Are the current chronic allograft nephropathy grading systems sufficient to predict renal allograft survival?

A major problem in renal transplantation is identifying a grading system that can predict long-term graft survival. The present study determined the extent to which the two existing grading systems (Banff 97 and chronic allograft damage index, CADI) correlate with each other and with graft loss. A total of 161 transplant patient biopsies with chronic allograft nephropathy (CAN) were studied. The samples were coded and evaluated blindly by two pathologists using the two grading systems. Logistic regression analyses were used to evaluate the best predictor index for renal allograft loss. Patients with higher Banff 97 and CADI scores had higher rates of graft loss. Moreover, these measures also correlated with worse renal function and higher proteinuria levels at the time of CAN diagnosis. Logistic regression analyses showed that the use of angiotensin-converting enzyme inhibitor (ACEI), hepatitis C virus (HCV), tubular atrophy, and the use of mycophenolate mofetil (MMF) were associated with graft loss in the CADI, while the use of ACEI, HCV, moderate interstitial fibrosis and tubular atrophy and the use of MMF were associated in the Banff 97 index. Although Banff 97 and CADI analyze different parameters in different renal compartments, only some isolated parameters correlated with graft loss. This suggests that we need to review the CAN grading systems in order to devise a system that includes all parameters able to predict long-term graft survival, including chronic glomerulopathy, glomerular sclerosis, vascular changes, and severity of chronic interstitial fibrosis and tubular atrophy.

QUALITY OF LIFE IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS IN NORTHEASTERN BRAZIL: IS HEALTH-RELATED QUALITY OF LIFE A PREDICTOR OF SURVIVAL FOR THESE PATIENTS?

Objective: To identify social, demographic and clinical characteristics that influence survival of patients with systemic lupus erythematosus (SLE). Methods: Sixty-three patients with a diagnosis of SLE were studied at our medical services in 1999 and then reviewed in 2005. We utilized a protocol to obtain demographic and clinical traits, activity and damage indices, and health-related quality of life via the SF-36. All statistical tests were performed using a significance level of 5%. Results: Out of the 63 patients examined in 1999, six died, four were lost for the follow-up and the previous protocol was applied to the remaining 53 patients. The six patients who died presented the worst recorded health-related quality of fife, in all aspects. The most important observed predictor of death was a mean lower score in the Role-Emotional Domain of the mental health component of the SF-36 (p<0.01). Conclusion: Health-related quality of life may be used as possible predictive factor of mortality among patients with SLE.

Chlorination treatment of aqueous samples reduces, but does not eliminate, the mutagenic effect of the azo dyes Disperse Red 1, Disperse Red 13 and Disperse Orange 1

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

Validation of the portuguese simple measure of impact of lupus erythematosus in youngsters (SMILEY) in Brazil

Background and Objective: Simple Measure of the Impact of Lupus Erythematosus in Youngsters (SMILEY) is a health-related quality of life (HRQOL) assessment tool for pediatric systemic lupus erythematosus (SLE), which has been translated into Portuguese for Brazil. We are reporting preliminary data on cross-cultural validation and reliability of SMILEY in Portuguese (Brazil). Methods: In this multi-center cross-sectional study, Brazilian children and adolescents 5-18 years of age with SLE and parents participated. Children and parents completed child and parent reports of Portuguese SMILEY and Portuguese Pediatric Quality of Life Inventory (PedsQLTM) Generic and Rheumatology modules. Parents also completed the Childhood Health Assessment Questionnaire (CHAQ). Physicians completed the SLE disease activity index (SLEDAI), Physician's Global Assessment of disease activity (PGA) and Systemic Lupus Erythematosus International Collaborating Clinics ACR Damage Index (SDI). Results: 99 subjects (84 girls) were enrolled; 93 children and 97 parents filled out the SMILEY scale. Subjects found SMILEY relevant and easy to understand and completed SMILEY in 5-15 minutes. Brazilian SMILEY was found to have good psychometric properties (validity and reliability), and the child-parent agreement was moderate. Conclusion: SMILEY may eventually be used routinely as a research/clinical tool in Brazil. It may be also adapted for other Portuguese-speaking nations offering critical information regarding the effect of SLE on HRQOL for children with SLE. © The Author(s), 2012.

