263 resultados para REPLACEMENTS
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Terapia supressiva antirretroviral reduz significativamente morbidades e mortalidade relacionadas ao HIV, mas a emergência de vírus resistentes pode limitar o sucesso do tratamento. Objetivou-se neste estudo descrever, em portadores de HIV/sida experimentando falha à terapia antirretroviral (TARV), no estado do Pará, a prevalência de mutações nas enzimas transcriptase reversa e protease do HIV-1 e correlacioná-las à resistência aos antirretrovirais (ARV). Foi um estudo descritivo, retrospectivo, do tipo transversal, com dados obtidos na Unidade de Referência Especializada em Doenças Infecciosas e Parasitárias Especiais de Belém do Pará, de pacientes com perfil laboratorial de falha terapêutica. A presente amostra incluiu genotipagem de cinquenta pacientes no período de janeiro de 2004 a dezembro de 2005. Os critérios de inclusão foram: adesão à terapia imediata a genotipagem, falha terapêutica, perfil de resistência viral à TARV e ser paciente da rede pública de saúde. Foram descritos aspectos demográficos da população estudada, perfil de uso de TARV previamente a genotipagem, tempo conhecido de infecção pelo HIV, perfil quantitativo de células CD4+ e de carga viral, além do teste de genotipagem realizado. A resistência encontrada predominou em pacientes residentes em Belém (72%), no sexo masculino (90%) e na faixa etária de 30 a 49 anos de idade. As maiores prevalências de mutações na transcriptase reversa do HIV-1 foram: 214F (86%), 184V (76%), 215FY (56%), 211K (48%), 219QEN, 67N e 103N (42%) cada, 41L (32%), 70R (28%) e 210W (20%). Na protease 46IL (38%), 90M (32%) e 82AFT (20%) foram as mais prevalentes dentre as mutações principais e, dentre as secundárias, 63P (74%), 93LM (52%), 10FIV (48%) e 35D (46%). Atribuiu-se estas mutações a pressão seletiva dos ARV mais utilizados: 3TC, AZT, D4T, DDI, EFZ, IDV, NFV, RTV e SQV. O uso de múltiplos esquemas ARV, favoreceu a prevalência das mutações encontradas. Houve impacto dentro das classes com 32% de resistência completa a uma classe, 22% a duas classes e 4% a três classes. Conclui-se que pacientes expostos a única TARV previamente à genotipagem comparados aos expostos a mais de uma TARV, apresentaram menor prevalência de resistência aos ARV, com possibilidade de resgate terapêutico com ARV ativos disponíveis na época que, entretanto foi a minoria.
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Através de pesquisa empírica junto ao conceito chave Organização e a categoria Sistema de Aviamento, somados a outros conceitos que perpassaram as suas analises neste estudo (poder reciprocidade, jogos), esta dissertação analisa a substituição do contexto extrativista da borracha pelo da extração e beneficiamento de madeira na área de um antigo seringal localizado na Ilha do Mututi, Município de Breves/PA. Com o intuito de experimentar e comprovar a abrangência dos resultados encontrados na Ilha, assim como, para garantir o distanciamento necessário à pesquisa social, a analise foi estendida a outras localidades às quais apresentavam semelhanças históricas em suas formações sociais e econômicas. Neste sentido, buscou-se aferir no âmbito das relações comerciais entre patrões e fregueses, substituições, permanências ou transformações, nesta segunda, da forma de organização anterior. Assim como, os fatores que contribuiram para o surgimento e manutenção desses eventos e as atuais consequências sociais e econômicas resultantes deste novo ou reelaborado modelo de organização na vida dos seus membros.
