937 resultados para high volume peritoneal dialysis


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A novel method of composite tube manufacture was developed for potential use in automotive crash structures. Tubes were crushed axially under quasi-static conditions and highly repeatable behaviour was observed with an average specific energy absorption of -85kJ/kg. DMTA results indicated that the tubes were fully cured, even when the cycle was reduced to 7 minutes, giving this process huge potential for high-volume production.

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There has been increased interest in the use of immobilized enzymes in fruit juice industry for debittering of citrus fruit juices due to their high efficiency to remove bitter flavonoids. The structure of naringin, responsible for immediate bitterness, and of limonin, responsible for "delayed bitterness" has been discussed. This chapter also discusses various attempts that have been made to immobilize enzymes on an appropriate support so as to enable their use in debittering of citrus fruit juices. These include physicochemical and enzyme biotechnological approaches which makes the fruit juice more acceptable and cost effective to the consumer. Despite of high volume of production of citrus fruits and fruit juices, suitable processes to produce non-bitter citrus juice by immobilized enzymes technology has not yet commercialized globally.

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BACKGROUND: Quality and effectiveness of care can be enhanced through the use of condition-specific measures of satisfaction with treatment. The aim of the present study was to design and develop a measure of satisfaction with treatment for patients with chronic kidney failure (CKF) for use in routine clinical care and clinical trials. The Renal Treatment Satisfaction Questionnaire (RTSQ) was designed to be suitable for people using any of the various treatment modalities for CKF. Items measure satisfaction with aspects of treatment, including convenience, flexibility, freedom, and satisfaction to continue with present form of treatment.

METHODS: A 12-item RTSQ was investigated at a UK hospital-based renal unit, using data from 140 outpatients undergoing renal replacement therapy (hemodialysis, n = 35; continuous ambulatory peritoneal dialysis, n = 57; transplantation, n = 46).

RESULTS: An 11-item scale was developed from the original 12-item version, with a single factor accounting for 59% of the variance and item loadings greater than 0.58. Scale reliability was excellent (alpha = 0.93) in the full sample and proved robust to analysis in separate treatment subgroups. As expected, RTSQ scores differed significantly ( P < 0.0001) between the transplantation and other treatment groups. Those who had received a transplant expressed greater overall satisfaction, with specific advantages of transplantation shown by all individual items, including convenience, time, lifestyle, freedom, and satisfaction to continue current treatment.

CONCLUSION: The RTSQ provides a brief reliable measure of satisfaction with treatment for patients with CKF that is suitable for use in routine clinical care and clinical trials.

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Background

Grass pollen allergens are the most important cause of hay fever and allergic asthma during summer in cool temperate climates. Pollen counts provide a guide to hay fever sufferers. However, grass pollen, because of its size, has a low probability of entering the lower airways to trigger asthma. Yet, grass pollen allergens are known to be associated with atmospheric respirable particles.
Objective

We aimed (1) to determine the concentration of group 5 major allergens in (a) pollen grains of clinically important grass species and (b) atmospheric particles (respirable and nonrespirable) and (2) to compare the atmospheric allergen load with clinical data to assess different risk factors for asthma and hay fever.
Methods

We have performed a continuous 24 h sampling of atmospheric particles greater and lower than 7.2 μm in diameter during the grass pollen season of 1996 and 1997 (17 October 1996–16 January 1997) by means of a high volume cascade impactor at a height of about 15 m above ground in Melbourne. Using Western analysis, we assessed the reactivity of major timothy grass allergen Phl p 5 specific monoclonal antibody (MoAb) against selected pollen extracts. A MoAb-based ELISA was then employed to quantify Phl p 5 and cross-reactive allergens in pollen extracts and atmospheric particles larger and smaller than 7.2 μm.
Results

Phl p 5-specific MoAb detected group 5 allergens in tested grass pollen extracts, indicating that the ELISA employed here determines total group 5 allergen concentrations. On average, 0.05 ng of group 5 allergens were detectable per grass pollen grain. Atmospheric group 5 allergen concentrations in particles > 7.2 μm were significantly correlated with grass pollen counts (rs = 0.842, P < 0.001). On dry days, 37% of the total group 5 allergen load, whereas upon rainfall, 57% of the total load was detected in respirable particles. After rainfall, the number of starch granule equivalents increased up to 10-fold; starch granule equivalent is defined as a hypothetical potential number of airborne starch granules based on known pollen count data. This indicates that rainfall tended to wash out large particles and contributed to an increase in respirable particles containing group 5 allergens by bursting of pollen grains. Four day running means of group 5 allergens in respirable particles and of asthma attendances (delayed by 2 days) were shown to be significantly correlated (P < 0.001).
Conclusion

