583 resultados para HSM IMA
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This paper describes a failure alert system and a methodology for content reuse in a new instructional design system called InterMediActor (IMA). IMA provides an environment for instructional content design, production and reuse, and for students’ evaluation based in content specification through a hierarchical structure of competences. The student assessment process and information extraction process for content reuse are explained.
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PURPOSE: To test the ability of two preparations of FGF2-saporin, either FGF2 chemically conjugated to saporin (FGF2-SAP) or genetically engineered FGF2-saporin (rFGF2-SAP) to inhibit the growth of bovine epithelial lens (BEL) cells in vitro when in solution and when immobilized on heparin surface-modified (HSM) polymethylmethacrylate (PMMA) intraocular lenses (IOLs). METHOD: Bovine epithelial lens cells were incubated with various concentrations FGF2-saporin for as long as 4 days. The number of surviving cells was determined by counting the number of nuclei. Because FGF2 binds to heparin, FGF2-saporin was incubated with HSM PMMA IOLs; excess toxin was washed off, and the BEL cells were grown on the FGF2-saporin-treated IOLs (HSM and non-HSM) for 4 days. Cell density was determined by image analysis. RESULTS: Both FGF2-SAP and rFGF2-SAP were highly cytotoxic (nM range), with rFGF2-SAP 10 times less active than FGF2-SAP. FGF2-saporin bound to the surface of HSM IOLs and eluted by 2M NaCl retained its activity. Toxin bound to HSM IOLs killed more than 90% of the BEL cells placed on the IOL surface within 4 days. The ability of FGF2-saporin to prevent the growth of cells on the IOL surface was strictly dependent on the presence of heparin on the IOL. CONCLUSIONS: FGF2-saporin is bound to HSM PMMA IOLs and prevents the growth of epithelial cells on the surface of the lens.
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1. Identifying those areas suitable for recolonization by threatened species is essential to support efficient conservation policies. Habitat suitability models (HSM) predict species' potential distributions, but the quality of their predictions should be carefully assessed when the species-environment equilibrium assumption is violated.2. We studied the Eurasian otter Lutra lutra, whose numbers are recovering in southern Italy. To produce widely applicable results, we chose standard HSM procedures and looked for the models' capacities in predicting the suitability of a recolonization area. We used two fieldwork datasets: presence-only data, used in the Ecological Niche Factor Analyses (ENFA), and presence-absence data, used in a Generalized Linear Model (GLM). In addition to cross-validation, we independently evaluated the models with data from a recolonization event, providing presences on a previously unoccupied river.3. Three of the models successfully predicted the suitability of the recolonization area, but the GLM built with data before the recolonization disagreed with these predictions, missing the recolonized river's suitability and badly describing the otter's niche. Our results highlighted three points of relevance to modelling practices: (1) absences may prevent the models from correctly identifying areas suitable for a species spread; (2) the selection of variables may lead to randomness in the predictions; and (3) the Area Under Curve (AUC), a commonly used validation index, was not well suited to the evaluation of model quality, whereas the Boyce Index (CBI), based on presence data only, better highlighted the models' fit to the recolonization observations.4. For species with unstable spatial distributions, presence-only models may work better than presence-absence methods in making reliable predictions of suitable areas for expansion. An iterative modelling process, using new occurrences from each step of the species spread, may also help in progressively reducing errors.5. Synthesis and applications. Conservation plans depend on reliable models of the species' suitable habitats. In non-equilibrium situations, such as the case for threatened or invasive species, models could be affected negatively by the inclusion of absence data when predicting the areas of potential expansion. Presence-only methods will here provide a better basis for productive conservation management practices.