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Práticas discursivas sobre o homoerotismo e docência são objetos de desejo nesta Tese produzida a partir do trabalho com narrativas docentes. Ao adotar-se uma investida em jogos discursivos subversivos que desmargeiam os centros e povoam as periferias na produção epistemológica, adveio perscrutar sobre docência e diferença e procurar em narrativas a produção da performatividade homoerótica na experiência do ensino superior. No encalce deste intento, rastros levaram ao pós-estruturalismo como teorização da diferença na busca de composições em devires e conduziram à produção de uma escritura que ocorre em uma conjunção epistemológica que considera a sua fragmentação, inconstância, deslizamentos e interpelamentos arquitetados enquanto tirocínios discursivos, orientados, e por vezes desorientados, por entendimentos deleuzianos e foucaultianos. Nas linhas de fuga dessas orientações se investe em uma experiência de escritura cartográfica multiplicadora de acontecimentos em jogos intensos de processualidades e experimentações para produzir uma poética da escrita com invenções, contos, poesias, devaneios e divagações. Atravessa o estudo a compreensão da experiência homoerótica na docência enquanto lugar da abjeção virtualizado e atualizado num continuum de problematizações e recolocações, achados e criações. A experiência homoerótica na docência opera, portanto, como um espaço móvel, provocativo, perturbador, instável e fronteiriço, atravessado por práticas discursivas que lhe imprimem governamento, performatividade e desproblematização, porém, lugar de onde emerge a possibilidade de dissensos. Por isso, quando o contrassenso da significação se instala no sítio da experiência docente, as performances são deslocadas e passam a operar de forma produtiva forjando sujeitos fronteiras, entre/através, na travessia de dois lugares simbólicos – o homoerotismo e a docência.
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Neste trabalho, é apresentado um estudo original e detalhado enfocando os aspectos petrográficos dos evaporitos de depósitos aptianos superiores expostos no sul e leste da Bacia de São Luís-Grajaú. O objetivo é o estabelecimento de critérios que permitam distinguir entre evaporitos primários e secundários, além da reconstrução de sua evolução pós-deposicional. Sete fases de evaporitos foram reconhecidas: 1. gipsita em chevron; 2. gipsita ou anidrita nodular a lenticular; 3. gipsita fibrosa a acicular; 4. gipsita em mosaico; 5. gipsita brechada a gipsarenito; 6. anidrita ou gipsita pseudo-nodular; e 7. gipsita em rosetas. As três primeiras fases apresentam características petrográficas condizentes com origem primária. Agipsita fibrosa a acicular e a gipsita em mosaico foramformadas por substituições de gipsita primária, com origem provável nos estágios iniciais da diagenêse, portanto ainda sob influência do ambiente deposicional. Estas morfologias de gipsita estão relacionadas com a fácies de evaporito laminado, tendo sido formadas por substituição, porém sem afetar a estruturação primária. A gipsita ou anidrita pseudo-nodular originou-se pela mobilização de soluções sulfatadas durante ou após soterramento, provavelmente associada à halocinese. A gipsita em rosetas, que intercepta todas as outras variedades de gipsita, representa o ultimo estágio de formação de evaporitos na área de estudo, tendo resultado de soluções intraestratais ou de águas superficiais durante intemperismo.
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Pós-graduação em Aquicultura - FCAV
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Pós-graduação em Engenharia Mecânica - FEG
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The possibilities of treatment with dental implants have revolutionized the field of oral rehabilitation in recent years, bringing a number of advantages over conventional prostheses. For years, a surgical protocol was followed that called for maintaining the implant without load for a certain period for osseointegration, but experimental studies have shown that immediate loading of implants also leads to the formation of peri-implant bone tissue along the time, similarly to that observed for conventionally loaded implants. This study aimed to conduct a literature review regarding the use of this alternative rehabilitation with single implants. The immediate loading of single-tooth replacements is presented as an excellent treatment alternative.
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Thermogravimetric analysis is one of the most common instrumental techniques used for the characterization of pastes, mortars and concretes based on both calcium hydroxide and Portland cement. Important information about pozzolanic materials can be assessed concerning calcium hydroxide consumption and the formation of new hydrated products. Nevertheless, in some cases, problems associated with the overlapped decomposition processes for hydrates make the analysis of obtained data difficult. In this paper, the use of high-resolution thermogravimetric analysis, a powerful technique that allows separating decomposition processes in analysis of hydrated binders, was performed for spent FCC catalyst-Portland cement pastes. These pastes were monitored for 1, 4, 8 h and 1, 2, 3, 7 and 28 curing days. In order to study the influence of the pozzolanic material (spent FCC catalyst), Portland cement replacements of 5, 15 and 30 % by mass were carried out. The presence of spent FCC catalyst in blended pastes modified the amount and the nature of the formed hydrates, mainly ettringite and stratlingite.
