Hydroxyamidinates et polymères de coordination : suspicions et valences mixtes

Dans un contexte où l’énergie représente un enjeu majeur pour les pays et organisations à économies émergentes et développées, la recherche de nouvelles sources renouvelables et la démocratisation des vecteurs énergétiques permettant l’approvisionnement mondial de façon durable constitue un devoir pour la communauté scientifique internationale. D’ailleurs, il serait essentiel que les nombreuses disciplines de la chimie concertent leurs efforts. Plus particulièrement, la croissance de la recherche en chimie de coordination orientée vers la photosynthèse artificielle ainsi que le développement de matériaux fonctionnels démontre l’importance indéniable de ce champ de recherche. Ce travail présente dans un premier temps l’étude des différentes voies de synthèse d’hydroxyamidines, un ligand chélatant aux propriétés de coordination prometteuses ne recevant que très peu d’attention de la part de la communauté scientifique. Dans un deuxième temps, nous présenterons le développement d’une stratégie d’assemblage de leurs complexes supramoléculaires impliquant des métaux de transition abondants et peu dispendieux de la première rangée. Dans un troisième temps, il sera question de l’investigation de leurs propriétés photophysiques et électrochimiques à des fins d’applications au sein de matériaux fonctionnels. Pour ce faire, les différentes voies de synthèse des hydroxyamidines et de leurs amidines correspondantes qui ont précédemment été étudiées par les membres du groupe seront tout d’abord perfectionnées, puis investiguées afin de déterminer leur versatilité. Ensuite, les propriétés de complexation des amox résultantes comportant des motifs sélectionnés seront déterminées pour enfin étudier les propriétés photophysiques et électrochimiques d’une série de complexes de métaux de transition de la première rangée. En somme, plusieurs designs qu’offrent les amox et bis-amox sont étudiés et les propriétés des architectures résultantes de leur auto-assemblage sont déterminées.

La synthèse philosophico-juridique de V.S. Soloviev : élaboration et mise en œuvre d’un cadre théorique

Vladimir S. Soloviev (1853-1900) était un philosophe russe, poète et dissident de la période prérévolutionnaire. Comme celle de beaucoup de ses contemporains prérévolutionnaires russes, la pensée de Soloviev fut constamment sollicitée par la réfection imminente de l’État russe dans un futur très proche. Dans le contexte de cette époque, un examen des fondements théoriques du système juridique était peut-être inévitable. Néanmoins, dans la pensée russe, c’est seulement avec Soloviev que le droit cessa d’être un sujet spécialisé dans le domaine de l’administration, ne concernant guère les grands enjeux de société, et devint intimement lié au développement même de la philosophie morale et sociale. Au sein du projet philosophique systématique que propose Soloviev, le concept de l’unitotalité est envahissant, en termes épistémologique et social. Une pierre d’assise également fondamentale est le concept philosophico-religieux de la divino-humanité, à travers lequel la source de la dignité humaine est ultimement exprimée. La philosophie juridique de Soloviev, contenue pour l’essentiel dans un traité intitulé La Justification du bien : essai de philosophie morale (1897), a pour principal objet l’interaction entre le droit et la morale. Alors que l’objet et la portée du droit peuvent être directement déduits de principes moraux, le droit ne peut pas coïncider exactement avec la morale, compte tenu de son caractère plus limité, fini et coercitif. Pour Soloviev, le droit doit imposer un niveau minimum du bien en fournissant les conditions de base (par ex. la primauté du droit, le droit à une existence digne, la liberté de conscience) pour le libre développement des facultés humaines sans transposer directement en lui la plénitude complète du bien. La principale motivation de Soloviev réside dans la prémisse théologique sous-jacente que le bien ne peut jamais être complètement subsumé sauf par un acte conscient de liberté personnelle. En tandem, Soloviev souligne le rôle progressiste de l’État pour favoriser le libre perfectionnement humain. En tant que tel, Soloviev nous fournit certaines voies innovatrices dans le façonnement de la relation tant théorique que pratique entre le droit et la religion. À l’encontre d’un compromis entre objets, c’est-à-dire un arrangement de type interculturel situé entre fragmentation culturelle (multiculturalisme idéologique) et assimilation antireligieuse (laïcité militante), l’analyse de Soloviev présente la nécessité d’une conciliation temporelle, dans une perspective historique beaucoup plus large, où la laïcité est considérée non pas comme une finalité ontologique en soi, figée dans le temps, mais comme un moyen au service d’une destinée humaine en cours d’actualisation. Le cadre philosophico-juridique de Soloviev peut être utilement mis en dialogue avec des auteurs contemporains comme Stephen L. Carter, Charles Taylor, John Witte Jr, Ronald Dworkin et Jürgen Habermas. La contribution potentielle de Soloviev sur la place de la religion dans la société russe contemporaine est également mentionnée, avec un accent particulier sur le réexamen critique de l’héritage durable de la notion byzantine de la symphonie entre l’Église et l’État. Enfin, une théorie du fédéralisme inspirée par Soloviev est développée en appliquant, sur une base comparative, des avancées théoriques dans le domaine de l’histoire juridique global à l’évolution constitutionnelle du Canada et d’Israël.