Here we present, for the first time, an estimation of the total group 5 allergen content in respirable and nonrespirable particles in the atmosphere of Melbourne. These results highlight the different environmental risk factors for hay fever and allergic asthma in patients, as on days of rainfall following high grass pollen count, the risk for asthma sufferers is far greater than on days of high pollen count with no associated rainfall. Moreover, rainfall may also contribute to the release of allergens from fungal spores and, along with the release of free allergen molecules from pollen grains, may be able to interact with other particles such as pollutants (i.e. diesel exhaust carbon particles) to trigger allergic asthma.

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Background: Birch-pollen allergens are an important cause of early spring hay fever and allergic asthma. Recently, we reported a mechanism for the release of respirable allergenic particles from birch pollen containing the major allergen Bet v 1. In this study, we aimed to assess the immunologic significance of the released Bet v 1-containing starch granules in the environment.

Methods: A two-site monoclonal antibody-based assay (ELISA) was employed to quantitate Bet v 1 in high-volume air sampler filter extracts, and immunogold-labelling was used on sections of these extracts to localize Bet v 1. Immunoblot analyses were performed with pooled sera from patients sensitive to birch pollen.

Results: Atmospheric starch granules contained Bet v 1, and the concentration increased upon light rainfall. Sera from patients allergic to birch allergens recognized extracts from isolated starch granules.

Conclusions: The clinical implications of these findings are that starch granules released from birch pollen are potentially able to trigger allergic asthmatic reactions to Bet v 1, since the allergen occurs in respirable particles. Thus, clinicians can advise asthma patients to remain indoors on days of light rainfall during the birch-pollen season to avoid high levels of allergen exposure.

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Allergenic proteins present in pollen grains, when inhaled, interact with the airways to cause an attack of asthma in susceptible humans. In one system, grass pollen grains rupture osmotically in rainfall, releasing allergen-containing inhalable particles into the atmosphere. In contrast, birch tree pollen grains do not rupture under these conditions, yet the major allergen, Bet v 1, has been detected in the atmosphere in inhalable particles of unknown origin. It is possible that Bet v 1 may diffuse from intact settled pollen grains and the allergenic material may again become airborne, interacting with settled fine particles from other sources prior to resuspension. This study investigates the mechanism for the release of birch pollen allergen-containing inhalable particles from pollen grains. We propose the hypothesis that (1) airborne birch pollen grains settle on nearby leaf surfaces; (2) then, following light rainfall, the grains germinate and, (3) later, pollen tubes burst, releasing inhalable particles carrying Bet v 1 into the atmospheric aerosol.   We used microscopic analyses of pollen behaviour following anther opening, a Burkard volumetric trap for pollen counts and a high volume air sampler with a two-stage cascade impactor for quantitative immunochemical analyses of Bet v 1. On dry days of high birch pollen count (48 grains/m3, 1.5 ng/m3 of Bet v 1), we found that the surfaces of birch leaves became coated with pollen. This ”pollen rain” is a source of secondary emission of allergens into the atmosphere. We observed that following light rainfall (<1 mm per day), about 80% of the birch pollen grains germinated, producing pollen tubes, especially in the sticky surface secretions of leaf glands. These pollen tubes may grow up to 300 μm in length prior to rupturing, each releasing about 400 starch granules coated with allergen molecules that may, after drying, be dispersed into the aerosol. On these days following light rainfall, the highest atmospheric levels of Bet v 1 (1.18 ng/m3) are associated with inhalable particles. Following heavy rainfall, both pollen and inhalable particles are washed from the atmosphere. Immunoprinting studies show that Bet v 1 is associated with starch granules rather than the smaller orbicules. Bet v 1 is present in the atmosphere in large particles, i.e. in particular pollen grains and in inhalable particles, i.e. in particular starch granules.