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Pós-graduação em Agronomia (Irrigação e Drenagem) - FCA
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We studied relations between river size, fish species diversity, and fish species composition along four major rivers in the Great Plains of southwestern South Dakota to assess patterns of species diversity and composition. We expected diversity to increase with river size and fish composition to change via species addition downstream. Previous surveys of 52 sampling stations provided fish assemblage data, and we used the Geographic Information System (GIS) to determine watershed area by station. Watershed area did not predict species richness or species diversity (Fisher's a), so species richness of 12 ± 3.5 SD species and Fisher's a of 2.3 ± 0.87 SD characterized species diversity in the study area. Cluster analysis of faunal similarity (Sorensen's Index) among the 52 sampling stations identified two geographically distinct faunal divisions, so species composition was variable within the study area, but changed via species replacements among faunas rather than species additions downstream. Nonnative species were a minor component of all faunas. Uniform species diversity may be a recent phenomenon caused by impacts of Missouri River dams on native large-river fishes and the unsuitability of rivers in the Great Plains for nonnative species. Variation in faunal composition may also be recent because it was affected by dams.
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This study compared the dimensions of gingival papillae in anterosuperior areas presenting at natural teeth (teeth sites) or single-tooth implants adjacent to natural teeth (implant-tooth sites) by analyzing determined distances. A total of 45 teeth and 46 implant-tooth sites were carefully selected. Clinical evaluation consisted of visual and quantitative analyses with millimeter grids on radiographs. Implant-tooth sites showed a smaller gingival papilla dimension than tooth sites (P < .01). Both evaluated distances (contact point to bone crest and between the roots of adjacent teeth or implant platform to root of adjacent tooth) in all groups significantly influenced the presence/absence of gingival papillae (P < .01). (Int J Periodontics Restorative Dent 2012;32:93-100.)
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Objectives: Because the mechanical behavior of the implant-abutment system is critical for the longevity of implant-supported reconstructions, this study evaluated the fatigue reliability of different implant-abutment systems used as single-unit crowns and their failure modes. Methods and Materials: Sixty-three Ti-6Al-4V implants were divided in 3 groups: Replace Select (RS); IC-IMP Osseotite; and Unitite were restored with their respective abutments. Anatomically correct central incisor metal crowns were cemented and subjected to separate single load to failure tests and step-stress accelerated life testing (n = 18). A master Weibull curve and reliability for a mission of 50,000 cycles at 200 N were calculated. Polarized-light and scanning electron microscopes were used for failure analyses. Results: The load at failure mean values during step-stress accelerated life testing were 348.14 N for RS, 324.07 N for Osseotite, and 321.29 N for the Unitite systems. No differences in reliability levels were detected between systems, and only the RS system mechanical failures were shown to be accelerated by damage accumulation. Failure modes differed between systems. Conclusions: The 3 evaluated systems did not present significantly different reliability; however, failure modes were different. (Implant Dent 2012;21:67-71)
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Primary stability of stems in cementless total hip replacements is recognized to play a critical role for long-term survival and thus for the success of the overall surgical procedure. In Literature, several studies addressed this important issue. Different approaches have been explored aiming to evaluate the extent of stability achieved during surgery. Some of these are in-vitro protocols while other tools are coinceived for the post-operative assessment of prosthesis migration relative to the host bone. In vitro protocols reported in the literature are not exportable to the operating room. Anyway most of them show a good overall accuracy. The RSA, EBRA and the radiographic analysis are currently used to check the healing process of the implanted femur at different follow-ups, evaluating implant migration, occurance of bone resorption or osteolysis at the interface. These methods are important for follow up and clinical study but do not assist the surgeon during implantation. At the time I started my Ph.D Study in Bioengineering, only one study had been undertaken to measure stability intra-operatively. No follow-up was presented to describe further results obtained with that device. In this scenario, it was believed that an instrument that could measure intra-operatively the stability achieved by an implanted stem would consistently improve the rate of success. This instrument should be accurate and should give to the surgeon during implantation a quick answer concerning the stability of the implanted stem. With this aim, an intra-operative device was designed, developed and validated. The device is meant to help the surgeon to decide how much to press-fit the implant. It is essentially made of a torsional load cell, able to measure the extent of torque applied by the surgeon to test primary stability, an angular sensor that measure the relative angular displacement between stem and femur, a rigid connector that enable connecting the device to the stem, and all the electronics for signals conditioning. The device was successfully validated in-vitro, showing a good overall accuracy in discriminating stable from unstable implants. Repeatability tests showed that the device was reliable. A calibration procedure was then performed in order to convert the angular readout into a linear displacement measurement, which is an information clinically relevant and simple to read in real-time by the surgeon. The second study reported in my thesis, concerns the evaluation of the possibility