Fatores de risco associados à lesão renal aguda em pacientes tratados com polimixina B em um hospital terciário

Resumo Introdução: O uso de polimixinas foi praticamente abandonado nos anos 1970 devido as altas taxas de nefropatia. Entretanto, foram reintroduzidas na prática médica devido a sua ação contra bactérias gram negativas resistentes a carbapenemicos. A literatura recente sugere uma taxa de nefropatia mais baixa do que a historicamente reportada. Objetivo: Determinar a incidência de nefropatia associada ao uso de polimixina utilizando os critérios de RIFLE. Métodos: Foi realizada coorte retrospectiva de todos pacientes adultos que receberam polimixina B no Hospital Nossa Senhora da Conceição de dezembro de 2010 até março de 2011. Resultados: 61 pacientes (43%) preencheram os critérios de rifle para injúria renal e 28 (13,7%) necessitaram de diálise. Preditores independentes para nefrotoxicidade foram hipotensão (OR, 2.79; CI 1.14-5.8; p = 0.006) e uso concomitante de vancomicina (OR, 2.86; CI, 1.27-6.4; p = 0.011). Conclusão: Nessa coorte retrospectiva, nefrotoxicidade (definida pelos criterios de RIFLE) ocorreu em 43% dos pacientes tratados com polimixina B. O uso concomitante de vancomicina e hipotensão foram fatores de risco independentes para desenvolvimento de nefropatia. Mais estudos são necessarios, particularmente com polimixina B, para esclarecer se as caracteristicas dessa droga e da colistina são sobreponíveis.

Efecto de la competencia en la escogencia de estándares educativos

En la literatura económica no se ha estudiado como la competencia entre las instituciones educativas afecta específicamente la escogencia de estándares educativos y el valor de matrícula. Usando un modelo teórico analizo como la competencia entre las instituciones educativas afectan la escogencia de estándares académicos, comparando la solución en competencia con la solución eficiente y la solución de monopolio. Los individuos son heterogéneos y se diferencian en su habilidad, las instituciones educativas compiten estableciendo en una primera etapa el estándar educativo, y en una segunda etapa el valor de matrícula. Una vez definidos los estándares y los valores de matrícula, estos son información pública, permitiendo a los individuos escoger entre ingresar o no a una institución educativa o a que institución educativa ingresar de acuerdo a la habilidad innata y al costo asociado al esfuerzo. En los resultados se muestra que el bienestar social aumenta cuando en la economía existe más de una institución educativa con estándares diferentes, y la solución de mercado, en monopolio o en competencia, obliga a los estudiantes a ejercer un mayor esfuerzo para alcanzar el título. Independiente a la relación de costos, el valor de matrícula es siempre mayor para la institución con estándar educativo más alto, y mayor en la solución de mercado. Cuando el costo unitario de la institución con estándar más alto es mayor o igual al costo de la institución con menor estándar, los estándares educativos escogidos por el planificador son mayores y el esfuerzo requerido por los individuos es menor respecto a la solución de mercado.

Uso de la matriz extracelular como material para ingeniería de tejidos

Introducción: La evaluación de injertos vasculares de submucosa de intestino delgado para la regeneración de vasos sanguíneos ha producido una permeabilidad variable (0-100%) que ha sido concurrente con la variabilidad en las técnicas de fabricación. Metodología: Investigamos los efectos de fabricación en permeabilidad y regeneración en un diseño experimental de 22factorial que combino: 1) preservación (P) o remoción (R) de la capa estratum compactum del intestino, y 2) deshidratada (D) o hidratada (H), dentro de cuatro grupos de estudio (PD, RD, PH, RH). Los injertos fueron implantados en las Arterias Carótidas de porcinos (ID 4.5mm, N=4, 7d). Permeabilidad, trombogenicidad, reacción inflamatoria, vascularización, infiltración de fibroblastos, perfil de polarización de macrófagos y fuerza tensil biaxial fueron evaluadas. Resultados: Todos los injertos PD permanecieron permeables (4/4), pero tuvieron escasa vascularización e infiltración de fibroblastos. El grupo RD permaneció permeable (4/4), presentó una extensa vascularización e infiltración de fibroblastos, y el mayor número del fenotipo de macrófagos (M2) asociado a regeneración. El grupo RH presentó menor permeabilidad (3/4), una extensa vascularización e infiltración de fibroblastos, y un perfil dominante de M2. El grupo PH presentó el menor grado de permeabilidad, y a pesar de mayor infiltración celular que PD, exhibió un fenotipo de macrófagos dominante adverso. La elasticidad de los injertos R evolucionó de una manera similar a las Carótidas nativas (particularmente RD, mientras que los injertos P mantuvieron su rigidez inicial. Discusión: Concluimos que los parámetros de fabricación afectan drásticamente los resultados, siendo los injertos RD los que arrojaron mejores resultados.