Evaluating demographic models for goat domestication using mtDNA sequences

Routes of migration and exchange are important factors in the debate about how the Neolithic transition spread into Europe. Studying the genetic diversity of livestock can help in tracing back some of these past events. Notably, domestic goat (Capra hircus) did not have any wild progenitors (Capra aegagrus) in Europe before their arrival from the Near East. Studies of mitochondrial DNA have shown that the diversity in European domesticated goats is a subset of that in the wild, underlining the ancestral relationship between both populations. Additionally, an ancient DNA study on Neolithic goat remains has indicated that a high level of genetic diversity was already present early in the Neolithic in northwestern Mediterranean sites. We used coalescent simulations and approximate Bayesian computation, conditioned on patterns of modern and ancient mitochondrial DNA diversity in domesticated and wild goats, to test a series of simplified models of the goat domestication process. Specifically, we ask if domestic goats descend from populations that were distinct prior to domestication. Although the models we present require further analyses, preliminary results indicate that wild and domestic goats are more likely to descend from a single ancestral wild population that was managed 11,500 years before present, and that serial founding events characterise the spread of Capra hircus into Europe.

Administración pública local y construcción de la central hidroeléctrica en la Amazonia

Exponemos los resultados de una observación exploratoria en la que se analizan los impactos funcionales en el sistema administrativo como consecuencia de la construcción de la Central Hidroeléctrica de Belo Monte (CHB) en el municipio de Altamira (Amazonia oriental brasileña). En la perspectiva teórico-conceptual de la teoría de sistemas sociales de Niklas Luhmann, realizamos una observación del sistema administrativo local sobre sus operaciones y funciones, en base a cuatro códigos preestablecidos: toma de decisiones, contingencia, significación simbólica del proyecto y planificación. Las conclusiones permiten entrever en un aplano conceptual la utilidad de los conceptos sistémicos de Luhmann, y en el empírico, una planificación y administración pública municipal reactivas.

Autoeficácia de alunos de Administração: um estudo com concluintes do curso de graduação em Administração no Estado do Pará