to have predictive information regarding the primary stability of a cementless stem, by measuring the micromotion of the last rasp used by the surgeon to prepare the femoral canal. This information would be really useful to the surgeon, who could check prior to the implantation process if the planned stem size can achieve a sufficient degree of primary stability, under optimal press fitting conditions. An intra-operative tool was developed to this aim. It was derived from a previously validated device, which was adapted for the specific purpose. The device is able to measure the relative micromotion between the femur and the rasp, when a torsional load is applied. An in-vitro protocol was developed and validated on both composite and cadaveric specimens. High correlation was observed between one of the parameters extracted form the acquisitions made on the rasp and the stability of the corresponding stem, when optimally press-fitted by the surgeon. After tuning in-vitro the protocol as in a closed loop, verification was made on two hip patients, confirming the results obtained in-vitro and highlighting the independence of the rasp indicator from the bone quality, anatomy and preserving conditions of the tested specimens, and from the sharpening of the rasp blades. The third study is related to an approach that have been recently explored in the orthopaedic community, but that was already in use in other scientific fields. It is based on the vibration analysis technique. This method has been successfully used to investigate the mechanical properties of the bone and its application to evaluate the extent of fixation of dental implants has been explored, even if its validity in this field is still under discussion. Several studies have been published recently on the stability assessment of hip implants by vibration analysis. The aim of the reported study was to develop and validate a prototype device based on the vibration analysis technique to measure intra-operatively the extent of implant stability. The expected advantages of a vibration-based device are easier clinical use, smaller dimensions and minor overall cost with respect to other devices based on direct micromotion measurement. The prototype developed consists of a piezoelectric exciter connected to the stem and an accelerometer attached to the femur. Preliminary tests were performed on four composite femurs implanted with a conventional stem. The results showed that the input signal was repeatable and the output could be recorded accurately. The fourth study concerns the application of the device based on the vibration analysis technique to several cases, considering both composite and cadaveric specimens. Different degrees of bone quality were tested, as well as different femur anatomies and several levels of press-fitting were considered. The aim of the study was to verify if it is possible to discriminate between stable and quasi-stable implants, because this is the most challenging detection for the surgeon in the operation room. Moreover, it was possible to validate the measurement protocol by comparing the results of the acquisitions made with the vibration-based tool to two reference measurements made by means of a validated technique, and a validated device. The results highlighted that the most sensitive parameter to stability is the shift in resonance frequency of the stem-bone system, showing high correlation with residual micromotion on all the tested specimens. Thus, it seems possible to discriminate between many levels of stability, from the grossly loosened implant, through the quasi-stable implants, to the definitely stable one. Finally, an additional study was performed on a different type of hip prosthesis, which has recently gained great interest thus becoming fairly popular in some countries in the last few years: the hip resurfacing prosthesis. The study was motivated by the following rationale: although bone-prosthesis micromotion is known to influence the stability of total hip replacement, its effect on the outcome of resurfacing implants has not been investigated in-vitro yet, but only clinically. Thus the work was aimed at verifying if it was possible to apply to the resurfacing prosthesis one of the intraoperative devices just validated for the measurement of the micromotion in the resurfacing implants. To do that, a preliminary study was performed in order to evaluate the extent of migration and the typical elastic movement for an epiphyseal prosthesis. An in-vitro procedure was developed to measure micromotions of resurfacing implants. This included a set of in-vitro loading scenarios that covers the range of directions covered by hip resultant forces in the most typical motor-tasks. The applicability of the protocol was assessed on two different commercial designs and on different head sizes. The repeatability and reproducibility were excellent (comparable to the best previously published protocols for standard cemented hip stems). Results showed that the procedure is accurate enough to detect micromotions of the order of few microns. The protocol proposed was thus completely validated. The results of the study demonstrated that the application of an intra-operative device to the resurfacing implants is not necessary, as the typical micromovement associated to this type of prosthesis could be considered negligible and thus not critical for the stabilization process. Concluding, four intra-operative tools have been developed and fully validated during these three years of research activity. The use in the clinical setting was tested for one of the devices, which could be used right now by the surgeon to evaluate the degree of stability achieved through the press-fitting procedure. The tool adapted to be used on the rasp was a good predictor of the stability of the stem. Thus it could be useful for the surgeon while checking if the pre-operative planning was correct. The device based on the vibration technique showed great accuracy, small dimensions, and thus has a great potential to become an instrument appreciated by the surgeon. It still need a clinical evaluation, and must be industrialized as well. The in-vitro tool worked very well, and can be applied for assessing resurfacing implants pre-clinically.