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[1] As part of the Large-Scale Biosphere-Atmosphere Experiment in Amazonia (LBA)-Cooperative LBA Airborne Regional Experiment (CLAIRE) 2001 campaign in July 2001, separate day and nighttime aerosol samples were collected at a ground-based site in Amazonia, Brazil, in order to examine the composition and temporal variability of the natural “background” aerosol. We used a high-volume sampler to separate the aerosol into fine (aerodynamic diameter, AD < 2.5 μm) and coarse (AD > 2.5 μm) size fractions and quantified a range of organic compounds in methanolic extracts of the samples by a gas chromatographic-mass spectrometric technique. The carbon fraction of the compounds could account for an average of 7% of the organic carbon (OC) in both the fine and coarse aerosol fractions. We observed the highest concentrations of sugars, sugar alcohols, and fatty acids in the coarse aerosol samples, which suggests that these compounds are associated with primary biological aerosol particles (PBAP) observed in the forest atmosphere. Of these, trehalose, mannitol, arabitol, and the fatty acids were found to be more prevalent at night, coinciding with a nocturnal increase in PBAP in the 2–10 μm size range (predominantly yeasts and other small fungal spores). In contrast, glucose, fructose, and sucrose showed persistently higher daytime concentrations, coinciding with a daytime increase in large fungal spores, fern spores, pollen grains, and, to a lesser extent, plant fragments (generally >20 μm in diameter), probably driven by lowered relative humidity and enhanced wind speeds/convective activity during the day. For the fine aerosol samples a series of dicarboxylic and hydroxyacids were detected with persistently higher daytime concentrations, suggesting that photochemical production of a secondary organic aerosol from biogenic volatile organic compounds may have made a significant contribution to the fine aerosol. Anhydrosugars (levoglucosan, mannosan, galactosan), which are specific tracers for biomass burning, were detected only at low levels in the fine aerosol samples. On the basis of the levoglucosan-to-OC emission ratio measured for biomass burning aerosol, we estimate that an average of ∼16% of the OC in the fine aerosol was due to biomass burning during CLAIRE 2001, indicating that the major fraction was associated with biogenic particles.

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The nephrology educators network [NEN] recognised in 2007 that inequities existed in the access and delivery of evidence based renal education programs particularly to nurses in regional and remote areas. To address this, a web-based approach to learning, through the development of peer reviewed, interactive nephrology e-learning programs was adopted. These programs aligned with the tenets of e-learning instructional design and afforded more effective and consistent clinical support and induction for nurses in the renal specialty. The e-learning programs promote a standardised evidence-based approach to nephrology education and were developed by content experts from across Australia and New Zealand. The design methodology avoided the duplication of resources while also encouraging knowledge transfer between participating health organisations.

This paper will discuss the development and successful implementation of these e-learning programs across renal healthcare units in Australasia. Implemented packages include: Introduction to Buttonhole Cannulation – featuring an interactive ultrasound and cannulation application; Introduction to Haemodialysis; Introduction to Peritoneal Dialysis [PD], featuring simulated PD machines, allowing for the teaching of troubleshooting without compromising patient safety. E-learning programs are further supported through interactive case scenarios that present unfolding real world simulations and enable learners to meet different patients and manage their care while learning about key messages relating to renal health. Modules currently in development include; Acute Kidney Injury; Fluid Assessment, Water Quality and Vascular Access. The implementation of these programs assist the facilitation of positive change in teaching and learning practices in nephrology nursing aimed at improving patient outcomes.

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Background: Haemolytic uraemic syndrome (HUS) is one of the main causes of acute kidney injury in children. It is a multifaceted disease, characterised by microangiopathic haemolytic anaemia and thrombocytopaenia. It can often affect multiple organ systems, including the central nervous and renal systems.

