, estatales, federales, particulares y sin fines de lucro se han unido para crear Como Reducir la Amenaza de Incendios Forestales, un programa dirigido a los propietarios de casas. Este no es un programa...
Diseño y Operación de un Secador Solar de Madera para Países Tropicales
Brian Bond; Omar Espinoza; Philip Araman
2011-01-01
La madera es usualmente secada a un contenido de humedad especÃfico antes de ser transformada en productos finales. A pesar de que la madera puede ser secada al aire, la humedad ambiental en la mayorÃa de las ubicaciones previene a la madera alcanzar el contenido de humedad necesario para su estabilidad dimensional y adecuado procesamiento, especialmente para usos de...
ERIC Educational Resources Information Center
Mountain Plains Regional Resource Center, Des Moines, IA.
This pamphlet, in Spanish, describes Colorado parents' educational rights under federal and state special education rules and regulations. It addresses: (1) free appropriate public education and termination of services; (2) required prior notice to parents if there is a proposed change or refusal to change a child's special education program; (3)…
Shinitzky, Meir; Elitzur, Avshalom C
2006-09-01
The two hydrogen atoms attached to the carbon in the methylene group are of two different spin configurations, similar to those in the case of water: ortho, where the two proton spins are parallel to each other, and para, where they are antiparallel. The ortho configuration has three degenerate states, while the para configuration is singular, leading to a statistical ratio of these isomers 3:1 ortho/para. Such spin isomers are present in glycine and most chiral amino acids where they may induce broadening of structural zones, a possibility which remains to be assessed. The implications of this neglected possibility could be far-reaching, in particular with respect to protein structure and the origins of biochirality.
Uma grade de perfis teóricos para estrelas massivas em transição
NASA Astrophysics Data System (ADS)
Nascimento, C. M. P.; Machado, M. A.
2003-08-01
Na XXVIII Reunião Anual da Sociedade Astronômica Brasileira (2002) apresentamos uma grade de perfis calculados de acordo com os pontos da trajetória evolutiva de metalicidade solar, Z = 0.02 e taxa de perda de massa () padrão, para estrelas com massa inicial de 25, 40, 60, 85 e 120 massas solares. Estes perfis foram calculados com o auxílio de um código numérico adequado para descrever os ventos de objetos massivos, supondo simetria esférica, estacionaridade e homogeneidade. No presente trabalho, apresentamos a complementação da grade com os perfis teóricos relativos às trajetórias de Z = 0.02 com taxa de perda de massa dobrada em relação a padrão (2´), e de metalicidade Z = 0.008. Para cada ponto das três trajetórias obtemos os perfis teóricos de Ha, Hb, Hg e Hd, e como esperado eles se apresentam em pura emissão, pura absorção ou em P-Cygni. Para valores de taxa de perda de massa muito baixos (~10-7) não há formação de linhas, o que é visto nos primeiros pontos em todas as trajetórias. Em geral, para um mesmo ponto a componente de emissão diminui e a absorção aumenta de Ha para Hd. É verificado que as trajetórias com Z = 0.02 e padrão possuem menos circuitos (loops) do que as com metalicidade Z = 0.02 e 2´ padrão, e seus perfis são, em geral, menos intensos. Em relação a trajetória de Z = 0.008, verifica-se menos circuitos e maior variação em luminosidade, e seus perfis mostram-se em, algumas trajetórias, mais intensos. Verificamos também que, pontos distintos em uma mesma trajetória, apresentam perfis diferentes para valores similares de luminosidade e temperatura efetiva. Sendo assim, uma grade de perfis teóricos parece ser útil para fornecer uma informação preliminar sobre o estágio evolutivo de uma estrela massiva.
Rotational spectra of the van der Waals complexes of molecular hydrogen and OCS.
Yu, Zhenhong; Higgins, Kelly J; Klemperer, William; McCarthy, Michael C; Thaddeus, Patrick; Liao, Kristine; Jäger, Wolfgang
2007-08-07
The a- and b-type rotational transitions of the weakly bound complexes formed by molecular hydrogen and OCS, para-H2-OCS, ortho-H2-OCS, HD-OCS, para-D2-OCS, and ortho-D2-OCS, have been measured by Fourier transform microwave spectroscopy. All five species have ground rotational states with total rotational angular momentum J=0, regardless of whether the hydrogen rotational angular momentum is j=0 as in para-H2, ortho-D2, and HD or j=1 as in ortho-H2 and para-D2. This indicates quenching of the hydrogen angular momentum for the ortho-H2 and para-D2 species by the anisotropy of the intermolecular potential. The ground states of these complexes are slightly asymmetric prolate tops, with the hydrogen center of mass located on the side of the OCS, giving a planar T-shaped molecular geometry. The hydrogen spatial distribution is spherical in the three j=0 species, while it is bilobal and oriented nearly parallel to the OCS in the ground state of the two j=1 species. The j=1 species show strong Coriolis coupling with unobserved low-lying excited states. The abundance of para-H2-OCS relative to ortho-H2-OCS increases exponentially with decreasing normal H2 component in H2He gas mixtures, making the observation of para-H2-OCS in the presence of the more strongly bound ortho-H2-OCS dependent on using lower concentrations of H2. The determined rotational constants are A=22 401.889(4) MHz, B=5993.774(2) MHz, and C=4602.038(2) MHz for para-H2-OCS; A=22 942.218(6) MHz, B=5675.156(7) MHz, and C=4542.960(7) MHz for ortho-H2-OCS; A=15 970.010(3) MHz, B=5847.595(1) MHz, and C=4177.699(1) MHz for HD-OCS; A=12 829.2875(9) MHz, B=5671.3573(7) MHz, and C=3846.7041(6) MHz for ortho-D2-OCS; and A=13 046.800(3) MHz, B=5454.612(2) MHz, and C=3834.590(2) MHz for para-D2-OCS.
Microstructure design of titanate-based electroceramics =
NASA Astrophysics Data System (ADS)
Amaral, Luis Miguel de Almeida
Electrocerâmicos sao uma classe de materiais avancados com propriedades electricas valiosas para aplicacoes. Estas propriedades sao geralmente muito dependentes da microestrutura dos materiais. Portanto, o objectivo geral deste trabalho e investigar o desenho da resposta dielectrica de filmes espessos obtidos por Deposicao Electroforetica (EPD) e cerâmicos monoliticos, atraves do controlo da evolucao da microestrutura durante a sinterizacao de electrocerâmicos a base de titanatos. Aplicacoes sem fios na industria microelectronica e de comunicacoes, em rapido crescimento, tornaram-se um importante mercado para os fabricantes de semicondutores. Devido a constante necessidade de miniaturizacao, reducao de custos e maior funcionalidade e integracao, a tecnologia de filmes espessos esta a tornar-se uma abordagem de processamento de materiais funcionais cada vez mais importante. Uma tecnica adequada neste contexto e EPD. Os filmes espessos resultantes necessitam de um passo subsequente de sinterizacao que e afectada pelo substrato subjacente, tendo este um forte efeito sobre a evolucao da microestrutura. Relacionado com a miniaturizacao e a discriminacao do sinal, materiais dielectricos usados como componentes operando a frequencias das microondas em aplicacoes na industria microelectronica de comunicacoes devem apresentar baixas perdas dielectricas e elevadas permitividade dielectrica e estabilidade com a temperatura. Materiais do sistema BaO-Ln2O3- TiO2 (BLnT: Ln = La ou Nd), como BaLa4Ti4O15 (BLT) e Ba4.5Nd9Ti18O54 (BNT), cumprem esses requisitos e sao interessantes para aplicacoes, por exemplo, em estacoes de base para comunicacoes moveis ou em ressonadores para telefones moveis, onde a miniaturizacao dos dispositivos e muito importante. Por sua vez, o titanato de estroncio (SrTiO3, STO) e um ferroelectrico incipiente com constante dielectrica elevada e baixas perdas, que encontra aplicacao em, por exemplo, condensadores de camada interna, tirando partido de fronteiras de grao altamente resistivas. A dependencia da permitividade dielectrica do campo electrico aplicado torna este material muito interessante para aplicacoes em dispositivos de microondas sintonizaveis. Materiais a base de STO sao tambem interessantes para aplicacoes termoelectricas, que podem contribuir para a reducao da actual dependencia de combustiveis fosseis por meio da geracao de energia a partir de calor desaproveitado. No entanto, as mesmas fronteiras de grao resistivas sao um obstaculo relativamente a eficiencia do STO para aplicacoes termoelectricas. (Abstract shortened by ProQuest.).
Abundâncias de oxigênio e enxofre nas estrelas de tipo solar da vizinhança solar
NASA Astrophysics Data System (ADS)
Requeijo, F.; Porto de Mello, G. F.
2003-08-01
Alguns resultados sugerem que o Sol seja 58% mais abundante em oxigênio que o meio interestelar local. Esta anomalia parece estender-se para o carbono e o criptônio. Entre as possíveis explicações deste fenômeno estão: uma supernova de tipo II que tenha enriquecido a nebulosa protosolar, tornando-a superabundante em oxigênio; um episódio de infall de material pobre em metais sobre o disco Galático, diluindo o meio interestelar local ou uma migração dinâmica do Sol de uma órbita mais interna da Galáxia para sua posição atual. A escolha entre estes cenários exige o conhecimento preciso da abundância solar em relação às anãs G da vizinhança. Neste contexto, o oxigênio e enxofre, são elementos-chave por serem ambos produzidos pelas supernovas de tipo II, devendo portanto possuir o mesmo padrão de abundância. Este projeto visa esclarecer qual a posição do Sol na distribuição local de abundâncias de enxofre e oxigênio para uma amostra de estrelas de tipo solar com idades e metalicidades bem conhecidas. Para tal, analisamos espectros de alta resolução e alta relação sinal-ruído nas regiões espectrais de ll 6300, 7774 (O) e l8695 (S). Para o enxofre encontramos que o Sol parece ser uma estrela típica dentre as da vizinhança, e que este elemento não mostra a sobreabundância para baixas metalicidades, já bem estabelecida para o oxigênio. Discutimos as abundâncias do enxofre no contexto da Evolução Química da Galáxia. Apresentamos resultados preliminares muito precisos para a linha proibida do oxigênio l6300 e comparamos estes com os obtidos para o tripleto em l7774. Quantificamos os efeitos não-ETL presentes no tripleto em função dos parâmetros atmosféricos estelares.
NASA Astrophysics Data System (ADS)
Balan, Catalin
Na ultima decada, foram feitos grandes progressos no desenvolvimento dos detetores de detecao direta das particulas que constituem a materia negra. Com estrategias do aumento gradual do volume do alvo e, simultaneamente, de reducao dos niveis de fundo, a experiencia XENON obteve resultados muito bons e perspetivas promissoras para a detecao de materia negra. Tarefas relativas a analise de dados experimentais adquiridos com o detetor de dupla fase em uso, assim como as simulacoes do campo eletrico, desenvolvimento, montagem e testes para o proximo detetor XENON1T, assim como a participacao regular na manutencao geral e monitorizacao do prototipo atual XENON100 no LNGS, constituiram o plano de trabalhos para as atividades de investigacao do presente doutoramento e a minha contribuicao para a otimizacao da detecao de cintilacao nos detetores da experiencia XENON. A necessidade de alcancar niveis elevados de sensibilidade, requer inovacao em todos os aspetos fisicos do detetor, assim como a reducao de todas as fontes de radioatividade que contribuem para o fundo. O modo mais indicado de operacao para os detetores com enchimento a Xe no estado liquido e gasoso envolve a medicao da cintilacao primaria e da secundaria provenientes da interacao das particulas no Xe liquido. A razao entre estes dois sinais permite diferenciar claramente a maior parte dos eventos correspondentes as fundo dos eventos correspondentes a WIMPs. Deste modo, a leitura dos sinais correspondentes a cintilacao e de extrema importancia. A amplitude do sinal de cintilacao antes dos fotossensores e maximizada atraves da otimizacao de varios parametros, tais como a geometria do alvo do detetor, a transparencia das grelhas dos eletrodos, a uniformidade do ganho em cintilacao secundaria e a utilizacao de material reflectivo para cobrir as superficies que nao sao fotossensiveis.
Prieto Bohórquez, Signed Esperanza; Rodríguez Velásquez, Javier Oswaldo; Correa Herrera, Catalina; Pardo Oviedo, Juan Mauricio; Ardila, Javier
2018-03-23
Introducción: una ley exponencial se ha hallado para los sistemas dinámicos caóticos cardiacos, logrando cuantificar las diferencias entre dinámicas cardiacas normales y patológicas.Metodología: Se analizaron 120 registros electrocardiográficos, 40 correspondían a sujetos dentro de los límites de normalidad y 80 con diferentes patologías. Para cada holter se analizaron los atractores generados con los datos durante 18 horas y durante toda la dinámica. Se calculó la dimensión fractal del atractor y su ocupación espacial. A estas medidas se aplicó la evaluación matemática diagnostica desarrollada previamente, comparando la evaluación para 18 horas y para todo el registro; finalmente se calculó la sensibilidad, especificidad y coeficiente Kappa.Resultados: Para las dinámicas normales los espacios de ocupación en la rejilla Kp estuvieron entre 200 y 381 en la evaluación de la totalidad del holter, y entre 201 y 384 en la evaluación durante 18 horas, mostrando la cercanía en las medidas, lo que permite que la disminución en el tiempo de la evaluación sea consistente, esta misma cercanía se observó para las dinámicas enfermas y agudas.Conclusión: Se evidenció la aplicabilidad clínica en 18 horas de la ley exponencial en la dinámica cardiaca caótica asociada a arritmias mostrando ser de utilidad para la predicción de la evolución hacia estados agudos de la dinámica.
Identificación de Intervenciones para el Desarrollo Positivo de la Juventud
Sardiñas, Lili M.; Padilla, Viviana; Aponte, Mari; Boscio, Ana Morales; Pedrogo, Coralee Pérez; Santiago, Betzaida; Morales, Ángela Pérez; Dávila, Paloma Torres; Cesáreo, Marizaida Sánchez
2017-01-01
Resumen En el mundo hay más personas en la etapa de la juventud que en cualquier otra etapa del desarrollo. La juventud en Puerto Rico enfrenta muchas situaciones que inciden en su desarrollo y preparación para la adultez. Por lo tanto, es imperante identificar intervenciones para el desarrollo positivo de la juventud que han demostrado ser basadas en la evidencia. Además, a partir de dicha identificación, desarrollar prácticas que ayuden a los jóvenes a desarrollarse para prevenir situaciones adversas, promover experiencias positivas y propiciar que los niños y jóvenes estén involucrados y comprometidos. Se identificaron 147 intervenciones a través de una revisión tradicional de la literatura científica estadounidense. Los resultados reflejan que las intervenciones atienden la reducción de factores de riesgo y el incremento de factores de protección. Sin embargo, ninguna intervención propicia que los niños y jóvenes estén involucrados y comprometidos con su desarrollo óptimo y con sus comunidades. No obstante, todas brindan herramientas que podrían ser de utilidad para fomentar dichas prácticas en el contexto de Puerto Rico. De las 147 intervenciones identificadas seis están diseñadas para la población puertorriqueña residente en la Isla. Con el propósito de hacer la información accesible a los profesionales y la comunidad se expandió la colección del Archivo de Programas y Prácticas Basadas en Evidencia para la Prevención. PMID:28919943
Vio, Fernando; Lera, Lydia; Salinas, Judith
2016-07-19
Objetivo: mediante la técnica de consenso Delphi, conocer la opinión de un grupo de expertos en nutrición, educación y gastronomía para buscar consenso sobre metodologías educativas en alimentación saludable, alumnos de tercero a quinto año básico, sus familias y profesores.Métodos: con los resultados de encuestas y grupos focales realizados previamente a niños, padres y profesores, se elaboró un cuestionario que fue enviado a 51 expertos en nutrición, educación y gastronomía en una primera ronda. Los resultados fueron analizados y reenviados en una segunda ronda con las preguntas no consensuadas, obteniendo 38 respuestas.Resultados: hubo consenso en que se pueden cambiar hábitos en escuelas mediante talleres de cocina con chefs o monitores, educación activo-participativa y huertos escolares. Padres y profesores deben tener habilidades culinarias saludables para educar a los niños. Estos deben hacer uso racional del dinero en la escuela. Para ello es necesario cambiar la oferta del kiosko hacia alimentos saludables, o suprimirlo si no es saludable. Los profesores deben capacitarse con talleres de autocuidado y vida sana para educar en alimentación saludable a los niños en horarios de clase con material educativo, talleres de cocina con recetas y aprovechar horarios de desayuno y almuerzo para actividades educativas. Los padres deben participar en talleres para escoger alimentos saludables en lugares de venta y preparar menús saludables. Los niños deben aprender habilidades culinarias simples, preparando y degustando alimentos saludables. Conclusiones: estos resultados son fundamentales para diseñar materiales educativos en alimentación saludable que cambien los malos hábitos alimentarios actuales.
Mahrooz, Abdolkarim; Gohari, Ghorban; Hashemi, Mohammad-Bagher; Zargari, Mehryar; Musavi, Hadis; Abedini, Mahmoud; Alizadeh, Ahad
2012-12-01
The polymorphic gene of serum paraoxonase (PON1) and its activity involved in atherosclerosis. The purpose of the study was to analyze PON1 192 Q/R polymorphism and the enzyme activities in ischemic stroke. The polymorphism as the most common polymorphism in PON1 gene coding sequence is associated with variation in the enzyme activity and vascular disease. The study included 85 stroke patients and 71 control subjects. PON1 192 polymorphism was genotyped using PCR protocol. Paraoxonase activity (Para) and arylesterase activity (Aryl) were determined spectrophotometrically using paraoxon and phenylacetate as the substrates. The QR and RR genotypes were more frequent in stroke population compared to controls, resulting in a higher frequency of the R allele in patients (0.24 vs 0.18, OR = 1.41). Patients had significantly higher Para/Aryl ratio than that of controls (P = 0.016). In stroke patients, Para/Aryl and Para/HDL ratios increased with this order: QQ < QR < RR. Hypertension significantly increased the risk of ischemic stroke by 15-fold among R-containing people, while this was significantly increased 4-fold for QQ homozygotes. Smoking increased the risk of having ischemic stroke in both QQ homozygote and QR + RR group (OR = 2.84 and OR = 2.33, respectively). In conclusion, these data highlight the importance of PON1 192 R allele and high Para/Aryl ratio in susceptibility to ischemic stroke in the population. The presence of the 192 R allele potentiates the risk of stroke especially in hypertensive people. Decreased Aryl and increased Para/Aryl, Para/HDL and Aryl/HDL ratios may be markers indicated the increased susceptibility to ischemic stroke in the population.
Calcisponges have a ParaHox gene and dynamic expression of dispersed NK homeobox genes.
Fortunato, Sofia A V; Adamski, Marcin; Ramos, Olivia Mendivil; Leininger, Sven; Liu, Jing; Ferrier, David E K; Adamska, Maja
2014-10-30
Sponges are simple animals with few cell types, but their genomes paradoxically contain a wide variety of developmental transcription factors, including homeobox genes belonging to the Antennapedia (ANTP) class, which in bilaterians encompass Hox, ParaHox and NK genes. In the genome of the demosponge Amphimedon queenslandica, no Hox or ParaHox genes are present, but NK genes are linked in a tight cluster similar to the NK clusters of bilaterians. It has been proposed that Hox and ParaHox genes originated from NK cluster genes after divergence of sponges from the lineage leading to cnidarians and bilaterians. On the other hand, synteny analysis lends support to the notion that the absence of Hox and ParaHox genes in Amphimedon is a result of secondary loss (the ghost locus hypothesis). Here we analysed complete suites of ANTP-class homeoboxes in two calcareous sponges, Sycon ciliatum and Leucosolenia complicata. Our phylogenetic analyses demonstrate that these calcisponges possess orthologues of bilaterian NK genes (Hex, Hmx and Msx), a varying number of additional NK genes and one ParaHox gene, Cdx. Despite the generation of scaffolds spanning multiple genes, we find no evidence of clustering of Sycon NK genes. All Sycon ANTP-class genes are developmentally expressed, with patterns suggesting their involvement in cell type specification in embryos and adults, metamorphosis and body plan patterning. These results demonstrate that ParaHox genes predate the origin of sponges, thus confirming the ghost locus hypothesis, and highlight the need to analyse the genomes of multiple sponge lineages to obtain a complete picture of the ancestral composition of the first animal genome.
Advanced Hydrogen Liquefaction Process
DOE Office of Scientific and Technical Information (OSTI.GOV)
Schwartz, Joseph; Kromer, Brian; Neu, Ben
2011-09-28
The project identified and quantified ways to reduce the cost of hydrogen liquefaction, and reduce the cost of hydrogen distribution. The goal was to reduce the power consumption by 20% and then to reduce the capital cost. Optimizing the process, improving process equipment, and improving ortho-para conversion significantly reduced the power consumption of liquefaction, but by less than 20%. Because the efficiency improvement was less than the target, the program was stopped before the capital cost was addressed. These efficiency improvements could provide a benefit to the public to improve the design of future hydrogen liquefiers. The project increased themore » understanding of hydrogen liquefaction by modeling different processes and thoroughly examining ortho-para separation and conversion. The process modeling provided a benefit to the public because the project incorporated para hydrogen into the process modeling software, so liquefaction processes can be modeled more accurately than using only normal hydrogen. Adding catalyst to the first heat exchanger, a simple method to reduce liquefaction power, was identified, analyzed, and quantified. The demonstrated performance of ortho-para separation is sufficient for at least one identified process concept to show reduced power cost when compared to hydrogen liquefaction processes using conventional ortho-para conversion. The impact of improved ortho-para conversion can be significant because ortho para conversion uses about 20-25% of the total liquefaction power, but performance improvement is necessary to realize a substantial benefit. Most of the energy used in liquefaction is for gas compression. Improvements in hydrogen compression will have a significant impact on overall liquefier efficiency. Improvements to turbines, heat exchangers, and other process equipment will have less impact.« less
Para-Nonylphenol Induces Apoptosis of U937 Human Monocyte Leukemia Cells in vitro.
Santa, Kazuki; Ohsawa, Tomonori; Sakimoto, Takehiko
2016-01-01
Human autoimmune diseases are caused by a variety of factors, such as environmental chemicals, including para-nonylphenol. Macrophages play many critical roles in the regulation of immunity and the progression of autoimmune diseases. However, little information is available regarding the effects of para-nonylphenol on cellular signaling pathways and the death of these cells in vitro. Here, we show that very high concentrations of para-nonylphenol (50-100 μM) induce apoptosis in U937 human monocyte leukemia cells in a dose-dependent manner. Cell viability was judged using the trypan blue exclusion method. FACS analysis for DNA fragmentation was conducted, cellular signaling pathways were evaluated using western blot analysis, and caspase activity was measured by using substrates. U937 cells were differentiated by PMA. Treatment with > 50 μM para-nonylphenol induced apoptosis in U937 monocyte cells and MCF- 7 and MDA-MB231 human breast cancer cells. We found cytochrome c release from the mitochondria to the cytoplasm, DNA fragmentation, and decreased expression of anti-apoptotic protein Bcl-XL. Caspase 3 and 9 were induced, but caspase 1 and 3-inhibitor treatment suppressed apoptosis. Para-nonylphenol decreased the levels of activated AKT and increased the levels of activated JNK/SAPK at 15 min after treatment. Furthermore, with PMA treatment, U937 cells were differentiated into a macrophage-like phenotype and showed attenuated cell death against para-nonylphenol. As this assay system is simple and rapid, it may represent a useful artificial tool to clarify the signaling pathways of apoptotic cell death in human monocytes in vitro. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.
Gauchat, Dominique; Mazet, Françoise; Berney, Cédric; Schummer, Michèl; Kreger, Sylvia; Pawlowski, Jan; Galliot, Brigitte
2000-01-01
The conservation of developmental functions exerted by Antp-class homeoproteins in protostomes and deuterostomes suggested that homologs with related functions are present in diploblastic animals. Our phylogenetic analyses showed that Antp-class homeodomains belong either to non-Hox or to Hox/paraHox families. Among the 13 non-Hox families, 9 have diploblastic homologs, Msx, Emx, Barx, Evx, Tlx, NK-2, and Prh/Hex, Not, and Dlx, reported here. Among the Hox/paraHox, poriferan sequences were not found, and the cnidarian sequences formed at least five distinct cnox families. Two are significantly related to the paraHox Gsx (cnox-2) and the mox (cnox-5) sequences, whereas three display some relatedness to the Hox paralog groups 1 (cnox-1), 9/10 (cnox-3) and the paraHox cdx (cnox-4). Intermediate Hox/paraHox genes (PG 3 to 8 and lox) did not have clear cnidarian counterparts. In Hydra, cnox-1, cnox-2, and cnox-3 were not found chromosomally linked within a 150-kb range and displayed specific expression patterns in the adult head. During regeneration, cnox-1 was expressed as an early gene whatever the polarity, whereas cnox-2 was up-regulated later during head but not foot regeneration. Finally, cnox-3 expression was reestablished in the adult head once it was fully formed. These results suggest that the Hydra genes related to anterior Hox/paraHox genes are involved at different stages of apical differentiation. However, the positional information defining the oral/aboral axis in Hydra cannot be correlated strictly to that characterizing the anterior–posterior axis in vertebrates or arthropods. PMID:10781050
NASA Astrophysics Data System (ADS)
María Velasco Sanz, Ana
Desde que se formuló, en 1996, la metodología Molecular de Orbitales de Defecto Cuántico (MQDO) [1], se han obtenido datos de calidad relativos a intensidades de bandas electrónicas que implican estados Rydberg para una gran variedad de sistemas moleculares [2]. Animados por los buenos resultados obtenidos, recientemente hemos abordado el estudio de transiciones vibrónicas, es decir aquellas que ocurren entre estados vibracionales que pertenecen a distintos estados Rydberg electrónicos. Como prototipo adecuado para nuestros propósitos hemos elegido la molécula de NO, importante en la química de la atmósfera, y para la cual existen en la bibliografía datos experimentales de calidad suficiente para contrastar la validez de nuestros resultados. En concreto, hemos calculado las fuerzas de oscilador y coeficientes de Einstein para transiciones electrónicas y vibrónicas de las principales bandas del NO, al igual que vidas medias radiativas de niveles vibracionales de dicha molécula. Las propiedades estudiadas son esenciales para la comprensión de los aspectos teóricos de los procesos físicos básicos relativos a la dispersión electrónica en moléculas heteronucleares con capas abiertas. Además, valores fiables de probabilidades de transición moleculares tienen importantes aplicaciones en Astrofísica, en la modelización de procesos fotodinámicos moleculares, etc., al igual que para evaluar más profundamente la validez de nuestra metodología teórica.
ERIC Educational Resources Information Center
Miller, Jerri; Petersen, Sandy
The Individuals with Disabilities Education Act entitles each family with an eligible infant or toddler to service coordination at no cost to them. This publication sets forth guidelines and describes the vision for how service coordination will be provided to families in Colorado. The publication, in English and Spanish versions, notes that…
Functional Genomics of a Non-Toxic Alexandrium Lusitanicum Culture
2007-02-01
OCE-0402707. This work was also supported by a graduate fellowship from the Fundacao para a Ciencia e Tecnologia , Portugal. Reproduction in whole or...that lead to this point. This work was supported by a graduate fellowship from the Fundaqa-o para a Ciencia e Tecnologia , Portugal. 3 4 TABLE OF...from the Fundaqo para a Ci~ncia e cultures (data not shown). It is therefore possible that the Tecnologia (FCT), Portugal. Funding provided in part
Military Personnel Law Deskbook
2006-08-01
Maintain physical and mental well-being. 3. Encourage the constructive use of time. B-3 4. Aid in recruitment and retention . 5. Assist in the... Job Grading System entalities (Oct. 1981). 4. AFI 34-262, para 2.3.4. and AFI 65-106, Chapter 4. ability. AR 215-1, para. 3-1, and para. 14-14. 1...Procedures. H. AR 600-37, Unfavorable Information. I. AR 601-280, Total Army Retention Program. J. AR 635-200, Active Duty Enlisted Administrative
Sistemas Correctores de Campo Para EL Telescopio Ritchey-Chretien UNAM212
NASA Astrophysics Data System (ADS)
Cobos, F. J.; Galan, M. J.
1987-05-01
El telescopio UNAM2l2 fue inaugurado hace siete años y concebido para trabajar en las razones focales: f/7.5, F/13.5, F/27 y F/98. El diseño Ritchey-Chretién corresponde a la razón focal F/7.5 y el foco primario (F/2.286) no se consideró como utilizable para fotografía directa. En el Instituto de Astronomía de la UNAM, se diseñó y construyó un sistema corrector de campo para la razón focal F/7.5, que actualmente está en funcionamiento. Dentro de un programa de colaboración en diseflo y evaluación de sistemas ópticos, entre el Instituto de Astrofísica de Canarias y el Instituto de Astronomía de la UNAM, decidimos intentar el diseño de una correctora de campo para el foco primario del tȩlescopio UNAM212 bajo la consideración de que no son insalvables los problemas que implicaría su instalación y de que es muy posible que, en un futuro relativamente cercano, podamom tener un detector bidimenmional tipo Mepsicrón cuya área sensible haga tentadora la idea de construir la cámara directa para foco primario
Pratap, Chandra Bhan; Kumar, Gopal; Patel, Saurabh Kumar; Shukla, Vijay K; Kumar, Kailash; Singh, Tej Bali
2014-01-01
Introduction: Enteric fever is a systemic disease caused by Salmonella organism such as serotypes Typhi and ParaTyphi A, B, C. Salmonella ParaTyphi A contributes more than 50% of all the enteric fever cases and it has recently been projected as an emerging pathogen. Materials and Methods: The present study was aimed to detect Salmonella Typhi and ParaTyphi A in urine, blood and stool specimens collected from cases of enteric fever (110), chronic typhoid carriers (46) and healthy controls (75) to explore the possibility of mixed infection by nested PCR. A new nested PCR primer was designed targeting putative fimbrial protein (stkG) gene which is one of the fimbrial gene families to Salmonella ParaTyphi A and for S. Typhi already reported primers targeting flagellin (fliC) gene. Results: Large volume of urine specimens (15 ml) was found to be the best for detection of Salmonella serotypes. The urine sample was found to have mixed-infection by both the serotypes in 40.9% of the cases but lower in blood (27.3%) and stool (13.6%). Conclusion: The present study concludes that occurrence of mixed infection may be quite frequent in typhoid and chronic typhoid carriers’ individuals, although the reported recent rise in ParaTyphi A incidence may not be real. PMID:25584217
Serious game development as a strategy for health promotion and tackling childhood obesity.
Dias, Jéssica David; Mekaro, Marcelo Shinyu; Cheng Lu, Jennifer Kaon; Otsuka, Joice Lee; Fonseca, Luciana Mara Monti; Zem-Mascarenhas, Silvia Helena
2016-08-15
to develop and assess a serious game on healthy eating and physical activity to promote health and tackle childhood obesity. a descriptive, applied and methodological study.For the development of the game, the following steps were taken: conceptualization, pre-production with the development of the game documentation, prototyping, production and assessment of thecomputer and health experts. a prototype has been developed up to beta version. The game was positively assessed both in terms of gameplay and mechanics, and in relation to the content presented, standing out as a powerful strategy for health promotion. The information from the assessment phase contributed to the settings in the software in order to make it available in the future for the target population of this research. The greatest advantage of the proposed game is the fact that it is an open educational resource. the expert assessments showed that the game has great educational potential and it is considered suitable for future application to the target audience.The serious game can become a technological teaching resource available for use in schools and health facilities, and can also be reused for the production of other educational games by accessing its source code. desenvolver e avaliar um serious game (Jogo sério) sobre alimentação saudável e exercício físico para promoção da saúde e auxílio ao enfrentamento da obesidade infantil. estudo descritivo, aplicado e metodológico. Para o desenvolvimento do jogo, foram percorridas as seguintes etapas: conceituação, pré-produção com desenvolvimento da documentação do jogo, prototipagem, produção e avaliação de especialistas de computação e saúde. desenvolveu-se um protótipo até a versão beta. O jogo foi avaliado positivamente tanto em relação à jogabilidade e mecânica, quanto em relação ao conteúdo apresentado, destacando-se como uma estratégia potente para a promoção de saúde. As informações oriundas da fase de avaliação serviram de subsídio para adequações no software com a finalidade de disponibilizá-lo futuramente à população alvo da pesquisa. O grande diferencial do jogo proposto é o fato do mesmo ser um recurso educacional aberto. as avaliações com especialistas demonstraram que o jogo tem grande potencial educacional e considerado adequado para a aplicação futura com o público-alvo. O serious game pode ser um recurso didático tecnológico acessível para uso em escolas e unidades de saúde, além de poder ser reutilizado para a produção de outros jogos educacionais através do acesso de seu código fonte. desarrollar y evaluar un serious game (Juego serio) sobre alimentación saludable y ejercicio físico para la promoción de la salud y ayudar en el enfrentamiento de la obesidad infantil. estudio descriptivo, aplicado y metodológico. Para el desarrollo del juego, se iniciaron los siguientes pasos: conceptualización, pre-producción con el desarrollo de la documentación del juego, creación de prototipos, producción y evaluación por expertos informáticos y en salud. un prototipo se ha desarrollado hasta la versión beta. El juego se evaluó positivamente tanto en términos de jugabilidad y mecánica como en relación con el contenido presentado, destacándose como una poderosa estrategia para la promoción de la salud. La información de la fase de evaluación contribuyó a los ajustes en el software con el fin de que esté disponible en el futuro para la población objetivo de esa investigación. La gran vantaja del juego propuesto es el hecho de que es un recurso educativo abierto. las evaluaciones de los expertos mostraron que el juego tiene un gran potencial educativo y es considerado adecuado para la aplicación futura para el público objetivo. El serious game puede convertirse en un recurso para la enseñanza tecnológica disponible para uso en las escuelas y en los centros de salud, y también puede ser reutilizado para la producción de otros juegos educativos mediante el acceso a su código fuente.
Autoguía para el telescopio 2,15 mts de CASLEO
NASA Astrophysics Data System (ADS)
Aballay, J. A.; Casagrande, A. R.; Pereyra, P. F.; Marún, A. H.
Se está desarrollando un sistema de autoguía para el telescopio de 2,15 mts. El mismo se realizará aprovechando el Offset Guider. Al ocular móvil de éste se vinculará alguna cámara digital (ST4-ST7-CH250) para lograr la visión del objeto. El funcionamiento del equipo será el siguiente: primero, dadas las coordenadas del objeto a observar, se tomarán las coordenadas del telescopio para que, a través de una base de datos, se determine un campo de objetos que sirvan para la cámara de visión, luego, la PC obtendrá el offset entre la estrella de observación y la estrella seleccionada como guía, este valor será trasladado a los motores que posicionarán en forma automática el ocular. Una vez que la estrella es visualizada en la cámara (monitor de PC ) se correrá el programa que guiará el telescopio automáticamente.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Smith, Kyle K. G., E-mail: kylesmith@utexas.edu; Rossky, Peter J., E-mail: peter.rossky@austin.utexas.edu; Poulsen, Jens Aage, E-mail: jens72@chem.gu.se
The dynamic structure factor of liquid para-hydrogen and ortho-deuterium in corresponding thermodynamic states (T = 20.0 K, n = 21.24 nm{sup −3}) and (T = 23.0 K, n = 24.61 nm{sup −3}), respectively, has been computed by both the Feynman-Kleinert linearized path-integral (FK-LPI) and Ring-Polymer Molecular Dynamics (RPMD) methods and compared with Inelastic X Ray Scattering spectra. The combined use of computational and experimental methods enabled us to reduce experimental uncertainties in the determination of the true sample spectrum. Furthermore, the refined experimental spectrum of para-hydrogen and ortho-deuterium is consistently reproduced by both FK-LPI and RPMD results at momentum transfers lower than 12.8 nm{sup −1}.more » At larger momentum transfers the FK-LPI results agree with experiment much better for ortho-deuterium than for para-hydrogen. More specifically we found that for k ∼ 20.0 nm{sup −1} para-hydrogen provides a test case for improved approximations to quantum dynamics.« less
Shchepin, Roman V; Barskiy, Danila A; Coffey, Aaron M; Manzanera Esteve, Isaac V; Chekmenev, Eduard Y
2016-05-10
A scalable and versatile methodology for production of vinylated carboxylic compounds with (13) C isotopic label in C1 position is described. It allowed synthesis of vinyl acetate-1-(13) C, which is a precursor for preparation of (13) C hyperpolarized ethyl acetate-1-(13) C, which provides a convenient vehicle for potential in vivo delivery of hyperpolarized acetate to probe metabolism in living organisms. Kinetics of vinyl acetate molecular hydrogenation and polarization transfer from para-hydrogen to (13) C via magnetic field cycling were investigated. Nascent proton nuclear spin polarization (%PH ) of ca. 3.3 % and carbon-13 polarization (%P13C ) of ca. 1.8 % were achieved in ethyl acetate utilizing 50 % para-hydrogen corresponding to ca. 50 % polarization transfer efficiency. The use of nearly 100% para-hydrogen and the improvements of %PH of para-hydrogen-nascent protons may enable production of (13) C hyperpolarized contrast agents with %P13C of 20-50 % in seconds using this chemistry. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Ball, G; Dawnay, N; Stafford-Allen, B; Panasiuk, M; Rendell, P; Blackman, S; Duxbury, N; Wells, S
2015-05-01
The ParaDNA® Intelligence Test enables STR profiling directly from human biological samples and evidence items collected from crime scene in 75min. Designed for non-expert use this system allows DNA information to be available to investigators before it would typically be available from a laboratory. The ParaDNA Intelligence Test system amplifies D3S1358, D8S119, D16S539, D18S1358 and TH01 STR loci and the gender typing locus amelogenin and detects the alleles present with HyBeacon® probes. Individual DNA samples from 381 UK Caucasian individuals were analysed using AmpFlSTR® SGM Plus® and the ParaDNA Intelligence Test with the derived STR profiles compared. Here we describe the high level of concordance demonstrated between the two systems and discuss this with reference to allele frequencies and the discriminatory power offered by the ParaDNA Intelligence Test. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
NASA Astrophysics Data System (ADS)
El-Megharbel, Samy M.; Hamza, Reham Z.; Refat, Moamen S.
2014-10-01
Keeping in view that some metal complexes are found to be more potent than their parent drugs, therefore, our present paper aimed to synthesized Cd(II), Hg(II) and Pb(II) complexes of paracetamol (Para) anti-inflammatory drug. Paracetamol complexes with general formula [M(Para)2(H2O)2]·nH2O have been synthesized and characterized on the basis of elemental analysis, conductivity, IR and thermal (TG/DTG), 1H NMR, electronic spectral studies. The conductivity data of these complexes have non-electrolytic nature. Comparative antimicrobial (bacteria and fungi) behaviors and molecular weights of paracetamol with their complexes have been studied. In vivo the antihepatotoxicity effect and some liver function parameters levels (serum total protein, ALT, AST, and LDH) were measured. Hematological parameters and liver antioxidant capacities of both Para and their complexes were performed. The Cd2+ + Para complex was recorded amelioration of antioxidant capacities in liver homogenates compared to other Para complexes treated groups.
NASA Astrophysics Data System (ADS)
Woltjer, L.
1987-06-01
En la reunion celebrada en diciembre dei ano pasado informe al Consejo de mi deseo de terminar mi contrato como Director General de la ESO una vez que fuera aprobado el proyecto dei VLT, que se espera sucedera hacia fines de este aAo. Cuando fue renovada mi designacion hace tres aAos, el Consejo conocia mi intencion de no completar los cinco aAos dei contrato debido a mi deseo de disponer de mas tiempo para otras actividades. Ahora, una vez terminada la fase preparatoria para el VLT, Y habiendose presentado el proyecto formalmente al Consejo el dia 31 de marzo, y esperando su muy probable aprobacion antes dei termino de este ano, me parece que el 10 de enero de 1988 presenta una excelente fecha para que se produzca un cambio en la administracion de la ESO.
Binarias en cúmulos abiertos: ?`Qué hay de nuevo?
NASA Astrophysics Data System (ADS)
Levato, H.
Las herramientas modernas para detectar duplicidad han jugado un papel fundamental en el resurgimiento del estudio de la binaridad en cúmulos abiertos. El fracaso de las teorías de bifurcación para explicar la formación de estrellas dobles ha puesto en consideración los encuentros de estrellas en cúmulos para formar binarias. Existen muchas pruebas empíricas que pueden realizarse para verificar las creencias actuales. En esta revisión del tema se hace un breve resumen de la historia del problema y se analiza el conocimiento actual. Se proponen las investigaciones y programas que darían lugar a la comprobación de las predicciones que surgen de considerar que las binarias en cúmulos se forman por encuentros.
Production and characterization of para-hydrogen gas for matrix isolation infrared spectroscopy
NASA Astrophysics Data System (ADS)
Sundararajan, K.; Sankaran, K.; Ramanathan, N.; Gopi, R.
2016-08-01
Normal hydrogen (n-H2) has 3:1 ortho/para ratio and the production of enriched para-hydrogen (p-H2) from normal hydrogen is useful for many applications including matrix isolation experiments. In this paper, we describe the design, development and fabrication of the ortho-para converter that is capable of producing enriched p-H2. The p-H2 thus produced was probed using infrared and Raman techniques. Using infrared measurement, the thickness and the purity of the p-H2 matrix were determined. The purity of p-H2 was determined to be >99%. Matrix isolation infrared spectra of trimethylphosphate (TMP) and acetylene (C2H2) were studied in p-H2 and n-H2 matrices and the results were compared with the conventional inert matrices.
Photoisomerization of Trans Ortho-, Meta-, Para-Nitro Diarylbutadienes: A Case of Regioselectivity.
Agnihotri, Harsha; Paramasivam, Mahalingavelar; Palakollu, Veerabhadraiah; Kanvah, Sriram
2015-11-01
A series of ortho-, meta- and para-substituted trans-nitro aryl (phenyl and pyridyl) butadienes have been synthesized and characterized. The effect of substitution and positional selectivity on their fluorescence and photoisomerization were systematically investigated. Among all dienes, meta- and para-nitro phenyl-substituted derivatives exhibit remarkable solvatochromic emission shifts due to intramolecular charge transfer. On the other hand, ortho derivatives undergo regioselective isomerization upon photoexcitation in contrast to inefficient isomerization of para and meta nitro-substituted dienes. Single crystal X-ray analysis revealed existence of intramolecular hydrogen bonding between the nitro group and the hydrogen of the proximal double bond. This restricts the rotation of the proximal double bond thereby allowing regioselective isomerization. The observations were also supported by NMR spectroscopic studies. © 2015 The American Society of Photobiology.
Stratton, Christopher F; Namanja-Magliano, Hilda A; Cameron, Scott A; Schramm, Vern L
2015-10-16
Dihydropteroate synthase is a key enzyme in folate biosynthesis and is the target of the sulfonamide class of antimicrobials. Equilibrium binding isotope effects and density functional theory calculations indicate that the substrate binding sites for para-aminobenzoic acid on the dihydropteroate synthase enzymes from Staphylococcus aureus and Plasmodium falciparum present distinct chemical environments. Specifically, we show that para-aminobenzoic acid occupies a more sterically constrained vibrational environment when bound to dihydropteroate synthase from P. falciparum relative to that of S. aureus. Deletion of a nonhomologous, parasite-specific insert from the plasmodial dihydropteroate synthase abrogated the binding of para-aminobenzoic acid. The loop specific to P. falciparum is important for effective substrate binding and therefore plays a role in modulating the chemical environment at the substrate binding site.
Evidence for disequilibrium of ortho and para hydrogen on Jupiter from Voyager IRIS measurements
NASA Technical Reports Server (NTRS)
Conrath, B. J.; Gierasch, P. J.
1983-01-01
Preliminary results of an analysis of the ortho state/para state ratio (parallel/antiparallel) for molecular H2 in the Jovian atmosphere using Voyager IR spectrometer (IRIS) data are reported. The study was undertaken to expand the understanding of the thermodynamics of a predominantly H2 atmosphere, which takes about 100 million sec to reach equilibrium. IRIS data provided 4.3/cm resolution in the 300-700/cm spectral range dominated by H2 lines. Approximately 600 spectra were examined to detect any disequilibrium between the hydrogen species. The results indicate that the ortho-para ratio is not in an equilibrium state in the upper Jovian troposphere. A thorough mapping of the para-state molecules in the upper atmosphere could therefore aid in mapping the atmospheric flowfield.
Líneas metálicas en protuberancias solares
NASA Astrophysics Data System (ADS)
Stenborg, G.; Rovira, M. G.; Mauas, P.