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PURPOSE: To investigate the ability of fibroblast growth factor (FGF) 2-saporin to prevent lens regrowth in the rabbit. METHODS: Chemically conjugated and genetically fused FGF2-saporin (made in Escherichia coli) were used. Extracapsular extraction of the lens was performed on the rabbit, and the cytotoxin either was injected directly into the capsule bag or was administered by FGF2-saporin-coated, heparin surface-modified (HSM) polymethylmethacrylate intraocular lenses. The potential of the conjugate was checked by slit lamp evaluation of capsular opacification and by measuring crystallin synthesis. Toxin diffusion and sites of toxin binding were assessed by immunohistochemistry. Possible toxicity was determined by histologic analysis of ocular tissues. RESULTS: FGF2-saporin effectively inhibited lens regrowth when it was injected directly into the capsular bag. However, high concentration of the toxin induced transient corneal edema and loss of pigment in the iris. Intraocular lenses coated with FGF2-saporin reduced lens regrowth and crystallin synthesis without any detectable clinical side effect. After implantation, FGF2-saporin was shown to have bound to the capsules and, to a lesser extent, to the iris; no histologic damage was found on ocular tissues as a result of implantation of drug-loaded HSM intraocular lenses. CONCLUSIONS: Chemically conjugated (FGF2-SAP) and genetically fused FGF2-saporin (rFGF2-SAP) bound to HSM intraocular lenses can prevent lens regrowth in the rabbit.
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Non-malignant inflammatory sensory polyganglionopathy (NISP) is the most common form of acquired ganglionopathies, a rare and distinct subgroup of peripheral nerve diseases characterized by a primary degeneration of sensory neurons in dorsal root ganglia. There is a rational for the use of immune modifying agents (IMA) in NISP since an underlying auto-immune process is demonstrated or suspected. However, commonly used IMA such as corticosteroids, azathioprine, methotrexate or IVIG do not prevent disease's progression in the majority of patients. The use of newer IMA, especially those directed against B-cells, may be a therapeutic alternative. An interesting candidate is rituximab, a mouse-human chimeric anti CD20 antibody that specifically eliminates B-cells and B-cells precursors.Objectives: This is a prospective open label pilot study to determine the efficacy of rituximab treatment in NISP patients, who did not respond to commonly used IMA.Methods: Five patients (40% male) with a mean age of 55 years (range 49-67), diagnosed with NISP after extensive work-up, were treated (schema used for one cure: 2 9 1gr within 15 days interval). Neurological scores (NIS, ISSS, ODSS) and B cell counts were assessed at baseline and during clinical follow-up at 2 and 6 monthsto assess treatment efficacy.Results: The treatment was generally well tolerated. Minor adverse events reported were transient arterial hypotension during the infusions in two patients and intermittent mild leucopenia in one patient. Clinical evolution during the follow-up period was characterized by a stability of the functional scores in four patients (80%) and the continuation of disability progression of one patient (20%). CD4 cells disappeared in all patients after the second infusion, an effect that lasted until the follow up at 6 months.Conclusion: The preliminary results of this pilot study indicate that rituximab is generally well tolerated and prevents progression of disability during the 6-month observation period in NISP patients. Inclusion of additional patients and extending of the follow-up period are intended to further investigate the efficacy of rituximab in NISP.
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BACKGROUND: This study was designed to determine whether the pain pattern in patients with an internal mammary artery (IMA) harvest differs from that in other cardiac operations and whether these patients present specific characteristics with clinical implications. METHODS: One hundred patients with left IMA grafting (IMA group) were compared prospectively with 100 patients who had a heart operation without IMA harvest (non-IMA group). Pain assessment was performed on postoperative days (POD) 1, 2, 3, and 7, and included pain intensity (10-point scale) and pain localization. RESULTS: In the IMA group, pain intensity was higher on POD 2 (4.2 +/- 2.4 versus 3.2 +/- 2.3, p < 0.01), and there were more patients without pain on POD 7 (32 versus 19, p = 0.03). In the IMA group, more patients had left basal thoracic pain throughout the entire study period and had sternal pain on POD 7, whereas more patients in the non-IMA group complained about back pain during the early postoperative period. CONCLUSIONS: The impact of IMA harvest on pain intensity is moderate, but the pain localization pattern of each group exhibits specific features that could help to better target pain management.