The current study presents the characteristics of self-efficacy of students of Administration course, who work and do not work. The study was conducted through a field research, descriptive, addressed quantitatively using statistical procedures. Was studied a population composed of 394 students distributed in three Higher Education Institutions, in the metropolitan region of Belém, in the State of Pará. The sampling was not probabilistic by accessibility, with a sample of 254 subjects. The instrument for data collection was a questionnaire composed of a set of questions divided into three sections: the first related to sociodemographic data, the second section was built to identify the work situation of the respondent and the third section was built with issues related to General Perceived Self-Efficacy Scale proposed by Schwarzer and Jerusalem (1999). Sociodemographic data were processed using methods of descriptive statistics. This procedure allowed characterizing the subjects of the sample. To identify the work situation, the analysis of frequency and percentage was used, which allowed to classify in percentage, the respondents who worked and those that did not work, and the data related to the scale of self-efficacy were processed quantitatively by the method of multivariate statistics using the software of program Statistical Package for Social Sciences for Windows - SPSS, version 17 from the process of Exploratory Factor Analysis. This procedure allowed characterizing the students who worked and the students who did not worked. The results were discussed based on Social Cognitive Theory from the construct of self-efficacy of Albert Bandura (1977). The study results showed a young sample, composed the majority of single women with work experience, and indicated that the characteristics of self-efficacy of students who work and students who do not work are different. The self-efficacy beliefs of students who do not work are based on psychological expectations, whereas the students who work demonstrated that their efficacy beliefs are sustained by previous experiences. A student who does not work proved to be reliant in their abilities to achieve a successful performance in their activities, believing it to be easy to achieve your goals and to face difficult situations at work, simply by invest a necessary effort and trust in their abilities. One who has experience working proved to be reliant in their abilities to conduct courses of action, although know that it is not easy to achieve your goals, and in unexpected situations showed its ability to solve difficult problems

Os forrós da Serra da Gameleira (São Tomé/RN) : etnicidade, festa e sociabilidade

This work intends to describe and analyze the parties of forró that happen in Serra da Gameleira, in São Tomé/RN. Serra is a divided social space: groups of different ethnic origins live together in Gameleira de Baixo, Salgadinho (or Gameleira de Cima) and Chaves Belas. They are approximately two hundred families that live exclusively from agriculture. We try to understand how the parties inform about the social organization, the ethnic composition of the families that live there and the past of Serra, through the genealogy offorró players. In the discussion, we identify the festive places: in the total, we have Five houses of forró that function regularly one of them has been described. The private and public spaces inside them are intimate related, with no clear limits between the house of forró and the residence. Each house of forró has an owner, that regularly makes the parties, mobilizing a big part of the inhabitants, and provoking the straitening of the social relations. Observing the festive sociability between different social segments, the forró appears like na element that minimizes social conflicts, providing news ways of association and cooperation in the space of Serra da Gameleira. For the collection of facts, we used the ethnographic method, through the direct observation, interviewing and documentary research. The local history is recounted following the routes of oral memory and historical documents analysis. In the end of the analysis, we concluded that music and party are elements that aggregate the different groups that live in the location and determine forms of expression of what is seen as a traditional culture

O valor do empreendedorismo na Universidade

O objeto central deste estudo são os significados que os alunos do curso de Administração atribuem aos valores do ensino do Empreendedorismo em sua formação acadêmica, delineado à luz dos pressupostos teórico-metodológicos da psicologia de Vygotsky e alicerçado com a pesquisa efetuada durante o ano de 2015, com um cariz qualitativo. A proposta metodológica da pesquisa contempla a triangulação de procedimentos, a saber: questionários, entrevistas e grupo focal. Participaram do trabalho de entrevista e grupo focal um total de 14 alunos somados aos 109 que integraram o procedimento metodológico em forma de questionário. Todos os alunos participantes cursavam, no momento da pesquisa, o sexto e sétimos períodos do curso de administração. Como ponto de partida dos núcleos de significação deste trabalho, procurou-se verificar as possíveis formas de apreensão do conhecimento acadêmico com vistas à ação empreendedora dos sujeitos pesquisados, buscando estudá-los nas seguintes dimensões: quem são os alunos universitários; como é a sua vida acadêmica; de que maneira os estudantes constroem e significam a importância do conhecimento empreendedor para a construção de seu caminho na busca de seus objetivos e sonhos. O estudo permite defender a seguinte tese central: os significados atribuídos pelos alunos do Curso de Administração à sua formação empreendedora. A apreensão do conhecimento é significada com responsabilidade, compromisso, persistência e confiança em si mesmos. São pessoas que possuem esperança de ter um futuro promissor, de realizar seus objetivos, coroados de fortes sentimentos advindos de suas vivências, compreendendo o Empreendedorismo como forma de desenvolvimento social. A partir dessa tese central, outra se destacou por ter sido considerada a base de todo o processo empreendedor delineado pelos sujeitos pesquisados: a família. Esta instituição central declarou-se ser a base geradora para a sua motivação na construção de seus caminhos, rumo à conquista dos sonhos e anseios desejados. É ponto de destaque e elo firme em suprir uma das características do empreendedor, que é ter um “modelo”, aquele que o inspira, que o influencia para seguir em frente em sua meta. Outra tese que emergiu neste estudo foi o distanciamento da instituição de ensino das empresas, fato uníssono nas falas dos sujeitos pesquisados. A carência da prática no curso de administração foi sentida e evocada como um óbice a ser resolvido.