Para determinar cual de los modelos existentes de protuberancias solares explica mejor las observaciones, es necesario, no solo ajustar los perfiles de las líneas de hidrógeno, sino también utilizar perfiles de distintos metales. En este trabajo, utilizamos un código desarrollado especialmente para calcular el equilibrio estadístico de cualquier especie atómica, aplicándolo al cálculo de los perfiles de las líneas del Ca II, el Mg II y el He, para determinar cómo se comportan ante variaciones en los parámetros de los modelos de protuberancia (ancho, presión y temperatura centrales y número de hebras), y comparamos con las observaciones existentes para determinar que modelo las ajusta mejor.
American woodcock (Scolopax minor) mortality associated with a reovirus
Docherty, D.E.; Converse, K.A.; Hansen, W.R.; Norman, G.W.
1994-01-01
A virus isolate associated with a 1989-90 die-off in American woodcock (Scolopax minor) was identified as a reovirus. Emaciation was a consistent necropsy finding in the woodcock involved in this die-off. This reovirus infection appeared to be systemic, had the potential for fecal-oral virus transmission, and was associated with deterioration of body condition. To our knowledge this is the first report of a virus isolate from wild American woodcock. A survey conducted in 1990-92 indicated that this virus was not present at detectable levels in the woodcock breeding and wintering population. /// Un virus asociado con la mortalidad de becadas o perdices americanas (Scolopax minor) en 1989-1990-fue identificado como reovirus. La emaciaci??n fue un resultado com??n a la necropsia de las aves que murieron. Esta infecci??n por reovirus pareci?? ser sist??mica, ten?-a el potencial de transmisi??n fecal-oral y estuvo asociada con el deterioro del ave. Creemos que este sea el primer reporte de aislamiento viral a partir de becadas americanas. Una encuesta hecha entre 1990 y 1992 indic?? que este virus no estaba presente en los niveles detectables en los reproductores y en las aves invernales.
Soares, Thiago Rios; Avena, Kátia de Miranda; Olivieri, Flávia Milholo; Feijó, Luciana Ferreira; Mendes, Kristine Menezes Barberino; Souza Filho, Sydney Agareno de; Gomes, André Mansur de Carvalho Guanaes
2010-03-01
To describe the withdrawal of the bed frequency in mechanic ventilation patients and its impact on mortality and length of stay in the intensive care unit. This was a retrospective cohort study in mechanical ventilation patients. Clinical and epidemiological variables, withdrawal of bed related motor therapy, intensive care unit length of stay and mortality were evaluated. We studied 91 patients, mean age of 62.5± 18.8 years, predominantly female (52%) and mean intensive care unit length of stay of 07 days (95% CI, 8-13 days). Considering the withdrawal of the bed or not, no difference was observed between groups regarding length of stay in intensive care unit. Patients who were withdrawn of bed had a lower clinical severity. Their mortality rate was 29.7%. The not withdrawn of bed group had higher both actual and expected mortality. Patients withdrawn of bed following mechanical ventilation discontinuation showed lower mortality. It is suggested that early intensive care unit mobilization and withdrawal of bed should be stimulated.
Cambra Contín, K; Alonso Fustel, E
1999-01-01
The objective of this study was to assess the short-term impact of air pollution with sulfur dioxide (SO2), total suspended particles (TSP), nitrogen dioxide (NO2) and black smoke (BS) on the daily number of deaths in the metropolitan area of Bilbao. The EMECAM project protocol was followed. Increases in TSP, in both maximum hourly figures and daily averages, are significantly associated with increases in the daily number of deaths from all causes, from circulatory causes and from all causes among those older than 70. No differences between six-month periods were found. NO2 average levels were associated with daily mortality from respiratory causes in the entire period and during the warm season, and from all causes among those older than 70 in the cool months. TSP levels are associated with daily mortality in the metropolitan area of Bilbao. The relationship between NO2 and the number of deaths from respiratory causes, very high in the warm season, needs further research to assess its independence.
Maaitah, Rowaida Al; AbuAlRub, Raeda Fawzi
2017-01-30
to explore priority actions for strengthening the role of Advanced Practice Nurses (APNs) towards the achievement of Universal Health Converge (UHC) as perceived by health key informants in Jordan. an exploratory qualitative design, using a semi-structured survey, was utilized. A purposive sample of seventeen key informants from various nursing and health care sectors was recruited for the purpose of the study. Content analysis utilizing the five-stage framework approach was used for data analysis. the findings revealed that policy and regulation, nursing education, research, and workforce were identified as the main elements that influence the role of APNs in contributing to the achievement of UHC. Priority actions were identified by the participants for the main four elements. study findings confirm the need to strengthen the role of APNs to achieve UHC through a major transformation in nursing education, practice, research, leadership, and regulatory system. Nurses should unite to come up with solid nursing competencies related to APNs, PHC, UHC, leadership and policy making to strengthen their position as main actors in influencing the health care system and evidence creation. analisar as ações prioritárias para o fortalecimento do papel da enfermeira em prática avançada na Cobertura Universal de Saúde , segundo a percepção dos informantes-chave na Jordânia. foi utilizado desenho qualitativo exploratório, com um questionário semiestruturado. A amostra intencional de dezessete informantes-chave de vários setores de enfermagem e de saúde foi recrutado para o propósito do estudo. A análise de conteúdo utilizando a abordagem do quadro de cinco estágios foi utilizada para a análise de dados. os resultados revelaram que as políticas e regulações, educação em enfermagem, pesquisa e força de trabalho foram identificados como os principais elementos que influenciam o papel da enfermeira em prática avançada em contribuir para a realização da Cobertura Universal de Saúde. As ações prioritárias foram identificadas pelos participantes para os quatro principais elementos. os resultados do estudo confirmam a necessidade de reforçar o papel da enfermeira em prática avançada para alcançar Cobertura Universal de Saúde através de uma grande transformação no ensino de enfermagem, prática, pesquisa, liderança e sistema regulatório. A Enfermagem deve unir-se para obter competências consistentes relacionadas com a enfermeira em prática avançada, atenção primaria de saúde, Cobertura Universal em Saúde, liderança e elaboração de políticas para reforçar sua posição como atores principais que influenciam o sistema de saúde e a geração de evidências. explorar las acciones prioritarias para el fortalecimiento del papel de las enfermeras con práctica avanzada para el logro de la Cobertura Universal de Salud según la percepción de informantes clave de la salud en Jordania. se utilizó diseño cualitativo exploratorio, utilizando una encuesta semi-estructurada. Una muestra intencional de diecisiete informantes clave de diversos sectores de enfermería y cuidados de la salud fue reclutada para el propósito de este estudio. Se utilizó análisis de contenido usando el método del marco de cinco etapas para el análisis de datos. los resultados revelaron que la política y la regulación, la formación de enfermería, la investigación y la fuerza laboral fueron identificados como los principales elementos que influyen en el papel de la enfermeras con práctica avanzada para contribuir a la consecución de la Cobertura Universal de Salud. Las acciones prioritarias fueron identificadas por los participantes para los cuatro elementos principales. los hallazgos del estudio confirman la necesidad de fortalecer el papel de la enfermeras con práctica avanzada para lograr la Cobertura Universal de Salud a través de una transformación importante en la formación, la práctica, la investigación, el liderazgo, y el sistema de regulación. Las enfermeras deben unirse para alcanzar competencias consistentes de enfermería relacionados con la enfermeras con práctica avanzada, la Atención Primaria de Salud , Cobertura Universal de Salud, liderazgo y formulación de políticas, para fortalecer su posición como actores principales que influyen en el sistema de salud y la generación de evidencias.
English, Lauren Lacey; Dunsmuir, Dustin; Kumbakumba, Elias; Ansermino, John Mark; Larson, Charles P; Lester, Richard; Barigye, Celestine; Ndamira, Andrew; Kabakyenga, Jerome; Wiens, Matthew O
2016-02-15
Postdischarge death in children is increasingly being recognized as a major contributor to overall child mortality. The PAediatric Risk Assessment (PARA) app is an mHealth tool developed to aid health care workers in resource-limited settings such as Sub-Saharan Africa to identify pediatric patients at high risk of both in-hospital and postdischarge mortality. The intended users of the PARA app are health care workers (ie, nurses, doctors, and clinical officers) with varying levels of education and technological exposure, making testing of this clinical tool critical to successful implementation. Our aim was to summarize the usability evaluation of the PARA app among target users, which consists of assessing the ease of use, functionality, and navigation of the interfaces and then iteratively improving the design of this clinical tool. Health care workers (N=30) were recruited to participate at Mbarara Regional Referral Hospital and Holy Innocents Children's Hospital in Mbarara, Southwestern Uganda. This usability study was conducted in two phases to allow for iterative improvement and testing of the interfaces. The PARA app was evaluated using quantitative and qualitative measures, which were compared between Phases 1 and 2 of the study. Participants were given two patient scenarios that listed hypothetical information (ie, demographic, social, and clinical data) to be entered into the app and to determine the patient's risk of in-hospital and postdischarge mortality. Time-to-completion and user errors were recorded for each participant while using the app. A modified computer system usability questionnaire was utilized at the end of each session to elicit user satisfaction with the PARA app and obtain suggestions for future improvements. The average time to complete the PARA app decreased by 30% from Phase 1 to Phase 2, following user feedback and modifications. Participants spent the longest amount of time on the oxygen saturation interface, but modifications following Phase 1 cut this time by half. The average time-to-completion (during Phase 2) for doctors/medical students was 3 minutes 56 seconds. All participants agreed they would use the PARA app if available at their health facility. Given a high PARA risk score, participants suggested several interventions that would be appropriate for the sociocultural context in southwestern Uganda, which involved strengthening discharge and referral procedures within the current health care system. Through feedback and modifications made during this usability study, the PARA app was developed into a user-friendly app, encompassing user expectations and culturally intuitive interfaces for users with a range of technological exposure. Doctors and medical students had shorter task completion times, though all participants reported the usefulness of this tool to improve postdischarge outcomes.
English, Lauren Lacey; Dunsmuir, Dustin; Kumbakumba, Elias; Ansermino, John Mark; Larson, Charles P; Lester, Richard; Barigye, Celestine; Ndamira, Andrew; Kabakyenga, Jerome
2016-01-01
Background Postdischarge death in children is increasingly being recognized as a major contributor to overall child mortality. The PAediatric Risk Assessment (PARA) app is an mHealth tool developed to aid health care workers in resource-limited settings such as Sub-Saharan Africa to identify pediatric patients at high risk of both in-hospital and postdischarge mortality. The intended users of the PARA app are health care workers (ie, nurses, doctors, and clinical officers) with varying levels of education and technological exposure, making testing of this clinical tool critical to successful implementation. Objective Our aim was to summarize the usability evaluation of the PARA app among target users, which consists of assessing the ease of use, functionality, and navigation of the interfaces and then iteratively improving the design of this clinical tool. Methods Health care workers (N=30) were recruited to participate at Mbarara Regional Referral Hospital and Holy Innocents Children’s Hospital in Mbarara, Southwestern Uganda. This usability study was conducted in two phases to allow for iterative improvement and testing of the interfaces. The PARA app was evaluated using quantitative and qualitative measures, which were compared between Phases 1 and 2 of the study. Participants were given two patient scenarios that listed hypothetical information (ie, demographic, social, and clinical data) to be entered into the app and to determine the patient’s risk of in-hospital and postdischarge mortality. Time-to-completion and user errors were recorded for each participant while using the app. A modified computer system usability questionnaire was utilized at the end of each session to elicit user satisfaction with the PARA app and obtain suggestions for future improvements. Results The average time to complete the PARA app decreased by 30% from Phase 1 to Phase 2, following user feedback and modifications. Participants spent the longest amount of time on the oxygen saturation interface, but modifications following Phase 1 cut this time by half. The average time-to-completion (during Phase 2) for doctors/medical students was 3 minutes 56 seconds. All participants agreed they would use the PARA app if available at their health facility. Given a high PARA risk score, participants suggested several interventions that would be appropriate for the sociocultural context in southwestern Uganda, which involved strengthening discharge and referral procedures within the current health care system. Conclusions Through feedback and modifications made during this usability study, the PARA app was developed into a user-friendly app, encompassing user expectations and culturally intuitive interfaces for users with a range of technological exposure. Doctors and medical students had shorter task completion times, though all participants reported the usefulness of this tool to improve postdischarge outcomes. PMID:26879041
1991-02-01
MULTIFUNCTIONAL MATERIALS *MULTIFUNCTIONAL MOLECULAR AND POLYMERIC MATERIALS FOR NONLINEAR OPTICS AND PHOTONICS 79 Paras N. Prasad ENHANCEMENT OF...in solution 121. Only the ortho photo-Fries product can be formed for the polymer as well as for 5 since the para positions in both cases are blocked...fhII11111 Itf 111111111ll1111111II 111 111 , 9 MULTIFUNCTIONAL MOLECULAR AND POLYMERIC MATERIALS FOR NONLINEAR OPTICS AND PHOTONICS PARAS N. PRASAD
ERIC Educational Resources Information Center
Instituto Nacional para la Educacion de los Adultos, Mexico City (Mexico).
This manual is part of a Mexican series of instructional materials designed for Spanish speaking adults who are in the process of becoming literate or have recently become literate in their native language. This document describes the concept of a model for community adult education for the purpose of supporting local educational committees…
ERIC Educational Resources Information Center
Molina, Carmen Eneida, Ed.; And Others
This guide for teachers, in English and Spanish, examines the stereotyped work roles assigned to men and women. The guide examines educational materials that perpetuate these roles and presents teaching alternatives which reinforce students' self esteem and confidence. A pre-test and post-test are included to measure the user's awareness of…
2009-09-01
Internet is “the most powerful tool for spreading extremist violence around the world" ( Kotler , 2007, para. 4). A view shared by Frank Cilluffo, Director...approximately 80 Islamic extremist sites online; by 2007, there were close to 8,000 ( Kotler , 2007, para. 2). Some of these forums had up to 20,000...members and half a million postings ( Kotler , 2007, para. 7). Unfortunately, the Internet’s impact goes well beyond radicalization, it has
Quantum rotation of ortho and para-water encapsulated in a fullerene cage
Beduz, Carlo; Carravetta, Marina; Chen, Judy Y.-C.; Concistrè, Maria; Denning, Mark; Frunzi, Michael; Horsewill, Anthony J.; Johannessen, Ole G.; Lawler, Ronald; Lei, Xuegong; Levitt, Malcolm H.; Li, Yongjun; Mamone, Salvatore; Murata, Yasujiro; Nagel, Urmas; Nishida, Tomoko; Ollivier, Jacques; Rols, Stéphane; Rõõm, Toomas; Sarkar, Riddhiman; Turro, Nicholas J.; Yang, Yifeng
2012-01-01
Inelastic neutron scattering, far-infrared spectroscopy, and cryogenic nuclear magnetic resonance are used to investigate the quantized rotation and ortho–para conversion of single water molecules trapped inside closed fullerene cages. The existence of metastable ortho-water molecules is demonstrated, and the interconversion of ortho-and para-water spin isomers is tracked in real time. Our investigation reveals that the ground state of encapsulated ortho water has a lifted degeneracy, associated with symmetry-breaking of the water environment. PMID:22837402
Prevendo a atividade solar através de redes neurais nebulosas
NASA Astrophysics Data System (ADS)
Martin, V. A. F.; Poppe, P. C. R.
2003-08-01
Atualmente, a integração de redes neurais com técnicas da Matemática Nebulosa (Fuzzy Sets), tem sido usada robustamente para fazer previsões em vários sistemas físicos. Este trabalho representa uma continuidade da contribuição apresentada anteriormente durante a XXVIIa Reunião Anual da SAB, onde exploramos a aplicação de redes neurais para previsões futuras de séries temporais. Para este, enfatizamos o uso da técnica ANFIS (Adaptative Neuro-Fuzzy Inference System), que consiste em uma rede do tipo back-propagation, onde os dados são processados em uma camada intermediária, tendo numa camada de saída, os dados numéricos. Para que a previsão seja feita com sucesso utilizando-se técnicas matemáticas adequadas, é fundamental a existência de uma série razoavelmente longa de modo que a dinâmica contida nesta possa ser melhor extraída pela rede neural. Nesse sentido, foram utilizados novamente os dados históricos das manchas do Sol (1818-2002) afim de verificar o comportamento futuro da atividade solar (Ciclos de Schawbe) a partir da técnica descrita acima. Previsões realizadas para o ciclo anterior (n.22, máximo de 158,5 em julho de 1989), bem como para o atual (n.23, máximo de 153 em setembro de 2000), apontam valores bastante coerentes com os publicados na literatura, levando em consideração, respectivamente, as barras de erros associadas: 166+/-18 e 160+/-14. Para o próximo ciclo de Schawbe (2006-2017), nossa previsão aponta o valor de 172+/-23 como máximo para o primeiro semestre de 2011 (Abril +/- 3 meses). A ANFIS acompanha de maneira satisfatória o movimento das séries estudadas durante o treinamento e durante a verificação (menor dispersão das funções de pertinência), com erro absoluto inferior a 20 por cento.
Hammer, Chris; Podlog, Leslie; Wadey, Ross; Galli, Nick; Forber-Pratt, Anjali J; Newton, Maria
2018-04-25
To examine how deliberate rumination and psychological need satisfaction interact to facilitate posttraumatic growth for para sport athletes with acquired disability. Utilizing a sample of 70 para sport athletes, the hypothesized mediating role of deliberate rumination was examined via a simple mediation model. The interaction between needs satisfaction and deliberate rumination and their effect on posttraumatic growth was examined utilizing a moderated mediation procedure. Disruption to one's core beliefs was significantly associated with posttraumatic growth. This relationship, was in part, explained by the deliberate rumination engaged in soon after the trauma. Needs satisfaction, while a significant predictor of posttraumatic growth, did not moderate the indirect effect. Although deliberate rumination at both timeframes and needs satisfaction were independently associated with posttraumatic growth, they did not interact in the hypothesized manner to influence posttraumatic growth. There remains a need to better understand how the experience of posttraumatic growth is achieved amongst individuals with acquired disability, and the role that para sport may play in this process. Implications for rehabilitation The disruption to one's core beliefs caused by acquiring a physical disability is not only a natural experience but also a necessary antecedent to posttraumatic growth. As such, rehabilitation practitioners ought to normalize these types of challenges when working with individuals with acquired disability. Practitioners may help to facilitate growth outcomes by encouraging individuals to deliberately ruminate about their acquired disability. That is, practitioners can help those with acquired disability to seek meaning and understanding about their disability or the precipitating event. For those who struggle to deliberately ruminate in the immediate disability aftermath, practitioners may encourage para sport participation to potentially prompt constructive cognitive processing. Individuals with acquired disabilities would also be well served by rehabilitation practitioners and para sport organizations that provide opportunities for basic psychological needs satisfaction. Specifically, individuals with acquired disabilities should be given the opportunity to demonstrate physical competence, make meaningful relationships, and feel a sense of volitional control over their rehabilitation or para sport participation. For example, practitioners and para sport organizations could establish mentorship programs wherein individuals with more recent disabilities can be mentored by those with greater disability experience.
La masa de los grandes impactores
NASA Astrophysics Data System (ADS)
Parisi, M. G.; Brunini, A.
Los planetas han sido formados fundamentalmente acretando masa a través de colisiones con planetesimales sólidos. La masa más grande de la distribución de planetesimales y las masas máxima y mínima de los impactores, han sido calculadas usando los valores actuales del período y de la inclinación de los planetas (Lissauer & Safronov 1991; Parisi & Brunini 1996). Recientes investigaciones han mostrado, que las órbitas de los planetas gigantes no han sufrido variaciones con el tiempo, siendo su movimiento regular durante su evolución a partir de la finalización de la etapa de acreción (Laskar 1990, 1994). Por lo tanto, la eccentricidad actual de los planetas gigantes se puede utilizar para imponer una cota máxima a las masas y velocidades orbitales de los grandes impactores. Mediante un simple modelo dinámico, y considerando lo arriba mencionado, obtenemos la cota superior para la masa del planetesimal más grande que impactó a cada planeta gigante al final de su etapa de acreción. El resultado más importante de este trabajo es la estimación de la masa máxima permitida para impactar a Júpiter, la cúal es ~ 1.136 × 10 -1, siendo en el caso de Neptuno ~ 3.99 × 10 -2 (expresada en unidades de la masa final de cada planeta). Además, fue posible obtener la velocidad orbital máxima permitida para los impactores como una función de su masa, para cada planeta. Las cotas obtenidas para la masa y velocidad de los impactores de Saturno y Urano (en unidades de la masa y velocidad final de cada planeta respectivamente) son casi las mismas que las obtenidas para Júpiter debido a que estos tres planetas poseen similar eccentricidad actual. Nuestros resultados están en buen acuerdo con los obtenidos por Lissauer & Safronov (1991). Estas cotas podrían ser utilizadas para obtener la distribución de planetesimales en el Sistema Solar primitivo.
NASA Astrophysics Data System (ADS)
Tang, X. D.; Henkel, C.; Chen, C.-H. R.; Menten, K. M.; Indebetouw, R.; Zheng, X. W.; Esimbek, J.; Zhou, J. J.; Yuan, Y.; Li, D. L.; He, Y. X.
2017-04-01
Context. The kinetic temperature of molecular clouds is a fundamental physical parameter affecting star formation and the initial mass function. The Large Magellanic Cloud (LMC) is the closest star-forming galaxy with a low metallicity and provides an ideal laboratory for studying star formation in such an environment. Aims: The classical dense molecular gas thermometer NH3 is seldom available in a low-metallicity environment because of photoionization and a lack of nitrogen atoms. Our goal is to directly measure the gas kinetic temperature with formaldehyde toward six star-forming regions in the LMC. Methods: Three rotational transitions (JKAKC = 303-202, 322-221, and 321-220) of para-H2CO near 218 GHz were observed with the Atacama Pathfinder EXperiment (APEX) 12 m telescope toward six star-forming regions in the LMC. These data are complemented by C18O 2-1 spectra. Results: Using non-local thermal equilibrium modeling with RADEX, we derive the gas kinetic temperature and spatial density, using as constraints the measured para-H2CO 321-220/303-202 and para-H2CO 303-202/C18O 2-1 ratios. Excluding the quiescent cloud N159S, where only one para-H2CO line could be detected, the gas kinetic temperatures derived from the preferred para-H2CO 321-220/303-202 line ratios range from 35 to 63 K with an average of 47 ± 5 K (errors are unweighted standard deviations of the mean). Spatial densities of the gas derived from the para-H2CO 303-202/C18O 2-1 line ratios yield 0.4-2.9 × 105 cm-3 with an average of 1.5 ± 0.4 × 105 cm-3. Temperatures derived from the para-H2CO line ratio are similar to those obtained with the same method from Galactic star-forming regions and agree with results derived from CO in the dense regions (n(H2) > 103 cm-3) of the LMC. A comparison of kinetic temperatures derived from para-H2CO with those from the dust also shows good agreement. This suggests that the dust and para-H2CO are well mixed in the studied star-forming regions. A comparison of kinetic temperatures derived from para-H2CO 321-220/303-202 and NH3(2, 2)/(1, 1) shows a drastic difference, however. In the star-forming region N159W, the gas temperature derived from the NH3(2, 2)/(1, 1) line ratio is 16 K (Ott et al. 2010, ApJ, 710, 105), which is only half the temperature derived from para-H2CO and the dust. Furthermore, ammonia shows a very low abundance in a 30'' beam. Apparently, ammonia only survives in the most shielded pockets of dense gas that are not yet irradiated by UV photons, while formaldehyde, less affected by photodissociation, is more widespread and also samples regions that are more exposed to the radiation of young massive stars. A correlation between the gas kinetic temperatures derived from para-H2CO and infrared luminosity, represented by the 250 μm flux, suggests that the kinetic temperatures traced by para-H2CO are correlated with the ongoing massive star formation in the LMC. The reduced spectra (FITS files) are only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (http://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/600/A16
[Return of the sick at home: importance of the level of dependency and family support].
Monteiro, Pinto Elsa Maria Esteves; Martins, Rosa Maria Lopes
2013-01-01
Although aging is not synonymous with illness and dependency, the process enhances the progressive limitation of the capabilities of the individual to meet daily living activities with autonomy, leading to greater need for informal and / or formal support. To identify the functional independence of the participants and their relation to the socio demographic, clinical, housing and social support variables;to assess the difficulties of informal caregivers in care when returning home. We opted for a triangulated methodology (quantitative and qualitative) following a descriptive-correlational path, using for this purpose a non-probabilistic sample of convenience consisting of 50 patients admitted in the Centro Hospitalar Tondela - Viseu, EPE, and their informal caregivers. The measuring instruments used were the Barthel Index and a semi-structured interview. The participants are mostly male, with an average age of 73.7 years, married, residing in rural areas. Their qualifications are the 1st cycle of basic education (four years of Primary School) and have a predominance of cerebrovascular diseases. They show moderate dependence at discharge, preferably returning to their own home. Functional independence is significantly influenced by age, educational attainment, place of residence after admission, housing adaptation and formal support. The informal caregiveris mainly the female spouse and daughters, presenting as main difficulties, employment, lack of support andtechnical assistance, the existence of architectural barriers and caregiver overload. The inexistent of the caregiver's profile, their absence or inability to care was predictive of institutionalization.
SURFING BIOLOGICAL SURFACES: EXPLOITING THE NUCLEOID FOR PARTITION AND TRANSPORT IN BACTERIA
Vecchiarelli, Anthony G.; Mizuuchi, Kiyoshi; Funnell, Barbara E.
2012-01-01
The ParA family of ATPases are responsible for transporting bacterial chromosomes, plasmids, and large protein machineries. ParAs pattern the nucleoid in vivo, but how patterning functions or is exploited in transport is of considerable debate. Here we discuss the process of self-organization into patterns on the bacterial nucleoid and explore how it relates to the molecular mechanism of ParA action. We review ParA-mediated DNA partition as a general mechanism of how ATP-driven protein gradients on biological surfaces can result in spatial organization on a mesoscale. We also discuss how the nucleoid acts as a formidable diffusion barrier for large bodies in the cell, and make the case that the ParA family evolved to overcome the barrier by exploiting the nucleoid as a matrix for movement. PMID:22934804
Descripción de la zona de alta difusión en un modelo bidimensional para hojas de corriente
NASA Astrophysics Data System (ADS)
Montero, M. F.; Paola, C. A.; Platzeck, A. M.
Los modelos bidimensionales para describir hojas de corriente de alta simetría no suministran una descripción detallada de las regiones donde la difusión es considerablemente importante. Tal es el caso de los modelos desarrollados en la década del '60 por Sweet, Parker, Petschek y Sonnerup. En esta comunicación presentamos una solución de las ecuaciones MHD en el entorno del origen, construyendo series bidimensionales para todas las magnitudes físicas involucradas. Valiéndonos de la alta simetría y de las características del problema, logramos reducir el número de coeficientes a calcular. Utilizamos un programa autoconsistente para extender el cálculo a regiones vecinas con difusión moderada o despreciable.
Ortho-para-H2 conversion by hydrogen exchange: comparison of theory and experiment.
Lique, François; Honvault, Pascal; Faure, Alexandre
2012-10-21
We report fully-quantum time-independent calculations of cross sections and rate coefficients for the collisional (de)excitation of H(2) by H. Our calculations are based on the H(3) global potential energy surface of Mielke et al. [J. Chem. Phys. 116, 4142 (2002)]. The reactive hydrogen exchange channels are taken into account. We show that the ortho-para and para-ortho conversion of H(2) are significant processes at temperatures above ~300 K and for the last process we provide the first comparison with available experimental rate coefficients between 300 and 444 K. The good agreement between theory and experiment is a new illustration of our detailed understanding of the simplest chemical reaction. The importance of the ortho-para-H(2) conversion by hydrogen exchange in astrophysics is discussed.
Attempted suicide by ingestion of hair dye containing p-phenylenediamine: a case report.
Beshir, Lamis; Kaballo, Babiker; Young, Donald
2017-07-01
Para-phenylenediamine is widely used as a chemical in hair dyes and in combination with henna. This dye is used to paint the body for decorative reasons, to speed the processing time of henna and to intensify the results. Para-phenylenediamine is widely used in the Middle East, North Africa and India. Several reports have been published of the fatal ingestion of hair dye containing para-phenylenediamine. Here, we describe the case of a 14-year-old girl who ingested the compound but whose prompt treatment prevented her death. Ingestion of para-phenylenediamine produces a typical triad of angioneurotic oedema, rhabdomyolysis and acute tubular necrosis. Awareness of signs of these associated conditions in our patient, together with a comprehensive history, facilitated appropriate treatment to be instituted. We document the steps we took to enable her complete physical recovery.
Molecular hydrogen in the vicinity of NGC 7538 IRS 1 and IRS 2 - Temperature and ortho-to-para ratio
NASA Technical Reports Server (NTRS)
Hoban, Susan; Reuter, Dennis C.; Mumma, Michael J.; Storrs, Alex D.
1991-01-01
Near-infrared spectroscopic observations of the active star-forming region near NGC 7538 IRS 1 and IRS 2 were made. The relative intensities of the v = 1-0 Q(1), Q(3), and Q(5) lines of molecular hydrogen are used to calculate a rotational excitation temperature. Comparison of the measured intensity of the Q(2) transition relative to the intensity of Q(1) and Q(3) permitted the retrieval of the ratio of ortho-to-para hydrogen. It is found that an ortho-to-para ratio of between 1.6 and 2.35 is needed to explain the Q-branch line intensity ratios, depending on the excitation model used. This range in ortho-to-para ratios implies a range of molecular hydrogen formation temperature of approximately 105 K to 140 K.
Separating para and ortho water.
Horke, Daniel A; Chang, Yuan-Pin; Długołęcki, Karol; Küpper, Jochen
2014-10-27
Water exists as two nuclear-spin isomers, para and ortho, determined by the overall spin of its two hydrogen nuclei. For isolated water molecules, the conversion between these isomers is forbidden and they act as different molecular species. Yet, these species are not readily separated, and no pure para sample has been produced. Accordingly, little is known about their specific physical and chemical properties, conversion mechanisms, or interactions. The production of isolated samples of both spin isomers is demonstrated in pure beams of para and ortho water in their respective absolute ground state. These single-quantum-state samples are ideal targets for unraveling spin-conversion mechanisms, for precision spectroscopy and fundamental symmetry-breaking studies, and for spin-enhanced applications, for example laboratory astrophysics and astrochemistry or hypersensitized NMR experiments. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
The School of Posture as a postural training method for Paraíba Telecommunications Operators.
Cardia, M C; Soares Màsculo, F
2001-01-01
This work proposes to show the experience of posture training accomplished in the Paraíba State Telecommunication Company, using the knowledge of the Back School. The sample was composed of 12 operators, employees of the company, representing 31% of this population. The model applied in TELPA (Paraíba Telecommunication Company, Brazil) was based on the models of Sherbrooke, Canada, and of the School of Posture of Paraìba Federal University. Fifty-eight point four percent of participants showed a reduction of column pain, 25% improved the quality of the rest and the received training was considered enough for the learning of correct postures at work in 75% of the cases. The whole population approved of the training, and 83.3% of the cases considered that this training influenced their lives very positively.
Size and morphology controlled NiSe nanoparticles as efficient catalyst for the reduction reactions
NASA Astrophysics Data System (ADS)
Subbarao, Udumula; Marakatti, Vijaykumar S.; Amshumali, Mungalimane K.; Loukya, B.; Singh, Dheeraj Kumar; Datta, Ranjan; Peter, Sebastian C.
2016-12-01
Facile and efficient ball milling and polyol methods were employed for the synthesis of nickel selenide (NiSe) nanoparticle. The particle size of the NiSe nanoparticle has been controlled mechanically by varying the ball size in the milling process. The role of the surfactants in the formation of various morphologies was studied. The compounds were characterized by powder X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM) and X-ray energy dispersive spectroscopy (EDS). The efficiency of the NiSe nanoparticle as a catalyst was tested for the reduction of para-nitroaniline (PNA) to para-phenyldiamine (PPD) and para-nitrophenol (PNP) to para-aminophenol (PAP) using NaBH4 as the reducing agent. Particle size, morphology and the presence of surfactant played a crucial role in the reduction process.
Turchin, Irina; Moreau, Linda; Warshaw, Erin; Sasseville, Denis
2006-12-01
Parabens are alkyl ester derivatives of para-hydroxybenzoic acid and are the most commonly used preservatives in the cosmetic industry. Cross-reactions with para-amino compounds, namely, benzocaine and para-phenylenediamine (PPD), have been reported but are thought to be extremely rare. To evaluate the rate of cross-reactivity between parabens, PPD, and benzocaine in a population of patients patch-tested in a hospital-based contact dermatitis clinic. A retrospective analysis of 4,368 patients consecutively patch-tested between July 1989 and June 2005. Our study demonstrated that the rate of cross-reactions to parabens in PPD- and benzocaine-positive patients combined is 2%. This cross-reaction rate is significant in the tested population but still falls within the previously reported rates of sensitivity to parabens in the general population (0 to 3.5%).
Kang, Sokbom; Lee, Jong-Min; Lee, Jae-Kwan; Kim, Jae-Weon; Cho, Chi-Heum; Kim, Seok-Mo; Park, Sang-Yoon; Park, Chan-Yong; Kim, Ki-Tae
2014-03-01
The purpose of this study is to develop a Web-based nomogram for predicting the individualized risk of para-aortic nodal metastasis in incompletely staged patients with endometrial cancer. From 8 institutions, the medical records of 397 patients who underwent pelvic and para-aortic lymphadenectomy as a surgical staging procedure were retrospectively reviewed. A multivariate logistic regression model was created and internally validated by rigorous bootstrap resampling methods. Finally, the model was transformed into a user-friendly Web-based nomogram (http://http://www.kgog.org/nomogram/empa001.html). The rate of para-aortic nodal metastasis was 14.4% (57/397 patients). Using a stepwise variable selection, 4 variables including deep myometrial invasion, non-endometrioid subtype, lymphovascular space invasion, and log-transformed CA-125 levels were finally adopted. After 1000 repetitions of bootstrapping, all of these 4 variables retained a significant association with para-aortic nodal metastasis in the multivariate analysis-deep myometrial invasion (P = 0.001), non-endometrioid histologic subtype (P = 0.034), lymphovascular space invasion (P = 0.003), and log-transformed serum CA-125 levels (P = 0.004). The model showed good discrimination (C statistics = 0.87; 95% confidence interval, 0.82-0.92) and accurate calibration (Hosmer-Lemeshow P = 0.74). This nomogram showed good performance in predicting para-aortic metastasis in patients with endometrial cancer. The tool may be useful in determining the extent of lymphadenectomy after incomplete surgery.
Balán, Iván C.; Carballo-Diéguez, Alex; Marone, Rubén O.; Pando, María A.; Barreda, Victoria; Ávila, María M.
2011-01-01
Resumen El uso del diagnóstico rápido para HIV en Argentina, así como otros países de Latinoamérica, ha sido limitado hasta el momento. Este trabajo reporta los resultados provenientes de un estudio cualitativo realizado entre hombres gays y otros hombres que tienen sexo con hombres (G&HSH) de la Ciudad de Buenos Aires, Argentina. El objetivo principal del mismo fue conocer las ventajas y desventajas que los hombres G&HSH perciben en relación al diagnóstico rápido casero para HIV. Se realizaron ocho grupos focales con 73 participantes en los cuales se discutió acerca de las ventajas y desventajas del uso de los diagnósticos rápidos. Las respuestas fueron codificadas utilizando un programa para análisis de datos cualitativos (NVivo) y analizadas temáticamente. Los participantes describieron numerosas ventajas sobre el uso del diagnóstico rápido casero, aunque algunos reportaron importantes preocupaciones dentro de las cuales se destaca la posibilidad de impulsos suicidas si alguien recibe un resultado positivo estando solo. En términos generales se observó una gran aceptabilidad para el uso del diagnóstico rápido si el mismo es realizado por personal de salud en lugares acondicionados para este fin. PMID:25284951
Rotational excitation of HCN by para- and ortho-H₂.
Vera, Mario Hernández; Kalugina, Yulia; Denis-Alpizar, Otoniel; Stoecklin, Thierry; Lique, François
2014-06-14
Rotational excitation of the hydrogen cyanide (HCN) molecule by collisions with para-H2(j = 0, 2) and ortho-H2(j = 1) is investigated at low temperatures using a quantum time independent approach. Both molecules are treated as rigid rotors. The scattering calculations are based on a highly correlated ab initio 4-dimensional (4D) potential energy surface recently published. Rotationally inelastic cross sections among the 13 first rotational levels of HCN were obtained using a pure quantum close coupling approach for total energies up to 1200 cm(-1). The corresponding thermal rate coefficients were computed for temperatures ranging from 5 to 100 K. The HCN rate coefficients are strongly dependent on the rotational level of the H2 molecule. In particular, the rate coefficients for collisions with para-H2(j = 0) are significantly lower than those for collisions with ortho-H2(j = 1) and para-H2(j = 2). Propensity rules in favor of even Δj transitions were found for HCN in collisions with para-H2(j = 0) whereas propensity rules in favor of odd Δj transitions were found for HCN in collisions with H2(j ⩾ 1). The new rate coefficients were compared with previously published HCN-para-H2(j = 0) rate coefficients. Significant differences were found due the inclusion of the H2 rotational structure in the scattering calculations. These new rate coefficients will be crucial to improve the estimation of the HCN abundance in the interstellar medium.
NASA Technical Reports Server (NTRS)
Neufeld, David A.; Melnick, Gary J.; Harwit, Martin
1998-01-01
We have detected the S(1), S(2), S(3), S(4), and S(5) pure rotational lines of molecular hydrogen toward the outflow source HH 54 using the Short Wavelength Spectrometer on board the Infrared Space Observatory. The observed H2 line ratios indicate the presence of warm molecular gas with an H2 density of at least 10(sup 5) /cc and a temperature approximately 650 K in which the ratio of ortho- to para-H2 is only 1.2 -+ 0.4, significantly smaller than the equilibrium ratio of 3 expected in gas at that temperature. These observations imply that the measured ratio of ortho- to para-H2 is the legacy of an earlier stage in the thermal history of the gas when the gas had reached equilibrium at a temperature approximately 90 K. Based upon the expected timescale for equilibration, we argue that the nonequilibrium ratio of ortho- to para-H2 observed in HH 54 serves as a chronometer that places a conservative upper limit of approximately 5000 yr on the period for which the emitting gas has been warm. The S(2)/,S(l) and S(3)/S(1) H2 line ratios measured toward HH 54 are consistent with recent theoretical models of Timmermann for the conversion of para- to ortho-H2 behind slow, C-type shocks, but only if the preshock ratio of ortho- to para-H2 was approximately < 0.2.
Ewing, Tom A; van Noord, Aster; Paul, Caroline E; van Berkel, Willem J H
2018-01-14
Vanillyl alcohol oxidase (VAO) and eugenol oxidase (EUGO) are flavin-dependent enzymes that catalyse the oxidation of para -substituted phenols. This makes them potentially interesting biocatalysts for the conversion of lignin-derived aromatic monomers to value-added compounds. To facilitate their biocatalytic exploitation, it is important to develop methods by which variants of the enzymes can be rapidly screened for increased activity towards substrates of interest. Here, we present the development of a screening assay for the substrate specificity of para -phenol oxidases based on the detection of hydrogen peroxide using the ferric-xylenol orange complex method. The assay was used to screen the activity of VAO and EUGO towards a set of twenty-four potential substrates. This led to the identification of 4-cyclopentylphenol as a new substrate of VAO and EUGO and 4-cyclohexylphenol as a new substrate of VAO. Screening of a small library of VAO and EUGO active-site variants for alterations in their substrate specificity led to the identification of a VAO variant (T457Q) with increased activity towards vanillyl alcohol (4-hydroxy-3-methoxybenzyl alcohol) and a EUGO variant (V436I) with increased activity towards chavicol (4-allylphenol) and 4-cyclopentylphenol. This assay provides a quick and efficient method to screen the substrate specificity of para -phenol oxidases, facilitating the enzyme engineering of known para- phenol oxidases and the evaluation of the substrate specificity of novel para -phenol oxidases.
Balán, Iván C; Carballo-Diéguez, Alex; Marone, Rubén O; Pando, María A; Barreda, Victoria; Avila, María M
2011-03-01
El uso del diagnóstico rápido para HIV en Argentina, así como otros países de Latinoamérica, ha sido limitado hasta el momento. Este trabajo reporta los resultados provenientes de un estudio cualitativo realizado entre hombres gays y otros hombres que tienen sexo con hombres (G&HSH) de la Ciudad de Buenos Aires, Argentina. El objetivo principal del mismo fue conocer las ventajas y desventajas que los hombres G&HSH perciben en relación al diagnóstico rápido casero para HIV. Se realizaron ocho grupos focales con 73 participantes en los cuales se discutió acerca de las ventajas y desventajas del uso de los diagnósticos rápidos. Las respuestas fueron codificadas utilizando un programa para análisis de datos cualitativos (NVivo) y analizadas temáticamente. Los participantes describieron numerosas ventajas sobre el uso del diagnóstico rápido casero, aunque algunos reportaron importantes preocupaciones dentro de las cuales se destaca la posibilidad de impulsos suicidas si alguien recibe un resultado positivo estando solo. En términos generales se observó una gran aceptabilidad para el uso del diagnóstico rápido si el mismo es realizado por personal de salud en lugares acondicionados para este fin.
Oliveira, Lanuza Borges; Soares, Fernanda Amaral; Silveira, Marise Fagundes; Pinho, Lucinéia de; Caldeira, Antônio Prates; Leite, Maísa Tavares de Souza
2016-08-18
to develop and validate an instrument to evaluate the knowledge of health professionals about domestic violence on children. this was a study conducted with 194 physicians, nurses and dentists. A literature review was performed for preparation of the items and identification of the dimensions. Apparent and content validation was performed using analysis of three experts and 27 professors of the pediatric health discipline. For construct validation, Cronbach's alpha was used, and the Kappa test was applied to verify reproducibility. The criterion validation was conducted using the Student's t-test. the final instrument included 56 items; the Cronbach alpha was 0.734, the Kappa test showed a correlation greater than 0.6 for most items, and the Student t-test showed a statistically significant value to the level of 5% for the two selected variables: years of education and using the Family Health Strategy. the instrument is valid and can be used as a promising tool to develop or direct actions in public health and evaluate knowledge about domestic violence on children. elaborar e validar um instrumento para avaliação do conhecimento dos profissionais de saúde sobre a violência doméstica contra a criança. estudo realizado com 194 profissionais médicos, enfermeiros e cirurgiões dentistas. Para elaboração dos itens e identificação das dimensões, realizou-se a revisão da literatura. A validação aparente e de conteúdo foram realizadas por meio da análise de três especialistas e de 27 professores universitários da área de saúde da criança. Para a validação de construto, avaliou-se o coeficiente alfa de Cronbach, e o teste Kappa foi usado para verificar a reprodutibilidade. A validação de critério foi conduzida com uso do teste t-student. o instrumento final apresentou 56 itens, o alfa Cronbach foi de 0,734, o teste Kappa revelou concordância superior a 0,6 para a maioria dos itens, e o teste t-student apresentou valor estatisticamente significante até o nível de 5% para as duas variáveis selecionadas, tempo de formação e tempo na Estratégia Saúde da Família. o instrumento apresentou-se válido e, deste modo , pode ser usado como ferramenta promissora para desenvolver ou direcionar as ações em saúde pública e avaliação do conhecimento sobre a violência doméstica contra a criança. elaborar y validar un instrumento para evaluación del conocimiento de los profesionales de la salud sobre la violencia doméstica ejercida contra el niño. estudio realizado con 194 profesionales: médicos, enfermeros y cirujanos dentistas. Para elaboración de los ítems e identificación de las dimensiones, se realizó una revisión de la literatura. La validación aparente y de contenido fueron realizadas por medio del análisis de tres especialistas y de 27 profesores universitarios del área de la salud del niño. Para la validación de constructo, se evaluó el coeficiente alfa de Cronbach, y la prueba Kappa fue usada para verificar la reproductibilidad. La validación de criterio fue realizada con uso de la prueba t de Student. el instrumento final presentó 56 ítems, el alfa Cronbach fue de 0,734, la prueba Kappa reveló concordancia superior a 0,6 para la mayoría de los ítems, y la prueba t de Student presentó valor estadísticamente significativo hasta el nivel de 5% para las dos variables seleccionadas: tiempo de graduación y tiempo en el programa Estrategia Salud de la Familia. el instrumento se presentó válido y, de ese modo, puede ser usado como herramienta promisora para desarrollar o dirigir acciones de salud pública y evaluar el conocimiento sobre la violencia doméstica contra el niño.