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The Highway Safety Manual is the national safety manual that provides quantitative methods for analyzing highway safety. The HSM presents crash modification factors related to work zone characteristics such as work zone duration and length. These crash modification factors were based on high-impact work zones in California. Therefore there was a need to use work zone and safety data from the Midwest to calibrate these crash modification factors for use in the Midwest. Almost 11,000 Missouri freeway work zones were analyzed to derive a representative and stratified sample of 162 work zones. The 162 work zones was more than four times the number of work zones used in the HSM. This dataset was used for modeling and testing crash modification factors applicable to the Midwest. The dataset contained work zones ranging from 0.76 mile to 9.24 miles and with durations from 16 days to 590 days. A combined fatal/injury/non-injury model produced a R2 fit of 0.9079 and a prediction slope of 0.963. The resulting crash modification factors of 1.01 for duration and 0.58 for length were smaller than the values in the HSM. Two practical application examples illustrate the use of the crash modification factors for comparing alternate work zone setups.
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We propose an innovative, integrated, cost-effective health system to combat major non-communicable diseases (NCDs), including cardiovascular, chronic respiratory, metabolic, rheumatologic and neurologic disorders and cancers, which together are the predominant health problem of the 21st century. This proposed holistic strategy involves comprehensive patient-centered integrated care and multi-scale, multi-modal and multi-level systems approaches to tackle NCDs as a common group of diseases. Rather than studying each disease individually, it will take into account their intertwined gene-environment, socio-economic interactions and co-morbidities that lead to individual-specific complex phenotypes. It will implement a road map for predictive, preventive, personalized and participatory (P4) medicine based on a robust and extensive knowledge management infrastructure that contains individual patient information. It will be supported by strategic partnerships involving all stakeholders, including general practitioners associated with patient-centered care. This systems medicine strategy, which will take a holistic approach to disease, is designed to allow the results to be used globally, taking into account the needs and specificities of local economies and health systems.
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Pain is defined as an unpleasant sensory or emotional experience, associated with tissue damage, that is a reality linked to the surgical procedure and the postoperative period. Objective: Knowing the degree of pain experienced by patients after cardiac surgery, depending on the type of intervention they underwent, over the post-operative period in an intensive care unit (ICU). Method: Descriptive observational study. Pain was assessed by the visual analog scale (VAS), going from 0 to 10, thereby obtaining the first VAS1 assessment at 2 h post-extubation and every 8 hours thereafter up to 48 hours or until discharge to floor VAS7. It included patients having undergone cardiac surgery [valve surgery, bypass, combined procedure (including valve surgery and bypass) and mediastinitis]. Data were processed using Spss.v 20. Results: 120 patients 70 years old on average (standard deviation (SD): 13.3 years old) were included, out of which 70% were male. 40.8% of them had underwent bypass coronary revascularization. Patients subjected to the bypass technique showed an VAS1 mean value of 4.35 (SD: 2.45), unlike those subjected to valve surgery, who showed a mean value of 2.89 (SD: 2.27), those subjected to the combined procedure, who showed a mean value of 3.87 (SD: 2.90), and those with mediastinitis, who showed a mean value of 3.33 (SD: 3.51); (p < 0.031). 28.5% of patients had underwent revascularization (n = 49 ) by an internal mam mary artery (IMA) graft. These patients showed a mean value for VAS1 of 5.4 (SD: 1.89), unlike those who had underwent a combined procedure [IMA and saphenous vein (SV)], who showed a mean value of 3.9 (SD: 2.6), and those who had underwent a SV procedure , who showed a mean value of 3.5 (SD: 2.1); (p < 0.045). Conclusions: Patients having underwent bypass and IMA procedures perceive more pain than in other cardiac surgery and graft interventions
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Em três experimentos de campo, realizados em Cambará-PR e Londrina-PR, no ano agrícola 2011/12 e em Piracicaba-SP no ano 2012/13, e sob ocorrência natural do patógeno, foi avaliada a reação de 12 genótipos de algodoeiro à incidência da mancha-de-alternária (Alternaria macrospora). Diferenças altamente significativas entre os genótipos foram observadas nas três localidades, dando margem à formação de três, quatro e seis grupos de reação à doença, conforme o ambiente considerado. Nas posições extremas, e sem que houvesse grandes desvios no desempenho, situaram-se, no grupo dos mais resistentes, os genótipos IAC 08-2031, FMT 709 e BRS 336, e no grupo dos mais suscetíveis FMT 705, IMA CD 08-12427 e DP 555 BG RR. Nos grupos intermediários ocorreram algumas inconsistências, para certos genótipos, o que explica a interação significativa genótipos x locais verificada. Entretanto, como o desempenho menos satisfatório ocorreu na localidade em que a doença incidiu com maior intensidade, tal interação pode traduzir apenas instabilidade fenotípica da resistência ao patógeno, nos genótipos envolvidos.