A critical review of methodologies for measuring rental depreciation applied to UK commercial real estate

Real estate depreciation continues to be a critical issue for investors and the appraisal profession in the UK in the 1990s. Depreciation-sensitive cash flow models have been developed, but there is a real need to develop further empirical methodologies to determine rental depreciation rates for input into these models. Although building quality has been found to be an important explanatory variable in depreciation it is very difficult to incorporate it into such models or to analyse it retrospectively. It is essential to examine previous depreciation research from real estate and economics in the USA and UK to understand the issues in constructing a valid and pragmatic way of calculating rental depreciation. Distinguishing between 'depreciation' and 'obsolescence' is important, and the pattern of depreciation in any study can be influenced by such factors as the type (longitudinal or crosssectional) and timing of the study, and the market state. Longitudinal studies can analyse change more directly than cross-sectional studies. Any methodology for calculating rental depreciation rate should be formulated in the context of such issues as 'censored sample bias', 'lemons' and 'filtering', which have been highlighted in key US literature from the field of economic depreciation. Property depreciation studies in the UK have tended to overlook this literature, however. Although data limitations and constraints reduce the ability of empirical property depreciation work in the UK to consider these issues fully, 'averaging' techniques and ordinary least squares (OLS) regression can both provide a consistent way of calculating rental depreciation rates within a 'cohort' framework.

Preferences, common knowledge and speculative trade

We study the proposition that if it is common knowledge that en allocation of assets is ex-ante pareto efficient, there is no further trade generated by new information. The key to this result is that the information partitions and other characteristics of the agents must be common knowledge and that contracts, or asset markets, must be complete. It does not depend on learning, on 'lemons' problems, nor on agreement regarding beliefs and the interpretation of information. The only requirement on preferences is state-additivity; in particular, traders need not be risk-averse. We also prove the converse result that "no-trade results" imply that traders' preferences can be represented by state-additive utility functions. We analyze why examples of other widely studied preferences (e.g., Schmeidler (1989)) allow "speculative" trade.

Construção e desenvolvimento de um secador de leito pulso-fluidizado para secagem de pastas e polpas

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

Condições ótimas para o desverdecimento da laranja 'Pêra' e do limão 'Eureka' e alterações pós-colheita no armazenamento

Pós-graduação em Agronomia (Horticultura) - FCA

Diversidade genética de Xanthomonas citri subsp. citri, caracterização molecular e patogênica de Xanthomonas fuscans subsp. aurantifolii e detecção de Xanthomonas alfalfae em citrumelo ‘Swingle’ (Citrus paradisi Macf. x Poncirus trifoliata L. Raf.) no Brasil

Pós-graduação em Microbiologia Agropecuária - FCAV

Orange pectin mediated growth and stability of aqueous gold and silver nanocolloids

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

Sum Insured Determination for Cereal, Citrus and Vineyards in the Spanish Agricultural Insurance System.

In general, insurance is a form of risk management used to hedge against a contingent loss. The conventional definition is the equitable transfer of a risk of loss from one entity to another in exchange for a premium or a guaranteed and quantifiable small loss to prevent a large and possibly devastating loss being agricultural insurance a special line of property insurance. Agriculture insurance, as actually are designed in the Spanish scenario, were established in 1978. At the macroeconomic insurance studies scale, it is necessary to know a basic element for the insurance actuarial components: sum insured. When a new risk assessment has to be evaluated in the insurance framework, it is essential to determinate venture capital in the total Spanish agriculture. In this study, three different crops (cereal, citrus and vineyards) cases are showed to determinate sum insured as they are representative of the cases found in the Spanish agriculture. Crop sum insured is calculated by the product of crop surface, unit surface production and crop price insured. In the cereal case, winter as spring cereal sowing, represents the highest Spanish crop surface, above to 6 millions of hectares (ha). Meanwhile, the four citrus species (oranges, mandarins, lemons and grapefruits) occupied an extension just over 275.000 ha. On the other hand, vineyard target to wine process shows almost one million of ha in Spain.