Avaliação dos efeitos de diferentes manobras de fisioterapia respitatória no desfecho de pacientes ventilados mecanicamente

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Monitoramento da integridade em estruturas aeronáuticas

Pós-graduação em Engenharia Mecânica - FEIS

Avaliação in vitro do efeito genotóxico e neurotóxico da rotenona em populações neuronais de encéfalo de ratos

A doença de Parkinson (DP) é uma doença neurodegenerativa, que afeta principalmente neurônios dopaminérgicos da substância negra que projetam para o estriado. A rotenona, um composto amplamente usado como pesticida, pode estar relacionada a influências ambientais que aumentam o risco do aparecimento da DP. Estudo com análise de danos no DNA, como o ensaio em eletroforese do cometa foi introduzido neste trabalho para uma melhor compreensão de efeitos neurotóxicos da rotenona em modelo experimental da DP. O teste do cometa foi aplicado em neurônios provenientes de culturas mesencefálicas mistas de ratos expostas a diferentes concentrações em dois tempos de exposição, 24 e 48 horas. A média do índice de dano dos cometas mostrou-se, segundo análise estatística, significativamente diferente em relação ao grupo controle em todas as concentrações de rotenona testadas e nas duas durações analisadas. No entanto, na análise comparativa do índice de dano considerando o tempo de exposição para concentrações equivalentes, somente 20 e 30 nano molares demonstraram diferença significativa entre 24 e 48 horas de exposição. Este trabalho demonstrou que, nas condições empregadas, o teste do cometa detectou danos no material genético sem alteração detectável no teste de viabilidade celular pelo MTT (5 nM de rotenona por 24h), sugerindo que alterações genotóxicas podem anteceder alterações de viabilidade celular em neurônios expostos à rotenona. Entretanto, não é possível afirmar se tais alterações possuem caráter irreversível ou não.

Avaliação clinimétrica do desfecho em uma série de casos de Lúpus Eritomatoso Sistêmico Juvenil (LESJ)

Pós-graduação em Saúde Coletiva - FMB

Quality of cut and basecutter blade configuration for the mechanized harvest of green sugarcane

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Ferramentas da qualidade na colheita mecanizada de cana-de-açúcar

Pós-graduação em Agronomia (Produção Vegetal) - FCAV

Adaptação cultural e validação do JAMAR - Juvenile Arthritis Multidimensional Assessment Report para a artrite idiopática juvenil

Pós-graduação em Saúde Coletiva - FMB

Avaliação in vitro do tempo de fotopolimerização com led de alta potência de bráquetes ortodônticos e remoção de adesivo remanescente sob luz ultravioleta

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Flujo de potencia entre estructuras complejas sometidas a excitaciones de alta frecuencia y aplicaciones a la detección de daño estructural