Abordagens mistas na pesquisa em administração: Uma análise bibliométrica do uso demultimétodos no Brasil

Com o objetivo de contribuir para as discussões acerca do uso conjunto de métodos qualitativos e quantitativos na pesquisa em Administração, este artigo apresenta uma análise bibliométrica dos estudos publicados na Revista de Administração de Empresas da Fundação Getúlio Vargas (RAE), na Revista de Administração Contemporânea (RAC) e na Revista de Administração da Universidade de São Paulo (RAUSP), no período de 2010 a 2014, dimensionando a frequência de uso de abordagens mistas como metodologia de pesquisa e como tal prática está caracterizada em estudos publicados nesse campo no Brasil. Os resultados indicam ser o índice de uso de abordagens mistas ainda pequeno em relação ao uso isolado de métodos qualitativos e quantitativos, denotando uma visão dicotômica envolvendo os paradigmas positivista e interpretativista na prática de pesquisa na disciplina. Conclui-se com a sugestão de novas investigações como, por exemplo, identificar entre os próprios pesquisadores as razões pelas quais utilizam ou não abordagens mistas e as dificuldades implicadas, visando à continuidade do debate sobre os métodos de pesquisa empregados na ciência da Administração.

Sistemas de custeio na gestão hospitalar

The cost management in any organization provides a number of benefits such as security in the good management of resources, but it is little used in the public hospital sector which is shaped like a paradox, facing the complexity of hospital organization and the underfunding situation of Cheers. The purpose of this book was to develop and submit an application method of a costing system in public hospitals. This proposal was developed in partnership with the Secretariat of the State of Paraná Health, with financial support from PPSUS and Araucaria Foundation. The study was conducted as an action research in two public hospitals in Paraná, but it can be replicated in any hospital from the premises of the developed method. For this, We developed the concepts of administration and public governance, the right to health in Brazil, the costs in the public sector and the detailed presentation of the proposed costing system model. The results constitute an important management tool for hospitals and Ministry of Health, enabling greater security leaders in the face of difficulties and challenges in this segment. Thus, it is expected that the book will contribute to governments for better management of public funds allocated to health; with academia, as a still incipient theme in literature; and society, so that more hospitals were professionalize its cost management and thereby provide a more efficient and effective service.