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A utilização de pellets de madeira é bastante difundida nos países desenvolvidos, em particular na Europa, e apresenta demanda crescente para a produção de energia elétrica e térmica, incluindo a calefação residencial. O Brasil apresenta capacidade indiscutível para a geração de diferentes biomassas e em quantidades expressivas, dada à vantagem competitiva de suas condições edafo-climáticas, sua extensão territorial e de ter baixos custos de produção. Apontar-se-á neste trabalho as condições mercadológicas, logísticas, normativas, de incentivos fiscais e de ambiente econômico, com as quais o país poderá se consolidar como um grande produtor e consumidor desta fonte de energia limpa e renovável. Este estudo apresenta as melhores técnicas conhecidas para a venda a pequenos e médios consumidores e para a produção, eficiente e com escala, de pellets de madeira, dentro do Estado de São Paulo. É discutida a necessidade de se ter florestas plantadas com o único propósito de serem transformadas em pellets. Nos últimos anos, os preços dos resíduos de madeira subiram no mercado interno, praticamente os excluindo como fonte de matéria-prima, num cenário de longo prazo. O objetivo final desta dissertação é apresentar os principais aspectos econômico-financeiros que influenciam os cenários para que os pellets de madeira possam substituir o óleo BPF-A1 no mercado regional, e assim discutindo se sua produção se mostrará atraente e confiável para potenciais investidores. Para a avaliação da viabilidade financeira, são utilizados os métodos-chave, Payback, Valor Presente Líquido e Taxa Interna de Retorno, e uma análise de sensibilidade das principais variáveis identificadas. Os principais resultados revelam um Payback de 47 meses, um NPV de R$10.942.127 e uma IRR de 25,18% a.a. em termos reais, para o cenário-base, além de identificar o preço da matéria-prima e a escala de produção como as variáveis mais sensíveis.

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Esta dissertação investigou, no mercado brasileiro, se o atraso no ajuste de preços das ações de baixa liquidez gera previsibilidade do retorno dessas ações quando comparadas às mais líquidas. O interesse estava em confrontar os resultados com os existentes na literatura internacional que apresentavam esse efeito. Para tanto, utilizamos a metodologia proposta no artigo “Trading volume and cross-autocorrelations in stock returns”, de Chordia e Swaminathan (2000), onde foi analisada a Bolsa de Valores de Nova York (NYSE). Verificamos que, na Bolsa de Valores de São Paulo (BOVESPA), uma vez controlados pelo tamanho das empresas, os retornos, sejam diários ou semanais, de portfólios com maior liquidez antecipam os retornos dos portfólios de menor liquidez, mais explicitamente nos quartis com pequenas e médias empresas. Os efeitos de não sincronia nas negociações e as autocorrelações próprias não são suficientes para explicar os padrões de antecipação-defasagem observados nos retornos das ações, já que esses são mais significativamente influenciados pelo volume negociado. As diferenças na velocidade da incorporação de novas informações aos preços ocorrem porque as ações menos líquidas parecem responder mais lentamente a informações de mercado, pelo menos nos portfólios de empresas de menor tamanho. Dessa maneira, podemos afirmar que no Brasil, assim como nos Estados Unidos, a baixa liquidez induz um atraso no ajuste de preços das ações de pequenas e médias empresas capaz de gerar previsibilidade dos retornos dessas ações, sugerindo alguma ineficiência do mercado. Os resultados são interessantes, já que indicam que, tanto no mercado nacional quanto nos de países desenvolvidos, os volumes negociados possuem um papel significativo na velocidade em que os preços se ajustam, jogando uma luz sobre como eles podem se tornar mais eficientes.