El tema central de investigación en esta Tesis es el estudio del comportamientodinámico de una estructura mediante modelos que describen la distribución deenergía entre los componentes de la misma y la aplicación de estos modelos parala detección de daños incipientes.Los ensayos dinámicos son un modo de extraer información sobre las propiedadesde una estructura. Si tenemos un modelo de la estructura se podría ajustar éstepara que, con determinado grado de precisión, tenga la misma respuesta que elsistema real ensayado. Después de que se produjese un daño en la estructura,la respuesta al mismo ensayo variará en cierta medida; actualizando el modelo alas nuevas condiciones podemos detectar cambios en la configuración del modeloestructural que nos condujeran a la conclusión de que en la estructura se haproducido un daño.De este modo, la detección de un daño incipiente es posible si somos capacesde distinguir una pequeña variación en los parámetros que definen el modelo. Unrégimen muy apropiado para realizar este tipo de detección es a altas frecuencias,ya que la respuesta es muy dependiente de los pequeños detalles geométricos,dado que el tamaño característico en la estructura asociado a la respuesta esdirectamente proporcional a la velocidad de propagación de las ondas acústicas enel sólido, que para una estructura dada es inalterable, e inversamente proporcionala la frecuencia de la excitación. Al mismo tiempo, esta característica de la respuestaa altas frecuencias hace que un modelo de Elementos Finitos no sea aplicable enla práctica, debido al alto coste computacional.Un modelo ampliamente utilizado en el cálculo de la respuesta de estructurasa altas frecuencias en ingeniería es el SEA (Statistical Energy Analysis). El SEAaplica el balance energético a cada componente estructural, relacionando la energíade vibración de estos con la potencia disipada por cada uno de ellos y la potenciatransmitida entre ellos, cuya suma debe ser igual a la potencia inyectada a cadacomponente estructural. Esta relación es lineal y viene caracterizada por los factoresde pérdidas. Las magnitudes que intervienen en la respuesta se consideranpromediadas en la geometría, la frecuencia y el tiempo.Actualizar el modelo SEA a datos de ensayo es, por lo tanto, calcular losfactores de pérdidas que reproduzcan la respuesta obtenida en éste. Esta actualización,si se hace de manera directa, supone la resolución de un problema inversoque tiene la característica de estar mal condicionado. En la Tesis se propone actualizarel modelo SEA, no en término de los factores de pérdidas, sino en términos deparámetros estructurales que tienen sentido físico cuando se trata de la respuestaa altas frecuencias, como son los factores de disipación de cada componente, susdensidades modales y las rigideces características de los elementos de acoplamiento.Los factores de pérdidas se calculan como función de estos parámetros. Estaformulación es desarrollada de manera original en esta Tesis y principalmente sefunda en la hipótesis de alta densidad modal, es decir, que en la respuesta participanun gran número de modos de cada componente estructural.La teoría general del método SEA, establece que el modelo es válido bajounas hipótesis sobre la naturaleza de las excitaciones externas muy restrictivas,como que éstas deben ser de tipo ruido blanco local. Este tipo de carga es difícil dereproducir en condiciones de ensayo. En la Tesis mostramos con casos prácticos queesta restricción se puede relajar y, en particular, los resultados son suficientementebuenos cuando la estructura se somete a una carga armónica en escalón.Bajo estas aproximaciones se desarrolla un algoritmo de optimización por pasosque permite actualizar un modelo SEA a un ensayo transitorio cuando la carga esde tipo armónica en escalón. Este algoritmo actualiza el modelo no solamente parauna banda de frecuencia en particular sino para diversas bandas de frecuencia demanera simultánea, con el objetivo de plantear un problema mejor condicionado.Por último, se define un índice de daño que mide el cambio en la matriz depérdidas cuando se produce un daño estructural en una localización concreta deun componente. Se simula numéricamente la respuesta de una estructura formadapor vigas donde producimos un daño en la sección de una de ellas; como se tratade un cálculo a altas frecuencias, la simulación se hace mediante el Método delos Elementos Espectrales para lo que ha sido necesario desarrollar dentro de laTesis un elemento espectral de tipo viga dañada en una sección determinada. Losresultados obtenidos permiten localizar el componente estructural en que se haproducido el daño y la sección en que éste se encuentra con determinado grado deconfianza.AbstractThe main subject under research in this Thesis is the study of the dynamic behaviourof a structure using models that describe the energy distribution betweenthe components of the structure and the applicability of these models to incipientdamage detection.Dynamic tests are a way to extract information about the properties of astructure. If we have a model of the structure, it can be updated in order toreproduce the same response as in experimental tests, within a certain degree ofaccuracy. After damage occurs, the response will change to some extent; modelupdating to the new test conditions can help to detect changes in the structuralmodel leading to the conclusión that damage has occurred.In this way incipient damage detection is possible if we are able to detect srnallvariations in the model parameters. It turns out that the high frequency regimeis highly relevant for incipient damage detection, because the response is verysensitive to small structural geometric details. The characteristic length associatedwith the response is proportional to the propagation speed of acoustic waves insidethe solid, but inversely proportional to the excitation frequency. At the same time,this fact makes the application of a Finite Element Method impractical due to thehigh computational cost.A widely used model in engineering when dealing with the high frequencyresponse is SEA (Statistical Energy Analysis). SEA applies the energy balance toeach structural component, relating their vibrational energy with the dissipatedpower and the transmitted power between the different components; their summust be equal to the input power to each of them. This relationship is linear andcharacterized by loss factors. The magnitudes considered in the response shouldbe averaged in geometry, frequency and time.SEA model updating to test data is equivalent to calculating the loss factorsthat provide a better fit to the experimental response. This is formulated as an illconditionedinverse problem. In this Thesis a new updating algorithm is proposedfor the study of the high frequency response regime in terms of parameters withphysical meaning such as the internal dissipation factors, modal densities andcharacteristic coupling stiffness. The loss factors are then calculated from theseparameters. The approach is developed entirely in this Thesis and is mainlybased on a high modal density asumption, that is to say, a large number of modescontributes to the response.General SEA theory establishes the validity of the model under the asumptionof very restrictive external excitations. These should behave as a local white noise.This kind of excitation is difficult to reproduce in an experimental environment.In this Thesis we show that in practical cases this assumption can be relaxed, inparticular, results are good enough when the structure is excited with a harmonicstep function.Under these assumptions an optimization algorithm is developed for SEAmodel updating to a transient test when external loads are harmonic step functions.This algorithm considers the response not only in a single frequency band,but also for several of them simultaneously.A damage index is defined that measures the change in the loss factor matrixwhen a damage has occurred at a certain location in the structure. The structuresconsidered in this study are built with damaged beam elements; as we are dealingwith the high frequency response, the numerical simulation is implemented witha Spectral Element Method. It has therefore been necessary to develop a spectralbeam damaged element as well. The reported results show that damage detectionis possible with this algorithm, moreover, damage location is also possible withina certain degree of accuracy.