NASA Astrophysics Data System (ADS)
De Jesus Roman, Sandra
Concepciones Alternativas de Fotosíntesis en estudiantes Universitariosdel curso básico de Biología y posibles correcciones con el Modelo Educativo MODEF El modelo educativo para la enseñanza de Fotosíntesis (MODEF) se implantó para trabajar el problema de las concepciones alternativas (CA) en un curso de Biología General. Se evaluaron los resultados en cuanto al logro del aprendizaje significativo. La pregunta central de la investigación fue: ¿Cómo aporta el modelo educativo en la didáctica y comprensión del tema de fotosíntesis? Se efectuó una investigación acción con una fase cuantitativa y una cualitativa. Para la fase cuantitativa se elaboró una prueba para determinar las concepciones alternativas, se validó y se sometió a los estudiantes que participaron en el estudio antes y después de ofrecer la unidad de metabolismo celular. Los participantes eran estudiantes de primer año de la Universidad de Puerto Rico en Bayamón (UPRB). Se llevó a cabo un análisis de consistencia interna de la prueba mediante el método Alfa de Cronbach. Se analizaron las contestaciones a cada pregunta mediante la prueba de Ji cuadrado de contingencia, se efectuó la prueba de t y el coeficiente r de Pearson. La fase cualitativa incluyó la observación participativa de la investigadora- profesora, las reflexiones de los estudiantes y la información de las entrevistas semi-estructuradas que se realizaron a tres estudiantes del curso. El análisis se llevó a cabo mediante el Modelo de Wolcott. Se trabajaron diez CA de las cuales siete fueron corregidas mediante el Modelo MODEF. Las actividades más importantes para el proceso de aprendizaje incluyeron el trabajo de investigación o búsqueda de información para hacer una presentación digital, la elaboración de tablas, los mapas de conceptos, el uso de visuales o videos y las analogías para explicar conceptos o procesos. En conclusión: se recomienda el uso del Modelo MODEF para la discusión del tema de Fotosíntesis a base de los resultados cuantitativos y cualitativos de esta investigación. El Comité Institucional para la Protección de los Seres Humanos en la Investigación (CIPSHI) autorizó el estudio.
Reyes-Rodríguez, Mae Lynn; García, Marissa; Silva, Yormeri; Sala, Margarita; Quaranta, Michela; Bulik, Cynthia M.
2016-01-01
Resumen El objetivo de este estudio fue desarrollar fotonovelas, un tipo de novela gráfica popular en la población latina, para crear conciencia y educar sobre los trastornos de la conducta alimentaria (TCA). Cuatro caricaturas ilustradas y guiones adaptados para adultos y adolescentes de ambos sexos fueron presentados en discusiones focales y en una entrevista de profundidad. Diecisiete latinos adultos (14 mujeres; 3 hombres) y 10 adolescentes (9 féminas; 1 varón) participaron en el estudio. Los participantes encontraron las fotonovelas interesantes y que captaban más la atención que los folletos tradicionales. El uso del espanglish y la clarificación de las diferencias entre los TCA fueron sugeridos por las adolescentes femeninas. Los adultos varones sugirieron cambiar el título, que se enfocara en las consecuencias en la salud de los TCA para que llame la atención en los hombres a leer la historia. Basado en la aceptación encontrada en este estudio, la fotonovela pudiera ser una avenida prometedora para crear conciencia y educar a la comunidad latina sobre los TCA en los Estados Unidos. PMID:27313838
Alonzo, Jorge; Mann, Lilli; Simán, Florence; Sun, Christina J.; Andrade, Mario; Villatoro, Guillermo; Rhodes, Scott D.
2016-01-01
Resumen Las minorías sexuales y de identidad de género en Guatemala son afectadas de manera desproporcionada por el VIH y otras infecciones transmitidas sexualmente (ITS). Sin embargo, poco se sabe de los factores que contribuyen al riesgo de infección en estas minorías. Investigadores de Estados Unidos y Guatemala quisimos informarnos sobre las necesidades de salud sexual e identificar características de programas de prevención de VIH/ITS para estas minorías. Llevamos a cabo 8 grupos focales con hombres gay, bisexuales y personas transgénero y entrevistas en profundidad con líderes comunitarios. Utilizamos el Método Comparativo Constante para analizar las transcripciones. Identificamos 24 factores que influyen en la salud sexual y 16 características de programas para reducir el riesgo de VIH/ITS en estas poblaciones. La identificación de factores de conductas sexuales de riesgo y de características de programas potencialmente efectivos ofrece gran potencial para desarrollar intervenciones que contribuyan a reducir el riesgo de infección por VIH/ITS en estas minorías en Guatemala. PMID:27494000
Violencia de Pareja en Mujeres Hispanas: Implicaciones para la Investigación y la Práctica
Gonzalez-Guarda, Rosa Maria; Becerra, Maria Mercedes
2012-01-01
Las investigaciones sobre la violencia entre parejas sugieren que las mujeres hispanas están siendo afectadas desproporcionadamente por la ocurrencia y consecuencias de este problema de salud pública. El objetivo del presente artículo es dar a conocer el estado del arte en relación a la epidemiologia, consecuencias y factores de riesgo para VP entre mujeres Hispanas, discutiendo las implicaciones para la investigación y la práctica. Investigaciones han demostrado una fuerte asociación del status socioeconómico, abuso de droga y el alcohol, la salud mental, aculturación, inmigración, comportamientos sexuales riesgosos e historia de abuso con la violencia entre parejas. Sin embargo, más estudios se deben llevar a cabo para identificar otros factores de riesgos y de protección a poblaciones hispanas no clínicas. Mientras que el conocimiento sobre la etiología de la VP entre mujeres Hispanas se expanda, enfermeras y otros profesionales de la salud deben desarrollar, implementar y evaluar estrategias culturalmente adecuadas para la prevención primaria y secundaria de la violencia entre pareja. PMID:26166938
NASA Astrophysics Data System (ADS)
Mishra, Piyush; Hewett, Daniel M.; Zwier, Timothy S.
2017-06-01
This talk focuses on the single-conformation spectroscopy of small-chain para-dialkylbenzenes. This work builds on previous studies from our group on long-chain n-alkylbenzenes that identified the first folded structure in octylbenzene. The dialkylbenzenes are representative of a class of molecules that are common components of coal and aviation fuel and are known to be present in vehicle exhaust. We bring the molecules para-diethylbenzene, para-dipropylbenzene and para-dibutylbenzene into the gas phase and cool the molecules in a supersonic expansion. The jet-cooled molecules are then interrogated using laser-induced fluorescence excitation, fluorescence dip IR spectroscopy (FDIRS) and dispersed fluorescence. The LIF spectra in the S_{0}-S_{1} origin region show dramatic increases in the number of resolved transitions with increasing length of alkyl chains, reflecting an explosion in the number of unique low-energy conformations formed when two independent alkyl chains are present. Since the barriers to isomerization of the alkyl chain are similar in size, this results in an 'egg carton' shape to the potential energy surface. We use a combination of electronic frequency shift and alkyl CH stretch infrared spectra to generate a consistent set of conformational assignments.
Rivera-Portalatin, Nilka M; Vera-Serrano, José L; Prokai-Tatrai, Katalin; Prokai, Laszlo
2007-01-01
Ortho-quinones formed from catechol estrogens are considered prooxidants due to the production of superoxide radical anions through redox cycling via semiquinones. Para-quinols have been identified as novel metabolites of and as the major products of hydroxyl-radical scavenging by estrogens. Cycling of these compounds has also been discovered, because they are converted back to the parent estrogen via reductive aromatization in vitro and in vivo. We hypothesized that, unlike ortho-quinones, para-quinols do not induce oxidative stress due to this cycling. Like the estrogen itself, the 17beta-estradiol-derived para-quinol (10beta,17beta-dihydroxyestra-1,4-diene-3-one) did not induce oxidative stress, as the rate of hydrogen peroxide production during the incubations of the compounds in various tissue homogenates was not significantly different from that of the control experiments performed without the addition of a test compound. We also confirmed that the estrogen metabolite estra-1,5(10)-dien-3,4,17-trione (estrone 3,4-quinone) was a profound prooxidant due to redox cycling, especially in uterine tissue. Therefore, we concluded that para-quinols do not induce oxidative stress.
Infrared spectra of CO2-doped hydrogen clusters, (H2)N-CO2.
McKellar, A R W
2012-03-07
Clusters of para-H(2) and/or ortho-H(2) containing a single carbon dioxide molecule are studied by high resolution infrared spectroscopy in the 2300 cm(-1) region of the CO(2) ν(3) fundamental band. The (H(2))(N)-CO(2) clusters are formed in a pulsed supersonic jet expansion from a cooled nozzle and probed using a rapid scan tunable diode laser. Simple symmetric rotor type spectra are observed with little or no resolved K-structure, and prominent Q-branch features for ortho-H(2) but not para-H(2). Observed rotational constants and vibrational shifts are reported for ortho-H(2) up to N = 7 and para-H(2) up to N = 15, with the N > 7 assignments only made possible with the help of theoretical simulations. The para-H(2) cluster with N = 12 shows clear evidence for superfluid effects, in good agreement with theory. The presence of larger clusters with N > 15 is evident in the spectra, but specific assignments are not possible. Mixed para- + ortho-H(2) cluster transitions are well predicted by linear interpolation between corresponding pure cluster line positions. © 2012 American Institute of Physics
Kurimura, Muneaki; Liu, Hehua; Sulima, Agnieszka; Hashimoto, Akihiro; Przybyl, Anna K.; Ohshima, Etsuo; Kodato, Shinichi; Deschamps, Jeffrey R.; Dersch, Christina M.; Rothman, Richard B.; Lee, Yong Sok; Jacobson, Arthur E.; Rice, Kenner C.
2008-01-01
In the isomeric series of 12 racemic topologically rigid N-methyl analogues of oxide-bridged phenylmorphans, all but two of the racemates, the ortho- and para-b-oxide-bridged phenylmorphansa 20 and 12, have remained to be synthesized. The b-isomers were very difficult to synthesize because of the highly strained 5,6-trans-fused ring junction that had to be formed. Our successful strategy required functionalization of the position para (or ortho) to a fluorine atom on the aromatic ring using an electron-withdrawing nitro group to activate that fluorine. The racemic N-phenethyl analogues 24 and 16 were moderately potent κ-receptor antagonists in the [35S]GTPγS assay. We synthesized the N-phenethyl-substituted oxide-bridged phenylmorphans in the ortho- and para-d oxide-bridged phenylmorphana series (51 and 52) which had not been previously evaluated using contemporary receptor binding assays to see whether they also have higher affinity for opioid receptors than their N-methyl relatives 46 and 47. PMID:19053757
Rivera-Portalatin, Nilka M.; Vera-Serrano, José L.; Prokai-Tatrai, Katalin; Prokai, Laszlo
2009-01-01
Ortho-quinones formed from catechol estrogens are considered prooxidants due to the production of superoxide radical anions through redox cycling via semiquinones. Para-quinols have been identified as novel metabolites of and as the major products of hydroxyl-radical scavenging by estrogens. Cycling of these compounds has also been discovered, because they are converted back to the parent estrogen via reductive aromatization in vitro and in vivo. We hypothesized that, unlike ortho-quinones, para-quinols do not induce oxidative stress due to this cycling. Like the estrogen itself, the 17β-estradiol-derived para-quinol (10β,17β-dihydroxyestra-1,4-diene-3-one) did not induce oxidative stress, as the rate of hydrogen peroxide production during the incubations of the compounds in various tissue homogenates was not significantly different from that of the control experiments performed without the addition of a test compound. We also confirmed that the estrogen metabolite estra-1,5(10)-dien-3,4,17-trione (estrone 3,4-quinone) was a profound prooxidant due to redox cycling, especially in uterine tissue. Therefore, we concluded that para-quinols do not induce oxidative stress. PMID:17582759
da Silva, Patricia Mirella; Vianna, Rogério Tubino; Guertler, Cristhiane; Ferreira, Liana Pinho; Santana, Lucas Nunes; Fernández-Boo, Sergio; Ramilo, Andrea; Cao, Asunción; Villalba, Antonio
2013-05-01
The present work aimed to study the infection by Perkinsus sp. in the mangrove oysters Crassostrea rhizophorae from the estuary of the Paraíba River (Paraíba State, Brazil). Perkinsosis was detected by incubation of oyster gill pieces in Ray's fluid thioglycollate medium. The monthly prevalence values were all above 70%, thus infection was not likely to be a transient event. Perkinsus sp. parasites isolated from eight oysters were propagated in vitro. PCR-RFLP analysis of in vitro cultured cells as well as the sequences of the rDNA ITS region allowed the identification of the in vitro propagated parasites as Perkinsus marinus. Phylogenetic analyses using rDNA ITS region sequences strongly supported the Perkinsus sp. from Paraíba in a monophyletic group with P. marinus. Thus, the results confirmed the species affiliation of Paraíba Perkinsus sp. as P. marinus. This is the first report of P. marinus in Brazil and South America and the first report of P. marinus naturally infecting C. rhizophorae. Copyright © 2013 Elsevier Inc. All rights reserved.
2013-06-13
en especial al Instituto para la Cooperación de la Seguridad Hemisférica (WHINSEC) por haberme brindado la gran oportunidad de participar en este...contra cualquiera de los países de América como un sistema de seguridad colectivo, dicho pacto fue suscrito en la Conferencia Interamericana para el...Mantenimiento de la Paz y la Seguridad del Continente, esto en Rio de Janeiro del 15 de agosto al 2 de septiembre de 1947, consecuentemente para
Deborah S. Page-Dumroese; Ann M. Abbott; Thomas M. Rice
2013-01-01
Este documento-El Volumen II: Métodos complementarios, estadÃstica y recolección de datos- define las bases, los métodos estadÃsticos y de almacenamiento de datos de un Protocolo Nacional para la Evaluación de Disturbios en Suelos Forestales. Esta guÃa técnica proporciona las bases de un método consistente, con definiciones comunes, para generar datos de alta calidad,...
Distinct roles of the DmNav and DSC1 channels in the action of DDT and pyrethroids.
Rinkevich, Frank D; Du, Yuzhe; Tolinski, Josh; Ueda, Atsushi; Wu, Chun-Fang; Zhorov, Boris S; Dong, Ke
2015-03-01
Voltage-gated sodium channels (Nav channels) are critical for electrical signaling in the nervous system and are the primary targets of the insecticides DDT and pyrethroids. In Drosophila melanogaster, besides the canonical Nav channel, Para (also called DmNav), there is a sodium channel-like cation channel called DSC1 (Drosophila sodium channel 1). Temperature-sensitive paralytic mutations in DmNav (para(ts)) confer resistance to DDT and pyrethroids, whereas DSC1 knockout flies exhibit enhanced sensitivity to pyrethroids. To further define the roles and interaction of DmNav and DSC1 channels in DDT and pyrethroid neurotoxicology, we generated a DmNav/DSC1 double mutant line by introducing a para(ts1) allele (carrying the I265N mutation) into a DSC1 knockout line. We confirmed that the I265N mutation reduced the sensitivity to two pyrethroids, permethrin and deltamethrin of a DmNav variant expressed in Xenopus oocytes. Computer modeling predicts that the I265N mutation confers pyrethroid resistance by allosterically altering the second pyrethroid receptor site on the DmNav channel. Furthermore, we found that I265N-mediated pyrethroid resistance in para(ts1) mutant flies was almost completely abolished in para(ts1);DSC1(-/-) double mutant flies. Unexpectedly, however, the DSC1 knockout flies were less sensitive to DDT, compared to the control flies (w(1118A)), and the para(ts1);DSC1(-/-) double mutant flies were even more resistant to DDT compared to the DSC1 knockout or para(ts1) mutant. Our findings revealed distinct roles of the DmNav and DSC1 channels in the neurotoxicology of DDT vs. pyrethroids and implicate the exciting possibility of using DSC1 channel blockers or modifiers in the management of pyrethroid resistance. Copyright © 2015 Elsevier Inc. All rights reserved.
Abundâncias químicas de estrelas T Tauri fracas
NASA Astrophysics Data System (ADS)
Rojas, G. A.; Gregorio-Hetem, J.
2003-08-01
Apresentamos resultados do estudo de 44 estrelas pré-seqüência principal, para as quais buscamos realizar uma classificação espectroscópica e determinar parâmetros estelares e abundâncias químicas. A amostra foi escolhida da seguinte maneira : 21 objetos selecionados a partir de catálogos de objetos jovens, como o Pico dos Dias Survey e o Herbig Bell Catalogue, e 23 objetos selecionados a partir de contrapartidas ópticas de fontes de raios X detectadas pelo satélite ROSAT. Dentre 24 objetos previamente classificados como estrelas T Tauri Fracas, apenas 7 revelaram ser realmente pertencentes à essa classe, sendo os demais objetos T Tauri Clássicas ou estrelas evoluídas da pré-seqüência principal. Esse resultado demonstra que o critério mais utilizado para distinguir as T Tauri Clássicas das T Tauri Fracas, baseado na largura equivelente da emissão Ha, não é suficiente para determinar o estágio evolutivo desses objetos. Para o cálculo de parâmetros estelares e abundâncias, foram escolhidas as estrelas que apresentam características ideais para esse tipo de estudo, como ausência de velamento, baixa velocidade de rotação e espectros com razão sinal-ruído adequada. Os parâmetros estelares como temperatura efetiva e gravidade foram determinados através do equilíbrio de excitação e ionização das linhas de Ferro, e as abundâncias químicas foram calculadas utilizando o método de síntese espectral. Serão apresentados os parâmetros estelares e as abundâncias de Lítio para toda a amostra, e abundâncias de vários elementos quimicos para 7 estrelas estudadas em maior detalhe
... rayos-X, revelan solamente la estructura anatómica. Existen más de 100 exámenes diferentes de medicina nuclear para ... se le permite abandonar el hospital y regresar más tarde para el procedimiento del estudio de imagen. ...
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Surfing biological surfaces: exploiting the nucleoid for partition and transport in bacteria.
Vecchiarelli, Anthony G; Mizuuchi, Kiyoshi; Funnell, Barbara E
2012-11-01
The ParA family of ATPases is responsible for transporting bacterial chromosomes, plasmids and large protein machineries. ParAs pattern the nucleoid in vivo, but how patterning functions or is exploited in transport is of considerable debate. Here we discuss the process of self-organization into patterns on the bacterial nucleoid and explore how it relates to the molecular mechanism of ParA action. We review ParA-mediated DNA partition as a general mechanism of how ATP-driven protein gradients on biological surfaces can result in spatial organization on a mesoscale. We also discuss how the nucleoid acts as a formidable diffusion barrier for large bodies in the cell, and make the case that the ParA family evolved to overcome the barrier by exploiting the nucleoid as a matrix for movement. Published 2012. This article is a U.S. Government work and is in the public domain in the USA.
Au nanoparticles films used in biological sensing
NASA Astrophysics Data System (ADS)
Rosales Pérez, M.; Delgado Macuil, R.; Rojas López, M.; Gayou, V. L.; Sánchez Ramírez, J. F.
2009-05-01
Lactobacillus para paracasei are used commonly as functional food and probiotic substances. In this work Au nanoparticles self-assembled films were used for Lactobacillus para paracasei determination at five different concentrations. Functionalized substrates were immersed in a colloidal solution for one and a half hour at room temperature and dried at room temperature during four hours. After that, drops of Lactobacillus para paracasei in aqueous solution were put into the Au nanoparticles film and let dry at room temperature for another two hours. Infrared spectroscopy in attenuated total reflectance sampling mode was used to observe generation peaks due to substrate silanization, enhancement of Si-O band intensity due to the Au colloids added to silanized substrate and also to observe the enhancement of Lactobacillus para paracasei infrared intensity of the characteristic frequencies at 1650, 1534 and 1450 cm-1 due to surface enhancement infrared absorption.
Breakup of a homeobox cluster after genome duplication in teleosts
Mulley, John F.; Chiu, Chi-hua; Holland, Peter W. H.
2006-01-01
Several families of homeobox genes are arranged in genomic clusters in metazoan genomes, including the Hox, ParaHox, NK, Rhox, and Iroquois gene clusters. The selective pressures responsible for maintenance of these gene clusters are poorly understood. The ParaHox gene cluster is evolutionarily conserved between amphioxus and human but is fragmented in teleost fishes. We show that two basal ray-finned fish, Polypterus and Amia, each possess an intact ParaHox cluster; this implies that the selective pressure maintaining clustering was lost after whole-genome duplication in teleosts. Cluster breakup is because of gene loss, not transposition or inversion, and the total number of ParaHox genes is the same in teleosts, human, mouse, and frog. We propose that this homeobox gene cluster is held together in chordates by the existence of interdigitated control regions that could be separated after locus duplication in the teleost fish. PMID:16801555
NASA Astrophysics Data System (ADS)
Gardner, Adrian M.; Tuttle, William Duncan; Groner, Peter; Wright, Timothy G.
2017-06-01
Insight gained from examining the "pure" torsional, vibrational and vibration-torsional (vibtor) levels of the single rotor molecules: toluene (methylbenzene) and para-fluorotoluene (pFT), is applied to the double rotor para-xylene (p-dimethylbenzene) molecule . Resonance-enhanced multiphoton ionization (REMPI) spectroscopy and zero-kinetic-energy (ZEKE) spectroscopy are employed in order to investigate the S_{1} and ground cationic states of para-xylene. Observed transitions are assigned in the full molecular symmetry group (G_{72}) for the first time. J. R. Gascooke, E. A. Virgo, and W. D. Lawrance, J. Chem. Phys., 143, 044313 (2015). A. M. Gardner, W. D. Tuttle, L. Whalley, A. Claydon, J. H. Carter and T. G. Wright, J. Chem. Phys., 145, 124307 (2016). A. M. Gardner, W. D. Tuttle, P. Groner and T. G. Wright, J. Chem. Phys., (2017, in press).
DOE Office of Scientific and Technical Information (OSTI.GOV)
Jones, J.
The Department of Energy of the United States of America works to guarantee provisions of safe energy, reliable and economically accessible to support to one developing economy and to protect the atmosphere. These suggestions and ideas to increase the energy efficiency in their house represent simple ways in which our citizens can contribute to preserve the atmosphere at world-wide level, to reduce the level of contamination of the air and to reserve our natural resources for future generations. [Spanish] El Departamento de Energa de los Estados Unidos de America trabaja para garantizar suministros de energa seguros, confiables y econmicamente accesiblesmore » para apoyar a una economa en desarrollo y proteger el medio ambiente. Estas sugerencias e ideas para aumentar la eficiencia energetica en su casa representan maneras sencillas en que nuestros ciudadanos pueden contribuir a preservar el medio ambiente a nivel mundial, a reducir el nivel de contaminacin del aire y a reservar nuestros recursos naturales para las generaciones futuras.« less
Reineri, Francesca; Santelia, Daniela; Viale, Alessandra; Cerutti, Erika; Poggi, Luisa; Tichy, Tomas; Premkumar, Samuel S D; Gobetto, Roberto; Aime, Silvio
2010-05-26
A set of molecules in which a glucose moiety is bound to a hydrogenable synthon has been synthesized and evaluated for hydrogenation reactions and for the corresponding para-hydrogen-induced polarization (PHIP) effects, in order to select suitable candidates for an in vivo magnetic resonance imaging (MRI) method for the assessment of glucose cellular uptake. It has been found that amidic derivatives do not yield any polarization enhancement, probably due to singlet-triplet state mixing along the reaction pathway. In contrast, ester derivatives are hydrogenated in high yield and afford enhanced (1)H and (13)C NMR spectra after para-hydrogenation. The obtained PHIP patterns are discussed and explained on the basis of the calculated spin level populations in the para-hydrogenated products. These molecules may find interesting applications in (13)C MRI as hyperpolarized probes for assessing the activity of glucose transporters in cells.
Rapid Catalyst Capture Enables Metal-Free para-Hydrogen-Based Hyperpolarized Contrast Agents.
Barskiy, Danila A; Ke, Lucia A; Li, Xingyang; Stevenson, Vincent; Widarman, Nevin; Zhang, Hao; Truxal, Ashley; Pines, Alexander
2018-05-10
Hyperpolarization techniques based on the use of para-hydrogen provide orders of magnitude signal enhancement for magnetic resonance spectroscopy and imaging. The main drawback limiting widespread applicability of para-hydrogen-based techniques in biomedicine is the presence of organometallic compounds (the polarization transfer catalysts) in solution with hyperpolarized contrast agents. These catalysts are typically complexes of platinum-group metals, and their administration in vivo should be avoided. Herein, we show how extraction of a hyperpolarized compound from an organic phase to an aqueous phase combined with a rapid (less than 10 s) Ir-based catalyst capture by metal scavenging agents can produce pure para-hydrogen-based hyperpolarized contrast agents, as demonstrated by high-resolution nuclear magnetic resonance (NMR) spectroscopy and inductively coupled plasma atomic emission spectroscopy (ICP-AES). The presented methodology enables fast and efficient means of producing pure hyperpolarized aqueous solutions for biomedical and other uses.
Sobre la terapia génica para enfermedades de la retina.
Fischer, M Dominik
2017-07-11
Las mutaciones en un gran número de genes provocan degeneración de la retina y ceguera sin que exista actualmente cura alguna. En las últimas décadas, la terapia génica para enfermedades de la retina ha evolucionado y se ha convertido en un nuevo y prometedor paradigma terapéutico para estas enfermedades poco comunes. Este artículo refleja las ideas y los conceptos que parten de la ciencia básica hacia la aplicabilidad de la terapia génica en el ámbito clínico. Se describen los avances y las reflexiones actuales sobre la eficacia de los ensayos clínicos en la actualidad y se discuten los posibles obstáculos y soluciones de cara al futuro de la terapia génica para enfermedades de la retina. © 2017 S. Karger AG, Basel.
2016 CSSE L3 Milestone: Deliver In Situ to XTD End Users
DOE Office of Scientific and Technical Information (OSTI.GOV)
Patchett, John M.; Nouanesengsy, Boonthanome; Fasel, Patricia Kroll
This report summarizes the activities in FY16 toward satisfying the CSSE 2016 L3 milestone to deliver in situ to XTD end users of EAP codes. The Milestone was accomplished with ongoing work to ensure the capability is maintained and developed. Two XTD end users used the in situ capability in Rage. A production ParaView capability was created in the HPC and Desktop environment. Two new capabilities were added to ParaView in support of an EAP in situ workflow. We also worked with various support groups at the lab to deploy a production ParaView in the LANL environment for both desktopmore » and HPC systems. . In addition, for this milestone, we moved two VTK based filters from research objects into the production ParaView code to support a variety of standard visualization pipelines for our EAP codes.« less
NASA Astrophysics Data System (ADS)
Azevedo Sobreira, Paulo Henrique
2012-07-01
There are several interesting astronomical topics that must be addressed in the High School and Elementary/Middle School in the disciplines of Geography and of Sciences. Among them, the topic of time zones which is one of the most important to understand the correlation of the Earth's rotation and its implications on daily activities of citizens in local scale, regional and global scales which involve problems of time differences. For the teaching of time zones in the lessons of Geography, for example, there are bi-dimensional representations of thematic maps of world time zones, textbooks and atlas. It happens that teachers face some difficulties to permit its students to view three-dimensionally this astronomical phenomenon from the textbooks available in schools. The aim of this paper is to present two proposals with low-cost materials, which allow the preparation of three-dimensional models for the teaching of time zones. Há vários temas astronômicos interessantes que devem ser trabalhados nos Ensinos Médio e Fundamental, nas disciplinas de Geografia e de Ciências. Entre eles, o tema dos fusos horários que é um dos mais importantes para se correlacionar a rotação da Terra e suas implicações nas atividades cotidianas dos cidadãos em escala local, regional e global, que envolvem problemas de diferenças horárias. Para o ensino dos fusos horários nas aulas de Geografia, por exemplo, há representações bidimensionais de mapas temáticos de fusos horários mundiais, nos livros didáticos e nos atlas. Ocorre que os professores enfrentam algumas dificuldades para possibilitar aos seus alunos a visão tridimensional deste fenômeno astronômico, a partir dos materiais didáticos disponíveis nas escolas. O objetivo deste trabalho é apresentar duas propostas para a confecção de materiais de baixo custo, que possibilitem a elaboração de modelos tridimensionais para o ensino dos fusos horários. Hay algunos temas astronómicos interesantes que se deben trabajar en la enseñanza media y básica, en las asignaturas de Geografía y de Ciencias. Entre ellos, el de los husos horarios que es uno de los más importantes para correlacionar la rotación de la Tierra y sus implicaciones en las actividades diarias de los ciudadanos en escala local, regional y global, y en general, cuestiones que implican problemas de las diferencias horarias. Para la enseñanza de los husos horarios en las clases de Geografía, por ejemplo, hay representaciones bidimensionales de los mapas temáticos de husos horarios mundiales, en libros y atlas didácticos. Sin embargo, los profesores se enfrentan con algunas dificultades para hacer posible que sus alumnos tengan una visión tridimensional de este fenómeno astronómico, usando los materiales didácticos disponibles en las escuelas. El objetivo de este trabajo es presentar la construcción de dos propuestas de materiales de bajo costo, que hacen posible la elaboración de modelos tridimensionales para la enseñanza de los husos horarios.
NASA Technical Reports Server (NTRS)
Neufeld, David A.; Melnick, Gary J.; Harwit, Martin
1998-01-01
We have detected the S(1), S(2), S(3), S(4), and S(5) pure rotational lines of molecular hydrogen toward the outflow source HH 54 using the Short Wavelength Spectrometer on board the Infrared Space Observatory. The observed H2 line ratios indicate the presence of warm molecular gas with an H2 density of at least 10(exp 5) cm(exp -3) and a temperature approximately 650 K in which the ratio of ortho- to para-H2 is only 1.2 +/- 0.4, significantly smaller than the equilibrium ratio of 3 expected in gas at that temperature. These observations imply that the measured ratio of ortho- to para-H2 is the legacy of an earlier stage in the thermal history of the gas when the gas had reached equilibrium at a temperature approximately less than 90 K. Based upon the expected timescale for equilibration, we argue that the nonequilibrium ratio of ortho- to para-H2 observed in HH 54 serves as a chronometer that places a conservative upper limit of approximately 5000 yr on the period for which the emitting gas has been warm. The S(2)/S(1) and S(3)/S(1) H2 line ratios measured toward HH 54 are consistent with recent theoretical models of Timmermann for the conversion of para- to ortho-H2 behind slow, C-type shocks, but only if the preshock ratio of ortho- to para-H2 was approximately less than 0.2.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hodges, Joseph C.; Das, Prajnan, E-mail: PrajDas@mdanderson.or; Eng, Cathy
2009-11-01
Purpose: To determine the rates of toxicity, locoregional control, distant control, and survival in anal cancer patients with para-aortic nodal involvement, treated with intensity-modulated radiotherapy (IMRT) and concurrent chemotherapy at a single institution. Methods and Materials: Between 2001 and 2007, 6 patients with squamous cell anal cancer and para-aortic nodal involvement were treated with IMRT and concurrent infusional 5-fluorouracil and cisplatin. The primary tumor was treated with a median dose of 57.5 Gy (range, 54-60 Gy), involved para-aortic, pelvic, and inguinal lymph nodes were treated with a median dose of 55 Gy (range, 50.5-55 Gy), and noninvolved nodal regions weremore » treated with a median dose of 45 Gy (range, 43.5-45 Gy). Results: After a median follow-up of 25 months, none of the patients had a recurrence at the primary tumor, pelvic/inguinal nodes, or para-aortic nodes, whereas 2 patients developed distant metastases to the liver. Four of the 6 patients are alive. The 3-year actuarial locoregional control, distant control, and overall survival rates were 100%, 56%, and 63%, respectively. Four of the 6 patients developed Grade 3 acute gastrointestinal toxicity during chemoradiation. Conclusions: Intensity-modulated radiotherapy and concurrent chemotherapy could potentially serve as definitive therapy in anal cancer patients with para-aortic nodal involvement. Adjuvant chemotherapy may be indicated in these patients, as demonstrated by the distant failure rates. These patients need to be followed carefully because of the potential for treatment-related toxicities.« less
Cuban Telecommunications, Computer Networking, and U.S. Policy Implications,
1996-07-01
Informacion para la Prensa Federacion de Mujeres Cubanas Grupo para la Educacion sobre el SIDA Instituto Superior Latinoamericano de Ajedrez...DIR) Informacion sobre Medio Ambiente (DIR) Medicina Alternativa (DIR) Servicio Especial de la Mujer (DIR) Eventos Internacionales (DIR
Federal Register 2010, 2011, 2012, 2013, 2014
2013-10-22
...), Solicitud en Papel/Registro Para Asistencia De Desastre; FEMA Form 009-0-1S (English) Smartphone, Disaster Assistance Registration; FEMA Form 009-0-2S (Spanish) Smartphone, Registro Para Asistencia De Desastre; and...
Vínculos observacionais para o processo-S em estrelas gigantes de Bário
NASA Astrophysics Data System (ADS)
Smiljanic, R. H. S.; Porto de Mello, G. F.; da Silva, L.
2003-08-01
Estrelas de bário são gigantes vermelhas de tipo GK que apresentam excessos atmosféricos dos elementos do processo-s. Tais excessos são esperados em estrelas na fase de pulsos térmicos do AGB (TP-AGB). As estrelas de bário são, no entanto, menos massivas e menos luminosas que as estrelas do AGB, assim, não poderiam ter se auto-enriquecido. Seu enriquecimento teria origem em uma estrela companheira, inicialmente mais massiva, que evolui pelo TP-AGB, se auto-enriquece com os elementos do processo-s e transfere material contaminado para a atmosfera da atual estrela de bário. A companheira evolui então para anã branca deixando de ser observada diretamente. As estrelas de bário são, portanto, úteis como testes observacionais para teorias de nucleossíntese pelo processo-s, convecção e perda de massa. Análises detalhadas de abundância com dados de alta qualidade para estes objetos são ainda escassas na literatura. Neste trabalho construímos modelos de atmosferas e, procedendo a uma análise diferencial, determinamos parâmetros atmosféricos e evolutivos de uma amostra de dez gigantes de bário e quatro normais. Determinamos seus padrões de abundância para Na, Mg, Al, Si, Ca, Sc, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Sr, Y, Zr, Ba, La, Ce, Nd, Sm, Eu e Gd, concluindo que algumas estrelas classificadas na literatura como gigantes de bário são na verdade gigantes normais. Comparamos dois padrões médios de abundância, para estrelas com grandes excessos e estrelas com excessos moderados, com modelos teóricos de enriquecimento pelo processo-s. Os dois grupos de estrelas são ajustados pelos mesmos parâmetros de exposição de nêutrons. Tal resultado sugere que a ocorrência do fenômeno de bário com diferentes intensidades não se deve a diferentes exposições de nêutrons. Discutimos ainda efeitos nucleossintéticos, ligados ao processo-s, sugeridos na literatura para os elementos Cu, Mn, V e Sc.
Intact cluster and chordate-like expression of ParaHox genes in a sea star
2013-01-01
Background The ParaHox genes are thought to be major players in patterning the gut of several bilaterian taxa. Though this is a fundamental role that these transcription factors play, their activities are not limited to the endoderm and extend to both ectodermal and mesodermal tissues. Three genes compose the ParaHox group: Gsx, Xlox and Cdx. In some taxa (mostly chordates but to some degree also in protostomes) the three genes are arranged into a genomic cluster, in a similar fashion to what has been shown for the better-known Hox genes. Sea urchins possess the full complement of ParaHox genes but they are all dispersed throughout the genome, an arrangement that, perhaps, represented the primitive condition for all echinoderms. In order to understand the evolutionary history of this group of genes we cloned and characterized all ParaHox genes, studied their expression patterns and identified their genomic loci in a member of an earlier branching group of echinoderms, the asteroid Patiria miniata. Results We identified the three ParaHox orthologs in the genome of P. miniata. While one of them, PmGsx is provided as maternal message, with no zygotic activation afterwards, the other two, PmLox and PmCdx are expressed during embryogenesis, within restricted domains of both endoderm and ectoderm. Screening of a Patiria bacterial artificial chromosome (BAC) library led to the identification of a clone containing the three genes. The transcriptional directions of PmGsx and PmLox are opposed to that of the PmCdx gene within the cluster. Conclusions The identification of P. miniata ParaHox genes has revealed the fact that these genes are clustered in the genome, in contrast to what has been reported for echinoids. Since the presence of an intact cluster, or at least a partial cluster, has been reported in chordates and polychaetes respectively, it becomes clear that within echinoderms, sea urchins have modified the original bilaterian arrangement. Moreover, the sea star ParaHox domains of expression show chordate-like features not found in the sea urchin, confirming that the dynamics of gene expression for the respective genes and their putative regulatory interactions have clearly changed over evolutionary time within the echinoid lineage. PMID:23803323
Wang, Zhen; Liu, Shuoyan
2015-09-01
To analyze the pattern of lymphatic metastasis in middle thoracic esophageal squamous cell carcinoma (ESCC) with different T staging and to investigate the clinical value of para-recurrent laryngeal nerve lymphadenectomy. Clinicopathological data of 717 patients with middle thoracic ESCC undergoing Mckeown esophagectomy plus three-field lymph node dissection in Fujian Provincial Hospital from January 1999 to December 2007 were analyzed retrospectively. Lymph node metastatic rates of different T stages were calculated. Clinical value of each station lymphadenectomy, especially the para-recurrent laryngeal nerve lymphadenectomy, was evaluated by the efficacy index (EI, cross product of one station metastatic rate and 5-year survival of patient with positive lymph nodes of above station). Rates of lymph node metastasis were 29.0% (18/62), 61.1% (91/149) and 64.8% (328/506) in stage T1, T2 and T3 patients respectively. Despite T staging, metastatic rates of right para-recurrent laryngeal nerve lymph node (rRLN LN) were 21.0% (13/62), 28.9% (43/149) and 29.4% (149/506) in stage T1, T2 and T3 patients respectively, which was the most common among all lymph node stations. Metastatic rates of left para-recurrent laryngeal nerve lymph node (lRLN LN) were the second, with 8.1% (5/62), 17.4% (26/149) and 24.7% (125/506) in stage T1, T2, T3 patients respectively. Follow-up period lasted more than 5 years. The 5-year survival rates of positive rRLN LN were 53.8%, 39.5% and 32.2% in stage T1, T2 and T3 patients respectively, whose EI values were 11.3, 11.4 and 9.5 respectively. The 5-year survival rates of positive lRLN LN were 40.0%, 34.6% and 40.0% in stage T1, T2 and T3 patients respectively, whose EI values were 3.2, 6.0 and 9.9 respectively. Bilateral para-recurrent laryngeal nerve lymph nodes are the common sites of metastasis in middle thoracic esophageal squamous cell carcinoma. Right para-recurrent laryngeal nerve lymphadenectomy is of high clinical value despite the T staging. Left para-recurrent laryngeal nerve lymphadenectomy has better efficacy in stage T2 and T3 patients, but is limited in stage T1 patients.
Sistemas Correctores de Campo Para EL Telescopio Cassegrain IAC80
NASA Astrophysics Data System (ADS)
Galan, M. J.; Cobos, F. J.
1987-05-01
El proyecto de instrumentación de mayor importancia que ha tenido el Instituto de Astrofisica de Canarias en los últimos afios ha sido el diseflo y construcción del te1escopio IAC8O. Este requería del esfuerzo con junto en mec´nica, óptica y electrónica, lo que facilitó la estructuración y el crecimiento de los respectivos grupos de trabajo, que posteriormente se integraron en departamentos En su origen (1977), el telescopio IAC80 fue concebido como un sistema clásico tipo Cassegrain, con una razón focal F/i 1.3 para el sistema Casse grain y una razón focal F/20 para el sistema Coudé. Posteriormente, aunque se mantuvo la filosofia de que el sistema básico fuera el F/11.3, se consideró conveniente el diseño de secundarios para razones focales F/16 y F/32, y se eliminó el de F/20. Sin embargo, dada la importancia relativa que un foco estrictamente fotográfico tiene en un telescopio moderno, diseñado básicamente para fotometría fotoeléctrica y con un campo util mínimamente de 40 minutos de arco, se decídió Ilevar a cabo el diseño de un secundario F/8 con un sistema corrector de campo, pero que estuviera formado únicamente por lentes con superficies esféricas para que asl su construcción fuera posible en España ó en México. La creciente utilización de detectores bidimensionales para fines de investigación astron6mica y la viabilidad de que en un futuro cercano éstos tengan un área sensible cada vez mayor, hicieron atractiva la idea de tener diseñado un sistema corrector de campo para el foco primario (F/3), con un campo útil mínimo de un grado, y también con la limitante de que sus componentes tuvieron sólamente supérficies esféricas. Ambos diseños de los sis-temas correctores de campo se llevaron a cabo, en gran medida, como parte de un proyecto de colaboración e intercambio en el área de diseño y evaluación de sistemas ópticos.
Jupiter's para-H2 distribution from SOFIA/FORCAST and Voyager/IRIS 17-37 μm spectroscopy
NASA Astrophysics Data System (ADS)
Fletcher, Leigh N.; de Pater, I.; Reach, W. T.; Wong, M.; Orton, G. S.; Irwin, P. G. J.; Gehrz, R. D.
2017-04-01
Spatially resolved maps of Jupiter's far-infrared 17-37 μm hydrogen-helium collision-induced spectrum were acquired by the FORCAST instrument on the Stratospheric Observatory for Infrared Astronomy (SOFIA) in May 2014. Spectral scans in two grisms covered the broad S(0) and S(1) absorption lines, in addition to contextual imaging in eight broad-band filters (5-37 μm) with spatial resolutions of 2-4″. The spectra were inverted to map the zonal-mean temperature and para-H2 distribution (fp, the fraction of the para spin isomer with respect to the ortho spin isomer) in Jupiter's upper troposphere (the 100-700 mbar range). We compared these to a reanalysis of Voyager-1 and -2 IRIS spectra covering the same spectral range. Tropospheric temperature contrasts match those identified by Voyager in 1979, within the limits of temporal variability consistent with previous investigations. Para-H2 increases from equator to pole, with low-fp air at the equator representing sub-equilibrium conditions (i.e., less para-H2 than expected from thermal equilibration), and high-fp air and possible super-equilibrium at higher latitudes. In particular, we confirm the continued presence of a region of high-fp air at high northern latitudes discovered by Voyager/IRIS, and an asymmetry with generally higher fp in the north than in the south. Far-IR aerosol opacity is not required to fit the data, but cannot be completely ruled out. We note that existing collision-induced absorption databases lack opacity from (H2)2 dimers, leading to under-prediction of the absorption near the S(0) and S(1) peaks. There appears to be no spatial correlation between para-H2 and tropospheric ammonia, phosphine and cloud opacity derived from Voyager/IRIS at mid-infrared wavelengths (7-15 μm). We note, however, that para-H2 tracks the similar latitudinal distribution of aerosols within Jupiter's upper tropospheric and stratospheric hazes observed in reflected sunlight, suggesting that catalysis of hydrogen equilibration within the hazes (and not the main clouds) may govern the equator-to-pole gradient, with conditions closer to equilibrium at higher latitudes. This gradient is superimposed onto smaller-scale variations associated with regional advection of para-H2 at the equator and poles.
Kinetic temperature of massive star forming molecular clumps measured with formaldehyde
NASA Astrophysics Data System (ADS)
Tang, X. D.; Henkel, C.; Menten, K. M.; Zheng, X. W.; Esimbek, J.; Zhou, J. J.; Yeh, C. C.; König, C.; Yuan, Y.; He, Y. X.; Li, D. L.
2017-02-01
Context. For a general understanding of the physics involved in the star formation process, measurements of physical parameters such as temperature and density are indispensable. The chemical and physical properties of dense clumps of molecular clouds are strongly affected by the kinetic temperature. Therefore, this parameter is essential for a better understanding of the interstellar medium. Formaldehyde, a molecule which traces the entire dense molecular gas, appears to be the most reliable tracer to directly measure the gas kinetic temperature. Aims: We aim to determine the kinetic temperature with spectral lines from formaldehyde and to compare the results with those obtained from ammonia lines for a large number of massive clumps. Methods: Three 218 GHz transitions (JKAKC = 303-202, 322-221, and 321-220) of para-H2CO were observed with the 15 m James Clerk Maxwell Telescope (JCMT) toward 30 massive clumps of the Galactic disk at various stages of high-mass star formation. Using the RADEX non-LTE model, we derive the gas kinetic temperature modeling the measured para-H2CO 322-221/303-202 and 321-220/303-202 ratios. Results: The gas kinetic temperatures derived from the para-H2CO (321-220/303-202) line ratios range from 30 to 61 K with an average of 46 ± 9 K. A comparison of kinetic temperature derived from para-H2CO, NH3, and the dust emission indicates that in many cases para-H2CO traces a similar kinetic temperature to the NH3 (2, 2)/(1, 1) transitions and the dust associated with the HII regions. Distinctly higher temperatures are probed by para-H2CO in the clumps associated with outflows/shocks. Kinetic temperatures obtained from para-H2CO trace turbulence to a higher degree than NH3 (2, 2)/(1, 1) in the massive clumps. The non-thermal velocity dispersions of para-H2CO lines are positively correlated with the gas kinetic temperature. The massive clumps are significantly influenced by supersonic non-thermal motions. The reduced spectra (FITS files) are only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (http://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/598/A30
Diagnosis of compliance of health care product processing in Primary Health Care.
