Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.

The promoter of filamentation (POF1) protein from Saccharomyces cerevisiae is an ATPase involved in the protein quality control process

Background: The gene YCL047C, which has been renamed promoter of filamentation gene (POF1), has recently been described as a cell component involved in yeast filamentous growth. The objective of this work is to understand the molecular and biological function of this gene. Results: Here, we report that the protein encoded by the POF1 gene, Pof1p, is an ATPase that may be part of the Saccharomyces cerevisiae protein quality control pathway. According to the results, Δpof1 cells showed increased sensitivity to hydrogen peroxide, tert-butyl hydroperoxide, heat shock and protein unfolding agents, such as dithiothreitol and tunicamycin. Besides, the overexpression of POF1 suppressed the sensitivity of Δpct1, a strain that lacks a gene that encodes a phosphocholine cytidylyltransferase, to heat shock. In vitro analysis showed, however, that the purified Pof1p enzyme had no cytidylyltransferase activity but does have ATPase activity, with catalytic efficiency comparable to other ATPases involved in endoplasmic reticulum-associated degradation of proteins (ERAD). Supporting these findings, co-immunoprecipitation experiments showed a physical interaction between Pof1p and Ubc7p (an ubiquitin conjugating enzyme) in vivo. Conclusions: Taken together, the results strongly suggest that the biological function of Pof1p is related to the regulation of protein degradation.

Deficiency symptoms and uptake of micronutrients by castor bean grown in nutrient solution

Castor bean is a nutrient-demanding species, but there is still little information on its micronutrient requirements. The objectives of this study were to evaluate the effects of levels of B (2.5, 12.5 and 25.0 µmol L-1), Cu (0.05, 0.25 and 0.50 µmol L-1), Mn (0.2, 1.0 and 2.0 µmol L-1) and Zn (0.2, 1.0 and 2.0 µmol L-1) in a nutrient solution on plant B, Cu, Mn and Zn concentrations and uptake, vegetative growth and fruit yield of castor bean "Iris", grown in greenhouse. The experiment was arranged in a completely randomized block design with three replicates. The first deficiency symptoms were observed for B, followed by Zn, Cu and Mn. The main changes in the cell ultrastructure due to lack of B were thickening of the cell walls and middle lamellae, distorted chloroplasts and tightly stacked thylakoids, besides the absence of starch grains. The Mn, Zn and Cu deficiencies led to disruption of chloroplasts, disintegration of thylakoids and absence of amyloplasts. The concentration and uptake of B, Cu, Mn, and Zn in castor bean plants increased with micronutrient supply in the solution. Fruit yield was drastically reduced by B and Mn deficiencies. On the other hand, the dry matter yield of the shoot and root of castor bean plants was not. In the treatment with full nutrient solution, the leaves accumulated 56 and 48 % of the total B and Mn taken up by the plants, respectively, and the seeds and roots 85 and 61 % of the total Cu and Zn taken up, respectively. This shows the high demand of castor bean Iris for B and Mn for fruit yield.

O ensino libertário e a relação entre trabalho e educação: algumas reflexões

Um dos principais desafios nos estudos a respeito da pedagogia escolar anarquista consiste, precisamente, em apreender os conteúdos de ensino. Com essa preocupação, este texto tem triplo objetivo: analisar a proposta educativa da instituição a cargo do professor libertário João Penteado, em São Paulo, nas primeiras décadas do século XX; indicar aspectos considerados relevantes relacionados à concepção de educação integral e à forma como o trabalho está presente na organização do ensino; e, por fim, apresentar alguns apontamentos de pesquisa que possam contribuir para sua continuidade e seu aprofundamento. Optou-se por abarcar período relativo a dois momentos de existência da escola dirigida por João Penteado - a Escola Moderna Nº 1 (1912-1919) e a Escola Nova (1920-1923). Entende-se que a cronologia definida consegue abranger a pluralidade de práticas escolares necessárias aos propósitos da análise. A documentação utilizada limita-se basicamente a jornais e demais fontes produzidas e/ou acumuladas nos diferentes períodos de existência da(s) escola(s), em particular, os jornais Boletim da Escola Moderna, Boletim da Escola Nova, Boletim da Academia Saldanha Marinho, O Início, O Iris. No estudo do primeiro período, que coincide com o da Escola Moderna, são também utilizadas notícias publicadas por alguns jornais da imprensa operária e anarquista, como A Lanterna, A Vida e O Amigo do Povo, entre outros.

A identificação da ansiedade por meio da análise da íris: uma possibilidade

A ansiedade é um comportamento relacionado com doenças psicossomáticas. Por meio da avaliação da íris é possível determinar características de personalidade e intervir precocemente para evitar que algum comportamento mal adaptativo colabore para o desenvolvimento de uma doença. Os anéis de tensão sugerem predisposição para ansiedade. O objetivo deste trabalho foi verificar a correlação dos anéis de tensão presentes na íris com o Inventário de Diagnóstico da Ansiedade Traço-Estado (IDATE). Após aprovação pelo Comitê de Ética e Pesquisa, o estudo foi realizado com 62 funcionários do Centro de Aperfeiçoamento em Ciências da Saúde da Fundação Zerbini entre maio e julho de 2010. O coeficiente de correlação de Spearman mostrou correlação positiva e significativa entre o escore do IDATE e a quantidade dos anéis de tensão, sugerindo que a presença destes sinais indicam maior predisposição para ansiedade. Com a identificação precoce deste comportamento temos chances de diminuir o desenvolvimento de doenças.

Digital library of historical cartography: open access to cultural heritage and public good

This paper describes the integration of information between Digital Library of Historical Cartography and Bibliographical Database (DEDALUS), both of the University of São Paulo (USP), to guarantee open, public access by Internet to the maps in the collection and make them available to users everywhere. This digital library was designed by Historical Cartography Studies Laboratory team (LECH/USP), and provides maps images on the Web, of high resolution, as well as such information on these maps as technical-scientific data (projection, scale, coordinates), printing techniques and material support that have made their circulation and cultural consumption possible. The Digital Library of Historical Cartography is accessible not only to the historical cartography researchers, but also to students and the general public. Beyond being a source of information about maps, the Digital Library of Historical Cartography seeks to be interactive, exchanging information and seeking dialogue with different branches of knowledge

Novo espaço para a cartografia histórica

A Biblioteca Digital de Cartografia Histórica da Universidade de São Paulo disponibiliza uma série de versões em alta resolução de mapas impressos entre os séculos XV e XIX, acompanhados de referências biográficas, cartobibliográficas, editoriais e históricas. Concebida para rastrear dados de outros sites similares, ela se constitui também em uma útil ferramenta de pesquisa