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Asset Management (AM) is a set of procedures operable at the strategic-tacticaloperational level, for the management of the physical asset’s performance, associated risks and costs within its whole life-cycle. AM combines the engineering, managerial and informatics points of view. In addition to internal drivers, AM is driven by the demands of customers (social pull) and regulators (environmental mandates and economic considerations). AM can follow either a top-down or a bottom-up approach. Considering rehabilitation planning at the bottom-up level, the main issue would be to rehabilitate the right pipe at the right time with the right technique. Finding the right pipe may be possible and practicable, but determining the timeliness of the rehabilitation and the choice of the techniques adopted to rehabilitate is a bit abstruse. It is a truism that rehabilitating an asset too early is unwise, just as doing it late may have entailed extra expenses en route, in addition to the cost of the exercise of rehabilitation per se. One is confronted with a typical ‘Hamlet-isque dilemma’ – ‘to repair or not to repair’; or put in another way, ‘to replace or not to replace’. The decision in this case is governed by three factors, not necessarily interrelated – quality of customer service, costs and budget in the life cycle of the asset in question. The goal of replacement planning is to find the juncture in the asset’s life cycle where the cost of replacement is balanced by the rising maintenance costs and the declining level of service. System maintenance aims at improving performance and maintaining the asset in good working condition for as long as possible. Effective planning is used to target maintenance activities to meet these goals and minimize costly exigencies. The main objective of this dissertation is to develop a process-model for asset replacement planning. The aim of the model is to determine the optimal pipe replacement year by comparing, temporally, the annual operating and maintenance costs of the existing asset and the annuity of the investment in a new equivalent pipe, at the best market price. It is proposed that risk cost provide an appropriate framework to decide the balance between investment for replacing or operational expenditures for maintaining an asset. The model describes a practical approach to estimate when an asset should be replaced. A comprehensive list of criteria to be considered is outlined, the main criteria being a visà- vis between maintenance and replacement expenditures. The costs to maintain the assets should be described by a cost function related to the asset type, the risks to the safety of people and property owing to declining condition of asset, and the predicted frequency of failures. The cost functions reflect the condition of the existing asset at the time the decision to maintain or replace is taken: age, level of deterioration, risk of failure. The process model is applied in the wastewater network of Oslo, the capital city of Norway, and uses available real-world information to forecast life-cycle costs of maintenance and rehabilitation strategies and support infrastructure management decisions. The case study provides an insight into the various definitions of ‘asset lifetime’ – service life, economic life and physical life. The results recommend that one common value for lifetime should not be applied to the all the pipelines in the stock for investment planning in the long-term period; rather it would be wiser to define different values for different cohorts of pipelines to reduce the uncertainties associated with generalisations for simplification. It is envisaged that more criteria the municipality is able to include, to estimate maintenance costs for the existing assets, the more precise will the estimation of the expected service life be. The ability to include social costs enables to compute the asset life, not only based on its physical characterisation, but also on the sensitivity of network areas to social impact of failures. The type of economic analysis is very sensitive to model parameters that are difficult to determine accurately. The main value of this approach is the effort to demonstrate that it is possible to include, in decision-making, factors as the cost of the risk associated with a decline in level of performance, the level of this deterioration and the asset’s depreciation rate, without looking at age as the sole criterion for making decisions regarding replacements.