Roseira, Camila Eugenia; Silva, Darlyani Mariano da; Passos, Isis Pienta Batista Dias; Orlandi, Fabiana Souza; Padoveze, Maria Clara; Figueiredo, Rosely Moralez de
2016-11-21
identify the compliance of health care product processing in Primary Health Care and assess possible differences in the compliance among the services characterized as Primary Health Care Service and Family Health Service. quantitative, observational, descriptive and inferential study with the application of structure, process and outcome indicators of the health care product processing at ten services in an interior city of the State of São Paulo - Brazil. for all indicators, the compliance indices were inferior to the ideal levels. No statistically significant difference was found in the indicators between the two types of services investigated. The health care product cleaning indicators obtained the lowest compliance index, while the indicator technical-operational resources for the preparation, conditioning, disinfection/sterilization, storage and distribution of health care products obtained the best index. the diagnosis of compliance of health care product processing at the services assessed indicates that the quality of the process is jeopardized, as no results close to ideal levels were obtained at any service. In addition, no statistically significant difference in these indicators was found between the two types of services studied. identificar a conformidade do processamento de produtos para saúde na Atenção Primária à Saúde e avaliar possível diferença na conformidade entre as unidades caracterizadas como Unidade Básica de Saúde e Unidade Saúde da Família. estudo quantitativo, observacional, descritivo e inferencial, com a aplicação de indicadores de estrutura, processo e resultado referentes ao processamento de produtos para a saúde em dez unidades, de um município do interior de São Paulo - Brasil. todos os indicadores obtiveram índice de conformidade inferior ao ideal. Não houve diferença estatisticamente significante nos indicadores entre os dois tipos de unidades investigadas, sendo o indicador de limpeza de produtos para saúde o de menor índice de conformidade, enquanto indicador de recursos técnico-operacionais para preparo, acondicionamento, desinfecção/esterilização, guarda e distribuição de produtos para saúde, o de melhor índice. o diagnóstico de conformidade do processamento de produtos para saúde nas unidades avaliadas indica comprometimento da qualidade do processo, uma vez que não foram obtidos resultados próximos ao valor ideal em nenhuma unidade. Além disso, não houve diferença estatisticamente significante desses indicadores entre os dois tipos de unidades estudadas. identificar la conformidad del procesamiento de productos para la salud en la Atención Primaria a la Salud y evaluar una posible diferencia en la conformidad entre las unidades caracterizadas: Unidad Básica de Salud y Unidad Salud de la Familia. estudio cuantitativo, observacional, descriptivo e inferencial; se aplicaron indicadores de estructura, proceso y resultado, referentes al procesamiento de productos para la salud en diez unidades de un municipio del interior de Sao Paulo, Brasil. todos los indicadores obtuvieron índice de conformidad inferior a lo ideal. No hubo diferencia estadísticamente significativa de los indicadores entre los dos tipos de unidades investigadas, siendo el indicador de limpieza de productos para la salud el de menor índice de conformidad; por otro lado, como indicador de recursos técnico-operacionales para preparación, acondicionamiento, desinfección/esterilización, almacenamiento y distribución de productos para la salud, fue el de mejor índice. el diagnóstico de conformidad del procesamiento de productos para la salud en las unidades evaluadas indica que está comprometida la calidad del proceso, ya que no fueron obtenidos resultados próximos al valor ideal en ninguna unidad. Además de eso, no hubo diferencia estadísticamente significativa de esos indicadores entre los dos tipos de unidades estudiadas.
Accuracy of probabilistic and deterministic record linkage: the case of tuberculosis.
Oliveira, Gisele Pinto de; Bierrenbach, Ana Luiza de Souza; Camargo, Kenneth Rochel de; Coeli, Cláudia Medina; Pinheiro, Rejane Sobrino
2016-08-22
To analyze the accuracy of deterministic and probabilistic record linkage to identify TB duplicate records, as well as the characteristics of discordant pairs. The study analyzed all TB records from 2009 to 2011 in the state of Rio de Janeiro. A deterministic record linkage algorithm was developed using a set of 70 rules, based on the combination of fragments of the key variables with or without modification (Soundex or substring). Each rule was formed by three or more fragments. The probabilistic approach required a cutoff point for the score, above which the links would be automatically classified as belonging to the same individual. The cutoff point was obtained by linkage of the Notifiable Diseases Information System - Tuberculosis database with itself, subsequent manual review and ROC curves and precision-recall. Sensitivity and specificity for accurate analysis were calculated. Accuracy ranged from 87.2% to 95.2% for sensitivity and 99.8% to 99.9% for specificity for probabilistic and deterministic record linkage, respectively. The occurrence of missing values for the key variables and the low percentage of similarity measure for name and date of birth were mainly responsible for the failure to identify records of the same individual with the techniques used. The two techniques showed a high level of correlation for pair classification. Although deterministic linkage identified more duplicate records than probabilistic linkage, the latter retrieved records not identified by the former. User need and experience should be considered when choosing the best technique to be used. Analisar a acurácia das técnicas determinística e probabilística para identificação de registros duplicados de tuberculose, assim como as características dos pares discordantes. Foram analisados todos os registros de tuberculose no período de 2009 a 2011 do estado do Rio de Janeiro. Foi desenvolvido algoritmo para relacionamento determinístico, usando conjunto de 70 regras, a partir da combinação de fragmentos das variáveis-chave com ou sem modificações (Soundex ou substring). Cada regra era formada por três ou mais fragmentos. Para a abordagem probabilística, foi necessário estabelecer ponto de corte para o escore, acima do qual os links seriam classificados automaticamente como pertencentes ao mesmo indivíduo. O ponto de corte foi obtido por meio do relacionamento da base de dados Sistema de Informação de Agravos de Notificação - Tuberculose com ela mesma, posterior revisão manual e curvas ROC e precision-recall. Foram calculadas a sensibilidade e especificidade para análise de acurácia. A acurácia variou de 87,2% a 95,2% para sensibilidade e 99,8% a 99,9% para especificidade para as técnicas probabilística e determinística, respectivamente. A presença de valores faltantes para as variáveis-chave e o baixo percentual da medida de similaridade para o nome e data de nascimento foram os principais responsáveis pela não identificação dos registros do mesmo indivíduo pelas técnicas utilizadas. As duas técnicas apresentam alta concordância para a classificação como par. Apesar de a técnica determinística ter identificado mais registros duplicados que a probabilística, a segunda recuperou registros não identificados pela primeira. A necessidade e a experiência do usuário devem ser consideradas para a escolha da técnica a ser utilizada.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Barnes, B.; Rosenberg, S.; Arnolds, L.
A mass-rearing facility for Mediterranean fruit fly Ceratitis capitata (Wiedemann) was commissioned in Stellenbosch in 1999 to produce sterile male fruit flies for a sterile insect technique (SIT) project in commercial fruit orchards and vineyards in the Western Cape province of South Africa. The mass-rearing procedure was largely based on systems developed by the FAO/IAEA Agriculture and Biotechnology Laboratory, Seibersdorf, Austria. A number of genetic sexing strains were used to produce only males for release. Initial cramped rearing and quality management conditions were alleviated in 2001 with the construction of a new adult rearing room and quality control laboratory. Inmore » 2002 a comprehensive Quality Management System was implemented, and in 2003 an improved genetic sexing strain, VIENNA 8, was supplied by the FAO/IAEA Laboratory in Seibersdorf. For most of the first 3 years the facility was unable to supply the required number of sterile male Mediterranean fruit flies for the SIT program without importing sterile male pupae from another facility. From mid-2002, after the quality management system was implemented, both production and quality improved but remained below optimum. After the introduction of the VIENNA 8 genetic sexing strain, and together with an improvement in the climate control equipment, production stability, and quality assurance parameters improved substantially. The critical factors influencing production and quality were an inadequate rearing infrastructure, problems with the quality of the larval diet, and the initial absence of a quality management system. The results highlight the importance of effective quality management, the value of a stable and productive genetic sexing strain, and the necessity for a sound funding base for the mass-rearing facility. (author) [Spanish] La facilidad para criar en masa la mosca mediterranea de la fruta, Ceratitis capitata (Wiedemann) fue comisionada en Stellenbosch en 1999 para producir machos esteriles de moscas para el proyecto de la tecnica del insecto esteril (TIE) en huertos de frutos y vinas comerciales en la provincia del Cabo Occidental del Sudafrica. El procedimiento de criar en masa fue en su mayor parte basado en los sistemas desarrollados por el Laboratorio de Agricultura y Biotecnologia de la FAO/IAEA, Seibersdorf, Austria. Un numero de razas que separara los sexos geneticamente fueron utilizadas para producir solo machos para la liberacion. La congestionada condicion inicial para criar las moscas y su manejo de calidad fueron aliviadas en 2001 con la construccion de un nuevo cuarto de cria para adultos y un laboratorio de control de calidad. En 2002, un Sistema de Manejo de Calidad comprensivo fue implementado, y en 2003 una raza mejorada que separa los sexos geneticamente, VIENNA 8, fue proveido por el Laboratorio de la FAO/IAEA en Seibersdorf. En la mayor parte de los primeros 3 anos la facilidad no pudo suplir el numero requerido de machos esteriles de la mosca mediterranea de la fruta para el programa de TIE sin la necesidad para importar machos esteriles de otra facilidad. Desde medio del ano de 2002, despues que el sistema de manejo de calidad fue implementado, la produccion y la calidad mejoraron pero aun quedaron por debajo del nivel optimo. Despues de la introduccion de la raza VIENNA 8 que separa los sexos geneticamente, y junto con el equipo mejorado de control de clima, la estabilidad y los parametros de seguridad de calidad mejoraron substancialmente. Los factores criticos que influyeron en la produccion y la calidad fueron la infraestructura inadecuada para criar las moscas, problemas con la calidad de la dieta para las larvas y la ausencia inicial de un sistema de manejo de calidad. Los resultados muestran claramente la importancia de un manejo efectivo de la calidad, el valor de una raza productiva que separa los sexos geneticamente y la necesidad de contar con una base solida de financimiento para la infraestructura de una cria en masa. (author)« less
NCEP HYSPLIT SMOKE & DUST Verification. NOAA/NWS/NCEP/EMC
April May June July August Summer September October November December Prod vs Para Summer 2013 CA/MX Hawaii All regions PROD run All regions PARA run Select averaged hour: 1 hr average Select forecast four
Seguridad Laboral al Usar Pesticidas
Para proteger a la gente que trabaja con pesticidas y quienes laboran en áreas tratadas con pesticidas; para educar al personal médico y al público acerca de cómo reconocer y tratar las enfermedades relacionadas a los pesticidas.
Dinámica de objetos transplutonianos: resultados preliminares
NASA Astrophysics Data System (ADS)
Fernández, S.; Brizuela, H.; Roig, F.; Varela, O.
Se presentan los resultados de una integración numérica de las ecuaciones de movimiento para objetos transplutonianos. Se han calculado los tiempos de Lyapunov para esos objetos y se analiza el comportamiento dinámico de los mismos.
La función de la EPA para la protección contra la radiación
Conforme al mandato congresional, la Agencia de Protección Ambiental de EE.UU. el la entidad responsable de establecer normas para proteger la salud humana y el medioambiente de materiales radioactivos.
2010-01-01
also from Estado de México (Hoffmann, 1969). Hosts in Mexico. Cricetidae and Hominidae ( Homo sapiens Linnaeus, 1758) (Mammalia) (Hoffmann, 1969...distribution El género Ixodes (Acari: Ixodidae) en México: claves de identifi cación para adultos, diagnosis, huéspedes y distribución Carmen Guzmán...postdoctoral scholarship under the Programa de Formación e Incorporación de Profesores de Carrera en Facultades y Escuelas para el Fortalecimiento de la
MARVEL analysis of the measured high-resolution rovibrational spectra of C2H2
NASA Astrophysics Data System (ADS)
Chubb, Katy L.; Joseph, Megan; Franklin, Jack; Choudhury, Naail; Furtenbacher, Tibor; Császár, Attila G.; Gaspard, Glenda; Oguoko, Patari; Kelly, Adam; Yurchenko, Sergei N.; Tennyson, Jonathan; Sousa-Silva, Clara
2018-01-01
Rotation-vibration energy levels are determined for the electronic ground state of the acetylene molecule, 12C2H2, using the Measured Active Rotational-Vibrational Energy Levels (MARVEL) technique. 37,813 measured transitions from 61 publications are considered. The distinct components of the spectroscopic network linking ortho and para states of the molecule are considered separately. The 20,717 ortho and 17,096 para transitions measured experimentally are used to determine 6013 ortho and 5200 para energy levels. The MARVEL results are compared with alternative compilations based on the use of effective Hamiltonians.
Viswanathan, Gopinath; Yadav, Sangya
2017-01-01
ABSTRACT In a Mycobacterium smegmatis mutant library screen, transposon mutants with insertions in fhaA, dprE2, rpsT, and parA displayed hypersusceptibility to antibiotics, including the β-lactams meropenem, ampicillin, amoxicillin, and cefotaxime. Sub-MIC levels of octoclothepin, a psychotic drug inhibiting ParA, phenocopied the parA insertion and enhanced the bactericidal activity of meropenem against Mycobacterium tuberculosis in combination with clavulanate. Our study identifies novel factors associated with antibiotic resistance, with implications in repurposing β-lactams for tuberculosis treatment. PMID:28438925
M. Torrez; W. Arendt; J. M. Maes
2013-01-01
Para evaluar la diversidad de aves y mariposas ninfálidas visitamos la Estación Biológica Juan Roberto Zarruk en Jinotega, donde colectamos datos en todos los hábitats presentes en la finca. Obtuvimos 123 especies de aves y 29 especies de ninfálidos. El hábitat con mayor riqueza para aves fue el cafetal y para ninfálidos el tacotal. Entre las especies más comunes...
Miller, Thomas F; Manolopoulos, David E; Madden, Paul A; Konieczny, Martin; Oberhofer, Harald
2005-02-01
We show that the two phase points considered in the recent simulations of liquid para hydrogen by Hone and Voth lie in the liquid-vapor coexistence region of a purely classical molecular dynamics simulation. By contrast, their phase point for ortho deuterium was in the one-phase liquid region for both classical and quantum simulations. These observations are used to account for their report that quantum mechanical effects enhance the diffusion in liquid para hydrogen and decrease it in ortho deuterium.(c) 2005 American Institute of Physics.
Theoretical Study of the Mechanism Behind the para-Selective Nitration of Toluene in Zeolite H-Beta
DOE Office of Scientific and Technical Information (OSTI.GOV)
Andersen, Amity; Govind, Niranjan; Subramanian, Lalitha
Periodic density functional theory calculations were performed to investigate the origin of the favorable para-selective nitration of toluene exhibited by zeolite H-beta with acetyl nitrate nitration agent. Energy calculations were performed for each of the 32 crystallographically unique Bronsted acid sites of a beta polymorph B zeolite unit cell with multiple Bronsted acid sites of comparable stability. However, one particular aluminum T-site with three favorable Bronsted site oxygens embedded in a straight 12-T channel wall provides multiple favorable proton transfer sites. Transition state searches around this aluminum site were performed to determine the barrier to reaction for both para andmore » ortho nitration of toluene. A three-step process was assumed for the nitration of toluene with two organic intermediates: the pi- and sigma-complexes. The rate limiting step is the proton transfer from the sigma-complex to a zeolite Bronsted site. The barrier for this step in ortho nitration is shown to be nearly 2.5 times that in para nitration. This discrepancy appears to be due to steric constraints imposed by the curvature of the large 12-T pore channels of beta and the toluene methyl group in the ortho approach that are not present in the para approach.« less
Monsiváis, María Guadalupe Moreno; Guzmán, Ma. Guadalupe Interial; Flores, Paz Francisco Sauceda; Arreola, Leticia Vázquez
2012-01-01
Resumen En el presente trabajo se muestra la importancia de entrenar al personal de enfermería para mejorar la documentación en el expediente electrónico. Se eligió el manejo del dolor por ser un área prioritaria; una alta proporción de pacientes en período post operatorio cursa con dolor, por lo tanto, la documentación debe ser útil para la toma de decisiones clínicas. Se implementó un programa de entrenamiento denominado “Manejo del Dolor” dirigido al personal de enfermería. Se utilizó la tecnología de la información como herramienta para fortalecer el conocimiento con base en la revisión sistemática de la literatura; el personal de enfermería participante seleccionó la mejor evidencia; posteriormente se trabajó en la transferencia de este conocimiento a la práctica a través del diseño de un protocolo para el manejo del dolor. Se concluye que el conocimiento del manejo del dolor es fundamental para que enfermería documente con mayor precisión sus intervenciones. PMID:24199106
Todua, Nino G; Mikaia, Anzor I
2016-01-01
Derivatives requiring either anhydrous or aqueous reaction conditions were prepared for robust and reliable gas chromatography/mass spectrometry (GC/MS) characterization of hydroxyl, mercapto, and amino benzoic acids Methylation and trialkylsilytation are employed for blocking the acidic function. Alkyl, trimethylsilyl, acetyl, perfluoroacyl and alkoxycarbonyl derivatization groups are introduced to hydroxyl, mercapto and amino functions. The electron ionization induced fragmentation characteristics of corresponding derivatives are explained by comparing the MS 1 spectra of unlabeled compounds to their 2 H and 13 C labeled analogs, and analysis of collision-induced dissociation data from MS 2 spectra. Competing fragmentation alternatives are identified and specific decomposition processes are detailed that characterize (a) ortho isomers due to interaction or vicinal functional substituents and (b) para isomers prone to forming para quinoid type structures. Skeletal and hydrogen rearrangements typical for methyl benzoates and the blocking groups are considered when discussing diagnostically important ions. Characteristic ions produced as a result of rearrangements in ortho isomers are classified, and skeletal rearrangements required to produce para quinoid type ions specific for para isomers are noted. Key ions for structure elucidation and differentiation of isomers for derivatives of substituted benzoic acids by GC/MS are suggested.
Initial value problem of space dynamics in universal Stumpff anomaly
NASA Astrophysics Data System (ADS)
Sharaf, M. A.; Dwidar, H. R.
2018-05-01
In this paper, the initial value problem of space dynamics in universal Stumpff anomaly ψ is set up and developed in analytical and computational approach. For the analytical expansions, the linear independence of the functions U_{j} (ψ;σ); {j=0,1,2,3} are proved. The differential and recurrence equations satisfied by them and their relations with the elementary functions are given. The universal Kepler equation and its validations for different conic orbits are established together with the Lagrangian coefficients. Efficient representations of these functions are developed in terms of the continued fractions. For the computational developments we consider the following items: 1.
Segurado, Manuel A P; Reis, João Carlos R; de Oliveira, Jaime D Gomes; Kabilan, Senthamaraikannan; Shanthi, Manohar
2007-07-06
Rate constants were measured for the oxidative chlorodehydrogenation of (R,S)-2-phenoxypropanoic acid and nine ortho-, ten para- and five meta-substituted derivatives using (R,S)-1-chloro-3-methyl-2,6-diphenylpiperidin-4-one (NCP) as chlorinating agent. The kinetics was run in 50% (v/v) aqueous acetic acid acidified with perchloric acid under pseudo-first-order conditions with respect to NCP at temperature intervals of 5 K between 298 and 318 K, except at the highest temperature for the meta derivatives. The dependence of rate constants on temperature was analyzed in terms of the isokinetic relationship (IKR). For the 20 reactions studied at five different temperatures, the isokinetic temperature was estimated to be 382 K, which suggests the preferential involvement of water molecules in the rate-determining step. The dependence of rate constants on meta and para substitution was analyzed using the tetralinear extension of the Hammett equation. The parameter lambda for the para/meta ratio of polar substituent effects was estimated to be 0.926, and its electrostatic modeling suggests the formation of an activated complex bearing an electric charge near the oxygen atom belonging to the phenoxy group. A new approach is introduced for examining the effect of ortho substituents on reaction rates. Using IKR-determined values of activation enthalpies for a set of nine pairs of substrates with a given substituent, a linear correlation is found between activation enthalpies of ortho and para derivatives. The correlation is interpreted in terms of the selectivity of the reactant toward para- or ortho-monosubstituted substrates, the slope of which being related to the ortho effect. This slope is thought to be approximated by the ratio of polar substituent effects from ortho and para positions in benzene derivatives. Using the electrostatic theory of through-space interactions and a dipole length of 0.153 nm, this ratio was calculated at various positions of a charged reaction center along the benzene C1-C4 axis, being about 2.5 near the ring and decreasing steeply with increasing distance until reaching a minimum value of -0.565 at 1.3 nm beyond the aromatic ring. Activation enthalpies and entropies were estimated for substrates bearing the isoselective substituent in either ortho and para positions, being demonstrated that they are much different from the values for the parent substrate. The electrophilic attack on the phenolic oxygen atom by the protonated chlorinating agent is proposed as the rate-determining step, this step being followed by the fast rearrangement of the intermediate thus formed, leading to products containing chlorine in the aromatic ring.
NASA Astrophysics Data System (ADS)
Tang, X. D.; Henkel, C.; Menten, K. M.; Wyrowski, F.; Brinkmann, N.; Zheng, X. W.; Gong, Y.; Lin, Y. X.; Esimbek, J.; Zhou, J. J.; Yuan, Y.; Li, D. L.; He, Y. X.
2018-01-01
We mapped the kinetic temperature structure of the Orion molecular cloud 1 (OMC-1) with para-H2CO (JKaKc = 303-202, 322-221, and 321-220) using the APEX 12 m telescope. This is compared with the temperatures derived from the ratio of the NH3 (2, 2)/(1, 1) inversion lines and the dust emission. Using the RADEX non-LTE model, we derive the gas kinetic temperature modeling the measured averaged line ratios of para-H2CO 322-221/303-202 and 321-220/303-202. The gas kinetic temperatures derived from the para-H2CO line ratios are warm, ranging from 30 to >200 K with an average of 62 ± 2 K at a spatial density of 105 cm-3. These temperatures are higher than those obtained from NH3 (2, 2)/(1, 1) and CH3CCH (6-5) in the OMC-1 region. The gas kinetic temperatures derived from para-H2CO agree with those obtained from warm dust components measured in the mid infrared (MIR), which indicates that the para-H2CO (3-2) ratios trace dense and warm gas. The cold dust components measured in the far infrared (FIR) are consistent with those measured with NH3 (2, 2)/(1, 1) and the CH3CCH (6-5) line series. With dust at MIR wavelengths and para-H2CO (3-2) on one side, and dust at FIR wavelengths, NH3 (2, 2)/(1, 1), and CH3CCH (6-5) on the other, dust and gas temperatures appear to be equivalent in the dense gas (n(H2) ≳ 104 cm-3) of the OMC-1 region, but provide a bimodal distribution, one more directly related to star formation than the other. The non-thermal velocity dispersions of para-H2CO are positively correlated with the gas kinetic temperatures in regions of strong non-thermal motion (Mach number ≳ 2.5) of the OMC-1, implying that the higher temperature traced by para-H2CO is related to turbulence on a 0.06 pc scale. Combining the temperature measurements with para-H2CO and NH3 (2, 2)/(1, 1) line ratios, we find direct evidence for the dense gas along the northern part of the OMC-1 10 km s-1 filament heated by radiation from the central Orion nebula. The reduced datacubes are only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (http://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/609/A16
Massage and Reiki used to reduce stress and anxiety: Randomized Clinical Trial.
Kurebayashi, Leonice Fumiko Sato; Turrini, Ruth Natalia Teresa; Souza, Talita Pavarini Borges de; Takiguchi, Raymond Sehiji; Kuba, Gisele; Nagumo, Marisa Toshi
2016-11-28
to evaluate the effectiveness of massage and reiki in the reduction of stress and anxiety in clients at the Institute for Integrated and Oriental Therapy in Sao Paulo (Brazil). clinical tests randomly done in parallel with an initial sample of 122 people divided into three groups: Massage + Rest (G1), Massage + Reiki (G2) and a Control group without intervention (G3). The Stress Systems list and the Trace State Anxiety Inventory were used to evaluate the groups at the start and after 8 sessions (1 month), during 2015. there were statistical differences (p = 0.000) according to the ANOVA (Analysis of Variance) for the stress amongst the groups 2 and 3 (p = 0.014) with a 33% reductions and a Cohen of 0.78. In relation to anxiety-state, there was a reduction in the intervention groups compared with the control group (p < 0.01) with a 21% reduction in group 2 (Cohen of 1.18) and a 16% reduction for group 1 (Cohen of 1.14). Massage + Reiki produced better results amongst the groups and the conclusion is for further studies to be done with the use of a placebo group to evaluate the impact of the technique separate from other techniques. RBR-42c8wp. avaliar a efetividade da Massagem e Reiki na redução de estresse e ansiedade em clientes do Instituto de Terapia Integrada e Oriental, em São Paulo (Brasil). ensaio clínico controlado randomizado paralelo com amostra inicial de 122 pessoas divididas em 3 grupos Massagem+Repouso (G1), Massagem+Reiki (G2) e Controle sem intervenção (G3). Foram avaliados pela Lista de Sintomas de Stress e pelo Inventário de Ansiedade Traço-Estado, no início e após 8 sessões (1 mês), durante o ano de 2015. houve diferença estatística (p = 0,000) segundo ANOVA para o estresse entre os grupos 2 e 3 (33% de redução e Cohen de 0,98) e entre os grupos 1 e 3 (p = 0,014), 24% de redução e Cohen de 0,78. Para a ansiedade-estado, houve redução nos grupos de intervenção comparados ao grupo Controle (p < 0,01), com 21% de redução para o Grupo 2 (Cohen de 1,18) e 16% de redução para o grupo 1 (Cohen de 1,14). a Massagem+Reiki conseguiu melhores resultados entre os grupos e se sugere outro estudo com uso de placebo para o Reiki, para avaliar o alcance da técnica em separado. RBR-42c8wp. evaluar la efectividad de Masaje y Reiki para reducción del estrés y ansiedad en clientes del Instituto de Terapia Integrada y Oriental, en Sao Paulo, Brasil. ensayo clínico controlado aleatorizado paralelo, con muestra inicial de 122 personas divididas en 3 grupos Masaje+Reposo (G1), Masaje+Reiki (G2) y Control sin intervención (G3). Los participantes fueron evaluados a través de la Lista de Síntomas de Stress y por el Inventario de Ansiedad Rasgo-Estado, en el inicio y después de 8 sesiones (1 mes), durante el año de 2015. hubo diferencia estadística (p = 0,000) según ANOVA para el estrés entre los grupos 2 y 3 (33% de reducción y Cohen de 0,98) y entre los grupos 1 y 3 (p = 0,014), 24% de reducción y Cohen de 0,78. Para la ansiedad-estado, hubo reducción en los grupos de intervención comparados al grupo Control (p < 0,01), con 21% de reducción para el Grupo 2 (Cohen de 1,18) y 16% de reducción para el grupo 1 (Cohen de 1,14). entre los grupos, el Masaje+Reiki consiguió mejores resultados; se sugiere realizar otro estudio con uso de placebo para el Reiki, para evaluar el alcance de la técnica de forma separada. RBR-42c8wp.
Transcultural adaptation of the Johns Hopkins Fall Risk Assessment Tool.
Martinez, Maria Carmen; Iwamoto, Viviane Ernesto; Latorre, Maria do Rosário Dias de Oliveira; Noronha, Adriana Moreira; Oliveira, Ana Paula de Sousa; Cardoso, Carlos Eduardo Alves; Marques, Ifigenia Augusta Braga; Vendramim, Patrícia; Lopes, Paula Cristina; Sant'Ana, Thais Helena Saes de
2016-08-29
to perform the transcultural adaptation and content validity analysis of the Johns Hopkins Fall Risk Assessment Tool to assess both fall risk and fall-related injury risk for hospitalized elderly in Brazil. the transcultural adaptation consisted of translating the scale to Portuguese (Brazil), back-translating it into its language of origin, establishing a consensus version, and having an expert committee verify its transcultural equivalence. Content assessment was conducted by a committee of judges, ending with the calculation of the items and scales' content validity index. Nurses tested the tool. the scale's translated version went through two evaluation rounds by the judges, based on which, the items with unsatisfactory performance were changed. The content validity index for the items was ≥80.0% and the global index 97.1%. The experimental application showed the scale is user-friendly. the scale presents valid content for the assessment of fall risk and risk of fall-related injuries and is easy to use, with the potential to contribute to the proper identification of risks and the establishment of care actions. realizar a adaptação transcultural para uso no Brasil e a avaliação da validade de conteúdo da Johns Hopkins Fall Risk Assessment Tool para avaliação de risco de quedas e de danos por quedas em pacientes adultos hospitalizados. adaptação transcultural consistiu na tradução da escala para a língua portuguesa (Brasil), retrotradução para a língua de origem, versão de consenso e análise da equivalência transcultural por um comitê de especialistas. A avaliação do conteúdo foi realizada por meio de um comitê de juízes, finalizando com o cálculo do índice de validade de conteúdo dos itens e da escala. Foi realizada a aplicação experimental do instrumento por enfermeiros. a versão traduzida da escala passou por duas rodadas de avaliação pelos juízes, a partir das quais os itens com desempenho insatisfatório foram modificados. O índice de validade de conteúdo para itens foi ≥80,0% e o global foi 97,1%. A aplicação experimental mostrou que a escala é de fácil operacionalização. a escala demonstrou conteúdo válido para a avaliação de risco de quedas e de danos por quedas e ser de fácil operacionalização, podendo contribuir para a adequada identificação dos riscos e consequente direcionamento de ações assistenciais. realizar la adaptación transcultural para ser usada en Brasil y confirmar la validez de contenido de la Johns Hopkins Fall Risk Assessment Tool que evalúa riesgo de caídas y de daños por caídas en pacientes adultos mayores. adaptación transcultural que consistió en la traducción de la escala para el idioma portugués (Brasil); retrotraducción para el idioma de origen; y versión de consenso y análisis de la equivalencia transcultural por un comité de especialistas. La evaluación del contenido fue realizada por medio de un comité de jueces, siendo finalizado con el cálculo del índice de validez de contenido de los ítems y de la escala. Fue realizada la aplicación experimental del instrumento por enfermeros. la versión traducida de la escala pasó por dos vueltas de evaluación por los jueces, a partir de las cuales los ítems con desempeño insatisfactorio fueron modificados. El índice de validez de contenido para los ítems fue ≥80,0% y el global fue 97,1%. La aplicación experimental mostró que la escala es de fácil ejecución. la escala demostró tener un contenido válido para la evaluación de riesgo de caídas y de daños por caídas, y de ser de fácil ejecución; esta escala puede contribuir para la adecuada identificación de los riesgos y consecuentemente para la orientación de acciones asistenciales.
Quality management systems for fruit fly (Diptera: Tephritidae) sterile insect technique
DOE Office of Scientific and Technical Information (OSTI.GOV)
Caceres, C.; Robinson, A.; McInnis, D.
The papers presented in this issue are focused on developing and validating procedures to improve the overall quality of sterile fruit flies for use in area-wide integrated pest management (AW-IPM) programs with a sterile insect technique (SIT) component. The group was coordinated and partially funded by the Joint FAO/IAEA Programme of Nuclear Techniques in Food and Agriculture, International Atomic Energy Agency, Vienna, Austria, under a five-year Coordinated Research Project (CRP) on 'Quality Assurance in Mass-Reared and Released Fruit Flies for Use in SIT Programmes'. Participants in the CRP from 16 countries came from both basic and applied fields of expertisemore » to ensure that appropriate and relevant procedures were developed. A variety of studies was undertaken to develop protocols to assess strain compatibility and to improve colonization procedures and strain management. Specific studies addressed issues related to insect nutrition, irradiation protocols, field dispersal and survival, field cage behavior assessments, and enhancement of mating competitiveness. The main objective was to increase the efficiency of operational fruit fly programs using sterile insects and to reduce their cost. Many of the protocols developed or improved during the CRP will be incorporated into the international quality control manual for sterile tephritid fruit flies, standardizing key components of the production, sterilization, shipment, handling, and release of sterile insects. (author) [Spanish] Los articulos presentados en este numero se enfocan en el desarrollo y la validacion de procedimientos para mejorar la calidad total de moscas de las frutas esteriles para su uso en programas de manejo integrado de plagas en donde la tecnica del insecto esteril (TIE) es uno de los componentes clave. El grupo fue coordinado y parcialmente financiado por la Division Conjunta de Tecnicas Nucleares para la Alimentacion y la Agricultura de la FAO/OIEA, Viena, Austria, por un periodo de cinco anos bajo el proyecto de Investigacion Coordinada (PIC) sobre 'el Aseguramiento de la Calidad de Moscas de las Frutas Criadas y Liberadas para su Uso en Programas de TIE'. Los participantes en el PIC representan 16 paises con experiencia en campos de investigacion basica y aplicada. Para asegurar que los procedimientos desarrollados fueran apropiados y pertinentes, se realizaron una variedad de estudios para el desarrollo de protocolos para evaluar la compatibilidad y para mejorar los procedimientos de colonizacion y manejo de cepas salvajes. Estudios especificos trataron asuntos relacionados con la nutricion de insectos, los protocolos de irradiacion, la dispersion y supervivencia en el campo, evaluacion del comportamiento en jaulas de campo, y el mejoramiento de la competitividad sexual. Los objetivos fundamentales fueron el aumentar la eficiencia y reducir los costos de los programas operacionales de control de moscas de las frutas donde TIE es utilizada. Muchos de los protocolos desarrollados o mejorados durante el PIC seran incorporados en el Manual Internacional de Control de Calidad para Moscas Estriles de la familia Tephritidae, para estandarizar componentes claves como la produccion, esterilizacion, envio, manejo y liberacion de insectos esteriles. (author)« less
Oliveira, Renata Marques de; Duarte, Alexandre Freitas; Alves, Domingos; Furegato, Antonia Regina Ferreira
2016-08-29
to develop a mobile app for research on the use of tobacco among psychiatric patients and the general population. applied research with the technological development of an app for data collection on an Android tablet. For its development, we considered three criteria: data security, benefits for participants and optimization of the time of researchers. We performed tests with twenty fictitious participants and a final test with six pilots. the app collects data, stores them in the database of the tablet and export then to an Excel spreadsheet. calculator, stopwatch, offline operation, branching logic, field validation and automatic tabulation. the app prevents human error, increases the quality of the data by validating them during the interview, allows the performing of automatic tabulation and makes the interviews less tiring. Its success may encourage the use of this and other computational resources by nurses as a research tool. desenvolver aplicativo mobile para pesquisa sobre o uso de tabaco entre pacientes psiquiátricos e a população geral. pesquisa aplicada com o desenvolvimento tecnológico de um aplicativo para coleta de dados em tablet Android. Para seu desenvolvimento, consideraram-se três critérios: segurança dos dados, benefícios para os participantes e otimização do tempo dos pesquisadores. Testes com 20 participantes fictícios e teste final com seis pilotos. o aplicativo coleta os dados, armazena-os no banco de dados do tablet e os exporta para planilha Excel. Recursos: calculadora; cronômetro; funcionamento off-line, lógica de ramificação, validação de campos e tabulação automática. o aplicativo previne erros humanos e aumenta a qualidade dos dados ao validá-los durante a entrevista, permite realizar tabulação automática e torna as entrevistas menos cansativas. Seu sucesso poderá incentivar o uso desse e outros recursos computacionais pelos enfermeiros, como ferramenta de pesquisa. desarrollar aplicativo móvil para hacer investigación sobre el uso de tabaco entre pacientes psiquiátricos y la población en general. investigación aplicada con el desarrollo tecnológico de un aplicativo para recolección de datos en tablet Android. Para su desarrollo, se consideraron tres criterios: seguridad de los datos, beneficios para los participantes y optimización del tiempo de los investigadores. Se realizaron pruebas con 20 participantes ficticios y un test piloto final. los datos del aplicativo almacenados en el banco de datos del tablet son exportados para planilla Excel. Recursos: calculadora, cronómetro, funcionamiento off-line, lógica de ramificación, validación de campos y tabulación automática. el aplicativo evita errores humanos y aumenta la calidad de los datos al validarlos durante la entrevista, también permite realizar una tabulación automática y torna las entrevistas menos agotadoras. Su éxito incentivará su uso y el de otros recursos computacionales por parte de los enfermeros, como herramienta de investigación.
El Programa Nacional de Estuarios (NEP)
Información general sobre el Programa Nacional de Estuarios (PNE, por sus siglas en inglés) establecido en el 1987 para restaurar y proteger los estuarios significativos para Estados Unidos, y sus territorios. La Agencia de Protección Ambiental de EE.UU.
ACUTE TOXICITY OF PARA-NONYLPHENOL TO SALTWATER ANIMALS
?para-Nonylphenol (PNP), a mixture of alkylphenols used in producing nonionic surfactants, is distributed widely in surface waters and aquatic sediments, where it can affect saltwater species. This article describes a database for acute toxicity of PNP derived for calculating a n...
Comparison of five methods of malaria detection in the outpatient setting.
Lema, O E; Carter, J Y; Nagelkerke, N; Wangai, M W; Kitenge, P; Gikunda, S M; Arube, P A; Munafu, C G; Materu, S F; Adhiambo, C A; Mukunza, H K
1999-02-01
In eastern Africa where 90% of the malaria is due to Plasmodium falciparum, the accuracy of malaria diagnosis at the outpatient level is becoming increasingly important due to problems of drug resistance and use of alternative, costly antimalarial drugs. The quantitative buffy coat (QBC) technique, acridine orange staining with an interference filter system, and the ParaSight-F test have been introduced as alternative methods to conventional microscopy for the diagnosis of malaria. Two hundred thirteen outpatients were tested using these alternative methods and conventional microscopy by five experienced technologists; two were randomly allocated to read the results of each test. Paired results showed the highest level of agreement with the ParaSight-F test (99%), followed by Field stain (92%). The results of the QBC technique showed the least agreement (73%). Using conventional microscopy as the reference standard, the ParaSight-F test had a sensitivity range of 90-92% and a specificity of 99%, staining with acridine orange had a sensitivity range of 77-96% and a specificity range of 81-98% and the QBC technique had a sensitivity range of 88-98% and a specificity range of 58-90%. All microscopic tests showed lower sensitivities (as low as 20% using staining with acridine orange) in detecting low parasitemias (< or = 320/microl) than the ParaSight-F test (70%). Due to the high cost of the ParaSight-F test, Field-stained blood films remain the most appropriate method for diagnosis of P. falciparum in eastern Africa. The ParaSight-F test may be used in situations where no trained microscopists are available, or where malaria is strongly suspected and the results of microscopy are negative.
Rotational excitation of HCN by para- and ortho-H{sub 2}
DOE Office of Scientific and Technical Information (OSTI.GOV)
Vera, Mario Hernández, E-mail: marhvera@gmail.com; InSTEC, Quinta de Los Molinos, Plaza, La Habana 10600; Kalugina, Yulia
Rotational excitation of the hydrogen cyanide (HCN) molecule by collisions with para-H{sub 2}( j = 0, 2) and ortho-H{sub 2}( j = 1) is investigated at low temperatures using a quantum time independent approach. Both molecules are treated as rigid rotors. The scattering calculations are based on a highly correlated ab initio 4-dimensional (4D) potential energy surface recently published. Rotationally inelastic cross sections among the 13 first rotational levels of HCN were obtained using a pure quantum close coupling approach for total energies up to 1200 cm{sup −1}. The corresponding thermal rate coefficients were computed for temperatures ranging from 5 to 100 K.more » The HCN rate coefficients are strongly dependent on the rotational level of the H{sub 2} molecule. In particular, the rate coefficients for collisions with para-H{sub 2}( j = 0) are significantly lower than those for collisions with ortho-H{sub 2}( j = 1) and para-H{sub 2}( j = 2). Propensity rules in favor of even Δj transitions were found for HCN in collisions with para-H{sub 2}( j = 0) whereas propensity rules in favor of odd Δj transitions were found for HCN in collisions with H{sub 2}( j ⩾ 1). The new rate coefficients were compared with previously published HCN-para-H{sub 2}( j = 0) rate coefficients. Significant differences were found due the inclusion of the H{sub 2} rotational structure in the scattering calculations. These new rate coefficients will be crucial to improve the estimation of the HCN abundance in the interstellar medium.« less
Baden, Craig; Whitley, Alexander; López-Araujo, Javier; Popple, Richard; Duan, Jun; Kim, Robert
2016-01-01
Aim To report outcomes for patients with para-aortic lymph node positive cervical cancer treated with a dynamic field-matching technique. Background PET staging of cervical cancer has increased identification of patients with para-aortic lymph node metastasis. IMRT enables dose escalation in this area, but matching IMRT fields with traditional whole pelvis fields presents a challenge. Materials and methods From 2003 to 2012, 20 patients with cervical cancer and para-aortic lymph node metastasis were treated utilizing the dynamic field-matching technique. As opposed to single-isocenter half-beam junction techniques, this technique employs wedge-shaped dose junctions for the abutment of fields. We reviewed the records of all patients who completed treatment with the technique and abstracted treatment, toxicity, and disease-related outcome data for analysis. Results Median prescribed dose to the whole pelvis field was 45 Gy and para-aortic IMRT field 50.4 Gy. All but 3 patients underwent HDR (13 pts) or LDR (4 pts) brachytherapy. All patients developed lower GI toxicity; 10 grade 1, 9 grade 2, and 1 grade 4 (enterovaginal fistula). Median DFS was 12.4 months with 1 and 2-year DFS 60.0% and 38.1%. One-year OS was 83.7% and 2-year OS, 64.4%. A total of 10 patients developed recurrence; none occurred at the matched junction. Conclusions The dynamic field-matching technique provides a means for joining conventional whole pelvis fields and para-aortic IMRT fields that substantially reduces dose deviations at the junction due to field mismatch. Treatment with the dynamic matching technique is simple, effective, and tolerated with no apparent increase in toxicity. PMID:26900356
Collisional excitation of sulfur dioxide by molecular hydrogen in warm molecular clouds
NASA Astrophysics Data System (ADS)
Balança, Christian; Spielfiedel, Annie; Feautrier, Nicole
2016-08-01
Interpretation of SO2 line emission in warm environments requires a detailed knowledge of collisional rate coefficients for a wide range of levels and temperatures. Using an accurate theoretical interaction potential for SO2-H2, rate coefficients for collisions of SO2 with para and ortho-H2 for the 31 first SO2, rotational levels are calculated for temperatures up to 500 K using the coupled states (CS) approximation. From a comparison with previously published close-coupling (CC) results, it was shown that the two sets of data agree within 20-30 per cent for both para- and ortho-H2 collisions. As previously found within the CC approach, the CS rate coefficients with ortho and para-H2 differ by a factor of 2 in average, the largest being mainly the rates for collisions with ortho-H2. For higher levels and temperatures, rate constants were computed within the infinite order sudden (IOS) approximation. Rate coefficients were obtained for the lowest 410 rotational levels of SO2 in the 100-1000 K temperature range. A comparison at 30, 100 and 300 K of the IOS data with the corresponding para-H2 CS results indicates that the IOS approximation systematically underestimates the CS results by a factor up to 2 at the lowest temperatures. As expected, IOS and CS rates are in a better agreement at higher temperatures. Considering that the IOS theory was developed for collisions with para-H2, this approach cannot describe with the same accuracy collisions with ortho-H2. So, our IOS data may be considered as quite reliable for collisions with para-H2 and less accurate for collisions with ortho-H2.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Demeure, I.M.