Discrimination of AE Signals From Friction and Concrete Cracking in a Reinforced Concrete Frame Subjected to Seismic Trainings

This paper shows the preliminary results of the development and application of a procedure to filter the Acoustic Emission (AE) signals to distinguish between AE signals coming from friction and AE signals coming from concrete cracking. These signals were recorded during the trainings of an experiment carried out on a reinforced concrete frame subjected to dynamic loadings with the shaking table of the University of Granada (Spain). Discrimination between friction and cracking AE signals is the base to develop a successful procedure and damage index based on AE testing for health monitoring of RC structures subjected to earthquakes.

Integration of embedded data processing algorithms inside PAMELA devices

PAMELA (Phased Array Monitoring for Enhanced Life Assessment) SHMTM System is an integrated embedded ultrasonic guided waves based system consisting of several electronic devices and one system manager controller. The data collected by all PAMELA devices in the system must be transmitted to the controller, who will be responsible for carrying out the advanced signal processing to obtain SHM maps. PAMELA devices consist of hardware based on a Virtex 5 FPGA with a PowerPC 440 running an embedded Linux distribution. Therefore, PAMELA devices, in addition to the capability of performing tests and transmitting the collected data to the controller, have the capability of perform local data processing or pre-processing (reduction, normalization, pattern recognition, feature extraction, etc.). Local data processing decreases the data traffic over the network and allows CPU load of the external computer to be reduced. Even it is possible that PAMELA devices are running autonomously performing scheduled tests, and only communicates with the controller in case of detection of structural damages or when programmed. Each PAMELA device integrates a software management application (SMA) that allows to the developer downloading his own algorithm code and adding the new data processing algorithm to the device. The development of the SMA is done in a virtual machine with an Ubuntu Linux distribution including all necessary software tools to perform the entire cycle of development. Eclipse IDE (Integrated Development Environment) is used to develop the SMA project and to write the code of each data processing algorithm. This paper presents the developed software architecture and describes the necessary steps to add new data processing algorithms to SMA in order to increase the processing capabilities of PAMELA devices.An example of basic damage index estimation using delay and sum algorithm is provided.