The Phase Space as a New Representation of the Dynamical Behaviour of Temperature and Enthalpy in a Reefer monitored with a Multidistributed Sensors Network

The study of temperature gradients in cold stores and containers is a critical issue in the food industry for the quality assurance of products during transport, as well as forminimizing losses. The objective of this work is to develop a new methodology of data analysis based on phase space graphs of temperature and enthalpy, collected by means of multidistributed, low cost and autonomous wireless sensors and loggers. A transoceanic refrigerated transport of lemons in a reefer container ship from Montevideo (Uruguay) to Cartagena (Spain) was monitored with a network of 39 semi-passive TurboTag RFID loggers and 13 i-button loggers. Transport included intermodal transit from transoceanic to short shipping vessels and a truck trip. Data analysis is carried out using qualitative phase diagrams computed on the basis of Takens?Ruelle reconstruction of attractors. Fruit stress is quantified in terms of the phase diagram area which characterizes the cyclic behaviour of temperature. Areas within the enthalpy phase diagram computed for the short sea shipping transport were 5 times higher than those computed for the long sea shipping, with coefficients of variation above 100% for both periods. This new methodology for data analysis highlights the significant heterogeneity of thermohygrometric conditions at different locations in the container.

Models for the prediction of handling damage in citrus and peaches grading lines, related to their physical properties.

Fruit damage during harvesting and handling is a standing problem, particularly for susceptible fruits like peaches and apricots. The resulting mechanical damage is a combination of fruit properties and damage inflicting effects due to procedures and to the equipment. Nine packing lines in the region of Murcia (SE Spain) have been tested with the aid of two different-size electronic fruits IS-100. Probabilities of impacts above three preset thresholds (50 g's, 100 g's and 150 g's) were calculated for each transfer point. Interaction fruit-packing line tests have been also performed in order to study the real incidence of packing lines on natural produce: apricots (1 variety), peaches (3 v.), lemons (1 v.) and oranges (3 v.). Bruises of handled and not handled samples of fruits were compared.

Supervisión multidistribuida para el control de procesos de conservación de productos agroalimentarios: optimización de calidad del producto