The research presented here is concerned with representation techniques and tools to support the design, prototyping, simulation, and evaluation of message-based parallel, distributed computations. The author describes ParaDiGM-Parallel, Distributed computation Graph Model-a visual representation technique for parallel, message-based distributed computations. ParaDiGM provides several views of a computation depending on the aspect of concern. It is made of two complementary submodels, the DCPG-Distributed Computing Precedence Graph-model, and the PAM-Process Architecture Model-model. DCPGs are precedence graphs used to express the functionality of a computation in terms of tasks, message-passing, and data. PAM graphs are used to represent the partitioning of a computationmore » into schedulable units or processes, and the pattern of communication among those units. There is a natural mapping between the two models. He illustrates the utility of ParaDiGM as a representation technique by applying it to various computations (e.g., an adaptive global optimization algorithm, the client-server model). ParaDiGM representations are concise. They can be used in documenting the design and the implementation of parallel, distributed computations, in describing such computations to colleagues, and in comparing and contrasting various implementations of the same computation. He then describes VISA-VISual Assistant, a software tool to support the design, prototyping, and simulation of message-based parallel, distributed computations. VISA is based on the ParaDiGM model. In particular, it supports the editing of ParaDiGM graphs to describe the computations of interest, and the animation of these graphs to provide visual feedback during simulations. The graphs are supplemented with various attributes, simulation parameters, and interpretations which are procedures that can be executed by VISA.« less
Braga, Rafael Benzi; Ferreira, Nelson
2014-01-01
Abstract Eight new species of DesmopachriaBabington, 1841 are described and illustrated from Brazil: D. dicrophallica sp. nov. , D. disticta sp. nov. , D. grammosticta sp. nov. , D . grandinigra sp. nov. , D. itamontensis sp. nov. , D. leptophallica sp. nov. , D. stethothrix sp. nov. , and D. ukuki sp. nov. The species D. amyaeMiller, 2001 , D. cheiMiller, 1999 , D. margarita Young, 1990, and D. volatidiscaMiller, 2001 are recorded for the first time from Brazil. From species of the Desmopachria reported in Brazil, D. aldessaYoung, 1980 has a new record from Pará state and D. fossulataZimmermann, 1928, D. granoidesYoung, 1986 , and D. laevis Sharp, 1882 have new records from Rio de Janeiro State. A checklist of all Desmopachria recorded from Brazil is presented with notes about some of the localities. Resumo Oito espécies novas de DesmopachriaBabington, 1841 são descritas e ilustradas para o Brasil, D. dicrophallica sp. nov. , D. disticta sp. nov. , D. grammosticta sp. nov. , D . grandinigra sp. nov., D. itamontensis sp. nov., D. leptophallica sp. nov., D. stethothrix sp. nov. e D. ukuki sp. nov. As espécies D. amyaeMiller, 2001, D. cheiMiller, 1999 , D. margarita Young, 1990 e D. volatidiscaMiller, 2001 são registradas pela primeira vez para o Brasil. Das espécies de Desmopachria registradas para o Brasil D. aldessaYoung, 1980 tem um novo registro para o estado do Pará e D. fossulataZimmermann, 1928 , D. granoidesYoung, 1986 e D. laevis Sharp, 1882 têm novos registros para o estado do Rio de Janeiro. Uma listagem de todos os Desmopachria registrados para o Brasil é apresentada, com notas acerca de algumas localidades. PMID:25373202
Bogani, Giorgio; Tagliabue, Elena; Ditto, Antonino; Signorelli, Mauro; Martinelli, Fabio; Casarin, Jvan; Chiappa, Valentina; Dondi, Giulia; Leone Roberti Maggiore, Umberto; Scaffa, Cono; Borghi, Chiara; Montanelli, Luca; Lorusso, Domenica; Raspagliesi, Francesco
2017-10-01
To estimate the prevalence of lymph node involvement in early-stage epithelial ovarian cancer in order to assess the prognostic value of lymph node dissection. Data of consecutive patients undergoing staging for early-stage epithelial ovarian cancer were retrospectively evaluated. Logistic regression and a nomogram-based analysis were used to assess the risk of lymph node involvement. Overall, 290 patients were included. All patients had lymph node dissection including pelvic and para-aortic lymphadenectomy. Forty-two (14.5%) patients were upstaged due to lymph node metastatic disease. Pelvic and para-aortic nodal metastases were observed in 22 (7.6%) and 42 (14.5%) patients. Lymph node involvement was observed in 18/95 (18.9%), 1/37 (2.7%), 4/29 (13.8%), 11/63 (17.4%), 3/41 (7.3%) and 5/24 (20.8%) patients with high-grade serous, low-grade-serous, endometrioid G1, endometrioid G2&3, clear cell and undifferentiated, histology, respectively (p=0.12, Chi-square test). We observed that high-grade serous histology was associated with an increased risk of pelvic node involvement; while, histology rather than low-grade serous and bilateral tumors were independently associated with para-aortic lymph node involvement (p<0.05). Nomograms displaying the risk of nodal involvement in the pelvic and para-aortic areas were built. High-grade serous histology and bilateral tumors are the main characteristics suggesting lymph node positivity. Our data suggested that high-grade serous and bilateral early-stage epithelial ovarian cancer are at high risk of having disease harboring in the lymphatic tissues of both pelvic and para-aortic area. After receiving external validation, our data will help to identify patients deserving comprehensive retroperitoneal staging. Copyright © 2017 Elsevier Inc. All rights reserved.
The Ortho-to-para Ratio of Water Molecules Desorbed from Ice Made from Para-water Monomers at 11 K
NASA Astrophysics Data System (ADS)
Hama, Tetsuya; Kouchi, Akira; Watanabe, Naoki
2018-04-01
Water has two nuclear-spin isomers: ortho- and para-H2O. Some observations of interstellar space and cometary comae have reported the existence of gaseous H2O molecules with anomalous ortho-to-para ratios (OPRs) less than the statistical value of three. This has been often used to estimate the formation temperature of ice on dust, which is inferred to be below 50 K. The relation between the nuclear-spin dynamics of H2O in ice at low temperatures and the OPR of gaseous H2O desorbed from the ice has yet to be explored in a laboratory. Consequently, the true meaning of the observed OPRs remains debated. We measure the OPR of H2O photodesorbed from ice made from para-H2O monomers at 11 K, which was prepared by the sublimation of Ne from a para-H2O/Ne matrix. The photodesorbed H2O molecules from the ice have the statistical OPR value of three, demonstrating the immediate nuclear-spin-state mixing of H2O toward the statistical value of ice even at 11 K. The OPR of H2O thermally desorbed from the ice also shows the expected statistical value. Our results indicate that the OPR of H2O desorbed from interstellar ice should be the statistical value regardless of the formation process of the ice, which cannot be used to deduce the ice-formation temperature. This study highlights the importance of interstellar gas-phase processes in understanding anomalous abundance ratios of nuclear-spin isomers of molecules in space.
Correa, Jorge E; Meneses-Echávez, José F; Barengo, Noël C; Tovar, Gustavo; Ruiz-Castellanos, Erika; Lobelo, Felipe; Ramírez-Vélez, Robinson
2015-09-01
Introducción: Los programas iniciados por la Fédération Internationale de Football Association (FIFA) consisten en la difusión de mensajes relacionados con el cuidado de la salud y como estrategia de prevención de lesiones deportivas entre los niños y jóvenes. El objetivo de esta revisión sistemática fue resumir los resultados de la implementación de los programas "FIFA 11 para la salud" y "FIFA 11+". Métodos: Se realizó una búsqueda sistemática en las bases de datos electrónicos de MEDLINE, EMBASE y Scopus, identificando los estudios que evaluaran la implementación de los programas "FIFA 11 para la salud" y "FIFA 11+", durante los últimos 10 años (1 enero 2003 a 1 diciembre 2013). Resultados: Incluimos 17 estudios. Dos estudios evaluaron la implementación del programa "FIFA 11 para la salud" y encontraron un aumento significativo en el conocimiento de los mensajes de promoción de la salud; 15 estudios evaluaron los efectos del programa "FIFA 11+", reportando una reducción en el riesgo de lesiones deportivas y mejorías en el rendimiento deportivo. Discusión: Los programas "FIFA 11 para la salud" y "FIFA 11+" han demostrado resultados positivos para la salud, en el ámbito escolar y deportivo. Conclusiones: Dichos programas del FIFA representan una oportunidad para crear hábitos protectores y fomentar modos de vida saludables en niños y jóvenes.
Sahu, S S; Gunasekaran, K; Jambulingam, P
2015-12-01
Rapid diagnostic tests (RDTs) have become an essential surveillance tool in the malaria control programme in India. The current study aimed to assess the performance of ParaHIT-f, a rapid test in diagnosis of Plasmodium falciparum infection through detecting its specific antigen, histidine rich protein 2 (PfHRP-2), in Odisha State, India. The study was undertaken in eight falciparum malaria endemic southern districts of Odisha State. Febrile patients included through active case detection, were diagnosed by Accredited Social Health Activists (ASHAs) for P. falciparum infection using the RDT, ParaHIT-f. The performance of ParaHIT-f was evaluated using microscopy as the gold standard. A total of 1030 febrile patients were screened by both microscopy and the RDT for P. falciparum infection. The sensitivity of ParaHIT-f was 63.6% (95% CI: 56.0-70.6) and specificity was 98.9% (95% CI: 97.9-99.5), with positive and negative predictive values (PPV and NPV) of 92.6% (95% CI: 86.0-96.3) and 93.0% (95% CI: 91.0-94.5), respectively. When related to parasitaemia, the RDT sensitivity was 47.8% at the low parasitaemia of 4 to 40 parasites/µl of blood. The results showed that the performance of the RDT, ParaHIT-f, was not as sensitive as microscopy in detecting true falciparum infections; a high specificity presented a low frequency of false-positive RDT results. t0 he sensitivity of ParaHIT-f was around 60 per cent. It is, therefore, essential to improve the efficiency (sensitivity) of the kit so that the true falciparum infections will not be missed especially in areas where P. falciparum has been the predominant species causing cerebral malaria.
Anuncios de servicio público para proteger a los trabajadores de plaguicidas
Estos archivos de anuncios de servicio público se pueden descargar libremente para su uso en la formación, transmisiones de audio, etc.(These public service announcement files can be freely downloaded for use in training, audio broadcasts, etc.)
El diseño final del espectrógrafo de banco (EBASIM) para CASLEO
NASA Astrophysics Data System (ADS)
Simmons, J.; Levato, H.
Utilizando el código de óptica ACCOS V se ha finalizado el diseño del espectrógrafo de banco para CASLEO. En una comunicación anterior habíamos indicado que utilizaríamos un colimador de 150 mm de diámetro con un radio de curvatura de 1540 mm. Para el espejo cámara, que tiene un diámetro de 200 mm, el radio de curvatura es de 1200 mm, ambos radios con una tolerancia no mayor a los 3 mm. En la presente, se informa sobre los detalles finales del cálculo del espectrógrafo que incluye el cómputo para 5 longitudes de onda diferentes y alrededor de 100 rayos. En todos los casos el 75 % de energía está dentro de un diámetro de 13 micrones. El diseño ha sido probado entre 3500 Å hasta 9000 Å con resultados satisfactorios.
NASA Astrophysics Data System (ADS)
Danhoni Neves, Marcos Cesar; Pereira, Ricardo Francisco
2007-12-01
In this paper will be introduced a method of astrophotography using a non-reflex photographic camera (a low-cost method). It will be revised some photographic processes commonly used nowadays for comparison with the aims of this paper. En este trabajo será introducido un método de astrofotografia que utiliza una cámara fotográfica non-reflex (un método de bajo costo). Serán revisados algunos procesos fotográficos comúnmente utilizados actualmente para comparación con los objetivos de este trabajo. O presente artigo procura introduzir um método de astrofotografia utilizando uma câmera fotográfica não reflex, de baixo custo. É feita uma revisão do processo fotográfico comumente empregado para fins de comparação com os objetivos pretendidos no presente trabalho.
Capital social de los padres de escolares de una zona vulnerable.
Cornejo, Susana; Herrera, Ariel; Hilas, Elena; Gigena, Y Pablo
2018-01-01
El capital social supone importantes inversiones materiales, simbólicas y de esfuerzos. Conocer el capital social de una comunidad puede facilitar la comprensión del beneficio de las relaciones comunitarias para la promoción de salud. Con el objetivo de reconocer los componentes del capital social de padres de escolares atendiendo una escuela en una zona vulnerable de la ciudad de Córdoba, Argentina, indagamos a través de grupos focales acerca de elementos esenciales del capital social. La asintonía socio-cultural entre los pobladores originarios y los reubicados, la estigmatización policial y el clientelismo político han generado desconfianza del uno hacia el otro en diferentes aspectos convivenciales, siendo la familia la única red de apoyo. La escuela se reconoce como espacio adonde la gente espontáneamente se organiza para invertir en redes sociales, presentándose así con potencialidad para la promoción de conductas saludables, por el lugar simbólico que ocupa para los padres.
Theoretical study of the design of a catalyst for para to ortho hydrogen conversion
NASA Technical Reports Server (NTRS)
Coffman, Robert E.
1992-01-01
The theory of Petzinger and Scalapino (1973) was thoroughly reviewed, and all of the basic equations for paramagnetic para to ortho hydrogen catalysis re-derived. There are only a few minor phase errors and errors of omission in the description of the theory. Three models (described by Petzinger and Scalapino) for the rate of para to ortho H2 catalysis were worked out, and uniform agreement obtained to within a constant factor of 2 pi. The analytical methods developed in the course of this study were then extended to two new models, which more adequately describe the process of surface catalysis including transfer of hydrogen molecules onto and off of the surface. All five equations for the para to ortho catalytic rate of conversion are described. The two new equations describe the catalytic rate for these models: H2 on the surface is a 2-D gas with lifetime tau; and H2 on the surface is a 2-D liquid undergoing Brownian motion (diffusion) with surface lifetime tau.
Cintrón-Bou, Francheska; Varas-Díaz, Nelson; Marzán-Rodríguez, Melissa; Neilands, Torsten B.
2016-01-01
Existe estigma relacionado al VIH. A las personas con VIH/SIDA-PCVS se les viola sus derechos y obstaculiza su bienestar mental/físico. Profesionales de la salud-PS son fuente de apoyo primordial, sin embargo estos/as le estigmatizan. Es útil adiestrar a PS en relación al estigma social. Implantamos la intervención para reducir el estigma relacionado al VIH/SIDA con 507 estudiantes de medicina. Resultó ser una intervención efectiva, hubo reducción en los niveles de estigma a partir de nuestra intervención y diferencias significativas con el grupo control (p≤.05). Generar espacios de adiestramiento para atender el estigma relacionado al VIH/SIDA es pertinente para la psicología comunitaria porque colaboramos en la reducción de actitudes estigmatizantes que afectan adversamente la prevención de nuevas infecciones, la adherencia al tratamiento antirretroviral y la calidad de vida. PMID:27829690
Electrical detection of ortho–para conversion in fullerene-encapsulated water
Meier, Benno; Mamone, Salvatore; Concistrè, Maria; Alonso-Valdesueiro, Javier; Krachmalnicoff, Andrea; Whitby, Richard J.; Levitt, Malcolm H.
2015-01-01
Water exists in two spin isomers, ortho and para, that have different nuclear spin states. In bulk water, rapid proton exchange and hindered molecular rotation obscure the direct observation of two spin isomers. The supramolecular endofullerene H2O@C60 provides freely rotating, isolated water molecules even at cryogenic temperatures. Here we show that the bulk dielectric constant of this substance depends on the ortho/para ratio, and changes slowly in time after a sudden temperature jump, due to nuclear spin conversion. The attribution of the effect to ortho–para conversion is validated by comparison with nuclear magnetic resonance and quantum theory. The change in dielectric constant is consistent with an electric dipole moment of 0.51±0.05 Debye for an encapsulated water molecule, indicating the partial shielding of the water dipole by the encapsulating cage. The dependence of bulk dielectric constant on nuclear spin isomer composition appears to be a previously unreported physical phenomenon. PMID:26299447
Sartori, Elena; Ruzzi, Marco; Lawler, Ronald G; Turro, Nicholas J
2008-09-24
The kinetics of para-ortho conversion and nuclear spin relaxation of H 2 in chloroform- d 1 were investigated in the presence of nitroxides as paramagnetic catalysts. The back conversion from para-hydrogen ( p-H 2) to ortho-hydrogen ( o-H 2) was followed by NMR by recording the increase in the intensity of the signal of o-H 2 at regular intervals of time. The nitroxides proved to be hundreds of times more effective at inducing relaxation among the spin levels of o-H 2 than they are in bringing about transitions between p-H 2 and the levels of o-H 2. The value of the encounter distance d between H 2 and the paramagnetic molecule, calculated from the experimental bimolecular conversion rate constant k 0, using the Wigner theory of para-ortho conversion, agrees perfectly with that calculated from the experimental relaxivity R 1 using the force free diffusion theory of spin-lattice relaxation.
Para-hydrogen perspectives in hyperpolarized NMR.
Glöggler, Stefan; Colell, Johannes; Appelt, Stephan
2013-10-01
The first instance of para-hydrogen induced polarization (PHIP) in an NMR experiment was serendipitously observed in the 1980s while investigating a hydrogenation reaction (Seldler et al., 1983; Bowers and Weitekamp, 1986, 1987; Eisenschmid et al., 1987) [1-4]. Remarkably a theoretical investigation of the applicability of para-hydrogen as a hyperpolarization agent was being performed in the 1980's thereby quickly providing a theoretical basis for the PHIP-effect (Bowers and Weitekamp, 1986) [2]. The discovery of signal amplification by a non-hydrogenating interaction with para-hydrogen has recently extended the interest to exploit the PHIP effect, as it enables investigation of compounds without structural alteration while retaining the advantages of spectroscopy with hyperpolarized compounds [5]. In this article we will place more emphasis of the future applications of the method while only briefly discussing the efforts that have been made in the understanding of the phenomenon and the development of the method so far. Copyright © 2013 Elsevier Inc. All rights reserved.
NASA Astrophysics Data System (ADS)
López García, Z.; Malaroda, S. M.; Faraggiana, R.
Se determinan las abundancias químicas de los elementos más livianos presentes en dos estrellas CP del grupo HgMn, μ Lep y 53 Tau, utilizando espectros IUE de alta resolución y técnicas de cálculo de espectros sintéticos. Para el cálculo de las líneas se utiliza la lista mas completa de datos atómicos disponible y el programa SYNTHE. Para el cálculo de la abundancia de un elemento se comparan, para cada imagen, los perfiles observados del mayor número de líneas presentes con los perfiles calculados obtenidos por variación de las abundancias iniciales, reteniendo la abundancia para la cual el acuerdo entre las líneas observadas y calculadas es considerado visualmente el mejor. Los resultados obtenidos son comparados con los estimados por la teoría de la difusión.
DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
1990-12-31
Cape Industries produces Dimethyl Terephthalate (DMT) and Terephthalic Acid (TA) which are used as raw materials in the production of polyester fibers and films. In this process para-cymene is used as a heat transfer fluid for the process equipment. As the para-cymene is circulated through the process and repeatedly reheated to operating temperatures, some thermal degradation of the cymene and minor contamination due to infiltration of the process material occurs. Prior to August 1988 this spent material was purged from the system and shipped off site for reclamation. The spent material was classified as a hazardous waste due to themore » characteristic of ignitability. In early 1988 existing equipment was retrofitted allowing for on site distillation of the spent para-cymene in a closed-loop system. Reclaimed para-cymene is returned to the system for reuse while the still bottoms are used as a feedstock in the production of DMT. No waste material is generated.« less
Um estudo espectrofotométrico da variável cataclísmica V3885 Sgr
NASA Astrophysics Data System (ADS)
Ribeiro, F. M. A.; Diaz, M. P.
2003-08-01
Variáveis Cataclísmicas são sistemas binários cerrados compostos de uma anã vermelha que transfere matéria para uma anã branca, em sistemas não magnéticos ocorre a formação de um disco de acresção em torno da anã branca. V3885 Sgr é uma variável cataclísmica classificada como sendo do tipo nova-like. É apresentado um estudo espectrofotométrico de V3885 Sgr de alta resolução temporal feito na região do visível. A região observada é centrada em Ha e abrange também a linha de HeI 6678. O primeiro resultado obtido neste estudo é a determinação do período orbital a partir de medidas da velocidade radial da linha de Ha como sendo 0,20716071(22) dias, resolvendo inconsistências quanto a esse valor na literatura e definindo uma efeméride a longo prazo para o sistema. Com este período e as medidas de velocidade radial do perfil de linha de Ha foi construído um diagrama de massas, através do qual restringimos as massas das componentes estelares do sistema e limitamos a inclinação orbital do sistema. Foram construídos diagramas de Greenstein para as linhas de Ha e HeI, onde os espectros médios em cada intervalo de fase são representados lado a lado em escala de cinza, indicando a existência de uma emissão intensa proveniente da parte posterior do disco. A partir da tomografia Doppler obtivemos perfis de emissividade radial para o disco tanto para a linha de Ha como para HeI. Os resultados obtidos são comparados com os de outros sistemas estudados com a mesma técnica. Serão apresentados também resultados da tomografia de flickering para o sistema.
Mansiz Kaplan, Basak; Akyuz, Gulseren; Kokar, Serdar; Yagci, Ilker
2018-02-17
The aim of the study was to compare different conservative treatments in patients with carpal tunnel syndrome (CTS). A single-blind randomized controlled study. Patients (n = 169) diagnosed with mild or moderate CTS were screened; 110 met study requirements. The patients were randomized into 3 groups. The control (CON) comparison provided to all patients was a fabricated night orthotic which held the wrist in a neutral position. The second group received adjunctive kinesiotaping (KIN) and the third group received paraffin (PARA). All patients were evaluated clinically, electrophysiologically, and ultrasonographically before treatment and at 3 weeks, 3 months, and 6 months. There were 36 patients in CON, 37 in KIN, and 37 in PARA. Pain reduction in KIN was better than the other groups at 3 weeks (mean difference [MD] in CON 2.4 ± 2.5, KIN 3.7 ± 2.0, PARA 2.7 ± 2.3; P < .01) and 6 months (MD in CON 3.4 ± 3.0, KIN 4.9 ± 3.1, PARA 3.7 ± 2.9; P < .05). KIN pain reduction was better than CON at 3 months (MD in CON 3.8 ± 2.8, KIN 5.0 ± 2.5; P < .05). Reduction of the cross-sectional area of median nerve at the level of radioulnar joint was greater for KIN than CON at 3 weeks (MD in CON 0.0 ± 0.5, KIN 0.3 ± 0.7; P < .01) than PARA at 3 months (MD in KIN 0.3 ± 0.8, PARA 0.0 ± 0.8; P < .05) and both groups at 6 months (MD in CON 0.1 ± 0.8, KIN 0.5 ± 0.9, PARA 0.0 ± 1.0 P < .05). Adding KIN to night use of an orthotic was more effective in achieving symptomatic and structural improvements than either the orthotic alone or adjunctive use of paraffin in patients with mild and moderate CTS. Copyright © 2018 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.
NASA Astrophysics Data System (ADS)
Isidro Villamizar, Gloria Maria
Este estudio utiliza metodologia de investigacion cualitativa, con el proposito de describir, analizar y evaluar los procesos de diseno y desarrollo de un modelo de accesibilidad que consiste en estrategias de ensenanza de las matematicas para estudiantes con impedimentos visuales matriculados en el curso de Astronomia Descriptiva en la UPR. Se utilizaron las siguientes estrategias para recopilar la informacion, 1) reflexiones de la investigadora en el proceso de diseno y desarrollo de las lecciones adaptadas, que se registraron en un diario reflexivo. 2) entrevista semiestructurada luego de haber trabajado las lecciones de aprendizaje adaptadas con los participantes. 3) observaciones y notas de la investigadora del trabajo de los participantes. Para obtener la informacion de los participantes se obtuvo los permisos institucionales necesarios; se seleccionaron los participantes y se validaron los instrumentos; se realizo el desarrollo de las lecciones adaptadas con los participantes; y finalmente, se analizo la informacion obtenida. El diseno de las lecciones de aprendizaje adaptadas se hizo siguiendo las recomendaciones curriculares de los temas de matematicas aplicados en el curso de Astronomia Descriptiva realizado por la investigadora durante su semestre de internado. El testimonio de las voces de los participantes se obtuvo del proceso de desarrollo de las lecciones de aprendizaje adaptadas de temas seleccionados de conceptos matematicos requeridos en el curso de Astronomia Descriptiva y de la entrevista semiestructurada con los participantes, luego de haber trabajado las lecciones de aprendizaje. Para el desarrollo de las lecciones de aprendizaje, se utilizaron materiales tactiles adaptados, materiales tactiles disenados y materiales disponibles comercialmente. Los textos de las lecciones se imprimieron en tinta y en Braille. Se exhorta a disenar y desarrollar estrategias de ensenanza accesibles, considerando como recursos para evaluar su efectividad a personas con impedimentos visuales. El utilizar estrategias de aprendizaje accesibles de acuerdo a las necesidades individuales de los estudiantes, contribuye para que los estudiantes con impedimentos visuales descubran, exploren, investiguen y formulen sus propias conclusiones durante su proceso de aprendizaje.
Pinilla, Gladys; Campos, Lesly; Durán, Andrea; Navarrete, Jeannette; Muñoz, Liliana
2018-03-15
Introducción. La sífilis es una enfermedad producida por Treponema pallidum subespecie pallidum cuya incidencia mundial es de 12 millones de casos por año, aproximadamente; de estos, más de dos millones se presentan en mujeres gestantes, siendo la sífilis congénita la complicación más grave de esta infección en el embarazo.Objetivo. Detectar la presencia de T. pallidum subespecie pallidum en muestras clínicas para el diagnóstico de sífilis congénita mediante reacción en cadena de la polimerasa (PCR) anidada y determinar su concordancia con las pruebas serológicas.Materiales y métodos. Mediante PCR convencional y anidada, se amplificaron tres genes diana (polA, 16S ADNr y TpN47) y se confirmaron los productos de amplificación de los genes TpN47 y polA por secuenciación. Las pruebas serológicas empleadas fueron la VDRL (Venereal Disease Research Laboratory), la de reagina plasmática rápida (Rapid Plasma Reagin, RPR) y la de aglutinación de partículas para Treponema pallidum (Treponema pallidum Particle Agglutination Assay, TPPA).Resultados. La sensibilidad para la PCR convencional fue de 52 pg y, para la PCR anidada, de 0,52 pg. La especificidad con los iniciadores TpN47 y polA fue de 100 %; los resultados de la secuenciación mostraron una identidad de 97 % con T. pallidum. En 70 % de las muestras, los resultados de las pruebas serológicas y la PCR anidada concordaron.Conclusión. El gen TpN47 resultó ser el mejor blanco molecular para la identificación de T. pallidum. La PCR anidada se presenta como una alternativa de diagnóstico molecular promisoria para el diagnóstico de sífilis congénita.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Takiar, Vinita; Fontanilla, Hiral P.; Eifel, Patricia J.
Purpose: Conformal treatment of para-aortic lymph nodes (PAN) in cervical cancer allows dose escalation and reduces normal tissue toxicity. Currently, data documenting the precise location of involved PAN are lacking. We define the spatial distribution of this high-risk nodal volume by analyzing fluorodeoxyglucose (FDG)-avid lymph nodes (LNs) on positron emission tomography/computed tomography (PET/CT) scans in patients with cervical cancer. Methods and Materials: We identified 72 PANs on pretreatment PET/CT of 30 patients with newly diagnosed stage IB-IVA cervical cancer treated with definitive chemoradiation. LNs were classified as left-lateral para-aortic (LPA), aortocaval (AC), or right paracaval (RPC). Distances from the LNmore » center to the closest vessel and adjacent vertebral body were calculated. Using deformable image registration, nodes were mapped to a template computed tomogram to provide a visual impression of nodal frequencies and anatomic distribution. Results: We identified 72 PET-positive para-aortic lymph nodes (37 LPA, 32 AC, 3 RPC). All RPC lymph nodes were in the inferior third of the para-aortic region. The mean distance from aorta for all lymph nodes was 8.3 mm (range, 3-17 mm), and from the inferior vena cava was 5.6 mm (range, 2-10 mm). Of the 72 lymph nodes, 60% were in the inferior third, 36% were in the middle third, and 4% were in the upper third of the para-aortic region. In all, 29 of 30 patients also had FDG-avid pelvic lymph nodes. Conclusions: A total of 96% of PET positive nodes were adjacent to the aorta; PET positive nodes to the right of the IVC were rare and were all located distally, within 3 cm of the aortic bifurcation. Our findings suggest that circumferential margins around the vessels do not accurately define the nodal region at risk. Instead, the anatomical extent of the nodal basin should be contoured on each axial image to provide optimal coverage of the para-aortic nodal compartment.« less
Avaliação da influência de alterações cardíacas na ultrassonografia vascular periférica de idosos
Ribeiro, Alcides José Araújo; Ribeiro, Andréa Campos de Oliveira; Rodrigues, Márcia Marisia Maciel; Negreiros, Sandra de Barros Cobra; Nogueira, Ana Cláudia Cavalcante; Almeida, Osório Luís Rangel; Silva, José Carlos Quináglia e; de Paula, Ana Patrícia
2016-01-01
Resumo Contexto As cardiopatias podem causar alterações no formato das ondas da ultrassonografia vascular (UV) em vasos periféricos. Essas alterações, tipicamente bilaterais e sistêmicas, são pouco conhecidas e estudadas. Objetivo Avaliar as ondas periféricas da UV de pacientes idosos para identificar alterações decorrentes de cardiopatias. Métodos Foram estudados 183 pacientes idosos submetidos a UV periférica no ano de 2014. Resultados Foram avaliados 102 mulheres (55,7%) e 81 homens (44,3%) com idade entre 60 e 91 anos (média de 70,4±7,2 anos). Encontraram-se alterações pela UV em 84 pacientes (45,9%). Foram identificadas 138 alterações de oito dos 13 tipos descritos na literatura: arritmia, onda bisferiens de pico sistólico, baixa velocidade de pico sistólico, pulsatilidade em veias femorais, bradicardia, taquicardia, onda de pulso parvus tardus e onda de pulso alternans. Houve baixa concordância entre a presença e a não presença de alterações na UV e na avaliação cardiológica. Na análise específica das alterações, os exames tiveram uma concordância variável, que foi boa para o achado de taquicardia, moderada para arritmia e baixa para bradicardia. Não houve concordância entre a UV e os exames cardiológicos para as demais alterações. Conclusões É possível identificar determinadas alterações cardíacas em idosos por meio da análise do formato das ondas periféricas da UV. É importante reconhecer e relatar a presença dessas alterações, pela possibilidade de alertar para um diagnóstico ainda não identificado nesses pacientes. Entretanto, mais estudos são necessários para que seja definida a importância das alterações no formato das ondas Doppler periféricas no reconhecimento de cardiopatias. PMID:29930591
ERIC Educational Resources Information Center
Lazos, Hector, Comp.
This guide on training bilingual education teachers focuses on parent participation in school activities. The guide addresses three groups of people: paraprofessionals and non-graduate students, bilingual teachers, and graduate students. Two units are presented, one dealing with the important influence parents have on their child's language…
Sutherland, Liese -Marie; Knudson, James N.; Mocko, Michal; ...
2015-12-17
An experiment was designed and developed to prototype a fiber-optic-based laser system, which measures the ratio of ortho-hydrogen to para-hydrogen in an operating neutron moderator system at the Los Alamos Neutron Science Center (LANSCE) spallation neutron source. Preliminary measurements resulted in an ortho to para ratio of 3.06:1, which is within acceptable agreement with the previously published ratio. As a result, the successful demonstration of Raman Spectroscopy for this measurement is expected to lead to a practical method that can be applied for similar in-situ measurements at operating neutron spallation sources.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sutherland, Liese -Marie; Knudson, James N.; Mocko, Michal
An experiment was designed and developed to prototype a fiber-optic-based laser system, which measures the ratio of ortho-hydrogen to para-hydrogen in an operating neutron moderator system at the Los Alamos Neutron Science Center (LANSCE) spallation neutron source. Preliminary measurements resulted in an ortho to para ratio of 3.06:1, which is within acceptable agreement with the previously published ratio. As a result, the successful demonstration of Raman Spectroscopy for this measurement is expected to lead to a practical method that can be applied for similar in-situ measurements at operating neutron spallation sources.
Synthesis and antitumor activity of quinonoid derivatives of cannabinoids.
Kogan, Natalya M; Rabinowitz, Ruth; Levi, Paloma; Gibson, Dan; Sandor, Peter; Schlesinger, Michael; Mechoulam, Raphael
2004-07-15
Three cannabis constituents, cannabidiol (1), Delta(8)-tetrahydrocannabinol (3), and cannabinol (5), were oxidized to their respective para-quinones 2, 4, and 6. In the 1960s, the oxidized product 4 had been assigned a para-quinone structure, which was later modified to an ortho-quinone. To distinguish between the two possible quinone structures, a detailed NMR investigation was undertaken. The original para-quinone structure was confirmed. X-ray crystallography elucidated the structures of the crystalline 2 and 6. All three compounds displayed antiproliferative activity in several human cancer cell lines in vitro, and quinone 2 significantly reduced cancer growth of HT-29 cancer in nude mice.
Soluciones analiticas AL problema de jets con velocidad de eyeccion variable EN EL tiempo.
NASA Astrophysics Data System (ADS)
Canto, J.; Raga, A. C.; D'Alessio, P.
1998-11-01
Se presenta un nuevo metodo que permite resolver de manera exacta y analitica las ecuaciones que describen un jet hipersonico con velocidad de eyeccion variable en el tiempo. El metodo se basa en consideraciones sencillas de conservacion de momento para las superficies de trabajo que se forman en el interior del jet. Como ejemplo, se presentan soluciones para jets con variacion sinusoidal en la velocidad de eyeccion, y tambien para el caso de un incremento lineal en el tiempo. Estas soluciones analiticas tienen una clara aplicacion en la interpretacion de las observaciones de jets asociados a objetos Herbig-Haro.
González-Pelayo, Silvia; López, Enol; Borge, Javier; de-Los-Santos-Álvarez, Noemí; López, Luis A
2018-06-01
The reaction of para -hydroxybenzyl alcohols with ferrocene in the presence of a catalytic amount of InCl₃ provided ferrocenyl phenol derivatives, an interesting class of organometallic compounds with potential applications in medicinal chemistry. This transformation exhibited a reasonable substrate scope delivering the desired products in synthetically useful yields. Evidence of involvement of a para -quinone methide intermediate in this coupling process was also provided. Preliminary biological evaluation demonstrated that some of the ferrocene derivatives available by this methodology exhibit significant cytotoxicity against several cancer cell lines with IC 50 values within the range of 1.07⁻4.89 μM.
The influence of the day of the week of hospital admission on the prognosis of stroke patients.
Barros, Juliana B; Goulart, Alessandra Carvalho; Alencar, Airlane P; Lotufo, Paulo A; Bensenor, Isabela M
2013-04-01
This study aimed to evaluate the weekday and weekend distribution of stroke case hospital admissions and their respective prognosis based on a sample from the Estudo de Mortalidade e Morbidade do Acidente Vascular Cerebral (EMMA), a cohort of stroke patients admitted to a community hospital in the city of São Paulo, Brazil. We ascertained all consecutive cases of first-time strokes between April 2006 and December 2008 and performed a subsequent one-year follow-up. No association was found between frequency of hospital admissions due to ischemic and hemorrhagic strokes and the specific day of the week on which the admission occurred. However, ten-day and twelve-month case-fatality was higher in hemorrhagic stroke patients admitted at the weekend. We also found that intracerebral hemorrhage patients admitted on weekends had a worse survival rate (50%) compared with those admitted during weekdays (25.6%, P log-rank = 0.03). We found a multivariate hazard ratio of 2.49 (95%CI: 1.10-5.81, P trend = 0.03) for risk of death at the weekend compared to weekdays for intracerebral hemorrhage cases. No difference in survival was observed with respect to the overall sample of stroke or ischemic stroke patients.
Rajmil, L; Plasencia, A; Borrell, C
1993-11-01
The objective of this study was to verify the reliability of the classifications of perinatal mortality causes. An independent observer coded the cases of perinatal death (n = 152) collected in the Encuesta Confidencial de Mortalidad Perinatal de Barcelona (ECMP, Confidential Perinatal Mortality Inquiry of Barcelona), by using both the Aberdeen classification system (regarding obstetric factors) and the Wigglesworth classification system (according to the initial pathological cause), with the same information used previously by the ECMP Commission. For the Aberdeen classification, the observed concordance index (Po) was 86% and the Kappa coefficient (K) 0.77 (95% CI: 0.68-0.86). For the Wigglesworth classification, the figures were 89% and 0.82 (95% CI: 0.74-0.90), respectively. The disagreement was mainly due to differences in the interpretation of the sequence of death, minimal information available in order to classify the cause of death, and misunderstanding of the existing information. To a lesser extent, the disagreement was caused by a failure to comply with the rules laid down for classifications. The assessment of the causes of death was not significantly influenced by birth weight, gestational age, time of death or the presence of necropsy. These results support the use of classifications of perinatal mortality causes in the context of confidential inquiries.
Utilice en forma segura los productos con cebo para roedores
Si se usan de manera inadecuada, los productos con veneno para ratas y ratones podrían hacerle daño a usted, a sus hijos o a sus mascotas. Siempre que use pesticidas lea la etiqueta del producto y siga todas las indicaciones.
Remodelar Correctamente: Guía de Prácticas Acreditadas Seguras Para Trabajar Con Plomo
Información general sobre los requisitos legales de las prácticas relacionadas al manejo seguro del plomo para dueños de hogares, inquilinos, proveedores de cuido infantil, y padres durante las actividades de remodelación
Action mechanism of tyrosinase on meta- and para-hydroxylated monophenols.
Fenoll, L G; Rodríguez-López, J N; Varón, R; García-Ruiz, P A; García-Cánovas, F; Tudela, J
2000-04-01
The relationship between the structure and activity of meta- and para-hydroxylated monophenols was studied during their tyrosinase-catalysed hydroxylation and the rate-limiting steps of the reaction mechanism were identified. The para-hydroxylated substrates permit us to study the effect of a substituent (R) in the carbon-1 position (C-1) of the benzene ring on the nucleophilic attack step, while the meta group permits a similar study of the effect on the electrophilic attack step. Substrates with a -OCH3 group on C-1, as p-hydroxyanisol (4HA) and m-hydroxyanisol (3HA), or with a -CH2OH group, as p-hydroxybenzylalcohol (4HBA) and m-hydroxybenzylalcohol (3HBA), were used because the effect of the substituent (R) size was assumed to be similar. However, the electron-donating effect of the -OCH3 group means that the carbon-4 position (C-4) is favoured for nucleophilic attack (para-hydroxylated substrates) or for electrophilic attack (meta-hydroxylated substrates). The electron-attracting effect of the -CH2OH group has the opposite effect, hindering nucleophilic (para) or electrophilic (meta) attack of C-4. The experimental data point to differences between the maximum steady-state rate (V(M)Max) of the different substrates, the value of this parameter depends on the nucleophilic and electrophilic attack. However, differences are greatest in the Michaelis constants (K(M)m), with the meta-hydroxylated substrates having very large values. The catalytic efficiency k(M)cat/K(M)m is much greater for thepara-hydroxylated substrates although it varies greatly between one substrate and the other. However, it varies much less in the meta-hydroxylated substrates since this parameter describes the power of the nucleophilic attack, which is weaker in the meta OH. The large increase in the K(M)m of the meta-hydroxylated substrates might suggest that the phenolic OH takes part in substrate binding. Since this is a weaker nucleophil than the para-hydroxylated substrates, the binding constant decreases, leading to an increase in K(M)m. The catalytic efficiency of tyrosinase on a monophenol (para or meta) is directly related to the nucleophilic power of the oxygen of the phenolic OH. The oxidation step is not limiting since if this were the case, the para and meta substrates would have the same V(M)max. The small difference between the absolute values of V(M)max suggests that the rate constants of the nucleophilic and electrophilic attacks are on the same order of magnitude.
Development cooperation in water and sanitation: is it based on the human rights framework?
Brown, Colin; Heller, Léo
2017-07-01
The water and sanitation sector is verifiably receiving increased attention and funding through international development cooperation. Not least because of the way that it affects incentives and institutions in partner countries, development cooperation can have either positive or negative effects on human rights though. The consolidated frameworks for the human rights to water and sanitation is becoming linked to the international community's coordinated development efforts, as evidenced notably in the 2030 Agenda for Sustainable Development. However, a review of major funders' official policies for development cooperation in the sector suggests that many only partially endorse the frameworks for the human rights to water and sanitation. An observation of development cooperation flows to the sector allows the hypothesis to be advanced that worldwide inequalities in access to these services may be reduced through a full and clear application of the human rights framework in development cooperation activities. The article presents findings of this research and explores key stakes for development cooperation in the water and sanitation sector that are relevant for their ability to either negatively or positively contribute to the realization of human rights. Resumen El sector de agua y saneamiento ha recibido creciente atención y financiación a través de la cooperación internacional para el desarrollo. La cooperación para el desarrollo puede tener efectos tanto positivos cuanto negativos sobre los derechos humanos. El hito que consolida los derechos humanos al agua y al saneamiento están articulados a esfuerzos de cooperación para el desarrollo promovidos por la comunidad internacional, como se evidencia en la Agenda 2030 para el Desarrollo Sostenible. Sin embargo, una revisión de las políticas oficiales de los principales financiadores del sector sugiere que muchos de ellos aprueban solo parcialmente los hitos de los derechos humanos al agua y el saneamiento. La observación de los flujos de esta cooperación para el sector permite formular la hipótesis de que las desigualdades en el acceso a estos servicios en diferentes partes del mundo pueden reducirse con la aplicación completa y clara del marco de los derechos humanos en las actividades de cooperación para el desarrollo. El artículo presenta los resultados de esta investigación y explora los desafíos de la cooperación para el desarrollo del sector de agua y aguas residuales que son relevantes para impactar tanto negativamente cuanto positivamente a los derechos humanos.
Giménez, Mariano E; Palermo, Mariano; Houghton, Eduardo; Acquafresca, Pablo; Finger, Caetano; Verde, Juan M; Cúneo, Jorge Cardoso
2016-01-01
Once a biliary injury has occurred, repair is done by a hepaticojejunostomy. The most common procedure is to perform a dilatation with balloon with a success of 70 %. Success rates range using biodegradable stents is from 85% to 95%. Biodegradable biliary stents should change the treatment of this complication. To investigate the use of biodegradable stents in a group of patients with hepaticojejunonostomy strictures. In a prospective study 16 biodegradable stents were placed in 13 patients with hepaticojejunostomy strictures secondary to bile duct repair of a biliary surgical injury. Average age was 38.7 years (23-67), nine were female and four male. All cases had a percutaneous drainage before at the time of biodegradable stent placement. In one case, temporary haemobilia was present requiring blood transfusion. In another, pain after stent placement required intravenous medication. In the other 11 patients, hospital discharge was the next morning following stent placement. During the patient´s follow-up, none presented symptoms during the first nine months. One patient presented significant alkaline phosphatase elevation and stricture recurrence was confirmed. One case had recurrence of cholangitis 11 months after the stent placement. 84.6% continued asymptomatic with a mean follow-up of 20 months. The placement of biodegradable stents is a safe and feasible technique. Was not observed strictures caused by the stent or its degradation. It could substitute balloon dilation in strictures of hepaticojejunostomy. Uma vez que lesão biliar ocorreu, o reparo é feito por hepaticojejunostomia. O procedimento mais comum é efetuar dilatação com balão com sucesso de 70%. As taxas de sucesso utilizando stents biodegradáveis é de 85% a 95%. Stents biliares biodegradáveis devem mudar o tratamento desta complicação. Investigar o uso de stents biodegradáveis em um grupo de pacientes com estenose hepaticojejunal. Em estudo prospectivo 16 stents biodegradáveis foram colocados em 13 pacientes com estenose de hepaticojejunostomia secundárias usados para reparação do ductos biliares de lesão cirúrgica. A média de idade foi de 38,7 anos (23-67), nove pacientes eram homens e quatro mulheres. Todos os casos tiveram drenagem percutânea antes do momento da colocação de stent biodegradável. Em um caso, haemobilia temporária estava presente com necessidade de transfusão de sangue. Em outro, dor após a colocação do stent necessitou de medicação intravenosa. Nos outros 11 pacientes, alta hospitalar foi na manhã seguinte após o procedimento. Durante o seguimento, nenhum apresentou sintomas durante os primeiros nove meses. Um paciente apresentou significativa elevação da fosfatase alcalina por recidiva da estenose. Um caso teve recorrência de colangite 11 meses após a colocação do stent. Continuaram assintomáticos 84,6% com média de acompanhamento de 20 meses. A colocação de stents biodegradáveis é técnica segura e viável. Não foram observadas restrições causadas pelo stent ou pela sua degradação. Stent pode substituir dilatação com balão na estenose de hepaticojejunostomia.