Uma metodologia heurística para minimizar o roteiro nos serviços de leitura de hidrômetros

Este trabalho tem por objetivo propor uma metodologia heurística para o Problema de Cobertura de Arcos aplicado aos serviços de saneamento, em específico na leitura de hidrômetros. Dentro deste contexto desenvolveu-se um aplicativo que permite o planejamento de rotas de maneira que os custos em distância percorrida sejam reduzidos e mantenham-se aproximadamente os mesmos em todos os percursos. A metodologia foi dividida em etapas. Na primeira etapa, para compreender melhor o problema, fez-se uma pesquisa de campo organizando os dados disponibilizados por uma empresa de saneamento. A segunda etapa foi caracterizada pela determinação de pontos em cada metade de trechos de quadra e nas interseções de ruas, os quais foram cadastrados, em um mapa georeferenciado. Este mapa contemplou a região escolhida para o estudo e os pontos cadastrados serviram para determinar e consequentemente, designar as medianas relacionadas, o que constitui a terceira etapa. Para isso utilizou-se respectivamente o algoritmo de Teitz Bart Modificado por CADP e o algoritmo de designação de Gillet e Johnson adaptado. Ao final desta etapa formaram-se subsetores dentro de um setor específico. Na última etapa encontrou-se as rotas de cada subsetor através do algoritmo genético. O aplicativo desenvolvido permitiu flexibilidade de ações, dando autonomia para o usuário na escolha das opções de cálculo. Sua interface gráfica possibilitou a elaboração de mapas e a visualização das rotas em cada subsetor. Além disso o aplicativo minimizou os percursos e distribuiu os subsetores com distâncias aproximadas. A eficiência das heurísticas que embasaram o aplicativo desenvolvido, foi comprovada através dos testes realizados, os quais obtiveram resultados de boa qualidade.

New clinical practice guideline on enteral feeding in very low birth weight infants: first part

Introduction: The nutrition of very low birth weight (VLBW) infants is aimed at promoting a similar growth to that occurring in the uterus. However, in practice this is difficult to achieve and extrauterine growth restriction is frequent. The current tendency is to avoid this restriction by means of early parenteral and enteral nutrition. Nonetheless, uncertainty about many of the practices related with nutrition has resulted in a great variation in the way it is undertaken. In 2009 and 2011 in our hospital there was an unexpected increase in necrotizing enterocolitis. To check to see whether our nutrition policy was involved, we undertook a systematic review and drew up clinical practice guidelines (CPG) about enteral feeding in VLBW infants. New considerations about the duration of the fortification and the use of probiotics have led to an update of these CPG. Methods: A total of 21 clinical questions were designed dealing with the type of milk, starting age, mode of administration, rate and volume of the increments, fortification, use of probiotics and protocol. After conducting a systematic search of the available evidence, the information was contrasted and summarized in order to draw up the recommendations. The quality of the evidence and the strength of the recommendations were determined from the SIGN scale Comment: These CPG aim to help physicians in their decision making. The protocolized application of well-proven measurements reduces the variation in clinical practice and improves results.

New clinical practice guideline on enteral feeding in very low birth weight infants: second part

Introduction: The nutrition of very low birth weight (VLBW) infants is aimed at promoting a similar growth to that occurring in the uterus. However, in practice this is difficult to achieve and extrauterine growth restriction is frequent. The current tendency is to avoid this restriction by means of early parenteral and enteral nutrition. Nonetheless, uncertainty about many of the practices related with nutrition has resulted in a great variation in the way it is undertaken. In 2009 and 2011 in our hospital there was an unexpected increase in necrotizing enterocolitis. To check to see wether our nutrition policy was involved, we underlook a systematic review and drewup clinical practice guidelines (CPG) about enteral feeding in VLBW infants. New considerations about the duration of the fortification and the use of probiotics have led to an update of these CPG. Methods: A total of 21 clinical questions were designed dealing with the type of milk, starting age, mode of administration, rate and volume of the increments, fortification, use of probiotics and protocol. Afete conducting a systematic search of the available evidence, the information was contrasted and summarized in order to draw up the recommendations. The quality of the evidence and the strength of the recommendations were determined from the SIGN scale. Comment: These CPG aim to help physicians in their decision making. The protocolized application of well-proven measurements reduces the variation in clinical practice and improves results.