La presente Tesis está orientada al análisis de la supervisión multidistribuida de tres procesos agroalimentarios: el secado solar, el transporte refrigerado y la fermentación de café, a través de la información obtenida de diferentes dispositivos de adquisición de datos, que incorporan sensores, así como el desarrollo de metodologías de análisis de series temporales, modelos y herramientas de control de procesos para la ayuda a la toma de decisiones en las operaciones de estos entornos. En esta tesis se han utilizado: tarjetas RFID (TemTrip®) con sistema de comunicación por radiofrecuencia y sensor de temperatura; el registrador (i-Button®), con sensor integrado de temperatura y humedad relativa y un tercer prototipo empresarial, módulo de comunicación inalámbrico Nlaza, que integra un sensor de temperatura y humedad relativa Sensirion®. Estos dispositivos se han empleado en la conformación de redes multidistribuidas de sensores para la supervisión de: A) Transportes de producto hortofrutícola realizados en condiciones comerciales reales, que son: dos transportes terrestre de producto de IV gama desde Murcia a Madrid; transporte multimodal (barco-barco) de limones desde Montevideo (Uruguay) a Cartagena (España) y transporte multimodal (barco-camión) desde Montevideo (Uruguay) a Verona (Italia). B) dos fermentaciones de café realizadas en Popayán (Colombia) en un beneficiadero. Estas redes han permitido registrar la dinámica espacio-temporal de temperaturas y humedad relativa de los procesos estudiados. En estos procesos de transporte refrigerado y fermentación la aplicación de herramientas de visualización de datos y análisis de conglomerados, han permitido identificar grupos de sensores que presentan patrones análogos de sus series temporales, caracterizando así zonas con dinámicas similares y significativamente diferentes del resto y permitiendo definir redes de sensores de menor densidad cubriendo las diferentes zonas identificadas. Las metodologías de análisis complejo de las series espacio-temporales (modelos psicrométricos, espacio de fases bidimensional e interpolaciones espaciales) permitieron la cuantificación de la variabilidad del proceso supervisado tanto desde el punto de vista dinámico como espacial así como la identificación de eventos. Constituyendo así herramientas adicionales de ayuda a la toma de decisiones en el control de los procesos. Siendo especialmente novedosa la aplicación de la representación bidimensional de los espacios de fases en el estudio de las series espacio-temporales de variables ambientales en aplicaciones agroalimentarias, aproximación que no se había realizado hasta el momento. En esta tesis también se ha querido mostrar el potencial de un sistema de control basado en el conocimiento experto como es el sistema de lógica difusa. Se han desarrollado en primer lugar, los modelos de estimación del contenido en humedad y las reglas semánticas que dirigen el proceso de control, el mejor modelo se ha seleccionado mediante un ensayo de secado realizado sobre bolas de hidrogel como modelo alimentario y finalmente el modelo se ha validado mediante un ensayo en el que se deshidrataban láminas de zanahoria. Los resultados sugirieron que el sistema de control desarrollado, es capaz de hacer frente a dificultades como las variaciones de temperatura día y noche, consiguiendo un producto con buenas características de calidad comparables a las conseguidas sin aplicar ningún control sobre la operación y disminuyendo así el consumo energético en un 98% con respecto al mismo proceso sin control. La instrumentación y las metodologías de análisis de datos implementadas en esta Tesis se han mostrado suficientemente versátiles y transversales para ser aplicadas a diversos procesos agroalimentarios en los que la temperatura y la humedad relativa sean criterios de control en dichos procesos, teniendo una aplicabilidad directa en el sector industrial ABSTRACT This thesis is focused on the analysis of multi-distributed supervision of three agri-food processes: solar drying, refrigerated transport and coffee fermentation, through the information obtained from different data acquisition devices with incorporated sensors, as well as the development of methodologies for analyzing temporary series, models and tools to control processes in order to help in the decision making in the operations within these environments. For this thesis the following has been used: RFID tags (TemTrip®) with a Radiofrequency ID communication system and a temperature sensor; the recorder (i-Button®), with an integrated temperature and relative humidity and a third corporate prototype, a wireless communication module Nlaza, which has an integrated temperature and relative humidity sensor, Sensirion®. These devices have been used in creating three multi-distributed networks of sensors for monitoring: A) Transport of fruits and vegetables made in real commercial conditions, which are: two land trips of IV range products from Murcia to Madrid; multimodal transport (ship - ship) of lemons from Montevideo (Uruguay) to Cartagena (Spain) and multimodal transport (ship - truck) from Montevideo (Uruguay) to Verona (Italy). B) Two coffee fermentations made in Popayan (Colombia) in a coffee processing plant. These networks have allowed recording the time space dynamics of temperatures and relative humidity of the processed under study. Within these refrigerated transport and fermentation processes, the application of data display and cluster analysis tools have allowed identifying sensor groups showing analogical patterns of their temporary series; thus, featuring areas with similar and significantly different dynamics from the others and enabling the definition of lower density sensor networks covering the different identified areas. The complex analysis methodologies of the time space series (psychrometric models, bi-dimensional phase space and spatial interpolation) allowed quantifying the process variability of the supervised process both from the dynamic and spatial points of view; as well as the identification of events. Thus, building additional tools to aid decision-making on process control brought the innovative application of the bi-dimensional representation of phase spaces in the study of time-space series of environmental variables in agri-food applications, an approach that had not been taken before. This thesis also wanted to show the potential of a control system based on specialized knowledge such as the fuzzy logic system. Firstly, moisture content estimation models and semantic rules directing the control process have been developed, the best model has been selected by an drying assay performed on hydrogel beads as food model; and finally the model has been validated through an assay in which carrot sheets were dehydrated. The results suggested that the control system developed is able to cope with difficulties such as changes in temperature daytime and nighttime, getting a product with good quality features comparable to those features achieved without applying any control over the operation and thus decreasing consumption energy by 98% compared to the same uncontrolled process. Instrumentation and data analysis methodologies implemented in this thesis have proved sufficiently versatile and cross-cutting to apply to several agri-food processes in which the temperature and relative humidity are the control criteria in those processes, having a direct effect on the industry sector.

Single cell analysis of cytokine gene coexpression during CD4+ T-cell phenotype development.

CD4+ T cells from alpha beta-T-cell receptor transgenic mice were analyzed for coexpression of cytokine mRNAs during phenotype development using a double-label in situ hybridization technique. T cells that produced cytokines in the primary response were a fraction of the activated population, and only a minority of the cytokine-positive cells coexpressed two cytokines. In secondary responses, frequencies of double-positive cells increased, although they remained a minority of the total. Of the cytokine pairs examined, interleukin (IL)-4 and IL-5 were the most frequently coexpressed. IL-4 and interferon gamma showed the greatest tendency toward segregation of expression, being rarely coexpressed after the primary stimulation. These data indicate that there is significant heterogeneity of cytokine gene expression by individual CD4+ T cells during early antigenic responses. Coexpression of any pairs of cytokines, much less Th1 and Th2 cytokines, is generally the exception. The Th0 phenotype is a population phenotype rather than an individual cell phenotype.