Pivatto Junior, Fernando; Scheffel, Rafael Selbach; Ries, Lucas; Wolkind, Ricardo Roitman; Marobin, Roberta; Barkan, Sabrina Sigal; Amon, Luís Carlos; Biolo, Andréia
2017-04-01
The SAMe-TT2R2 score was developed to predict which patients on oral anticoagulation with vitamin K antagonists (VKAs) will reach an adequate time in therapeutic range (TTR) (> 65%-70%). Studies have reported a relationship between this score and the occurrence of adverse events. To describe the TTR according to the score, in addition to relating the score obtained with the occurrence of adverse events in patients with nonvalvular atrial fibrillation (AF) on oral anticoagulation with VKAs. Retrospective cohort study including patients with nonvalvular AF attending an outpatient anticoagulation clinic of a tertiary hospital. Visits to the outpatient clinic and emergency, as well as hospital admissions to the institution, during 2014 were evaluated. The TTR was calculated through the Rosendaal´s method. We analyzed 263 patients (median TTR, 62.5%). The low-risk group (score 0-1) had a better median TTR as compared with the high-risk group (score ≥ 2): 69.2% vs. 56.3%, p = 0.002. Similarly, the percentage of patients with TTR ≥ 60%, 65% or 70% was higher in the low-risk group (p < 0.001, p = 0.001 and p = 0.003, respectively). The high-risk group had a higher percentage of adverse events (11.2% vs. 7.2%), although not significant (p = 0.369). The SAMe-TT2R2 score proved to be effective to predict patients with a better TTR, but was not associated with adverse events. O escore SAMe-TT2R2 foi desenvolvido visando predizer quais pacientes em anticoagulação oral com antagonistas da vitamina K (AVKs) atingirão um tempo na faixa terapêutica (TFT) adequado (> 65%-70%) no seguimento. Estudos também o relacionaram com a ocorrência de eventos adversos. Descrever o TFT de acordo com o escore, além de relacionar a pontuação obtida com a ocorrência de eventos adversos adversos em pacientes com fibrilação atrial (FA) não valvar em anticoagulação oral com AVKs. Estudo de coorte retrospectivo incluindo pacientes com FA não valvar em acompanhamento em ambulatório de anticoagulação de um hospital terciário. Foi realizada uma avaliação retrospectiva de consultas ambulatoriais, visitas a emergência e internações hospitalares na instituição no período de janeiro-dezembro/2014. O TFT foi calculado aplicando-se o método de Rosendaal. Foram analisados 263 pacientes com TFT mediano de 62,5%. O grupo de baixo risco (0-1 ponto) obteve um TFT mediano maior em comparação com o grupo de alto risco (≥ 2 pontos): 69,2% vs. 56,3%, p = 0,002. Da mesma forma, o percentual de pacientes com TFT ≥ 60%, 65% ou 70% foi superior nos pacientes de baixo risco (p < 0,001, p = 0,001 e p = 0,003, respectivamente). Os pacientes de alto risco tiveram um percentual maior de eventos adversos (11,2% vs. 7,2%), embora não significativo (p = 0,369). O escore SAMe-TT2R2 foi uma ferramenta eficaz na predição do TFT em pacientes com FA em uso de AVKs para anticoagulação, porém não se associou à ocorrência de eventos adversos.
NASA Astrophysics Data System (ADS)
Bhand, Sujit; Patil, Rishikesh; Shinde, Yogesh; Lande, Dipali N.; Rao, Soniya S.; Kathawate, Laxmi; Gejji, Shridhar P.; Weyhermüller, Thomas; Salunke-Gawali, Sunita
2016-11-01
Structure and spectral characteristics of 'Ortho' ((E)-4-hydroxy-2-(2‧-(4‧-R)-hydroxyphenyl)-imino)-naphthalen-1(2H)-one) and 'para' (2-(2‧-(4‧-R)-hydroxyphenyl)-amino)-1,4-naphthoquinone) tautomers of o-hydroxyanilino-1,4-naphthoquinone derivatives (Rdbnd H, 1A; sbnd CH3, 2A; and -Cl, 3A) are investigated using the 1H, 13C, DEPT, gDQCOSY, gHSQCAD NMR, HPLC, cyclic voltammetry techniques combined with the density functional theory. The compound 2A crystallizes in monoclinic space group P21/c. wherein the polymer chain is facilitated via Osbnd H⋯O and Csbnd H⋯O intermolecular hydrogen bonding. Marginal variations in bond distances in quinonoid and aminophenol moieties render structural flexibility to these compounds those in solution exist as exist in 'ortho - para' tautomers. 1H and 13C NMR spectra in DMSO-d6 showed two sets of peaks in all compounds; whereas only the para tautomer of for 1A and 2A, the para tautomer is predominant in CD3CN solution. Further the ortho-para interconversion is accompanied by a large up-field signals for C(3)sbnd H(3) in their 1H and 13C NMR spectra. These inferences are corroborated by the density functional theoretic calculations.
paraGSEA: a scalable approach for large-scale gene expression profiling
Peng, Shaoliang; Yang, Shunyun
2017-01-01
Abstract More studies have been conducted using gene expression similarity to identify functional connections among genes, diseases and drugs. Gene Set Enrichment Analysis (GSEA) is a powerful analytical method for interpreting gene expression data. However, due to its enormous computational overhead in the estimation of significance level step and multiple hypothesis testing step, the computation scalability and efficiency are poor on large-scale datasets. We proposed paraGSEA for efficient large-scale transcriptome data analysis. By optimization, the overall time complexity of paraGSEA is reduced from O(mn) to O(m+n), where m is the length of the gene sets and n is the length of the gene expression profiles, which contributes more than 100-fold increase in performance compared with other popular GSEA implementations such as GSEA-P, SAM-GS and GSEA2. By further parallelization, a near-linear speed-up is gained on both workstations and clusters in an efficient manner with high scalability and performance on large-scale datasets. The analysis time of whole LINCS phase I dataset (GSE92742) was reduced to nearly half hour on a 1000 node cluster on Tianhe-2, or within 120 hours on a 96-core workstation. The source code of paraGSEA is licensed under the GPLv3 and available at http://github.com/ysycloud/paraGSEA. PMID:28973463
NASA Astrophysics Data System (ADS)
Vishwam, T.; Shihab, Suriya; Murthy, V. R. K.; Tiong, Ha Sie; Sreehari Sastry, S.
2017-05-01
Complex dielectric permittivity measurements of propylene glycol (PG) in ethanol at various mole fractions were measured by using open-ended coaxial probe technique at different temperatures in the frequency range 0.02 < ν/GHz < 20. The dipole moment (μ), excess dipole moment (Δμ),excess permittivity (εE), excess inverse relaxation time(1/τ)E, Bruggeman parameter (fB), excess Helmholtz energy (ΔFE) are determined using experimental data. From the minimum energy based geometry optimization, dipole moments of individual monomers of propylene glycol and ethanol and their binary system have been evaluated theoretically at gaseous state as well as alcoholic medium by using PCM and IEFPCM solvation models from the Hatree-Fock (HF) and Density Functional Theory (DFT-B3LYP) methods with 6-311G* and 6-311G** basis sets. The obtained results have been interpreted in terms of the short and long range ordering of the dipoles, Kirkwood correlation factor (geff), thermodynamic parameters, mean molecular polarizability (αM) and interaction in the mixture through hydrogen bonding. Dielectric relaxation study of propylene glycol in ethanol medium Determination of excess dielectric and thermodynamic parameters Comparison of experimental dipole moment with theoretical calculations Interpretation of the molecular interactions in the liquid through H-bonding Correlation between the evaluated dielectric parameters and theoretical results
Longitudinal nuclear spin relaxation of ortho- and para-hydrogen dissolved in organic solvents.
Aroulanda, Christie; Starovoytova, Larisa; Canet, Daniel
2007-10-25
The longitudinal relaxation time of ortho-hydrogen (the spin isomer directly observable by NMR) has been measured in various organic solvents as a function of temperature. Experimental data are perfectly interpreted by postulating two mechanisms, namely intramolecular dipolar interaction and spin-rotation, with activation energies specific to these two mechanisms and to the solvent in which hydrogen is dissolved. This permits a clear separation of the two contributions at any temperature. Contrary to the self-diffusion coefficients at a given temperature, the rotational correlation times extracted from the dipolar relaxation contribution do not exhibit any definite trend with respect to solvent viscosity. Likewise, the spin-rotation correlation time obeys Hubbard's relation only in the case of hydrogen dissolved in acetone-d6, yielding in that case a spin-rotation constant in agreement with literature data. Concerning para-hydrogen, which is NMR-silent, the only feasible approach is to dissolve para-enriched hydrogen in these solvents and to follow the back-conversion of the para-isomer into the ortho-isomer. Experimentally, this conversion has been observed to be exponential, with a time constant assumed to be the relaxation time of the singlet state (the spin state of the para-isomer). A theory, based on intermolecular dipolar interactions, has been worked out for explaining the very large values of these relaxation times which appear to be solvent-dependent.
Kumada, Takayuki; Tachikawa, Hiroto; Takayanagi, Toshiyuki
2005-03-07
The quartet electron paramagnetic resonance (EPR) lines observed in gamma- and X-ray irradiated solid para-H2, which have previously been assigned to H2-, are reinvestigated. We have reassigned the quartet lines to H6 rather than H2- mainly due to comparison of experimentally obtained EPR parameters to theoretical results. Based on the new assignment, trapping site, rotation, ortho-para conversion, quantum diffusion and isotope effect of H+ have been reinterpreted by the precise reanalysis as follows. The H6+ ion is composed of the collinearly aligned H2+ core at the center and two H2 rotors at both ends, occupies a single substitutional site, and has a precession motion around a crystalline axis with the angle of approximately 57 degrees. The ortho-para conversion of H2+ core of H6+ is completed within the time-scale of hours, whereas ortho-H2 molecules near H6+ convert much faster. H6+ diffuses quantum mechanically by the repetition of H6+ + H2 --> H2 + H6+ reaction. The diffusion terminates by the reaction, H6(+) + HD --> H5D(+) + H2, with a HD impurity contained in the para-H2 sample at natural abundance. Finally, we will propose a possible reason why H6+ is produced instead of H3+ in the irradiated solid H2.
Rascón-Martínez, Dulce María; Guzmán-Sánchez, Joaquín Antonio; Corral-Urdapilleta, Nora Paulina; Arguelles-Uribe, Gema Damaris; Velázquez-Loeza, Jazmín; Soto-Palma, Gustavo; Carrillo-Torres, Orlando
Observar el comportamiento de la gabapentina para aminorar la hipertensión reactiva secundaria a ansiedad y dolor en pacientes sometidos a cirugía oftálmica, así como el consumo de opiáceos entre los grupos. Ensayo clínico controlado aleatorizado y doble ciego que analizó a 125 pacientes divididos en tres grupos: grupo A, gabapentina 300 mg; grupo B, gabapentina 450 mg; grupo C, amaranto en grageas como control 2 horas antes del procedimiento quirúrgico. Se utilizó la prueba de ji al cuadrado para variables sociodemográficas y ANOVA de un factor para variables numéricas continuas. Se consideró como significativo un valor de p < 0.05 para un estudio de dos colas con un poder beta del 80%. La ansiedad y la analgesia transoperatoria y posoperatoria tuvieron diferencias significativas entre los grupos. Se encontró menor consumo de opiáceos en los grupos que usaron gabapentina. La gabapentina por vía oral, 300 o 450 mg, 2 horas antes de la cirugía, reduce el dolor, la ansiedad y el consumo de opiáceos durante el posoperatorio en pacientes sometidos a cirugía oftalmológica. Copyright: © 2018 SecretarÍa de Salud
Moreno, Marlene Aparecida; Zamunér, Antonio Roberto; Paris, Juliana Viana; Teodori, Rosana Macher; Barros, Ricardo M L
2012-06-01
The aim of this study was to evaluate the effects of wheelchair sports on respiratory muscle strength and the thoracic mobility of individuals with spinal cord injury. Thirty male subjects with chronic spinal cord injury (American Spinal Injury Association Impairment Scale grade A) took part in the study and were divided into four groups: sedentary subjects with quadriplegia (S-QUAD, n = 7), wheelchair rugby athletes with quadriplegia (A-QUAD, n = 8), sedentary subjects with paraplegia (S-PARA, n = 6), and wheelchair basketball athletes with paraplegia (A-PARA, n = 9). The main outcome measures were maximal inspiratory and expiratory pressure and the respiratory coefficients at the axillary and xiphoid levels. A-QUAD group presented values significantly higher for all respiratory variables studied compared with the S-QUAD group. No significant differences in any of the respiratory variables were observed between S-PARA and A-PARA groups. There was a negative correlation between spinal cord injury level and respiratory variables for the S-QUAD and S-PARA groups. There were positive correlations in the A-QUAD group between time of training and maximal inspiratory pressure (adjusted R = 0.84; P = 0.001) and respiratory coefficients at the axillary level (adjusted R = 0.80; P = 0.002). Physical training seems to have a positive influence on respiratory muscle strength and thoracic mobility, especially in subjects with quadriplegia.
Eleven Years of Parotid Gland Surgery in a Plastic and Reconstructive Department.
Correia-Sá, Inês Bastos; Correia-Sá, Mário; Costa-Ferreira, Pedro; Silva, Álvaro; Marques, Marisa
2016-01-01
Salivary gland tumors are an uncommon entity, comprising 3% to 6% of all head and neck tumors. Approximately 75% to 80% occur in the parotid gland, and 80% are benign. It is difficult to establish epidemiologic characteristics of parotid gland tumors due to their low incidence. We performed a retrospective study to analyze clinical diagnostic and therapeutic features of patients submitted to parotid gland surgery. A retrospective study was performed, regarding all the patients (n = 96) submitted to surgery for treatment of parotid gland disease in the Department of Plastic and Reconstructive Surgery of Centro Hospitalar de S. João (Porto, Portugal) between 2002 and 2012. Medical records were analyzed and the following data were collected: patient age at diagnosis, sex, tumor location, symptom, tumor position, preoperative diagnosis techniques, type of operation performed, pathology, postoperative complications, adjuvant therapy (radiotherapy or chemotherapy), follow-up time, and tumor recurrence. SPSS was used for statistical analysis. Fifty-two percent of the patients were males and 48% females and mean age of 52.02. In 68.75% of the patients, superficial parotidectomy was performed. Benign pathology was found in 72% patients, and pleomorphic adenoma the most common tumor (39%). Facial paralysis (41.7%), Frey syndrome (9.4%), and great auricular nerve hyposthesia (10.4%) were major complications. Tumor recurrence was observed in 16 patients (16.7%), which forced 17 reoperations (17.7%). There were 5 deaths (5.2%). For most tumors, superficial parotidectomy is an effective treatment with acceptable morbidity. In patients of malignancy, treatment should be aggressive.
Treatment of Anorexia Nervosa: The Importance of Disease Progression in the Prognosis.
Andrade, Rodrigo; Gonçalves-Pinho, Manuel; Roma-Torres, António; Brandão, Isabel
2017-08-31
Anorexia nervosa is a severe, usually chronic, life-threatening disease of complex etiology characterized by food restriction, overestimation of the importance of body weight and image, intense fear of weight gain and distortion of body image. Anorexia nervosa is associated with high rates of mortality, suicide and decreased quality of life. Our aim is to present an anorexia nervosa treatment program offered in a major university hospital in Portugal, and to determine the impact of illness duration before admission on the outcome. Our hypothesis is that patients with greater disease longevity may have worse prognosis and poorer outcome. The sample included data from case records of 169 patients seen consecutively and for the first time at Centro Hospitalar São João, between 2010 and 2015. We performed a retrospective observational study which included data collected at admission and from later follow-up years. From the initially selected patients, 14.8% reached total remission, 16% accomplished partial remission and 14.2% ended up with exacerbation/stagnation of the disease. The dropout rate was of 55% throughout our study period. We found significant differences on outcome rates between distinct illness duration groups (p = 0.007). There are several factors frequently associated with poor outcome for anorexia nervosa. The interpretation of outcome findings was limited by the high rate of dropout and lack of consistent definition criteria. Our results support the idea that illness duration has an important role on the outcome and prognostic features of these patients.
Rei, Joana; Pereira, Josué; Reis, Carina; Salvador, Sérgio; Vaz, Rui
2017-09-01
Hydrocephalus develops in up to 90% of patients born with myelomeningocele. Although endoscopic third ventriculostomy (ETV) is currently considered the preferred treatment for obstructive hydrocephalus, its results have been inconsistent in patients with myelomeningocele. This study focuses on clinical and radiologic outcomes of ETV in children with hydrocephalus related to myelomeningocele. Medical records of 18 pediatric patients with myelomeningocele treated with ETV from 1998 to 2015 at the Centro Hospitalar São João (Porto, Portugal) were reviewed retrospectively. Patients' caregivers were contacted to evaluate their clinical manifestations before and after surgery regarding signs and symptoms of hydrocephalus and Chiari malformation. Control neuroradiologic imaging of 9 patients was obtained and analyzed. Success of ETV was defined by clinical resolution and radiologic confirmation. ETV was successful in 8 of 18 cases (44.4%). Groups of patients were compared according to age at the time of surgery, with a 40% (2/5) success rate in newborns and a 50% success rate (3/6) in children older than 1 year. Eight patients underwent ETV as a first option, with a 37.5% success rate. Ten patients underwent the procedure after previous ventriculoperitoneal shunt (VPS), 5 for malfunction and 5 for VPS infection with 60% and 40% success rates, respectively. Early postoperative complications occurred in 2 patients. ETV can be performed in patients with myelomeningocele and hydrocephalus with success rates of almost 50%. Prior VPS or VPS malfunction or infection do not contraindicate ETV. If possible, the procedure should be delayed until the patient is at least 1 month old. Copyright © 2017 Elsevier Inc. All rights reserved.
Evolving Regional Security in the Andean Region
2004-03-19
November 2003. 5 Joseph R. Nuñez, “Luchando en Contra de la Trinidad Hobbesiana en Colombia: Una Estrategia Para la Paz” Aerospace Power Journal . Tercer...December 2002. Nuñez, Joseph R. Luchando en Contra de la Trinidad Obesiana en Colombia: Una Estrategia Para la Paz. Aerospace Power Journal. Tercer
ERIC Educational Resources Information Center
Guerra, Alfonso Rangel, Ed.
2003-01-01
This journal offers a collection of Spanish-language articles, including: "Educacion a Distancia y Uso de las Tecnologias: Experiencias Desafios y Oportunidades Educativas para Jovenes y Adultos" (Ma. Mercedes Ruiz); "Volver a a Educacion Fundamental? Notas para una Arquelogia de los Mandatos Fundacionales del CREFAL" (Jorge…
HOJA INFORMATIVA Presencia de PFOA y PFOS en el agua potable Avisos de salud
La EPA estableció avisos de salud sobre el ácido perfluorooctanoico (PFOA) y el sulfonato de perfluorooctano (PFOS) para proporcionar información a los operadores de sistemas de agua potable y funcionarios estatales y locales para que puedan adoptar las me
Background: Increased pesticide concentrations in house dust in agricultural areas have been attributed to several exposure pathways, including agricultural drift, para-occupational, and residential use. Objective: To guide future exposure assessment efforts, we quantified rel...
1990-09-01
presente testamento de mi puno y letra para hacer constar mi ultima y firme voluntad para que sea cumplida fielmente conforme a las siguientes clausulas...expresamente lo revoco y anulo. Esta es mi ultima voluntad , escrita de mi puno y letra en la que me ratifico, y en noznbre de Dios Todopoderoso
El Plan Estratégico de la EPA para los años fiscales 2018-2022 pone énfasis en la agenda para el “retorno a lo básico”. La agenda establecida en este plan tiene tres metas principales que reflejan las filosofías clave del administrador.
El estado de derecho y el proceso en la EPA
La EPA se está volviendo a enfocar en sus obligaciones estatutarias básicas y en la gestión de las leyes ambientales de la nación conforme a lo previsto por el Congreso para asegurar constancia y certeza para la comunidad regulada en EE. UU.
Clinical and epidemiological aspects of cornea transplant patients of a reference hospital.
Cruz, Giovanna Karinny Pereira; Azevedo, Isabelle Campos de; Carvalho, Diana Paula de Souza Rego Pinto; Vitor, Allyne Fortes; Santos, Viviane Euzébia Pereira; Ferreira, Marcos Antonio
2017-06-08
clinically characterizing cornea transplant patients and their distribution according to indicated and post-operative conditions of cornea transplantation, as well as estimating the average waiting time. a cross-sectional, descriptive and analytical study performed for all cornea transplants performed at a reference service (n=258). Data were analyzed using Statistical Package for the Social Sciences, version 20.0. the main indicator for cornea transplant was keratoconus. The mean waiting time for the transplant was approximately 5 months and 3 weeks for elective transplants and 9 days for urgent cases. An association between the type of corneal disorder with gender, age, previous surgery, eye classification, glaucoma and anterior graft failure were found. keratoconus was the main indicator for cornea transplant. Factors such as age, previous corneal graft failure (retransplantation), glaucoma, cases of surgeries prior to cornea transplant (especially cataract surgery) may be related to the onset corneal endothelium disorders. caracterizar clínicamente los pacientes trasplantados y su distribución, con descripción de las condiciones indicadoras y posoperatorias de los trasplantes de córneas, así como estimar el tiempo promedio en la fila de espera. estudio epidemiológico, transversal, descriptivo y analítico, realizado con todos los trasplantes de córnea realizados en un servicio de referencia (n=258). Los datos fueron analizados con el software Statistical Package for the Social Sciences, versión 20.0. la principal condición indicadora para el trasplante de córnea fue el queratocono. El tiempo promedio en fila de espera para realización del trasplante fue de aproximadamente 5 meses y tres semanas, para trasplantes electivos y de 9 días para los casos de urgencia. Existió asociación entre el tipo de disturbio de la córnea con: sexo, intervalo etario, cirugía previa, clasificación del ojo, glaucoma y rechazo del injerto anterior. el queratocono fue la principal condición indicadora para el trasplante de córnea. Factores como: edad; rechazo de injerto de córnea anterior (retrasplante); glaucoma; y casos de cirugías previas al trasplante de córnea, destacando la cirugía de catarata, pueden estar relacionados con el aparecimiento de disturbios de la córnea de tipo endotelial. caracterizar clinicamente os pacientes transplantados e sua distribuição com descrição das condições indicadoras e pós-operatórias dos transplantes de córneas, bem como estimar o tempo médio em fila de espera. estudo epidemiológico, transversal, descritivo e analítico, realizado com todos os transplantes de córnea realizados em um serviço de referência (n= 258). Os dados foram analisados com uso do software Statistical Package for the Social Sciences, versão 20.0. a principal condição indicadora para o transplante de córnea foi o ceratocone. O tempo médio em fila de espera para realização do transplante foi de aproximadamente 5 meses e três semanas para o transplantes eletivos e 9 dias para os casos de urgência. Existiu associação entre o tipo de distúrbio da córnea com sexo, faixa etária, cirurgia prévia, classificação do olho, glaucoma e falência do enxerto anterior. o ceratocone foi a principal condição indicadora para o transplante de córnea. Fatores como idade, falência de enxerto corneano anterior (retransplante), glaucoma, casos de cirurgias prévias ao transplante de córnea, com destaque para a cirurgia de catarata, podem estar relacionados com o aparecimento de distúrbios da córnea do tipo endotelial.
Gucer, Fatih; Misirlioglu, Selim; Ceydeli, Nuri; Taskiran, Cagatay
2018-03-01
To present our initial experience on the feasibility of robotic transperitoneal para-aortic lymphadenectomy up to left renal vein via single docking approach by high port insertion technique followed by left shoulder docking as a rescue backup procedure in surgically obstructed patients undergoing surgical staging because of locally advanced cervical cancer (LACC). Prospective observational preliminary study. Canadian Task Force classification II-3. Tertiary-care academic affiliated private hospital. Ten patients with LACC who underwent robotic transperitoneal infrarenal para-aortic lymphadenectomy between January 2012 and December 2014. All patients with pathologically proven cervical cancer underwent a PET/CT scanning in a similar fashion at the department of nuclear medicine. PET/CT scans were evaluated by the nuclear medicine specialist. Following pre-operative work-up, robot-assisted transperitoneal infrarenal para-aortic lymphadenectomy was performed up to left renal vein by the same experienced surgeon. Sections of 5 mm were performed and stained with routine hematoxylin and eosin (H&E), and node count was done separately by experienced gynecopathologist. During the study period, 12 consecutive patients with LACC were counseled for pre-therapeutic robot-assisted transperitoneal para-aortic lymphadenectomy. Two patients declined the procedure and underwent standardized chemo-radiation therapy whereas remaining ten patients constituted the study group. In the study group, the median age was 46 years (range 33-59 years), and the median body mass index 28.5 kg/m 2 (range 18.5-35.1 kg/m 2 ). Clinical staging was stage IIB in four patients, IIIB in four, and IVA in one. Histopathological diagnosis was squamous cell carcinoma in nine patients, and adenocarcinoma in one. On PET/CT scans, seven out of ten patients were positive for pelvic lymph node metastasis. With respect to para-aortic area, only one of the ten patients had suspected metastasis in PET/CT. For nine patients with LACC, the median docking time was 6.5 min (range 4-15 min), and the median operating time for para-aortic lymphadenectomy was 120 min (range 60-165 min). The median trocar time was 14.5 min (range 5-45 min). In two out of ten patients, the surgical removal of whole lymphatic tissue between inferior mesenteric artery and left renal vein was not completely possible by a single docking of robotic column. Therefore, a new optic trocar was placed in the umbilicus and the robotic column was relocated over the left shoulder of the patient and residual lymphatic tissue measuring approximately 2 cm in the long axis immediately below the left renal vein was removed and the surgery was completed up to the left renal vein. All para-aortic lymphadenectomies have been completed by robotic route. There were no intra-operative complications. No patient received a blood transfusion. Early post-operative grade 2 and 3a complications according to Dindo classification occurred in two patients: one symptomatic lymphocyst and one local infection on assistant port site in one patient. The patient with suspected para-aortic lymph node metastasis in PET/CT showed no metastatic disease on histopathologic exam of para-aortic lymph nodes. The patient with recurrent disease and negative para-aortic lymph nodes on frozen section examination underwent robot-assisted total pelvic exenteration. Five of the residual eight patients had histologically proven metastasis in the para-aortic lymph node(s). Treatment modification occurred in six patients related to pre-treatment staging surgery. According to pathological results, extended field radiation therapy has been added in five patients and it was omitted in one patient. The median time interval between surgery and initiation of radiotherapy was 12 days (range 6-23 days). Robotic transperitoneal infrarenal para-aortic lymphadenectomy up to left renal vein by high port insertion technique is a safe and feasible option for staging and treatment planning. However, technically, it is obstructed in a small group of patients and nodal staging surgery up to left renal vein can be completed by consecutive left shoulder docking approach as a backup rescue plan.
Validation of an instrument for evaluating health care services to ostomized people.
Moraes, Juliano Teixeira; Amaral, Carlos Faria Santos; Borges, Eline Lima; Ribeiro, Mauro Souza; Guimarães, Eliete Albano Azevedo
2016-12-08
to develop and validate an array of analysis and judgment for the evaluation of Health Care Services of people with stomas. cross-sectional study in 28 health facilities in the state of Minas Gerais. A descriptive analysis of the instrument and a study of its psychometric properties were performed. We used the Delphi technique for the validation of content and appearance. A psychometric analysis was carried out through the study of the reliability and validity of the measures obtained with the instrument. it was possible to construct an array analysis and judgment with 16 components (with scores from zero to five) grouped according to size and structure and process considered essential to evaluate the service. The results achieved in the reliability for structure and process, through the Cronbach alpha coefficient (α = 0.771 and α = 0.809, respectively), and the validity of content and construct demonstrated good internal consistency and satisfactory validity. An exploratory factor analysis indicated the item "main activity performed in the unit" as a limitation of the scale. the study provides a new tool for the evaluation of structure and process of Health Care Services of a Person with a stoma. desenvolver e validar uma matriz de análise e julgamento para a avaliação de Serviços de Atenção à Saúde da Pessoa Estomizada. estudo seccional em 28 unidades de saúde do estado de Minas Gerais. Foi realizada uma análise descritiva do instrumento e um estudo das suas propriedades psicométricas. Para a validação de conteúdo e de aparência foi utilizada a técnica Delphi. A análise psicométrica foi realizada por meio do estudo da confiabilidade e validade das medidas obtidas com o instrumento. foi possível construir uma matriz de análise e julgamento com 16 componentes (pontuados com escores de zero a cinco) agrupados de acordo com as dimensões estrutura e processo considerados fundamentais para a avaliação do serviço. Os resultados alcançados para a confiabilidade para estrutura e processo, por meio do Coeficiente alfa de Cronbach (α = 0,771 e α = 0,809 respectivamente), e validades de conteúdo e de construto, demonstraram boa consistência interna e satisfatória validade. A análise fatorial exploratória apontou o item "principal atividade realizada na unidade" como limitação da escala. o estudo disponibiliza nova ferramenta para a avaliação de estrutura e processo do Serviço de Atenção à Saúde da Pessoa Ostomizada. desarrollar y validar una matriz de análisis y juzgamiento para la evaluación de Servicios de Atención a la Salud de la Persona Ostomizada. estudio seccional en 28 unidades de salud del estado de Minas Gerais. Fue realizado un análisis descriptivo del instrumento y un estudio de sus propiedades psicométricas. Para la validación de contenido y de apariencia fue utilizada la técnica Delphi. El análisis psicométrico fue realizada por medio del estudio de la confiabilidad y validez de las medidas obtenidas con el instrumento. fue posible construir una matriz de análisis y juzgamiento con 16 componentes (evaluados con puntajes de cero a cinco) agrupados de acuerdo con las dimensiones estructura y proceso considerados fundamentales para la evaluación del servicio. Los resultados alcanzados para la confiabilidad para estructura y proceso, por medio del Coeficiente Alfa de Cronbach (α = 0,771 y α = 0,809 respectivamente), y validez de contenido y de constructo, demostraron buena consistencia interna y satisfactoria validez. El análisis factorial exploratória apuntó el ítem "principal actividad realizada en la unidad" como limitación de la escala. el estudio suministra una nueva herramienta para la evaluación de estructura y proceso del Servicio de Atención a la Salud de la Persona Ostomizada.
Anjos, Daniela Brianne Martins Dos; Rodrigues, Roberta Cunha Matheus; Padilha, Kátia Melissa; Pedrosa, Rafaela Batista Dos Santos; Gallani, Maria Cecília Bueno Jayme
2016-12-19
evaluate the practicality, acceptability and the floor and ceiling effects, estimate the reliability and verify the convergent construct's validity with the instrument called the Heart Valve Disease Impact on daily life (IDCV) of the valve disease in patients with mitral and or aortic heart valve disease. data was obtained from 86 heart valve disease patients through 3 phases: a face to face interview for a socio-demographic and clinic characterization and then other two done through phone calls of the interviewed patients for application of the instrument (test and repeat test). as for the practicality and acceptability, the instrument was applied with an average time of 9,9 minutes and with 110% of responses, respectively. Ceiling and floor effects observed for all domains, especially floor effect. Reliability was tested using the test - repeating pattern to give evidence of temporal stability of the measurement. Significant negative correlations with moderate to strong magnitude were found between the score of the generic question about the impact of the disease and the scores of IDCV, which points to the validity of the instrument convergent construct. the instrument to measure the impact of valve heart disease on the patient's daily life showed evidence of reliability and validity when applied to patients with heart valve disease. avaliar a praticabilidade, aceitabilidade e os efeitos teto e chão, estimar a confiabilidade e verificar a validade de construto convergente do Instrumento para Mensuração do Impacto da Doença no Cotidiano do Valvopata em pacientes com valvopatia mitral e/ou aórtica. dados foram obtidos junto a 86 pacientes valvopatas por meio de três etapas: uma entrevista presencial para caracterização sociodemográfica e clínica e as duas outras realizadas por meio de contato telefônico para as aplicações do instrumento (Teste e teste de repetição). quanto à praticabilidade e aceitabilidade, o instrumento foi aplicado com tempo médio de 9,9 minutos e com 110% de respostas, respectivamente. Constatados efeitos teto e chão para todos os domínios, principalmente efeito chão. A confiabilidade foi testada por meio do teste-teste de repetição, obtendo-se evidências de estabilidade temporal da medida. Foram constatadas correlações negativas significantes de moderada a forte magnitude entre o escore da questão genérica sobre o impacto da doença e os escores do IDCV, o que aponta para validade de construto convergente do instrumento. o Instrumento para Mensuração do Impacto da Doença no Cotidiano do Valvopata apresentou evidências de confiabilidade e validade quando aplicado em pacientes com valvopatia. evaluar la viabilidad, aceptabilidad y los efectos techo y suelo, estimar la confiabilidad y verificar la validez de constructo convergente del Instrumento para Medir el Impacto en lo Cotidiano (IDCV) del sujeto con valvulopatías mitral y/o aórtica. los datos fueron obtenidos de 86 pacientes con valvulopatías por medio de tres etapas: una entrevista presencial para caracterización sociodemográfica y clínica y las otras dos realizadas por medio de contacto telefónico para las aplicaciones del instrumento (test y test de repetición). en cuanto a la viabilidad y aceptabilidad, el instrumento fue aplicado con un tiempo promedio de 9,9 minutos y con 110% de respuestas, respectivamente. Fueron constatados los efectos techo y suelo para todos los dominios, principalmente el efecto suelo. La confiabilidad fue comprobada por medio del test de repetición, obteniéndose evidencias de estabilidad temporal de la medida. Fueron constatadas correlaciones negativas significativas de moderada a fuerte magnitud entre el puntaje de la pregunta genérica sobre el impacto de la enfermedad y los puntajes del IDCV, lo que apunta para la validez de constructo convergente del instrumento. el instrumento para medir el impacto de la valvulopatía en lo cotidiano del sujeto, presentó evidencias de confiabilidad y validez cuando aplicado en pacientes con esa enfermedad.
Accelerating Adaptation of Natural Resource Management to Address Climate Change
Cross, Molly S; McCarthy, Patrick D; Garfin, Gregg; Gori, David; Enquist, Carolyn AF
2013-01-01
Abstract Natural resource managers are seeking tools to help them address current and future effects of climate change. We present a model for collaborative planning aimed at identifying ways to adapt management actions to address the effects of climate change in landscapes that cross public and private jurisdictional boundaries. The Southwest Climate Change Initiative (SWCCI) piloted the Adaptation for Conservation Targets (ACT) planning approach at workshops in 4 southwestern U.S. landscapes. This planning approach successfully increased participants’ self-reported capacity to address climate change by providing them with a better understanding of potential effects and guiding the identification of solutions. The workshops fostered cross-jurisdictional and multidisciplinary dialogue on climate change through active participation of scientists and managers in assessing climate change effects, discussing the implications of those effects for determining management goals and activities, and cultivating opportunities for regional coordination on adaptation of management plans. Facilitated application of the ACT framework advanced group discussions beyond assessing effects to devising options to mitigate the effects of climate change on specific species, ecological functions, and ecosystems. Participants addressed uncertainty about future conditions by considering more than one climate-change scenario. They outlined opportunities and identified next steps for implementing several actions, and local partnerships have begun implementing actions and conducting additional planning. Continued investment in adaptation of management plans and actions to address the effects of climate change in the southwestern United States and extension of the approaches used in this project to additional landscapes are needed if biological diversity and ecosystem services are to be maintained in a rapidly changing world. Acelerando la Adaptación del Manejo de Recursos Naturales para Atender el Cambio Climático Resumen Los manejadores de recursos naturales están buscando herramientas para ayudarles a atender los efectos actuales y futuros del cambio climático. Presentamos un modelo para la planificación colaborativa enfocada a identificar formas para adaptar las acciones de manejo para atender los efectos del cambio climático en paisajes que cruzan límites jurisdiccionales públicos y privados. La Iniciativa Sudoccidental de Cambio Climático (ISCC) puso a prueba el método de planificación de Adaptación para Metas de Conservación (AMC) en talleres en cuatro paisajes del suroeste de E. U. A. Este método de planificación incrementó exitosamente la capacidad de los participantes para atender el cambio climático al proporcionarles un mejor entendimiento de los efectos potenciales y guiar la identificación de soluciones. Los talleres promovieron el diálogo trans-jurisdiccional y multidisciplinario sobre cambio climático mediante la participación activa de científicos y manejadores en la evaluación de efectos del cambio climático, la discusión de implicaciones de esos efectos para determinar las metas y actividades de manejo y desarrollar oportunidades para la coordinación regional de la adaptación de planes de manejo. La aplicación simplificada del marco AMC llevó las discusiones de grupo más allá de la evaluación de los efectos a la concepción de opciones para mitigar los efectos del cambio climático sobres determinadas especies, funciones ecológicas y ecosistemas. Los participantes abordaron la incertidumbre de las condiciones futuras al considerar más de un escenario de cambio climático. Delinearon oportunidades e identificaron los siguientes pasos para la implementación de varias acciones, y asociaciones locales han comenzado a implementar acciones y realizar planificación adicional. Se requiere inversión continua en la adaptación de planes y acciones de manejo para atender los efectos del cambio climático en el suroeste de Estados Unidos y la extensión de los métodos utilizados en este proyecto en paisajes adicionales si se quiere mantener la diversidad biológica y los servicios de los ecosistemas en un mundo que cambia rápidamente. PMID:23110636
Graziano, Kazuko Uchikawa; Pereira, Marta Elisa Auler; Koda, Elaine
2016-08-08
to elaborate and apply a method to assess the efficacy of automated flexible endoscope reprocessors at a time when there is not an official method or trained laboratories to comply with the requirements described in specific standards for this type of health product in Brazil. the present methodological study was developed based on the following theoretical references: International Organization for Standardization (ISO) standard ISO 15883-4/2008 and Brazilian Health Surveillance Agency (Agência Nacional de Vigilância Sanitária - ANVISA) Collegiate Board Resolution (Resolução de Diretoria Colegiada - RDC) no. 35/2010 and 15/2012. The proposed method was applied to a commercially available device using a high-level 0.2% peracetic acid-based disinfectant. the proposed method of assessment was found to be robust when the recommendations made in the relevant legislation were incorporated with some adjustments to ensure their feasibility. Application of the proposed method provided evidence of the efficacy of the tested equipment for the high-level disinfection of endoscopes. the proposed method may serve as a reference for the assessment of flexible endoscope reprocessors, thereby providing solid ground for the purchase of this category of health products. propor e aplicar um método para a avaliação da eficácia de processadoras automáticas de endoscópios flexíveis, em um momento em que ainda não existe no Brasil um método oficial, nem tampouco laboratórios capacitados que contemplem os requisitos das normas específicas aplicáveis a esse tipo de produto para a saúde. caracterizou-se como pesquisa metodológica e foi desenvolvido com base em três referenciais teóricos: norma técnica International Organization for Standardization (ISO) - ISO 15883-4/2008, Resolução de Diretoria Colegiada (RDC) nº35/2010 e RDC nº15/2012 da Agência Nacional de Vigilância Sanitária (ANVISA). Aplicou-se o método proposto em um equipamento específico, comercialmente disponível, utilizando desinfetante de alto nível à base de ácido peracético 0,2%. o método de avaliação proposto mostrou-se robusto, à medida que as recomendações das legislações pertinentes ao equipamento avaliado foram incorporadas, com algumas adaptações para sua exequibilidade. A aplicação do método proposto permitiu atestar a eficácia do equipamento utilizado na desinfecção de alto nível de endoscópios. o método pode servir de referência para a avaliação de reprocessadoras de endoscópios flexíveis, subsidiando a aquisição dessa categoria de produtos para a saúde. elaborar y aplicar un método para evaluar la eficacia de reprocesadores automatizados de endoscopios flexibles en un momento en el que no hay un método oficial o laboratorios capacitados para cumplir con los requisitos descritos en las normas específicas para este tipo de producto para la salud en Brasil. el presente estudio metodológico fue desarrollado en base a las siguientes referencias teóricas: Organización Internacional de Normalización (International Organization for Standardization - ISO) norma ISO 15883-4/2008 y Agencia Nacional de Vigilancia de la Salud de Brasil (Agência Nacional de Vigilância Sanitária - ANVISA) Resolución del Directorio Colegiado (Resolução de Diretoria Colegiada - RDC) № 35/2010 y 15/2012. El método propuesto se aplicó a un dispositivo comercialmente disponible usando un desinfectante al 0,2% a base de ácido peracético de alto nivel. el método de evaluación propuesto se evaluó como fuerte después de que las recomendaciones formuladas en la legislación pertinente se incorporaron con algunos ajustes para garantizar su factibilidad. La aplicación del método propuesto proporciona evidencia de la eficacia de los equipos de prueba para la desinfección de alto nivel de endoscopios. el método propuesto puede servir de referencia para la evaluación de reprocesadores de endoscopios flexibles, proporcionando de este modo bases sólidas para la compra de esta categoría de productos de salud.
Fernando, W Shirangi; Martins, André F; Zhao, Piyu; Wu, Yunkou; Kiefer, Garry E; Platas-Iglesias, Carlos; Sherry, A Dean
2016-03-21
EuDOTA-tetraamide complexes as paraCEST agents offer an attractive platform for designing biological sensors and responsive agents. The early versions of these agents showed low sensitivity at temperature and power levels suitable for in vivo applications partly due to non-optimal water exchange rates. Here we report two new EuDOTA derivatives having glutamyl-phosphonate side arms that display the slowest water exchange rates of any other paraCEST agent reported so far. The advantages of such systems are demonstrated experimentally both in vitro and in vivo and DFT calculations were performed to help understand the physical-chemical reasons for this interesting behavior.
2008-01-01
colágeno es un nuevo biomaterial utilizado para la administración de fármacos, la fabri- cación de apósitos o como sustrato para ingeniería tisular cuya...crecimiento de fi broblastos in vitro. MATERIALES Y MÉTODOS Materiales El tiburón lechoso (Rhizoprionodon acutus) se capturó en la costa local y se...1000 rpm durante 3-5 minutos, se suspendieron de nuevo en medio fresco con FCS al 10%, se sembraron por la matriz de soporte (25.000 células
1989-01-01
DATZ. An exemption to requirements of in eccnomic analysis .s :equested in icccrance with provisions AR 1,-28, Para. - 3d (3). Regulat.o references axe...provisions of XR 1I-28 Para !- 3d (3). :"gloos are required by AR 190-111, Ch. 4 and DOD 5100.76-M. Ch. 4-& 5. 12. SUPPLEMNTAL DATA: A. sti.mated Design...rdance witn AR ll-23, Para. D- 3d (2 Ths orolecm .z eu~_ - compiv .Ltn :onst=uction cr.:eria of AR0-_’:, ca. 4 and :CD 5i2 -.-. 21 4 A. Estzmated Design
Estudio de los Efectos Gravitomagnéticos en Cuerpos Masivos Rotantes
NASA Astrophysics Data System (ADS)
Velandia Heredia, N.; Tejeiro, J. M.
2008-03-01
A partir del estudio de los Efectos Gravitomagnéticos en cuerpos masivos rotantes, planteamos la expresión para medir el desfase en el tiempo, para diferentes observadores, que se dan cuando viajan dos rayos de luz por una guía de onda o de manera libre (geodésicas), en el plano azimutal y en el plano polar. Con lo anterior queremos abordar el experimento tipo Michelson y Morley, de forma que podamos involucrar el valor de la densidad del momento angular (a) en el retraso temporal para los dos haces de luz que viajan por los brazos del interferómetro, cuando este último es ubicado en el plano ecuatorial.
Bryant-Lukosius, Denise; Valaitis, Ruta; Martin-Misener, Ruth; Donald, Faith; Peña, Laura Morán; Brousseau, Linda
2017-01-30
to examine advanced practice nursing (APN) roles internationally to inform role development in Latin America and the Caribbean to support universal health coverage and universal access to health. we examined literature related to APN roles, their global deployment, and APN effectiveness in relation to universal health coverage and access to health. given evidence of their effectiveness in many countries, APN roles are ideally suited as part of a primary health care workforce strategy in Latin America to enhance universal health coverage and access to health. Brazil, Chile, Colombia, and Mexico are well positioned to build this workforce. Role implementation barriers include lack of role clarity, legislation/regulation, education, funding, and physician resistance. Strong nursing leadership to align APN roles with policy priorities, and to work in partnership with primary care providers and policy makers is needed for successful role implementation. given the diversity of contexts across nations, it is important to systematically assess country and population health needs to introduce the most appropriate complement and mix of APN roles and inform implementation. Successful APN role introduction in Latin America and the Caribbean could provide a roadmap for similar roles in other low/middle income countries. analisar o papel da enfermagem com prática avançada (EPA) a nível internacional para um relatório do seu desenvolvimento na América Latina e no Caribe, para apoiar a cobertura universal de saúde e o acesso universal à saúde. análise da bibliografia relacionada com os papéis da EPA, sua implantação no mundo e a eficácia da EPA em relação à cobertura universal de saúde e acesso à saúde. dada a evidência da sua eficácia em muitos países, as funções da EPA são ideais como parte de uma estratégia de recursos humanos de atenção primária de saúde na América Latina para melhorar a cobertura universal de saúde e o acesso à saúde. Brasil, Chile, Colômbia e México estão bem posicionados para construir esta força de trabalho. Barreiras à implementação destas funções incluem: a falta de clareza do seu papel, a legislação/regulamentação, educação, financiamento, e a resistência médica. Uma liderança forte de enfermagem é necessária para alinhar o papel da EPA com as prioridades políticas e trabalhar em colaboração com os profissionais de atenção primária e os decisores políticos para a implementação bem sucedida das suas funções. dada a diversidade de contextos dos diferentes países, é importante avaliar sistematicamente as necessidades de saúde do país e da população para introduzir a combinação mais adequada e complementar dos papéis da EPA e formatar sua aplicação. A introdução bem sucedida do papel da EPA na América Latina e no Caribe poderia fornecer um roteiro para funções semelhantes noutros países de baixa/média renda. examinar el rol de la enfermería con práctica avanzada (EPA) a nivel internacional para informar de su desarrollo en América Latina y el Caribe, en apoyo a la cobertura de salud universal y el acceso universal a la salud. se analizó la literatura relacionada con los roles de la EPA, su despliegue en el mundo y la eficacia de EPA en relación con la cobertura de salud universal y el acceso a la salud. dada la evidencia de su eficacia en muchos países, las funciones de la EPA son ideales como parte de una estrategia de recursos humanos de atención primaria de salud en América Latina para mejorar la cobertura de salud universal y el acceso a la salud. Brasil, Chile, Colombia y México están bien posicionados para construir esta fuerza de trabajo. Las barreras a la implementación de estas funciones incluyen: la falta de claridad de su rol, la legislación/regulación, educación, financiamiento, y la resistencia de los médicos. Se necesita un liderazgo fuerte de enfermería para alinear los roles de la EPA con las políticas prioritarias, y trabajar en colaboración con los profesionales de atención primaria y los responsables de las políticas para la implementación exitosa de sus funciones. teniendo en cuenta la diversidad de los contextos en diferentes naciones, es importante evaluar sistemáticamente las necesidades de salud del país y de la población para introducir la combinación más adecuada y complementaria de los papeles de la EPA y dar un formato a su aplicación. La introducción con éxito del papel de la EPA en América Latina y el Caribe podría proporcionar una hoja de ruta para funciones similares en otros países de bajos/medios ingresos.