Salted-Fish industry in Roman Lusitania: Trade Memories between Oceanus and Mare Nostrum

Initiated by Augustus, Rome’s Atlantic policy seems to have been consolidated in the age of Claudius, with the acknowledgement of the economic potential offered by the Atlantic region. It is in this context that we must understand the development of the salted-fish industry in Lusitania. In the same geographical contexts, and in close relationship with fish-processing factories, are known about 20 pottery centres producing amphorae, located in the regions of Peniche, Sado and Tejo valleys, and the coasts of Alentejo and Algarve. This production extended in time beyond the end of the Western Roman Empire and up to the end of the 5th and 6th centuries, according to the archaeological data of some amphora kilns and fish-processing sites. The identification of Lusitanian amphorae in distant consuming centres and several shipwrecks in the Mediterranean basin confirm the long-distance commerce and the total integration of this “peripheral” region into the trade routes of the Roman Empire.

Avaliação da suplementação materna com megadose de vitamina A sobre os níveis de retinol e alfa-tocoferol no colostro

The vitamins A and E are recognizably important in the initial stages of life and the newborn depends on nutritional adequacy of breast milk to meet their needs. These vitamins share routes of transport to the tissues and antagonistic effects have been observed in animals after supplementation with vitamin A. This study aimed to verify the effect of maternal supplementation with vitamin A megadose (200,000 UI) in the immediate post-partum on the concentration of alpha-tocopherol in colostrum. Healthy parturient women attended at a public maternity natalensis were recruited for the study and divided into two groups: control (n = 37) and supplemented (n = 36). Blood samples of colostrum and milk were collected until 12 hours after delivery. The women of the supplemented group was administered a retynil palmitate capsule and 24 hours after the first collection was obtained the 2nd sample of colostrum in two groups for analysis of retinol and alpha-tocopherol in milk. The mean retinol concentration of 50,7 ± 14,4 μg/dL (Mean ± standard deviation) and alpha-tocopherol of 1217.4 ± 959 mg/dL in the serum indicate the nutritional status biochemical appropriate. Supplementation with retynil palmitate resulted in increase not only retinol levels in the colostrum of the supplemented group (p = 0.002), but also the concentration of alpha-tocopherol (p = 0.04), changing from 1456.6 ± 1095.8 mg/dL to 1804.3 ± 1432.0 mg/dL (milk 0 and 24 respectively) compared to values in the control group, 984.6 ± 750.0 mg/dL and 1175.0 ± 730.8 mg/dL. The women had different responses to supplementation, influenced by baseline levels of retinol in colostrum. Those with previous by low levels of retinol in colostrum (<60 mg/dL) had increased the concentration of alpha-tocopherol in milk, whereas those with adequate levels (> 60 mg/dL), showed a reduction after supplementation. Supplementation with retinol palmitate is an important intervention in situations of high risk for vitamin A deficiency, when considering the need to maternal supplementation, since the excess vitamin can offer unfavorable interactions between nutrients essential for the mother-child group

Effet préventif de la milrinone inhalée chez les patients avec hypertension pulmonaire subissant une chirurgie cardiaque sous circulation extracorporelle : une approche pharmacométrique