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Plantas de clone de Eucalyptus grandis, em região de Cerrado, no espaçamento inicial de 3 x 3 m, foram submetidas à desrama artificial e ao desbaste. Os tratamentos de desrama tiveram início em três idades diferentes: 16, 20 ou 28 meses. Foram utilizadas três a quatro intervenções de desrama, com remoção de copa em diferentes alturas, para atingir 6 m de fuste livre de nó, quando se iniciou a desrama aos 16 ou 20 meses, e duas a três intervenções, quando se iniciou aos 28 meses. Foram aplicados dois tratamentos de desbaste aos 55 meses, com remoção de 0 e 35% do número de mudas plantadas. O crescimento foi avaliado no período pós-desbaste, entre 55 e 93 meses de idade, por meio da análise do diâmetro (DAP), altura total (Ht), volume com casca (V), incremento periódico anual pós-desbaste (IPA) e incremento médio anual (IMA). Aos 93 meses, não foram observadas diferenças significativas (p>0,05) em DAP, Ht, V, IPA e IMA, entre os tratamentos de desrama, e na interação entre desrama e desbaste. No tratamento desramado até 1,5 m de altura, aos 16 meses, houve remoção de 80% da biomassa de folhas e galhos. Nesse tratamento, 65% dos indivíduos estavam com DAP inferior a 15 cm, em comparação com 35% nos demais tratamentos. A Ht no povoamento desbastado foi menor (p<0,05) do que no não desbastado. O V, o IPA e o IMA foram, respectivamente, de 7,9, 23,0 e 7,3% mais elevados (p<0,05) no povoamento desbastado, quando a primeira intervenção de desrama foi aplicada aos 20 meses. O povoamento não desbastado teve crescimento estagnado aos 80 meses. No desbastado, essa estagnação deverá ocorrer entre 100 e 110 meses de idade, indicando necessidade de aplicação do segundo desbaste nessa faixa etária, para obtenção de toras de maior diâmetro e, consequentemente, maior extensão de madeira limpa.
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Neste trabalho, objetivou-se estudar a adaptabilidade de híbridos multiespécies de Eucalyptus em quatro ambientes do Estado do Rio Grande do Sul. Os ensaios foram realizados nas áreas da empresa CMPC Celulose Riograndense, nos Municípios de Minas do Leão (Horto Florestal Cambará), Encruzilhada do Sul (Horto Florestal Capivara), Dom Feliciano (Horto Florestal Fortaleza) e Vila Nova do Sul (Horto Florestal São João). No ano 2007 foi implantada uma rede de testes clonais com 146 clones de Eucalyptus, pertencentes a 34 diferentes espécies e, ou híbridos, em delineamento de blocos ao acaso com 30 repetições e uma planta por parcela (Single Tree Plot). Aos 3 anos de idade, foram mensurados o diâmetro à altura do peito (dap) e a altura total (Ht) das árvores dos experimentos. O incremento médio anual (IMA) foi calculado de acordo com o volume individual por clone e o estande de plantas no hectare na idade de avaliação do teste clonal. Concluiu-se que em um programa de melhoramento do eucalipto a análise simultânea de produtividade, estabilidade e adaptabilidade deve ser preferida em relação ao simples ordenamento de valores genotípicos. Na seleção simultânea, destacaram-se entre os melhores materiais genéticos do ordenamento, híbridos do tipo "three-way cross", formados por três diferentes espécies de Eucalyptus. Os híbridos mais promissores para a geração de clones superiores foram E. urophylla x (E. camaldulensis x E. grandis), E. grandis x (E. urophylla x E. grandis), E. saligna x (E. grandis x E. urophylla) e E. grandis x E. kirtoniana (E. robusta x E. tereticornis) e E. grandis x E. urophylla.