ESTRATEGIAS PARA HACER EL MEJOR USO DE LA PROTEINA EN RACIONES PARA VACAS LECHERAS
USDA-ARS?s Scientific Manuscript database
Dairy cows utilize feed CP with greater efficiency than other ruminants, but still excrete about 2 to 3 times more N in manure than they secrete in milk. This increases milk production costs plus environmental N pollution. Optimizing microbial protein formation in the rumen is the most effective way...
A travs de su historia, la Agencia de Proteccin del Medio Ambiente estadounidense (U.S. Environmental Protection Agency, EPA) ha evaluado distintas tecnologas para determinar su efectividad en el monitoreo, la prevencin, el control, y la limpieza de la contaminacin ambiental. Sin...
SYNTHESIS AND MUTAGENIC PROPERTIES OF 4,4'-DIAMINO-PARA-TERPHENYL AND 4,4'-DIAMINO-PARA-QUATERPHENYL
DBPs in drinking water can be controlled by the type of treatment and by knowing andd controlling major sources of DBP toxicant precursors and toxicants that "evade" treatment processes. Efforts are being directed at one category at a time. The initial precursor categories to be ...
Comunicado de prensa de la EPA: El administrador Pruitt anuncia $54.3 millones en subvenciones Brownfields para evaluar y limpiar las propiedades contaminadas y promover el redesarrollo económico a nivel nacional
ERIC Educational Resources Information Center
Lafford, Barbara A.; Ryan, John M.
1995-01-01
Examination of the development of form/function relations of the prepositions "por" and "para" at different levels of proficiency in the interlanguage of study-abroad students in Granada, Spain, revealed "noncanonical" as well as "canonical" uses of these prepositions. The most common noncanonical uses were…
ERIC Educational Resources Information Center
Raval, Harini; McKenney, Susan; Pieters, Jules
2010-01-01
Non-governmental organizations (NGOs) are being recognized globally for their influential role in realizing the UN Millennium Development Goal of education for all in developing countries. NGOs mostly employ untrained para-educators for grassroots activities. The professional development of these teachers is critical for NGO effectiveness, yet…
"Espanol para ti": A Video Program That Works.
ERIC Educational Resources Information Center
Steele, Elena; Johnson, Holly
2000-01-01
Describes the development of "Espanol para ti," a video program for teaching Spanish at the elementary school level. The program was designed for use in Clark County, Nevada elementary schools and is taught by a certified Spanish teacher via video twice a week, utilizing comprehensible input through visuals, games, and songs that are conducive to…
Factor Structure of the "Escala de Autoeficacia para la Depresion en Adolescentes" (EADA)
ERIC Educational Resources Information Center
Diaz-Santos, Mirella; Cumba-Aviles, Eduardo; Bernal, Guillermo; Rivera-Medina, Carmen
2011-01-01
The current concept and measures of self-efficacy for depression in adolescents do not consider developmental and cultural aspects essential to understand and assess this construct in Latino youth. We examined the factor structure of the "Escala de Autoeficacia para la Depresion en Adolescentes" (EADA), a Spanish instrument designed to…
Los Protectores del Planeta: actividades para niños y recursos educativos sobre reciclaje
Información sobre el Club Protectores del Planeta que enseña cómo reducir la basura desde el punto de origen, cómo reciclar y conservar los recursos naturales. La información incluye recursos educativos para el salón de clases.
ParaView visualization of Abaqus output on the mechanical deformation of complex microstructures
NASA Astrophysics Data System (ADS)
Liu, Qingbin; Li, Jiang; Liu, Jie
2017-02-01
Abaqus® is a popular software suite for finite element analysis. It delivers linear and nonlinear analyses of mechanical and fluid dynamics, includes multi-body system and multi-physics coupling. However, the visualization capability of Abaqus using its CAE module is limited. Models from microtomography have extremely complicated structures, and datasets of Abaqus output are huge, requiring a visualization tool more powerful than Abaqus/CAE. We convert Abaqus output into the XML-based VTK format by developing a Python script and then using ParaView to visualize the results. Such capabilities as volume rendering, tensor glyphs, superior animation and other filters allow ParaView to offer excellent visualizing manifestations. ParaView's parallel visualization makes it possible to visualize very big data. To support full parallel visualization, the Python script achieves data partitioning by reorganizing all nodes, elements and the corresponding results on those nodes and elements. The data partition scheme minimizes data redundancy and works efficiently. Given its good readability and extendibility, the script can be extended to the processing of more different problems in Abaqus. We share the script with Abaqus users on GitHub.
Gorrasi, Giuliana; Bugatti, Valeria; Vittoria, Vittoria
2012-06-05
Nanohybrids of layered double hydroxide (LDH) with intercalated active molecules: benzoate, 2,4-dichlorobenzoate, para-hydroxybenzoate and ortho-hydroxybenzoate, were incorporated into pectins from apples through high energy ball milling in the presence of water. Cast films were obtained and analysed. X-ray diffraction analysis showed a complete destructuration of all nanohybrids in the pectin matrix. Thermogravimetric analysis showed a better thermal resistance of pectin in the presence of fillers, especially para-hydroxybenzoate and ortho-hydroxybenzoate. Mechanical properties showed an improvement of elastic modulus in particular for LDH-para-hydroxybenzoate nanohybrid, due probably to a better interaction between pectin matrix and nanohybrid layers. Barrier properties (sorption and diffusion) to water vapour showed improvement in the dependence on the intercalated active molecule, the best improvement was achieved for composites containing para-hydroxybenzoate molecules, suggesting that the interaction between the filler phase and the polymer plays an important role in sorption and diffusion phenomena. Incorporation of these active molecules gave antimicrobial properties to the composite films giving opportunities in the field of active packaging. Copyright © 2012 Elsevier Ltd. All rights reserved.
The ortho:para-H_2 ratio in C- and J-type shocks
NASA Astrophysics Data System (ADS)
Wilgenbus, D.; Cabrit, S.; Pineau des Forêts, G.; Flower, D. R.
2000-04-01
We have computed extensive grids of models of both C- and J-type planar shock waves, propagating in dark, cold molecular clouds, in order to study systematically the behaviour of the ortho:para-H_2 ratio. Careful attention was paid to both macroscopic (dynamical) and microscopic (chemical reactions and collisional population transfer in H_2) aspects. We relate the predictions of the models to observational determinations of the ortho:para-H_2 ratio using both pure rotational lines and rovibrational lines. As an illustration, we consider ISO and ground-based H_2 observations of HH 54. Neither planar C-type nor planar J-type shocks appear able to account fully for these observations. Given the additional constraints provided by the observed ortho:para H_2 ratios, a C-type bowshock, or a C-type precursor followed by a J-type shock, remain as plausible models. Tables~2a-f and 4a-f are only available in electronic form at the CDS via anonymous ftp to cdsarc.u-strasbg.fr (130.79.128.5) or via http://cdsweb.u-strasbg.fr/Abstract.html
Obtención de perfiles teóricos de elementos metálicos con velocidades macroscópicas
NASA Astrophysics Data System (ADS)
Cirigliano, D.; Costa, A.; Rovira, M.
El propósito de este trabajo es poder establecer -a partir de la modelización de perfiles de distintas especies- patrones de comparación observacional que permitan caracterizar los fenómenos físicos que están presentes en las estructuras que se observan. Para ello se resuelven las ecuaciones de equilibrio de ionización para un determinado átomo y una atmósfera de parámetros determinados. A partir de ello se definen las poblaciones para los distintos grados de ionización. Considerando distintas configuraciones e intensidades de flujos de masa se deducen la función fuente, el espesor óptico y se calculan los perfiles de las distintas líneas. Se obtuvieron perfiles teóricos de líneas del CII, CIV y del OIV para flujos entrante, saliente y pasante. La forma del perfil, las intensidades relativas entre los distintos flujos y el corrimiento Doppler da cuenta de una caracterización teórica a partir de la cual se comparará con observaciones.
Estudio de eventos dinámicos en ondas milimétricas
NASA Astrophysics Data System (ADS)
Cristiani, G.; Martínez, G.; Raulin, J. P.; Giménez de Castro, G.; Rovira, M.
El estudio de la actividad solar con el telescopio para ondas submilimétricas (SST), nos permite, por vez primera, trabajar con una resolución temporal de milisegundos. Este hecho ha permitido observar emisión nunca antes comprobada, pulsos o flashes extremadamente rápidos provenientes de las regiones activas, los cuales parecen preanunciar fulguraciones en dichas regiones. Se muestra, como ejemplo, una fulguración observada con el telescopio HASTA en Hα, y los pulsos rápidos que la preceden observados con el SST. Para cuantificar la influencia de la atmósfera terrestre en los datos registrados, se está estudiando la variabilidad temporal de las opacidades a las frecuecias de trabajo (212 y 405 Ghz), es decir los rangos de tiempo para los cuales la opacidad puede variar apreciablemente. Con este fin se calcula la eficiencia de cada canal multiplicada por la temperatura del Sol a estas frecuencias (estas son conocidas con una incerteza del 20 %). Se muestran los resultados obtenidos para cada canal, en donde se grafica este producto como función de la opacidad.
NASA Astrophysics Data System (ADS)
Andrejeva, Anna; Gardner, Adrian M.; Tuttle, William D.; Wright, Timothy G.
2016-03-01
We give a description of the phenyl-ring-localized vibrational modes of the ground states of the para-disubstituted benzene molecules including both symmetric and asymmetric cases. In line with others, we quickly conclude that the use of Wilson mode labels is misleading and ambiguous; we conclude the same regarding the related ones of Varsányi. Instead we label the modes consistently based upon the Mulliken (Herzberg) method for the modes of para-difluorobenzene (pDFB). Since we wish the labelling scheme to cover both symmetrically- and asymmetrically-substituted molecules, we apply the Mulliken labelling under C2v symmetry. By studying the variation of the vibrational wavenumbers with mass of the substituent, we are able to identify the corresponding modes across a wide range of molecules and hence provide consistent assignments. Particularly interesting are pairs of vibrations that evolve from in- and out-of-phase motions in pDFB to more localized modes in asymmetric molecules. We consider the para isomers of the following: the symmetric dihalobenzenes, xylene, hydroquinone, the asymmetric dihalobenzenes, halotoluenes, halophenols and cresol.
TERS v2.0: An improved version of TERS
NASA Astrophysics Data System (ADS)
Nath, S.
2009-11-01
We present a new version of the semimicroscopic Monte Carlo code "TERS". The procedure for calculating multiple small angle Coulomb scattering of the residues in the target has been modified. Target-backing and residue charge-reset foils, which are often used in heavy ion-induced complete fusion reactions, are included in the code. New version program summaryProgram title: TERS v2.0 Catalogue identifier: AEBD_v2_0 Program summary URL:
Jin, Byung-Ju; Smith, Alex J.
2016-01-01
A “glymphatic system,” which involves convective fluid transport from para-arterial to paravenous cerebrospinal fluid through brain extracellular space (ECS), has been proposed to account for solute clearance in brain, and aquaporin-4 water channels in astrocyte endfeet may have a role in this process. Here, we investigate the major predictions of the glymphatic mechanism by modeling diffusive and convective transport in brain ECS and by solving the Navier–Stokes and convection–diffusion equations, using realistic ECS geometry for short-range transport between para-arterial and paravenous spaces. Major model parameters include para-arterial and paravenous pressures, ECS volume fraction, solute diffusion coefficient, and astrocyte foot-process water permeability. The model predicts solute accumulation and clearance from the ECS after a step change in solute concentration in para-arterial fluid. The principal and robust conclusions of the model are as follows: (a) significant convective transport requires a sustained pressure difference of several mmHg between the para-arterial and paravenous fluid and is not affected by pulsatile pressure fluctuations; (b) astrocyte endfoot water permeability does not substantially alter the rate of convective transport in ECS as the resistance to flow across endfeet is far greater than in the gaps surrounding them; and (c) diffusion (without convection) in the ECS is adequate to account for experimental transport studies in brain parenchyma. Therefore, our modeling results do not support a physiologically important role for local parenchymal convective flow in solute transport through brain ECS. PMID:27836940
Farashishiko, Annah; Slack, Jacqueline R; Botta, Mauro; Woods, Mark
2018-01-01
Although paraCEST is a method with immense scope for generating image contrast in MRI, it suffers from the serious drawback of high detection limits. For a typical discrete paraCEST agent the detection limit is roughly an order of magnitude higher than that of a clinically used relaxation agent. One solution to this problem may be the incorporation of a large payload of paraCEST agents into a single macromolecular agent. Here we report a new synthetic method for accomplishing this goal: incorporating a large payload of the paraCEST agent DyDOTAM 3+ into a Reverse Assembled nano-Capsule. An aggregate can be generated between this chelate and polyacrylic acid (PAA) after the addition of ethylene diamine. Subsequent addition of polyallylamine hydrochloride (PAH) followed by silica nanoparticles generated a robust encapsulating shell and afforded capsule with a mean hydrodynamic diameter of 650 ± 250 nm. Unfortunately this encapsulation did not have the effect of amplifying the CEST effect per agent, but quenched the CEST altogether. The quenching effect of encapsulation could be attributed to the effect of slowing molecular tumbling, which is inevitable when the chelate is incorporated into a nano-scale material. This increases the transverse relaxation rate of chelate protons and a theoretical examination using Solomon Bloembergen Morgan theory and the Bloch equations shows that the increase in the transverse relaxation rate constant for the amide protons, in even modestly sized nano-materials, is sufficient to significantly quench CEST.
Analyzing and Visualizing Cosmological Simulations with ParaView
NASA Astrophysics Data System (ADS)
Woodring, Jonathan; Heitmann, Katrin; Ahrens, James; Fasel, Patricia; Hsu, Chung-Hsing; Habib, Salman; Pope, Adrian
2011-07-01
The advent of large cosmological sky surveys—ushering in the era of precision cosmology—has been accompanied by ever larger cosmological simulations. The analysis of these simulations, which currently encompass tens of billions of particles and up to a trillion particles in the near future, is often as daunting as carrying out the simulations in the first place. Therefore, the development of very efficient analysis tools combining qualitative and quantitative capabilities is a matter of some urgency. In this paper, we introduce new analysis features implemented within ParaView, a fully parallel, open-source visualization toolkit, to analyze large N-body simulations. A major aspect of ParaView is that it can live and operate on the same machines and utilize the same parallel power as the simulation codes themselves. In addition, data movement is in a serious bottleneck now and will become even more of an issue in the future; an interactive visualization and analysis tool that can handle data in situ is fast becoming essential. The new features in ParaView include particle readers and a very efficient halo finder that identifies friends-of-friends halos and determines common halo properties, including spherical overdensity properties. In combination with many other functionalities already existing within ParaView, such as histogram routines or interfaces to programming languages like Python, this enhanced version enables fast, interactive, and convenient analyses of large cosmological simulations. In addition, development paths are available for future extensions.
Jin, Byung-Ju; Smith, Alex J; Verkman, Alan S
2016-12-01
A "glymphatic system," which involves convective fluid transport from para-arterial to paravenous cerebrospinal fluid through brain extracellular space (ECS), has been proposed to account for solute clearance in brain, and aquaporin-4 water channels in astrocyte endfeet may have a role in this process. Here, we investigate the major predictions of the glymphatic mechanism by modeling diffusive and convective transport in brain ECS and by solving the Navier-Stokes and convection-diffusion equations, using realistic ECS geometry for short-range transport between para-arterial and paravenous spaces. Major model parameters include para-arterial and paravenous pressures, ECS volume fraction, solute diffusion coefficient, and astrocyte foot-process water permeability. The model predicts solute accumulation and clearance from the ECS after a step change in solute concentration in para-arterial fluid. The principal and robust conclusions of the model are as follows: (a) significant convective transport requires a sustained pressure difference of several mmHg between the para-arterial and paravenous fluid and is not affected by pulsatile pressure fluctuations; (b) astrocyte endfoot water permeability does not substantially alter the rate of convective transport in ECS as the resistance to flow across endfeet is far greater than in the gaps surrounding them; and (c) diffusion (without convection) in the ECS is adequate to account for experimental transport studies in brain parenchyma. Therefore, our modeling results do not support a physiologically important role for local parenchymal convective flow in solute transport through brain ECS. © 2016 Jin et al.
ENVEJECIMIENTO, SALUD Y ECONOMÍA: La Encuesta Nacional sobre Salud y Envejecimiento en México*
2017-01-01
RESUMEN México vive una transición demográfica en la cual el porcentaje de la población mayor de 50 años de edad crece aceleradamente como resultado de un aumento considerable en la esperanza de vida. Dicha población tiene necesidades particulares que deben ser tomadas en cuenta en la formulación de políticas, sobre todo en materia de acceso a servicios de salud y seguridad social. En este artículo presentamos una descripción general de la Encuesta Nacional de Salud y Envejecimiento (Enasem), un estudio de panel que comenzó en 2001 y que ofrece una oportunidad única para abordar temas demográficos y económicos complejos por medio de la exploración de las características personales, transferencias socioeconómicas e indicadores de salud para una muestra de 15 186 adultos de edad media y avanzada. También presentamos los resultados más relevantes de diferentes estudios que han utilizado la Enasem hasta la fecha. Nuestra revisión indica que México enfrenta desafíos considerables para satisfacer la demanda de servicios médicos para una población que es amenazada por una creciente presencia de enfermedades crónicas, sobre todo para la población de edad avanzada que no cuenta con cobertura de seguro médico. PMID:29375164
Farashishiko, Annah; Slack, Jacqueline R.; Botta, Mauro; Woods, Mark
2018-01-01
Although paraCEST is a method with immense scope for generating image contrast in MRI, it suffers from the serious drawback of high detection limits. For a typical discrete paraCEST agent the detection limit is roughly an order of magnitude higher than that of a clinically used relaxation agent. One solution to this problem may be the incorporation of a large payload of paraCEST agents into a single macromolecular agent. Here we report a new synthetic method for accomplishing this goal: incorporating a large payload of the paraCEST agent DyDOTAM3+ into a Reverse Assembled nano-Capsule. An aggregate can be generated between this chelate and polyacrylic acid (PAA) after the addition of ethylene diamine. Subsequent addition of polyallylamine hydrochloride (PAH) followed by silica nanoparticles generated a robust encapsulating shell and afforded capsule with a mean hydrodynamic diameter of 650 ± 250 nm. Unfortunately this encapsulation did not have the effect of amplifying the CEST effect per agent, but quenched the CEST altogether. The quenching effect of encapsulation could be attributed to the effect of slowing molecular tumbling, which is inevitable when the chelate is incorporated into a nano-scale material. This increases the transverse relaxation rate of chelate protons and a theoretical examination using Solomon Bloembergen Morgan theory and the Bloch equations shows that the increase in the transverse relaxation rate constant for the amide protons, in even modestly sized nano-materials, is sufficient to significantly quench CEST. PMID:29682499
Barrows, F.T.; Lellis, W.A.
2006-01-01
Two methods were developed for the production of larval fish diets. The first method, microextrusion marumerization (MEM), has been tested in laboratory feeding trials for many years and produces particles that are palatable and water stable. The second method, particle-assisted rotational agglomeration (PARA), produced diets that have lower density than diets produced by MEM. Each method was used to produce diets in the 250- to 400- and 400- to 700-??m range and compared with a reference diet (Fry Feed Kyowa* [FFK]) for feeding larval walleye in two experiments. The effect of substituting 4% of the fish meal with freeze-dried artemia fines was also investigated. In the first experiment, 30-d survival was greater (P < 0.05) for fish fed a diet produced by PARA without Artemia (49.1.0%) than for fish fed the same diet produced by MEM (27.6%). The addition of Artemia to a diet produced by MEM did not increase survival of larval walleye. Fish fed the reference diet had 24.4% survival. In the second experiment, there was an effect of both processing method and Artemia supplementation, and an interaction of these effects, on survival. Fish fed a diet produced by PARA without Artemia supplementation had 48.4% survival, and fish fed the same diet produced by MEM had only 19.6% survival. Inclusion of 4% freeze-dried Artemia improved (P < 0.04) survival of fish fed MEM particles but not those fed PARA particles. Fish fed FFK had greater weight gain than fish fed other diets in both experiments. Data indicate that the PARA method of diet processing produces smaller, lower density particles than the MEM process and that diets produced by the PARA process support higher survival of larval walleye with low capital and operating costs. ?? Copyright by the World Aquaculture Society 2006.
Fiber-optic components for optical communicatios and sensing =
NASA Astrophysics Data System (ADS)
Marques, Carlos Alberto Ferreira
Nos ultimos anos, a Optoelectronica tem sido estabelecida como um campo de investigacao capaz de conduzir a novas solucoes tecnologicas. As conquistas abundantes no campo da optica e lasers, bem como em comunicacoes opticas tem sido de grande importancia e desencadearam uma serie de inovacoes. Entre o grande numero de componentes opticos existentes, os componentes baseados em fibra optica sao principalmente relevantes devido a sua simplicidade e a elevada de transporte de dados da fibra optica. Neste trabalho foi focado um destes componentes opticos: as redes de difraccao em fibra optica, as quais tem propriedades opticas de processamento unicas. Esta classe de componentes opticos e extremamente atraente para o desenvolvimento de dispositivos de comunicacoes opticas e sensores. O trabalho comecou com uma analise teorica aplicada a redes em fibra e foram focados os metodos de fabricacao de redes em fibra mais utilizados. A inscricao de redes em fibra tambem foi abordado neste trabalho, onde um sistema de inscricao automatizada foi implementada para a fibra optica de silica, e os resultados experimentais mostraram uma boa aproximacao ao estudo de simulacao. Tambem foi desenvolvido um sistema de inscricao de redes de Bragg em fibra optica de plastico. Foi apresentado um estudo detalhado da modulacao acustico-optica em redes em fibra optica de silica e de plastico. Por meio de uma analise detalhada dos modos de excitacao mecanica aplicadas ao modulador acustico-optico, destacou-se que dois modos predominantes de excitacao acustica pode ser estabelecidos na fibra optica, dependendo da frequencia acustica aplicada. Atraves dessa caracterizacao, foi possivel desenvolver novas aplicacoes para comunicacoes opticas. Estudos e implementacao de diferentes dispositivos baseados em redes em fibra foram realizados, usando o efeito acustico-optico e o processo de regeneracao em fibra optica para varias aplicacoes tais como rapido multiplexador optico add-drop, atraso de grupo sintonizavel de redes de Bragg, redes de Bragg com descolamento de fase sintonizaveis, metodo para a inscricao de redes de Bragg com perfis complexos, filtro sintonizavel para equalizacao de ganho e filtros opticos notch ajustaveis.
Quantifying reactivity for electrophilic aromatic substitution reactions with Hirshfeld charge.
Liu, Shubin
2015-03-26
An electrophilic aromatic substitution is a process where one atom or group on an aromatic ring is replaced by an incoming electrophile. The reactivity and regioselectivity of this category of reactions is significantly impacted by the group that is already attached to the aromatic ring. Groups promoting substitution at the ortho/para and meta position are called ortho/para and meta directing groups, respectively. Earlier, we have shown that regioselectivity of the electrophilic aromatic substitution is dictated by the nucleophilicity of the substituted aromatic ring, which is proportional to the Hirshfeld charge on the regioselective site. Ortho/para directing groups have the largest negative charge values at the ortho/para positions, whereas meta directing groups often have the largest negative charge value at the meta position. The electron donation or acceptance feature of a substitution group is irrelevant to the regioselectivity. In this contribution, we extend our previous study by quantifying the reactivity for this kind of reactions. To that end, we examine the transition-state structure and activation energy of an identity reaction for a series of monosubstituted-benzene molecules reacting with hydrogen fluoride using BF3 as the catalyst in the gas phase. A total of 18 substitution groups will be considered, nine of which are ortho/para directing and the other nine groups meta directing. From this study, we found that the barrier height of these reactions strongly correlates with the Hirshfeld charge on the regioselective site for both ortho/para and meta directing groups, with the correlation coefficient R(2) both better than 0.96. We also discovered a less accurate correlation between the barrier height and HOMO energy. These results reconfirm the validity and effectiveness of employing the Hirshfeld charge as a reliable descriptor of both reactivity and regioselectivity for this vastly important category of chemical transformations.
Clinical Utility of Preoperative Computed Tomography in Patients With Endometrial Cancer.
Bogani, Giorgio; Gostout, Bobbie S; Dowdy, Sean C; Multinu, Francesco; Casarin, Jvan; Cliby, William A; Frigerio, Luigi; Kim, Bohyun; Weaver, Amy L; Glaser, Gretchen E; Mariani, Andrea
2017-10-01
The aim of this study was to determine the clinical utility of routine preoperative pelvic and abdominal computed tomography (CT) examinations in patients with endometrial cancer (EC). We retrospectively reviewed records from patients with EC who underwent a preoperative endometrial biopsy and had surgery at our institution from January 1999 through December 2008. In the subset with an abdominal CT scan obtained within 3 months before surgery, we evaluated the clinical utility of the CT scan. Overall, 224 patients (18%) had a preoperative endometrial biopsy and an available CT scan. Gross intra-abdominal disease was observed in 10% and 20% of patients with preoperative diagnosis of endometrioid G3 and type II EC, respectively, whereas less than 5% of patients had a preoperative diagnosis of hyperplasia or low-grade EC. When examining retroperitoneal findings, we observed that a negative CT scan of the pelvis did not exclude the presence of pelvic node metastasis. Alternately, a negative CT scan in the para-aortic area generally reduced the probability of finding para-aortic dissemination but with an overall low sensitivity (42%). However, the sensitivity for para-aortic dissemination was as high as 67% in patients with G3 endometrioid cancer. In the case of negative para-aortic nodes in the CT scan, the risk of para-aortic node metastases decreased from 18.8% to 7.5% in patients with endometrioid G3 EC. Up to 15% of patients with endometrioid G3 cancer had clinically relevant incidental findings that necessitated medical or surgical intervention. In patients with endometrioid G3 and type II EC diagnosed by the preoperative biopsy, CT scans may help guide the operative plan by facilitating preoperative identification of gross intra-abdominal disease and enlarged positive para-aortic nodes that are not detectable during physical examinations. In addition, CT may reveal other clinically relevant incidental findings.
Morales Guerrero, Josefina Consuelo; Rosas Romero, Reina; García Zepeda, Rodrigo Antonio; Oropeza Hernández, Rodolfo; Ruiz Jiménez, Silvia; Ríos Chávez, Alejandra R; Cervantes Covarrubias, Leticia
2016-09-20
Introducción: el índice glucémico (IG) y la carga glucémica (CG) de productos lácteos fermentados (PLF) con lactobacilos puede ser una recomendación útil para pacientes diabéticos y para la población en general.Objetivo: el objetivo del estudio fue medir el IG y la CG de PLF con lactobacilos en sujetos sedentarios y deportistas, y evaluar si existe diferencia entre ellos.Métodos: el estudio se realizó en México (DF) de acuerdo con la ISO26642:210 (Organización Internacional de Normalización). Los participantes fueron: 10 sedentarios y 10 deportistas. Los PLF analizados fueron: Soful, Yakult, Gastroprotect, BeneGastro, Bonacult, Lala Bio 4 y leche descremada con sacarosa (LDS) y la cantidad de alimento que ingirieron dependió de ajustar a 25 g los HC en la porción.Resultados: el IG de la mayoría de los PLF fue bajo para ambos grupos de sujetos; en los deportistas los PLF Yakult y Bonacult presentaron los mayores IG y solo el Yakult puede considerarse como de IG medio para este grupo; estos dos PLF presentaron la menor relación de proteína/HC. La LDS, lácteo con los HC no fermentados, presentó un IG alto para ambos grupos. La CG de los PLF se encontró entre 4 a 7,6 y solo Gastroprotect presentó estadísticamente la menor CG, lo que pudo deberse a su bajo IG, aun cuando su tamaño de ración no fue la menor, entre los PLF.Conclusión: en general los valores de IG y CG de los PLF fueron bajos para ambos grupos. Por tanto, su consumo puede recomendarse en forma moderada. El IG y CG entre productos lácteos con azúcares fermentados y con azúcares no fermentados fueron diferentes.
El uso de la neuromodulación para el tratamiento del temblor
Bendersky, Damián; Ajler, Pablo; Yampolsky, Claudio
2014-01-01
Introducción: El temblor puede ser un desorden incapacitante y el tratamiento de primera línea para estos pacientes es farmacológico. Sin embargo, este tratamiento puede llevar a una reducción satisfactoria del temblor en sólo el 50% de los pacientes con temblor esencial. La talamotomía era el tratamiento de elección para el temblor refractario al tratamiento médico hasta que comenzó a utilizarse la estimulación cerebral profunda (ECP) del núcleo ventral intermedio (Vim) del tálamo. En la actualidad, raramente se realiza la talamotomía. Métodos: Este artículo es una revisión no sistemática de las indicaciones, resultados, parámetros de programación y técnica quirúrgica de la ECP del Vim para el tratamiento del temblor. Resultados: Aunque los resultados clínicos son similares usando la talamotomía o la ECP del Vim, la primera causa más efectos adversos que la última. Además, la ECP puede ser usada bilateralmente, mientras que la talamotomía tiene un alto riesgo de causar disartria cuando se realiza de ambos lados. La ECP del Vim logró una adecuada mejoría del temblor en varias series de pacientes con temblor causado por temblor esencial, enfermedad de Parkinson o esclerosis múltiple. Además del Vim, hay otros blancos que están siendo usados por varios autores, tales como la zona incerta y las radiaciones prelemniscales. Conclusión: La ECP del Vim es un tratamiento útil para el temblor incapacitante refractario al tratamiento médico. Es esencial realizar una precisa selección de pacientes, así como utilizar una técnica quirúrgica correcta. Aún se desconoce el mejor blanco estereotáctico para el temblor, aunque el Vim es el más usado. PMID:25165613
Garner, Colin R; Park, Kevin B; French, Neil S; Earnshaw, Caroline; Schipani, Alessandro; Selby, Andrew M; Byrne, Lindsay; Siner, Sarah; Crawley, Francis P; Vaes, Wouter H J; van Duijn, Esther; deLigt, Rianne; Varendi, Heili; Lass, Jane; Grynkiewicz, Grzegorz; Maruszak, Wioletta; Turner, Mark A
2015-01-01
Aims The aims of the study were to compare [14C]-paracetamol ([14C]-PARA) paediatric pharmacokinetics (PK) after administration mixed in a therapeutic dose or an isolated microdose and to develop further and validate accelerator mass spectrometry (AMS) bioanalysis in the 0–2 year old age group. Methods [14C]-PARA concentrations in 10–15 µl plasma samples were measured after enteral or i.v. administration of a single [14C]-PARA microdose or mixed in with therapeutic dose in infants receiving PARA as part of their therapeutic regimen. Results Thirty-four infants were included in the PARA PK analysis for this study: oral microdose (n = 4), i.v. microdose (n = 6), oral therapeutic (n = 6) and i.v. therapeutic (n = 18). The respective mean clearance (CL) values (SDs in parentheses) for these dosed groups were 1.46 (1.00) l h–1, 1.76 (1.07) l h–1, 2.93 (2.08) l h–1 and 2.72 (3.10) l h–1, t1/2 values 2.65 h, 2.55 h, 8.36 h and 7.16 h and dose normalized AUC(0-t) (mg l–1 h) values were 0.90 (0.43), 0.84 (0.57), 0.7 (0.79) and 0.54 (0.26). Conclusions All necessary ethical, scientific, clinical and regulatory procedures were put in place to conduct PK studies using enteral and systemic microdosing in two European centres. The pharmacokinetics of a therapeutic dose (mg kg–1) and a microdose (ng kg–1) in babies between 35 to 127 weeks post-menstrual age. [14C]-PARA pharmacokinetic parameters were within a two-fold range after a therapeutic dose or a microdose. Exploratory studies using doses significantly less than therapeutic doses may offer ethical and safety advantages with increased bionalytical sensitivity in selected exploratory paediatric pharmacokinetic studies. PMID:25619398
Garner, Colin R; Park, Kevin B; French, Neil S; Earnshaw, Caroline; Schipani, Alessandro; Selby, Andrew M; Byrne, Lindsay; Siner, Sarah; Crawley, Francis P; Vaes, Wouter H J; van Duijn, Esther; deLigt, Rianne; Varendi, Heili; Lass, Jane; Grynkiewicz, Grzegorz; Maruszak, Wioletta; Turner, Mark A
2015-07-01
The aims of the study were to compare [(14)C]-paracetamol ([(14)C]-PARA) paediatric pharmacokinetics (PK) after administration mixed in a therapeutic dose or an isolated microdose and to develop further and validate accelerator mass spectrometry (AMS) bioanalysis in the 0-2 year old age group. [(14)C]-PARA concentrations in 10-15 µl plasma samples were measured after enteral or i.v. administration of a single [(14)C]-PARA microdose or mixed in with therapeutic dose in infants receiving PARA as part of their therapeutic regimen. Thirty-four infants were included in the PARA PK analysis for this study: oral microdose (n = 4), i.v. microdose (n = 6), oral therapeutic (n = 6) and i.v. therapeutic (n = 18). The respective mean clearance (CL) values (SDs in parentheses) for these dosed groups were 1.46 (1.00) l h(-1), 1.76 (1.07) l h(-1), 2.93 (2.08) l h(-1) and 2.72 (3.10) l h(-1), t(1/2) values 2.65 h, 2.55 h, 8.36 h and 7.16 h and dose normalized AUC(0-t) (mg l(-1) h) values were 0.90 (0.43), 0.84 (0.57), 0.7 (0.79) and 0.54 (0.26). All necessary ethical, scientific, clinical and regulatory procedures were put in place to conduct PK studies using enteral and systemic microdosing in two European centres. The pharmacokinetics of a therapeutic dose (mg kg(-1)) and a microdose (ng kg(-1)) in babies between 35 to 127 weeks post-menstrual age. [(14)C]-PARA pharmacokinetic parameters were within a two-fold range after a therapeutic dose or a microdose. Exploratory studies using doses significantly less than therapeutic doses may offer ethical and safety advantages with increased bionalytical sensitivity in selected exploratory paediatric pharmacokinetic studies. © 2015 The British Pharmacological Society.
Usina de ciências: um espaço pedagógico para aprendizagens múltiplas
NASA Astrophysics Data System (ADS)
Martin, V. A. F.; Poppe, P. C. R.; Orrico, A. C. P.; Pereira, M. G.
2003-08-01
Entendemos que o Ensino de Astronomia é especialmente apropriado para motivar os alunos e aprofundar conteúdos em diversas áreas do conhecimento, pois envolve temas ligados à Física, Matemática, Química, Computação, Tratamento de Imagens e Instrumentação de Alta Precisão, além daqueles pertinentes as áreas de Geografia, História e Antropologia. Contudo, apesar do caráter interdisciplinar que esta ciência possui, a realidade atual é que a maioria dos professores em sala de aula não foram devidamente capacitados, durante o período de formação acadêmica, para ministrar conteúdos de Astronomia nos atuais Ensinos Fundamental e Médio. Neste trabalho, discutiremos de maneira ampla, num primeiro momento, a realidade do atual ensino de ciências praticado no Estado da Bahia, apontando por dependência administrativa, o crescimento e a redução do número de escolas, da taxa de analfabetismo por faixa etária, da escolarização, do atendimento, da aprovação, reprovação e abandono, de equipamentos e laboratórios e o grau de formação dos nossos atuais professores em pleno exercício de atividade docente. Num segundo momento, discutiremos o papel do Observatório Astronômico Antares/UEFS dentro desse contexto, ou seja, suas ações implementadas ao longo dos últimos anos e em particular, o recente projeto de extensão Ensino e Difusão de Astronomia, financiado pela Fundação Vitae, que procura traduzir no lúdico, no brincar de ciências, um espaço pedagógico para aprendizagens múltiplas. Neste, o papel do professor multiplicador associado ao laboratório de kits didáticos, de fácil construção e manipulação (alguns dos quais serão mostrados), perfazem os principais veículos para o desenvolvimento de conhecimentos, atitudes, habilidades e valores que preparam os nossos alunos para a carreira técnico-científica e para sua participação crítica e criativa na Sociedade.
Apoyo a Estudios Geodinamicos con GPS en Guatemala
NASA Astrophysics Data System (ADS)
Robles, V. R.
2013-05-01
El Instituto Geografico Nacional de Guatemala implemento 17 estaciones GNSS en el año 2009, como un proyecto de credito mixto de donacion de equipamiento del Gobierno de Suiza, el cual, este equipamiento de estaciones CORS GNSS es un sistema de recepción y transmisión de datos crudos GPS RInex que utiliza la tecnologia Spider Web de Leica, asi mismo este sistema esta sirviendo para el espablecimiento de un marco geodesico nacional de coordenadas geodesicas oficiales, el cual se calculan u obtienen las velocidades en tiempos temporales programados de las 17 Estaciones CORS. La infraestructura del marco geodesico de Guatemala esta sirviendo de base para las aplicaciones de estudios geodinamicos como el monitoreo de del desplazamiento de las placas tectonicas por medio de un estudio que se inicio en el año de 1999, llamado medicion con GPS el sistema de Fallas de los rios Polochic Motagua de Guatemala, tambien para un estudio que se implemento para deformación de corteza terrestre local en un Volcan Activo de Guatemala llamado Pacaya. Para el estudio de medicion con GPS en el sistema de falla de los Rios del polochic Motagua se implementaron 16 puntos para medir con GPS de dos frecuencias en el año de 1999, el cual, tres puntos son estaciones geodesicas CORS IGS llamados GUAT, ELEN y HUEH, despues en el año de 2003 se hizo otra medicion en un total de 20 puntos, que permitió calcular las velocidades de desplazamieinto de los puntos en mención, usando como referencia el modelo NUVEL 1A de DeMets de la placa de Norteamerica. Este estudio fue en cooperación internacional por la universidad de Nice de Francia y el IGNde Francia. Para el estudio del monitoreo con GPS del volcan activo de Guatemala, se implementaron cuatro puntos al rededor del volcan, el cual, se realizan cuatro mediciones al año, que permiten determinar axialmente la distancias entre los puntos, y rebisar estadisticamente cual es el comportamiento de las distancias en funcion del tiempo, si existen diferencias graduales crecientes o decrecientes, que nos da un indicativo del desplazamiento de la corteza terrestre al rededor del volcan.
NASA Astrophysics Data System (ADS)
Buchholz, B.; Ebert, V.
2014-07-01
Large systematic errors in absorption spectrometers (AS) can be caused by ‘parasitic’ optical absorption (parA) outside the measurement region. In particular, calibration-free direct tunable diode laser AS (dTDLAS) can take advantage of an effective parA-compensation to provide correct absolute values. However, parA also negatively affects calibrated AS in calibration frequency and stability. A common strategy to suppress parA in TDLAS systems is to fiber-couple the light source and even the detector. However, this can be a critical approach if the TDL spectrometer is validated/calibrated under laboratory conditions in ambient humidity and used afterwards in much drier and variable conditions, for example in aircrafts. This paper shows that, e.g., ‘hermetically sealed’ butterfly packages, despite fiber coupling, can possess fixed as well as variable parA sections. Two new methods for absolute parA-quantification in dTDLAS were developed, including a novel, fiber-coupled, parA-free I0-detector for permanent parA-monitoring. Their dependences on ambient humidity/pressure and temporal behavior were studied. For the example of a 1.4 µm dTDLAS hygrometer SEALDH-II with a commercial DFB-laser module and an extractive 1.5 m path cell, we quantified the parA-induced signal offsets and their dependence on cell pressure. The conversion of parA-uncertainty into H2O signal uncertainty was studied and an updated uncertainty budget including parA-uncertainty was derived. The studies showed that parA in commercial laser modules can cause substantial, systematic concentration offsets of ≈25 ppmv fixed and ≈100 ppmv variable offsets for one meter absorption path. Applying our parA-quantification techniques these offsets could be compensated by a factor of 20 to an overall offset uncertainty of 4.5 ppmv m-1. Finally, we developed an innovative, integrated, µ-pumped closed-loop air drying unit for the parA minimization and temporal stabilization in airborne laser hygrometers. This compact and light weight dryer eliminates the variable parA by ambient humidity in less than 120 min and is well suited for airborne applications as it fulfils all airborne operation and safety restrictions.
Astronomia para/com crianças carentes em Limeira
NASA Astrophysics Data System (ADS)
Bretones, P. S.; Oliveira, V. C.
2003-08-01
Em 2001, o Instituto Superior de Ciências Aplicadas (ISCA Faculdades de Limeira) iniciou um projeto pelo qual o Observatório do Morro Azul empreendeu uma parceria com o Centro de Promoção Social Municipal (CEPROSOM), instituição mantida pela Prefeitura Municipal de Limeira para atender crianças e adolescentes carentes. O CEPROSOM contava com dois projetos: Projeto Centro de Convivência Infantil (CCI) e Programa Criança e Adolescente (PCA), que atendiam crianças e adolescentes em Centros Comunitários de diversas áreas da cidade. Esses projetos têm como prioridades estabelecer atividades prazerosas para as crianças no sentido de retirá-las das ruas. Assim sendo, as crianças passaram a ter mais um tipo de atividade - as visitas ao observatório. Este painel descreve as várias fases do projeto, que envolveu: reuniões de planejamento, curso de Astronomia para as orientadoras dos CCIs e PCAs, atividades relacionadas a visitas das crianças ao Observatório, proposta de construção de gnômons e relógios de Sol nos diversos Centros Comunitários de Limeira e divulgação do projeto na imprensa. O painel inclui discussões sobre a aprendizagem de crianças carentes, relatos que mostram a postura das orientadoras sobre a pertinência do ensino de Astronomia, relatos do monitor que fez o atendimento no Observatório e o que o número de crianças atendidas representou para as atividades da instituição desde o início de suas atividades e, em particular, em 2001. Os resultados são baseados na análise de relatos das orientadoras e do monitor do Observatório, registros de visitas e matérias da imprensa local. Conclui com uma avaliação do que tal projeto representou para as Instituições participantes. Para o Observatório, em particular, foi feita uma análise com relação às outras modalidades de atendimentos que envolvem alunos de escolas e público em geral. Também é abordada a questão do compromisso social do Observatório na educação do público em questão.
Determination of inadvertent atrial capture during para-Hisian pacing.