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Com a descentralização que caracterizou a federação brasileira nas últimas décadas, os municípios receberam maiores atribuições e responsabilidades, implementando políticas públicas e provendo serviços básicos à população. Contudo, uma vez que as receitas próprias municipais são capazes de custear apenas parcialmente estas atividades, torna-se necessário um volume elevado de transferências que fluem dos níveis centrais aos municípios. Além do mais, o Brasil é um país de território vasto e heterogêneo, em que municípios com distintas capacidades de autofinanciamento, bem como diferentes demandas por serviços públicos, convivem no mesmo regime federativo. Diante deste quadro, torna-se fundamental estudar a distribuição dos recursos das transferências, verificando se os municípios que mais necessitam de suporte financeiro têm sido os efetivamente beneficiados. À este processo de reduzir as disparidades horizontais provenientes de diferenças nas bases tributárias e demandas locais dá-se o nome de equalização fiscal. A equalização fiscal permite que municípes de diferentes jurisdições recebam o mesmo nível de serviços públicos para dada carga tributária assumida por eles (net fiscal benefit), ou seja, a equalização promove a equidade na provisão dos serviços públicos, além de evitar a criação de ineficiência alocativa derivada de migrações motivadas por benefícios fiscais. Para criar a equalização fiscal as transferências devem beneficiar aqueles municípios com menor capacidade de autofinanciamento e maiores necessidades fiscais atreladas à custos e demandas pelos serviços públicos. Neste sentido, este trabalho busca avaliar o efeito das transferências intergovernamentais na equalização fiscal dos municípios, considerando as principais proxies de capacidade fiscal – potencial de geração de receita própria – e necessidade fiscal – volume de recursos demandados em virtude das características da região e da população do município. A análise é realizada para cada grupo de transferências, desde aquelas com finalidade essencialmente redistributiva como o FPM até aquelas predominantemente devolutivas, como a cota-parte de ICMS. Os resultados mostram que algumas transferências como o FPM contribuem pouco para a equalização fiscal, apesar do objetivo de natureza redistributiva implícito neste repasse, assim como algumas transferências condicionais, como o FUNDEB, apesar de não almejarem especificamente corrigir as disparidades horizontais na capacidade dos municípios realizarem suas funções, podem significar um efeito positivo para a equalização fiscal no nível municipal da federação. Outro resultado importante que desponta na análise é o efeito da transferência do Bolsa-família na equalização, pois esta transferência consegue atenuar as distorções realizadas pelas demais transferências distribuídas aos municípios. O Bolsa-família, apesar de não ser uma transferência intergovernamental, foi incorporada na análise por representar um expressivo volume de recursos, por concorrer com recursos de outras transferências e ainda ter efeito potencial semelhante ao das demais transferências intergovernamentais no âmbito da equalização fiscal, uma vez que libera recursos no orçamento do governo local que, do contrário, poderiam estar comprometidos com a política local de assistência social. Outro resultado é a observação de que as transferências voluntárias afetam menos a equalização, ou seja, não contribuem para a consecução deste objetivo nem prejudicam a redução das disparidades horizontais, sendo relativamente neutras ou menos intervenientes em relação às demandas e capacidade de arrecadação dos municípios, provavelmente por não seguirem critérios, nem econômicos, como o ICMS, nem redistributivos, como o FPM, e sim critérios políticos, como apontado pela literatura de ciência política.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Produced water has lately aroused interest due to their high degree of salinity, suspended oil particles, chemicals added in various manufacturing processes, heavy metals and radioactivity sometimes. Along with oil and due to its high volume production, water production is one of the pollutants of most concern in the process of oil extraction. PAHs due to their ubiquity and their characteristics carcinogenic or mutagenic and teratogenic even have attracted the attention of every scientific society. Formed from the incomplete combustion of organic matter may be natural or anthropogenic. Some materials have been researched with the goal of cleaning up environmental matrices that may be contaminated by hydrocarbons. Among these materials researched various clays have been employed, of which highlights the vermiculite. The family of phyllosilicates, vermiculite for its potential and its high hydrophobic surface area has been a tool widely used in the decontamination of water in processes of oil spills. However, when it loses its capacity expanded hydrophobic having the necessity of using a hidrofobizante to make it organophilic. Among the numerous hidrofobizantes researched and used the linseed oil was the pioneer. In this study sought to evaluate the capacity of removal of PAHs using the vermiculite hydrofobized with linseed oil and wax also, for it was made use of the 24 full factorial design as the main tool for the experiments. We also evaluated the clay grain size (-20 +48 and -48 +80 #), the percentage of hidrofobizante applied (5 and 10%) and salinity of the water produced synthesized in our laboratory (35,000 and 55,000 ppm). The molecular fluorescence spectroscopy due to its sensitivity and speed was used to verify the adsorption capacity of clay, as well as gas chromatography served as an auxiliary technique to identify and quantify the PAHs in solution. In order to characterize the vermiculite was made use of X-ray fluorescence and X-ray diffraction. The infrared and thermogravimetry were essential to note hydrophobization and the amount of coating of clay. According to the fluorescence analysis showed that the test 12 was the best result in about 98% adsorption of fluorescent compounds, however the high salinity, the smallest particle size, the highest percentage of hidrofobizante and the use of linseed oil showed greater efficiency in the removal capacity of these hydrocarbons, in accordance with the trend followed by the analysis of the major factors of the factorial design. To verify the adsorption capacity of clay using a fixed volume of water produced synthetically, used as the test base 12, at their respective levels and factors. Thus, it was observed that after adding about 1 ½ liters of water solution produced synthetically, about 300 times its volume in mass, the vermiculite was able to adsorb 80% of fluorescent species present in solution

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)