La circulation extracorporelle (CEC) est une technique utilisée en chirurgie cardiaque effectuée des milliers de fois chaque jour à travers le monde. L’instabilité hémodynamique associée au sevrage de la CEC difficile constitue la principale cause de mortalité en chirurgie cardiaque et l’hypertension pulmonaire (HP) a été identifiée comme un des facteurs de risque les plus importants. Récemment, une hypothèse a été émise suggérant que l'administration prophylactique (avant la CEC) de la milrinone par inhalation puisse avoir un effet préventif et faciliter le sevrage de la CEC chez les patients atteints d’HP. Toutefois, cette indication et voie d'administration pour la milrinone n'ont pas encore été approuvées par les organismes réglementaires. Jusqu'à présent, la recherche clinique sur la milrinone inhalée s’est principalement concentrée sur l’efficacité hémodynamique et l'innocuité chez les patients cardiaques, bien qu’aucun biomarqueur n’ait encore été établi. La dose la plus appropriée pour l’administration par nébulisation n'a pas été déterminée, de même que la caractérisation des profils pharmacocinétiques (PK) et pharmacodynamiques (PD) suite à l'inhalation. L'objectif de notre recherche consistait à caractériser la relation exposition-réponse de la milrinone inhalée administrée chez les patients subissant une chirurgie cardiaque sous CEC. Une méthode analytique par chromatographie liquide à haute performance couplée à un détecteur ultraviolet (HPLC-UV) a été optimisée et validée pour le dosage de la milrinone plasmatique suite à l’inhalation et s’est avérée sensible et précise. La limite de quantification (LLOQ) était de 1.25 ng/ml avec des valeurs de précision intra- et inter-dosage moyennes (CV%) <8%. Des patients souffrant d’HP pour lesquels une chirurgie cardiaque sous CEC était prévue ont d’abord été recrutés pour une étude pilote (n=12) et, par la suite, pour une étude à plus grande échelle (n=28) où la milrinone (5 mg) était administrée par inhalation pré-CEC. Dans l'étude pilote, nous avons comparé l'exposition systémique de la milrinone peu après son administration avec un nébuliseur pneumatique ou un nébuliseur à tamis vibrant. L’efficacité des nébuliseurs en termes de dose émise et dose inhalée a également été déterminée in vitro. Dans l'étude à plus grande échelle conduite en utilisant exclusivement le nébuliseur à tamis vibrant, la dose inhalée in vivo a été estimée et le profil pharmacocinétique de la milrinone inhalée a été pleinement caractérisé aux niveaux plasmatique et urinaire. Le ratio de la pression artérielle moyenne sur la pression artérielle pulmonaire moyenne (PAm/PAPm) a été choisi comme biomarqueur PD. La relation exposition-réponse de la milrinone a été caractérisée pendant la période d'inhalation en étudiant la relation entre l'aire sous la courbe de l’effet (ASCE) et l’aire sous la courbe des concentrations plasmatiques (ASC) de chacun des patients. Enfin, le ratio PAm/PAPm a été exploré comme un prédicteur potentiel de sortie de CEC difficile dans un modèle de régression logistique. Les expériences in vitro ont démontré que les doses émises étaient similaires pour les nébuliseurs pneumatique (64%) et à tamis vibrant (68%). Cependant, la dose inhalée était 2-3 fois supérieure (46% vs 17%) avec le nébuliseur à tamis vibrant, et ce, en accord avec les concentrations plasmatiques. Chez les patients, en raison des variations au niveau des facteurs liés au circuit et au ventilateur causant une plus grande dose expirée, la dose inhalée a été estimée inférieure (30%) et cela a été confirmé après récupération de la dose de milrinone dans l'urine 24 h (26%). Les concentrations plasmatiques maximales (Cmax: 41-189 ng/ml) et l'ampleur de la réponse maximale ΔRmax-R0 (0-65%) ont été observées à la fin de l'inhalation (10-30 min). Les données obtenues suite aux analyses PK sont en accord avec les données publiées pour la milrinone intraveineuse. Après la période d'inhalation, les ASCE individuelles étaient directement reliées aux ASC (P=0.045). Enfin, notre biomarqueur PD ainsi que la durée de CEC ont été identifiés comme des prédicteurs significatifs de la sortie de CEC difficile. La comparaison des ASC et ASCE correspondantes a fourni des données préliminaires supportant une preuve de concept pour l'utilisation du ratio PAm/PAPm comme biomarqueur PD prometteur et justifie de futures études PK/PD. Nous avons pu démontrer que la variation du ratio PAm/PAPm en réponse à la milrinone inhalée contribue à la prévention de la sortie de CEC difficile.