Obeyesekere, Manoj; Leong-Sit, Peter; Skanes, Allan; Krahn, Andrew; Yee, Raymond; Gula, Lorne J; Bennett, Matthew; Klein, George J
2011-08-01
Inadvertent capture of the atrium will lead to spurious results during para-Hisian pacing. We sought to establish whether the stimulation-to-atrial electrogram interval at the proximal coronary sinus (stim-PCS) or high right atrium (stim-HRA) could signal inadvertent atrial capture. Para-Hisian pacing with and without intentional atrial capture was performed in 31 patients. Stim-HRA and stim-PCS intervals were measured with atrial capture, His plus para-Hisian ventricular (H+V) capture, and para-Hisian ventricular (V) capture alone. The mean stim-HRA interval was significantly shorter with atrial capture (66 ± 18 ms) than with H+V (121 ± 27 ms, P < 0.001) or V capture alone (174 ± 38 ms, P < 0.001). The mean stim-PCS interval was significantly shorter with atrial capture (51 ± 16 ms) than with H+V (92 ± 22 ms, P<0.001) or V capture alone (146 ± 33 ms, P < 0.001). A stim-PCS < 60 ms (stim-HRA < 70 ms) was observed only with atrial capture. A stim-PCS >90 ms (stim-HRA >100 ms) was observed only in the absence of atrial capture. A stim-HRA of < 85 ms was highly specific and stim-PCS of < 85 ms highly sensitive at identifying atrial capture. Stim-HRA intervals of 75 to 97 ms and stim-PCS intervals of 65 to 88 ms were observed with either atrial, His, or para-Hisian ventricular capture without atrial capture. In this overlap zone, all patients demonstrated a stim-PCS or stim-HRA interval prolongation of at least 20 ms when the catheter was advanced to avoid deliberate atrial pacing. The QRS morphology was of limited value in distinguishing atrial capture due to concurrent ventricular or H+V capture, as observed in 20 of 31 (65%) patients. Stim-PCS and stim-HRA intervals can be used to monitor for inadvertent atrial capture during para-Hisian pacing. A stim-PCS < 60 ms (or stim-HRA < 70 ms) and stim-PCS > 90 ms (or stim-HRA > 100 ms) were observed only with and without atrial capture, respectively, but there was significant overlap between these values. Deliberate atrial capture and loss of capture reliably identifies atrial capture regardless of intervals.
NASA Astrophysics Data System (ADS)
Queiroz, A. S. B.; Jafelice, L. C.
2003-08-01
Tem-se constatado uma preocupante carência no ensino de astronomia nos diversos níveis de escolaridade. Neste trabalho discutimos várias práticas didático-pedagógicas que vimos desenvolvendo para crianças, jovens e adultos em processo de alfabetização, visando contribuir para reparar aquela carência. Propomos uma metodologia que incorpora as recentes exigências das políticas públicas educacionais, estimula o desenvolvimento de textos e materiais instrucionais, é compatível com a realidade desse público e é adaptável às respectivas faixas etárias. A observação do céu sempre esteve presente na vida de nossos antepassados, dando suporte à compreensão do ser humano como integrante da natureza. Visamos com este trabalho suprir a deficiência encontrada para se tratar a relação do ser humano com o céu, no ambiente escolar. Os resultados são animadores e envolvem práticas e textos que desenvolvemos e atividades realizadas pelos alunos. No primeiro grupo destacamos o desenvolvimento de várias práticas: "viagem aos planetas" (construímos o "foguete", os planetas em escala, contamos história e redigimos texto de orientação para os professores); "gnômon humano" (os próprios corpos dos alunos são usados para registrar o movimento aparente do Sol); "crateras da Lua" (concretização de "meteoritos" e "solo lunar" de gesso e exploração da relação entre energia cinética do bólido e tamanho da cratera formada); etc. No segundo grupo, produções de desenhos e redações e discussões dos alunos após a realização de cada prática, revelam que estas têm se mostrado muito eficientes, tanto para estimular a imaginação e a fantasia dos envolvidos, como para trabalhar-se habilidades, competências e conteúdos relacionados à astronomia, segundo uma perspectiva interdisciplinar contextualizada. (PPGECNM/UFRN; NUPA/USP; Temáticos/FAPESP)
Sousa, Fátima Aparecida Emm Faleiros; Silva, Talita de Cássia Raminelli da; Siqueira, Hilze Benigno de Oliveira Moura; Saltareli, Simone; Gomez, Rodrigo Ramon Falconi; Hortense, Priscilla
2016-08-18
to describe acute and chronic pain from the perspective of the life cycle. participants: 861 people in pain. The Multidimensional Pain Evaluation Scale (MPES) was used. in the category estimation method the highest descriptors of chronic pain for children/ adolescents were "Annoying" and for adults "Uncomfortable". The highest descriptors of acute pain for children/adolescents was "Complicated"; and for adults was "Unbearable". In magnitude estimation method, the highest descriptors of chronic pain was "Desperate" and for descriptors of acute pain was "Terrible". the MPES is a reliable scale it can be applied during different stages of development. descrever a dor aguda e a crônica na perspectiva do ciclo vital. Métodos: participaram 861 pessoas com dor. Foi utilizada a Escala Multidimensional de Avaliação da Dor (EMADOR). Resultados: no método da estimação de categoria o descritor da dor crônica de maior atribuição para crianças e adolescentes foi "Chata" e para adultos foi "Desconfortável". Os descritores de maior atribuição para dor aguda em crianças e adolescentes foram "Complicada" e em adultos "Insuportável". No método de estimação de magnitude, o descritor de maior atribuição na dor crônica foi "Atormentadora" e na dor aguda foi "Terrível". a EMADOR é uma escala confiável e pode ser utilizada nas diferentes etapas do desenvolvimento humano. la descripción del dolor agudo y crónico desde las perspectiva del ciclo de vida. participaron 861 personas con dolor. Se utilizó la Escala Multidimensional de Evaluación del Dolor (EMEDOR). en el método de estimación de categoría el descriptor de dolor crónico más alto para niños y adolescentes fue de Molesto y para adultos fue Incómodo. Los descriptores mayores de dolor agudo para niños y adolescentes fueron Complejo y para adultos Insoportable. En el método de estimación de magnitud, el mayor descriptor de dolor crónico fueron Atormentador y el mayor de dolor agudo fue Terrible. la EMEDOR es una escala confiable y puede ser utilizada en diferentes etapas de desarrollo.
Blunted perception of neural respiratory drive and breathlessness in patients with cystic fibrosis.
Reilly, Charles C; Jolley, Caroline J; Elston, Caroline; Moxham, John; Rafferty, Gerrard F
2016-01-01
The electromyogram recorded from the diaphragm (EMG di ) and parasternal intercostal muscle using surface electrodes (sEMG para ) provides a measure of neural respiratory drive (NRD), the magnitude of which reflects lung disease severity in stable cystic fibrosis. The aim of this study was to explore perception of NRD and breathlessness in both healthy individuals and patients with cystic fibrosis. Given chronic respiratory loading and increased NRD in cystic fibrosis, often in the absence of breathlessness at rest, we hypothesised that patients with cystic fibrosis would be able to tolerate higher levels of NRD for a given level of breathlessness compared to healthy individuals during exercise. 15 cystic fibrosis patients (mean forced expiratory volume in 1 s (FEV 1 ) 53.5% predicted) and 15 age-matched, healthy controls were studied. Spirometry was measured in all subjects and lung volumes measured in the cystic fibrosis patients. EMG di and sEMG para were recorded at rest and during incremental cycle exercise to exhaustion and expressed as a percentage of maximum (% max) obtained from maximum respiratory manoeuvres. Borg breathlessness scores were recorded at rest and during each minute of exercise. EMG di % max and sEMG para % max and associated Borg breathlessness scores differed significantly between healthy subjects and cystic fibrosis patients at rest and during exercise. The relationship between EMG di % max and sEMG para % max and Borg score was shifted to the right in the cystic fibrosis patients, such that at comparable levels of EMG di % max and sEMG para % max the cystic fibrosis patients reported significantly lower Borg breathlessness scores compared to the healthy individuals. At Borg score 1 (clinically significant increase in breathlessness from baseline) corresponding levels of EMG di % max (20.2±12% versus 32.15±15%, p=0.02) and sEMG para % max (18.9±8% versus 29.2±15%, p=0.04) were lower in the healthy individuals compared to the cystic fibrosis patients. In the cystic fibrosis patients EMG di % max at Borg score 1 was related to the degree of airways obstruction (FEV 1 ) (r=-0.664, p=0.007) and hyperinflation (residual volume/total lung capacity) (r=0.710, p=0.03). This relationship was not observed for sEMG para % max. These data suggest that compared to healthy individuals, patients with cystic fibrosis can tolerate much higher levels of NRD before increases in breathlessness from baseline become clinically significant. EMG di % max and sEMG para % max provide physiological tools with which to elucidate factors underlying inter-individual differences in breathlessness perception.
Condiciones Físicas en Nebulosas Gaseosas
NASA Astrophysics Data System (ADS)
Luridiana, V.
1999-03-01
El presente trabajo se ha enfocado a determinar y entender las condiciones físicas en una variedad de objetos nebulares, prestando particular atención al problema de la determinación de las abundancias químicas. Para este fin, hemos utilizado métodos analíticos en algunos casos, y modelos numéricos de fotoionización en otros. El objetivo general del trabajo es proveer de una visión amplia de las herramientas teórico-observacionales que se utilizan para la determinación de la estructura de temperatura y densidad de las regiones fotoionizadas, poniendo en evidencia posibles fuentes de errores sistemáticos y sus consecuencias para la determinación de las abundancias químicas, y proponiendo métodos para corregirlos. Los resultados principales de este trabajo est´n listados a continuación: a) Se discute el problema de la discrepancia entre T(C III) y T(O III) en las nebulosas planetarias, y se muestra como tal discrepancia implica probablemente la presencia de fluctuaciones de temperatura. Debido a que la temperatura de O++ es muy afectada por fluctuaciones de temperatura, se recomienda usar la temperatura de C++ para determinar la abundancia de carbono. b) Presentamos dos nuevos métodos para determinar la temperatura electrónica en nebulosas planetarias, basados en la medición de las intensidades de las líneas de He I. Las temperaturas que se obtienen a partir de estos métodos son menores que aquellas que se obtienen a partir de las líneas de [O III], implicando la presencia de fluctuaciones espaciales de temperatura. Despreciando las fluctuaciones de temperatura, se obtienen valores sesgados de las abundancias químicas. Determinamos las abundancias en las nebulosas planetarias de tipo I de algunos de los elementos más importantes, tomando en cuenta las fluctuaciones de temperatura. c) Presentamos modelos numéricos de las dos regiones H II extragalácticas gigantes NGC 2363 y NGC 5461. Con el modelaje numérico, pretendemos acotar las carácteristicas principales de las nubes ionizadas (distribución espacial del gas, estructura de ionización y de temperatura) y de los cúmulos ionizantes (función inicial de masa, historia de formación estelar, edad). En ambos casos, mostramos que con modelos numéricos calculados para el valor de metalicidad que se determina a partir de la temperatura de [O III], no es posible reproducir el espectro de emisión observado, y que para reproducir las restricciones más robustas es necesario subir la metalicidad de los modelos por un factor de 2. Esto constituye una fuerte indicación en favor de la presencia de fluctuaciones de temperatura. d) Para poder comparar los modelos numéricos con los datos observacionales. mostramos la importancia de corregir las predicciones de los modelos por el sesgo introducido por el tamaío finito de la rendija.
Siegel, Nicol; Hoegg, Simone; Salzburger, Walter; Braasch, Ingo; Meyer, Axel
2007-01-01
Background The evolutionary lineage leading to the teleost fish underwent a whole genome duplication termed FSGD or 3R in addition to two prior genome duplications that took place earlier during vertebrate evolution (termed 1R and 2R). Resulting from the FSGD, additional copies of genes are present in fish, compared to tetrapods whose lineage did not experience the 3R genome duplication. Interestingly, we find that ParaHox genes do not differ in number in extant teleost fishes despite their additional genome duplication from the genomic situation in mammals, but they are distributed over twice as many paralogous regions in fish genomes. Results We determined the DNA sequence of the entire ParaHox C1 paralogon in the East African cichlid fish Astatotilapia burtoni, and compared it to orthologous regions in other vertebrate genomes as well as to the paralogous vertebrate ParaHox D paralogons. Evolutionary relationships among genes from these four chromosomal regions were studied with several phylogenetic algorithms. We provide evidence that the genes of the ParaHox C paralogous cluster are duplicated in teleosts, just as it had been shown previously for the D paralogon genes. Overall, however, synteny and cluster integrity seems to be less conserved in ParaHox gene clusters than in Hox gene clusters. Comparative analyses of non-coding sequences uncovered conserved, possibly co-regulatory elements, which are likely to contain promoter motives of the genes belonging to the ParaHox paralogons. Conclusion There seems to be strong stabilizing selection for gene order as well as gene orientation in the ParaHox C paralogon, since with a few exceptions, only the lengths of the introns and intergenic regions differ between the distantly related species examined. The high degree of evolutionary conservation of this gene cluster's architecture in particular – but possibly clusters of genes more generally – might be linked to the presence of promoter, enhancer or inhibitor motifs that serve to regulate more than just one gene. Therefore, deletions, inversions or relocations of individual genes could destroy the regulation of the clustered genes in this region. The existence of such a regulation network might explain the evolutionary conservation of gene order and orientation over the course of hundreds of millions of years of vertebrate evolution. Another possible explanation for the highly conserved gene order might be the existence of a regulator not located immediately next to its corresponding gene but further away since a relocation or inversion would possibly interrupt this interaction. Different ParaHox clusters were found to have experienced differential gene loss in teleosts. Yet the complete set of these homeobox genes was maintained, albeit distributed over almost twice the number of chromosomes. Selection due to dosage effects and/or stoichiometric disturbance might act more strongly to maintain a modal number of homeobox genes (and possibly transcription factors more generally) per genome, yet permit the accumulation of other (non regulatory) genes associated with these homeobox gene clusters. PMID:17822543
76 FR 34296 - Proposed Collection; Comment Request for Forms 1040-PR and 1040-SS
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Can para-aryl-dithiols cross-link two plasmonic noble nanoparticles as monolayer dithiolate spacers
USDA-ARS?s Scientific Manuscript database
Para-aryl-dithiols (PADTs, HS-(C6H4)n-SH, n = 1, 2, and 3) have been used extensively in molecular electronics, surface-enhanced Raman spectroscopy (SERS), and quantum electron tunneling between two gold or silver nanoparticles (AuNPs and AgNPs). One popular belief is that these dithiols cross-link ...
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ERIC Educational Resources Information Center
Kollins, Judith M.; Hansman, Catherine A.
2005-01-01
This study examines how the Education Office of the "Oficina Juridica Para la Mujer" [Women's Legal Office] , a community-based popular education organization in Cochabamba, Bolivia, works with women to address personal, legal, and policy issues through local leadership training and popular education methodology. We investigate the…
ERIC Educational Resources Information Center
Washington Office of the State Superintendent of Public Instruction, Olympia.
This pamphlet guides parents of children with disabilities through the procedures for acquiring special education services in the state of Washington. Following an overview of special education, the pamphlet presents information on notice and consent procedures, confidentiality of records, individualized education programs (IEP), the placement…
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DESAFÍOS ÉTICOS DE LA INVESTIGACIÓN CON ANIMALES, MANIPULACIÓN GENÉTICA
Yunta, Eduardo Rodríguez
2012-01-01
En la investigación con animales existen cuestionamientos éticos tanto en el uso como modelos de enfermedades humanas y requisito previo para ensayos en humanos como en la introducción de modificaciones genéticas. Algunos de estos cuestionamientos son: no representar exactamente la condición humana como modelos, realizar pruebas de toxicidad con grave daño para los animales, alterar su naturaleza mediante modificaciones genéticas, riesgos de la introducción de organismos genéticamente modificados. El uso de animales en investigación para beneficio humano, impone al ser humano la responsabilidad moral de respetarlo, no haciéndoles sufrir innecesariamente, al estar trabajando con seres vivientes y sentientes. PMID:23338641
Kalantre, Atul; Vettukattil, Joseph; Haw, Marcus; Veldtman, Gruschen R
2007-12-01
Paravalvular leaks are a recognized complication of valve replacement surgery. We report a 47-year-old man with left atrial isomerism, interrupted left sided inferior caval vein with unilateral left sided superior caval vein, a common atrium, and anomalous pulmonary venous connection to the coronary sinus, who had recurrent severe para-right atrioventricular (AV) regurgitation with gross right heart failure following tricuspid valve (TCV) replacement. He underwent a hybrid surgery-transcatheter treatment strategy in the cardiac catheterization laboratory, which led to significant improvement in hemodynamics and symptoms. This to our knowledge is the first reported case of a minimally invasive approach to para-right sided AV valve regurgitation.
Reversible interactions with para-hydrogen enhance NMR sensitivity by polarization transfer.
Adams, Ralph W; Aguilar, Juan A; Atkinson, Kevin D; Cowley, Michael J; Elliott, Paul I P; Duckett, Simon B; Green, Gary G R; Khazal, Iman G; López-Serrano, Joaquín; Williamson, David C
2009-03-27
The sensitivity of both nuclear magnetic resonance spectroscopy and magnetic resonance imaging is very low because the detected signal strength depends on the small population difference between spin states even in high magnetic fields. Hyperpolarization methods can be used to increase this difference and thereby enhance signal strength. This has been achieved previously by incorporating the molecular spin singlet para-hydrogen into hydrogenation reaction products. We show here that a metal complex can facilitate the reversible interaction of para-hydrogen with a suitable organic substrate such that up to an 800-fold increase in proton, carbon, and nitrogen signal strengths are seen for the substrate without its hydrogenation. These polarized signals can be selectively detected when combined with methods that suppress background signals.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Lindenmaier, Rodica; Scharko, Nicole K.; Tonkyn, Russell G.
Xylenes contain a blend of the ortho-, meta-, and para- isomers, and all are abundant contaminants in the ground, surface waters, and air. To better characterize xylene and to better enable its detection, we report high quality quantitative vapor-phase infrared spectra of all three isomers over the 540-6500 cm -1 range. All fundamental vibrational modes are assigned based on these vapor-phase infrared spectra, liquid-phase infrared and Raman spectra, along with density functional theory (DFT), ab initio MP2 and high energy-accuracy compound theoretical model (W1BD) calculations. Both MP2 and DFT predict a single conformer with C 2v symmetry for ortho-xylene, andmore » two conformers each for meta- and para-xylene, depending on the preferred orientations of the methyl groups. For meta-xylene the two conformers have C s and C 2 symmetry, and for para-xylene these conformers have C 2v or C 2h symmetry. Since the relative population of the two conformers is approximately 50% for both isomers and predicted frequencies and intensities are very similar for each conformer, we made an arbitrary choice to discuss the C s conformer for meta-xylene and the C 2v conformer for para-xylene. We report integrated band intensities for all isomers. Using the quantitative infrared data, we determine the global warming potential values of each isomer and discuss potential bands for atmospheric monitoring.« less
Ortiz-Torres, Blanca; Rivera-Ortiz, Rafael J.; Mendoza, Sigrid
2014-01-01
Resumen La construcción de roles de género dominantes contribuyen al riesgo de contraer VIH, y por tal razón se ha urgido a que se integren las normas sociales relativas al género en las intervenciones preventivas del VIH. Este estudio pretende adaptar y desarrollar una intervención que facilite la transformación de normas sociales del género y de prácticas sexuales en hombres puertorriqueños. La intervención propone transformar normas sociales relacionadas al género y sexualidad en barras comunitarias utilizando el modelo de líderes de opinión. Luego de ser elegidos/as, los/as líderes de opinión diseminan mensajes integrando la importancia de relaciones equitativas entre parejas para la prevención del VIH. La primera fase de esta intervención es discutida en este artículo, la cual incluye un proceso de etnografía acelerada para identificar los escenarios comunitarios en los que podemos desarrollar esta intervención y permitirnos entender la cultura de las barras comunitarias. A partir de las observaciones etnográficas, pudimos: desarrollar un protocolo de seguridad para realizar las observaciones, desarrollar un perfil de la cultura de las barras, elegir las barras a participar en las dos condiciones del estudio y adaptar los instrumentos de la intervención para que respondieran a la particularidad de los/as participantes. PMID:25530828
Sobre el estado evolutivo de β Pictoris
NASA Astrophysics Data System (ADS)
Brunini, A.; Benvenuto, O. G.
Desde el descubrimiento de fuertes excesos infrarrojos en β Pictoris, esta estrella ha sido muy estudiada y es considerada candidata a poseer un sistema planetario propio. β Pic está rodeada de un disco asimétrico de polvo que se observa de canto y que esta vacío a distancias <= 40 AU. Esto se considera una fuerte evidencia en favor de la presencia de (al menos) un planeta gigante. Recientemente se han observado líneas de material circunestelar que se han interpretado como consecuencia de la caída de objetos cometarios sobre esta estrella. Recientemente se ha utilizado la existencia del disco de polvo para atribuir una edad corta (pre - secuencia principal) a βPic. Sin embargo, la evaporación de estos cometas provee suficiente polvo como para explicar la presencia del disco observado sin necesidad de edades cortas. En este trabajo mostramos que la comparación entre la tasa de impactos cometarios estimada en el Sistema Solar para diferentes etapas de su evolución y los datos observados en β Pic indica edades avanzadas para β Pic. Esta estimación debe tomarse con cautela ya que depende de la estructura de los sistemas planetarios. Además mostramos que, desde el punto de vista de la evolución estelar y con las incertezas presentes en la luminosidad y la temperatura efectiva, existe un continuo de edades posible para β Pic. Sin embargo, empleando los datos provenientes de los flujos cometarios encontramos que una edad prolongada es consistente con ambos tratamientos.
El-Houssini, Ola Mohamed
2013-01-01
Two simple, accurate and reproducible methods were developed and validated for the simultaneous determination of paracetamol (PARA) and pamabrom (PAMB) in pure form and in tablets. The first method was based on reserved-phase high-performance liquid chromatography, on a Thermo Hypersil ODS column using methanol:0.01 M sodium hexane sulfonate:formic acid (67.5:212.5:1 v/v/v) as the mobile phase. The flow rate was 2 mL/min and the column temperature was adjusted to 35 °C. Quantification was achieved with UV detection at 277 nm over concentration range of 100–600 and 4–24 μg/mL, with mean percentage recoveries were found to be 99.90 ± 0.586 and 99.26 ± 0.901 for PARA and PAMB, respectively. The second method was based on thin-layer chromatography separation of PARA and PAMB followed by densitometric measurement of the spots at 254 nm and 277 nm for PARA and PAMB respectively. Separation was carried out on aluminum sheet of silica gel 60F254 using dichloromethane:methanol:glacial acetic acid (7.5:1:0.5 v/v/v) as the mobile phase over concentration range of 1–10 and 0.32–3.20 μg per spot, with mean percentage recovery of 100.52 ± 1.332 and 99.71 ± 1.478 for PARA and PAMB, respectively. The methods retained their accuracy in presence of up to 50% of P-aminophenol and could be successfully applied in tablets. PMID:24046511
NASA Astrophysics Data System (ADS)
Lindenmaier, Rodica; Scharko, Nicole K.; Tonkyn, Russell G.; Nguyen, Kiet T.; Williams, Stephen D.; Johnson, Timothy J.
2017-12-01
Xylenes contain a blend of the ortho-, meta-, and para- isomers, and all are abundant contaminants in the ground, surface waters, and air. To better characterize xylene and to better enable its detection, high quality quantitative vapor-phase infrared spectra of all three isomers over the 6500 - 540 cm-1 range are reported. All fundamental vibrational modes are assigned based on these vapor-phase infrared spectra, liquid-phase infrared and Raman spectra, along with density functional theory (DFT), ab initio MP2 and high energy-accuracy compound theoretical model (W1BD) calculations. Both MP2 and DFT predict a single conformer with C2v symmetry for ortho-xylene, and two conformers each for meta- and para-xylene, depending on the preferred orientations of the methyl groups. For meta-xylene the two conformers have Cs and C2 symmetry, and for para-xylene these conformers have C2v or C2h symmetry. Since the relative population of the two conformers is approximately 50% for both isomers and predicted frequencies and intensities are very similar for each conformer, an arbitrary choice to discuss the Cs conformer for meta-xylene and the C2v conformer for para-xylene is made. Integrated band intensities for all isomers are reported. Using the quantitative infrared data, the global warming potential values of each isomer are determined. Potential bands for atmospheric monitoring are also discussed.
Attenuation of Ultraviolet Radiation by Dust in Interstellar Clouds
NASA Astrophysics Data System (ADS)
Escalante, V.
1994-07-01
Se han obtenido soluciones de la ecuación de transporte para la dispersión coherente, no conservativa y anisotrópica para estimar la precisión de métodos aproximados, usados en modelos de nubes en que la luz es atenuada principalmente por el polvo. En los cálculos se ha aplicado el metodo de armónicos esféricos para distintos parámetros del polvo. Se ha explorado la posibilidad de descubrir cambios en las caracterísiticas del polvo mediante observaciones de regiones fotodisociadas. Se muestra que para altos valores del albedo de dispersión simple y del parametro de asimetria de Ia función de fase que son adecuados para el polvo galáctico, no es posible determinar variaciones de más de un factor de 2 en el cociente de gas a polvo. Solutions to the transfer equation for coherent, non-conservative, anisotropic scattering have been obtained in order to estimate the accuracy of approximate methods used in models of clouds where light is attenuated mostly by dust. In the calculations the spherical harmonic method has been applied for different grain parameters. The possibility of discovering changes of dust characteristics through observations of photodissociation regions has been considered. It is shown that for the high values of the single scattering albedo and the asymmetry parameter of the phase function for redistribution that appear to be appropriate for galactic dust, it is not possible to determine variations of more than a factor of 2 in the gas to dust ratio.
Tompa, Emile; Kalcevich, Christina; McLeod, Chris; Lebeau, Martin; Song, Chaojie; McLeod, Kim; Kim, Joanne; Demers, Paul A
2017-01-01
Objectives To estimate the economic burden of lung cancer and mesothelioma due to occupational and para-occupational asbestos exposure in Canada. Methods We estimate the lifetime cost of newly diagnosed lung cancer and mesothelioma cases associated with occupational and para-occupational asbestos exposure for calendar year 2011 based on the societal perspective. The key cost components considered are healthcare costs, productivity and output costs, and quality of life costs. Results There were 427 cases of newly diagnosed mesothelioma cases and 1904 lung cancer cases attributable to asbestos exposure in 2011 for a total of 2331 cases. Our estimate of the economic burden is $C831 million in direct and indirect costs for newly identified cases of mesothelioma and lung cancer and $C1.5 billion in quality of life costs based on a value of $C100 000 per quality-adjusted life year. This amounts to $C356 429 and $C652 369 per case, respectively. Conclusions The economic burden of lung cancer and mesothelioma associated with occupational and para-occupational asbestos exposure is substantial. The estimate identified is for 2331 newly diagnosed, occupational and para-occupational exposure cases in 2011, so it is only a portion of the burden of existing cases in that year. Our findings provide important information for policy decision makers for priority setting, in particular the merits of banning the mining of asbestos and use of products containing asbestos in countries where they are still allowed and also the merits of asbestos removal in older buildings with asbestos insulation. PMID:28756416
Aslan, Sevda C; Randall, David C; Donohue, Kevin D; Knapp, Charles F; Patwardhan, Abhijit R; McDowell, Susan M; Taylor, Robert F; Evans, Joyce M
2007-03-01
We investigated autonomic control of cardiovascular function in able-bodied (AB), paraplegic (PARA), and tetraplegic (TETRA) subjects in response to head-up tilt following spinal cord injury. We evaluated spectral power of blood pressure (BP), baroreflex sensitivity (BRS), baroreflex effectiveness index (BEI), occurrence of systolic blood pressure (SBP) ramps, baroreflex sequences, and cross-correlation of SBP with heart rate (HR) in low (0.04-0.15 Hz)- and high (0.15-0.4 Hz)-frequency regions. During tilt, AB and PARA effectively regulated BP and HR, but TETRA did not. The numbers of SBP ramps and percentages of heartbeats involved in SBP ramps and baroreflex sequences increased in AB, were unchanged in PARA, and declined in TETRA. BRS was lowest in PARA and declined with tilt in all groups. BEI was greatest in AB and declined with tilt in all groups. Low-frequency power of BP and the peak of the SBP/HR cross-correlation magnitude were greatest in AB, increased during tilt in AB, remained unchanged in PARA, and declined in TETRA. The peak cross-correlation magnitude in HF decreased with tilt in all groups. Our data indicate that spinal cord injury results in decreased stimulation of arterial baroreceptors and less engagement of feedback control as demonstrated by lower 1) spectral power of BP, 2) number (and percentages) of SBP ramps and barosequences, 3) cross-correlation magnitude of SBP/HR, 4) BEI, and 5) changes in delay between SBP/HR. Diminished vasomotion and impaired baroreflex regulation may be major contributors to decreased orthostatic tolerance following injury.
NASA Astrophysics Data System (ADS)
Farashishiko, Annah; Slack, Jacqueline R.; Botta, Mauro; Woods, Mark
2018-04-01
Although paraCEST is a method with immense scope for generating image contrast in MRI, it suffers from the series the serious drawback of high detection limits. For a typical discrete paraCEST agent the detection limit is roughly an order of magnitude higher than that of a clinically used relaxation agent. One solution to this problem may be the incorporation of a large payload of paraCEST agents into a single macromolecular agent. Here we report a new synthetic method for accomplishing this goal: incorporating a large payload of the paraCEST agent DyDOTAM3+ into a Reverse Assembled nano-Capsule. An aggregate can be generated between this chelate and polyacrylic acid after the addition of ethylene diamine. Subsequent addition of polyallylamine hydrochloride followed by silica nanoparticles generated a robust encapsulating shell and afforded capsule with a mean hydrodynamic diameter of 650 ± 250 nm. Unfortunately this encapsulation did not have the effect of amplifying the CEST effect per agent, but quenched the CEST altogether. A significant proportion of the quenching effect of encapsulation could be attributed to the effect of slowing molecular tumbling, which is inevitable when the chelate is incorporated into a nano-scale material. This increases the transverse relaxation rate of chelate protons and a theoretical examination using Solomon Bloembergen Morgan theory and the Bloch equations shows that the increase in the transverse relaxation rate constant for the amide protons, in even modestly sized nano-materials, is sufficient to significantly quench CEST.
Lurry, Dee L.; Reutter, David C.; Wells, Frank C.; Rivera, M.C.; Munoz, A.
1998-01-01
La Oficina del Estudio Geologico de los Estados Unidos (U.S. Geological Survey, 0 USGS) ha monitoreado la calidad del agua de la cuenca del Rio Grande (Rio Bravo del Norte) desde 1995 como parte de la rediseiiada Red Nacional para Contabilizar la Calidad del Agua de los Rios (National Stream Quality Accounting Network, o NASOAN) (Hooper and others, 1997). EI programa NASOAN fue diseiiado para caracterizar las concentraciones y el transporte de sedimento y constituyentes quimicos seleccionados, encontrados en los grandes rios de los Estados Unidos - incluyendo el Misisipi, el Colorado y el Columbia, ademas del Rio Grande. En estas cuatro cuencas, el USGS opera actualmente (1998) una red de 40 puntos de muestreo pertenecientes a NASOAN, con un enfasis en cuantificar el flujo en masa (la cantidad de material que pasa por la estacion, expresado en toneladas por dial para cada constituyente. Aplicacando un enfoque consistente, basado en la cuantificacion de flujos en la cuenca del Rio Grande, el programa NASOAN esta generando la informacion necesaria para identificar fuentes regionales de diversos contaminantes, incluyendo sustancias qui micas agricolas y trazas elementos en la cuenca. EI efecto de las grandes reservas en el Rio Grande se puede observar segun los flujos de constituyentes discurren a 10 largo del rio. EI analisis de los flujos de constituyentes a escala de la cuenca proveera los medios para evaluar la influencia de la actividad humana sobre las condiciones de calidad del agua del Rio Grande.
NASA Astrophysics Data System (ADS)
Tuttle, William Duncan; Gardner, Adrian M.; Whalley, Laura E.; Wright, Timothy G.
2017-06-01
We have employed resonance-enhanced multiphoton ionisation (REMPI) spectroscopy and zero-kinetic-energy (ZEKE) spectroscopy to investigate the first excited electronic singlet (S_{1}) state and the cationic ground state (D_{0}^{+}) of para-fluorotoluene (pFT) and para-xylene (pXyl). Spectra have been recorded via a large number of selected intermediate levels, to support assignment of the vibration and vibration-torsion levels in these molecules and to investigate possible couplings. The study of levels in this region builds upon previous work on the lower energy regions of pFT and pXyl and here we are interested in how vibration-torsion (vibtor) levels might combine and interact with vibrational ones, and so we consider the possible couplings which occur. Comparisons between the spectra of the two molecules show a close correspondence, and the influence of the second methyl rotor in para-xylene on the onset of intramolecular vibrational redistribution (IVR) in the S_{1} state is a point of interest. This has bearing on future work which will need to consider the role of both more flexible side chains of substituted benzene molecules, and multiple side chains. A. M. Gardner, W. D. Tuttle, L. Whalley, A. Claydon, J. H. Carter and T. G. Wright, J. Chem. Phys., 145, 124307 (2016). A. M. Gardner, W. D. Tuttle, P. Groner and T. G. Wright, J. Chem. Phys., (2017, in press). W. D. Tuttle, A. M. Gardner, K. O'Regan, W. Malewicz and T. G. Wright, J. Chem. Phys., (2017, in press).
ERIC Educational Resources Information Center
Schwartz, Wendy
The educational experiences of Latinas are affected by the interaction of many factors, including poverty, racism, sexual harassment, and lack of English language proficiency. This Spanish-language digest presents a range of strategies that schools can employ to promote the academic achievement of Latinas. Schools should communicate that Hispanic…
Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-01
...) and El Comite Para El Bienstar de Earlimart v. Warmerdam, 539 F.3d 1062, 1067 (9th Cir. 2008... mandatory and unequivocal in nature: Be it further resolved, that the District will develop, adopt, submit... pesticidal VOC emissions based on 1991 pesticide use data * * *.'' El Comite Para El Bienestar de Earlimart v...
[Genetics and the Junta para Ampliación de Estudios e Investigaciones Científicas].
Peláez, Raquel Alvarez
2007-01-01
The aim of this paper is to show the essential paper developed by the Junta para Ampliación de Estudios in the origin of the Spanish genetics, using for that the most relevant researchers of the time, and between them two women, Jimena Fernández de la Vega and Käte Pariser.
ERIC Educational Resources Information Center
Merino, Claralynn
Many Native American communities have high rates of alcoholism. Children growing up in alcoholic families often exhibit co-dependent or para-alcoholic behaviors, which place them at high risk of educational failure. The Love Bug model was designed to encourage culturally appropriate self-expression and to promote self-love and detachment from…
Testing of the Kinetico Inc. and Alean Chemicals Para-FloTM PF60 Model AA08AS with Actiguard AAFS50 arsenic adsorption media filter system was conducted at the Orchard Hills Mobile Home Park (MHP) Water Treatment Plant (WTP) in Carroll Township, Pennsylvania. The source water,...
LBA-ECO TG-07 Trace Gas Fluxes, Undisturbed and Logged Sites, Para, Brazil: 2000-2002
M.M. Keller; R.K. Varner; J.D. Dias; H.S. Silva; P.M. Crill; Jr. de Oliveira; G.P. Asner
2009-01-01
Trace gas fluxes of carbon dioxide, methane, nitrous oxide, and nitric oxide were measured manually at undisturbed and logged forest sites in the Tapajos National Forest, near Santarem, Para, Brazil. Manual measurements were made approximately weekly at both the undisturbed and logged sites. Fluxes from clay and sand soils were completed at the undisturbed sites....
ERIC Educational Resources Information Center
Knotek, Steven E.; Sánchez, Marta
2017-01-01
The Madres para Niños (MpN) program uses consultee-centered consultation as a vehicle to help immigrant Latino parents focus and reframe their preexisting child advocacy skills toward their children's successful transition into elementary school in a new geographic and cultural context. This article describes the Latina mother's experience as…
Una Guia Para Padres Para El Cuidado de Ninos (A Parent's Guide to Child Care).
ERIC Educational Resources Information Center
Oregon State Dept. of Human Resources, Salem.
This booklet was designed to help parents in Oregon in finding and financing child care for their children. The first section of the booklet provides information on the Oregon Department of Human Resources' Adult and Family Services (AFS) Division's Aid for Dependent Children (ADC) and Employment Related Day Care (ERDC) programs. This section…
Jennifer Van Vleet; Thomas W. Jeffries; Lisbeth Olsson
2008-01-01
Overexpression of D-xylulokinase in Saccharomyces cerevisiae engineered for assimilation of xylose results in growth inhibition that is more pronounced at higher xylose concentrations. Mutants deficient in the para-nitrophenyl phosphatase, PHO13, resist growth inhibition on xylose. We studied this inhibition under aerobic growth conditions in well-controlled...
Madaffari, Antonio; Große, Anett; Raffa, Santi; Frommhold, Markus; Fink, Agnes; Geller, J Christoph
2016-12-01
Catheter ablation of para-Hisian premature ventricular contractions (PVCs) still represents a challenge and is a compromise between success and inadvertent AV block. We describe a possible strategy to address PVCs from this location with high-amplitude His-bundle potentials at the site of earliest activation.
ERIC Educational Resources Information Center
Bornstein, Joan L.
The booklet outlines ways to help children with learning disabilities in specific subject areas. Characteristic behavior and remedial exercises are listed for seven areas of auditory problems: auditory reception, auditory association, auditory discrimination, auditory figure ground, auditory closure and sound blending, auditory memory, and grammar…
ERIC Educational Resources Information Center
Paolantonio, Mario Di
2011-01-01
Recently, a few buildings within the "Espacio para la memoria" in Buenos Aires have been designated as a UNESCO Centre where, amongst other educational activities, evidentiary materials of the past repression are to be stored and displayed. Another building in the complex houses a Community Centre operated by the Mothers of the Plaza de…
Guía del Operador del Molino Preliminar -- 2009
Jan Wiedenbeck; Philip H. Mitchell; Bobby Ammerman; Daniel Saloni
2009-01-01
Los fabricantes de productos de madera requieren de una recuperación eficiente de los productos de la madera para que el negocio se mantenga lucrativo. La habilidad de una compañía para obtener el mayor rendimiento en las operaciones de corte de madera (e.g. Molino preliminar) puede variar de acuerdo a la material prima, productos, equipo de...
Otto, Frank; Gatti, Fabien; Meyer, Hans-Dieter
2008-02-14
We study the process of rotational excitation in the collisions of para-H(2) with para-H(2) by propagating wave packets with the multiconfiguration time-dependent Hartree (MCTDH) algorithm. Transition probabilities are then calculated by the method of Tannor and Weeks based on time-correlation functions. Calculations were carried out up to a total angular momentum of J=70 to compute integral cross sections up to 1.2 eV in collision energy and thermal rate coefficients from 100 to 3000 K. The process is studied on the full-dimensional potential energy surface of Boothroyd-Martin-Keogh-Peterson (BMKP) as well as on the rigid rotor surface of Diep and Johnson. We test the validity of the rigid rotor approximation by also considering two rigid rotor restrictions of the BMKP potential energy surface (PES). Additionally, we investigate a variant of the BMKP PES suggested by Pogrebnya and Clary [Chem. Phys. Lett. 363, 523 (2002)] with reduced anisotropy. We compare our results with previous theoretical data for the cross sections and with experimental data for the rate coefficients at low temperatures.
VizieR Online Data Catalog: Massive star forming molecular clumps Tkin (Tang+, 2017)
NASA Astrophysics Data System (ADS)
Tang, X. D.; Henkel, C.; Menten, K. M.; Zheng, X. W.; Esimbek, J.; Zhou, J. J.; Yeh, C. C.; Konig, C.; Yuan, Y.; He, Y. X.; Li, D. L.
2016-10-01
We have selected 30 massive clumps of the Galactic disk at various stages of high-mass star formation and with strong NH3 emission from the ATLASGAL survey (see Table 1). Our observations were carried out in 2015 April, July, and October with the 15m James Clerk Maxwell Telescope telescope (JCMT) on Mauna Kea. The beam size is ~23" and the main-beam efficiency is {eta}mb=Ta*/Tmb~=0.7 at 218GHz. The para-H2CO JKAKC =303-202, 322-221, and 321-220 transitions have rest frequencies of 218.222, 218.475, and 218.760GHz, respectively, which are measured simultaneously by employing the ACSIS digital autocorrelation spectrometer with the special backend configuration RxAH2CO250x3 allowing for three windows, each with a bandwidth of 250MHz. This provides a velocity resolution of 0.084km/s for para-H2CO (303-202 and 322-221) and 0.042km/s for para-H2CO (321-220); CH3OH (422-312) at 218.440GHz is also observed together with para-H2CO (322-221). (6 data files).
Neuroimagen en la enfermedad de Alzheimer: nuevas perspectivas
Becker, James T.
2012-01-01
Introducción y desarrollo En los próximos 50 años vamos a presenciar un incremento significativo de la población mayor de 65 años y por lo tanto va a aumentar, considerablemente, el número de individuos con riesgo de desarrollar demencias neurodegenerativas, especialmente la enfermedad de Alzheimer (EA). Las estrategias actuales de tratamiento farmacológico y no farmacológico se han centrado en las fases sintomáticas de esta enfermedad y, gradualmente, vamos teniendo una mayor comprensión de los posibles factores de riesgo del síndrome clínico. Conclusiones Los estudios de neuroimagen han sido muy útiles para mostrar los cambios estructurales del envejecimiento normal y patológico, así como también los factores de riesgo para la EA. Los tratamientos apropiados de los factores de riesgo y su posible combinación con tratamientos específicos para la EA podrían prolongar el período presintomático de la EA y, por tanto, mejorar la calidad de vida y disminuir la carga para el paciente, la familia y la sociedad. PMID:20517866
NASA Astrophysics Data System (ADS)
Iwakuni, Kana; Okubo, Sho; Inaba, Hajime; Onae, Atsushi; Hong, Feng-Lei; Sasada, Hiroyuki; Yamada, Koichi MT
2016-06-01
We observe that the pressure-broadening coefficients depend on the ortho-para levels. The spectrum is taken with a dual-comb spectrometer which has the resolution of 48 MHz and the frequency accuracy of 8 digit when the signal-to-noise ratio is more than 20. In this study, about 4.4-Tz wide spectra of the P(31) to R(31) transitions in the νb{1}+νb{3} vibration band of 12C_2H_2 are observed at the pressure of 25, 60, 396, 1047, 1962 and 2654 Pa. Each rotation-vibration absorption line is fitted to Voight function and we determined pressure-broadening coefficients for each rotation-vibration transition. The Figure shows pressure broadening coefficient as a function of m. Here m is J"+1 for R and -J" for P-branch. The graph shows obvious dependence on ortho and para. We fit it to Pade function considering the population ratio of three-to-one for the ortho and para levels. This would lead to detailed understanding of the pressure boarding mechanism. S. Okubo et al., Applied Physics Express 8, 082402 (2015)
Parasympathetic neural control of canine tracheal smooth muscle.
Kobayashi, Ichiro; Kondo, Tetsuri; Hayama, Naoki; Tazaki, Gen
2004-12-01
The middle segment of the trachea is innervated by the recurrent laryngeal and pararecurrent nerves. This study determined the pathway that mediated descending commands to the tracheal smooth muscle. Animals used were seven paralyzed and tracheostomized dogs. Tracheal contraction induced either by apnea, mechanical stimulation of the tracheal bifurcation or hypercapnia was always composed of tonic and rhythmic components. The rhythmic contraction developed in synchrony with rhythmic bursts on phrenic nerve activity (PNA). The respiratory-related bursts were also observed on the recurrent laryngeal nerve activity (RNA) and pararecurrent nerve activity (ParaRNA). During apnea there was no tonic activity neither on RNA or PNA, whereas ParaRNA had both tonic and rhythmic activities. Bursts on RNA preceded to correspondent PNA-bursts by 90+/-13 ms. In contrast, ParaRNA-burst always developed later than PNA-burst and it started at almost the same time as that of tracheal rhythmic contraction. During mechanical stimulation of the trachea or CO2-loading, though RNA did not include tonic component, ParaRNA had tonic activity during tracheal tonic contraction. These findings suggested that rhythmic and tonic contractions of the trachea were mediated through the pararecurrent nerve but not through the recurrent laryngeal nerve.
Operational characteristics of the J-PARC cryogenic hydrogen system for a spallation neutron source
DOE Office of Scientific and Technical Information (OSTI.GOV)
Tatsumoto, Hideki; Ohtsu, Kiichi; Aso, Tomokazu
2014-01-29
The J-PARC cryogenic hydrogen system provides supercritical hydrogen with the para-hydrogen concentration of more than 99 % and the temperature of less than 20 K to three moderators so as to provide cold pulsed neutron beams of a higher neutronic performance. Furthermore, the temperature fluctuation of the feed hydrogen stream is required to be within ± 0.25 K. A stable 300-kW proton beam operation has been carried out since November 2012. The para-hydrogen concentrations were measured during the cool-down process. It is confirmed that para-hydrogen always exists in the equilibrium concentration because of the installation of an ortho-para hydrogen convertor.more » Propagation characteristics of temperature fluctuation were measured by temporarily changing the heater power under off-beam condition to clarify the effects of a heater control for thermal compensation on the feed temperature fluctuation. The experimental data gave an allowable temperature fluctuation of ± 1.05 K. It is clarified through a 286-kW and a 524-kW proton beam operations that the heater control would be applicable for the 1-MW proton beam operation by extrapolating from the experimental data.« less