Prevalence rates of infection in intensive care units of a tertiary teaching hospital

OBJECTIVE: To determine the prevalence rates of infections among intensive care unit patients, the predominant infecting organisms, and their resistance patterns. To identify the related factors for intensive care unit-acquired infection and mortality rates. DESIGN: A 1-day point-prevalence study. SETTING:A total of 19 intensive care units at the Hospital das Clínicas - University of São Paulo, School of Medicine (HC-FMUSP), a teaching and tertiary hospital, were eligible to participate in the study. PATIENTS: All patients over 16 years old occupying an intensive care unit bed over a 24-hour period. The 19 intensive care unit s provided 126 patient case reports. MAIN OUTCOME MEASURES: Rates of infection, antimicrobial use, microbiological isolates resistance patterns, potential related factors for intensive care unit-acquired infection, and death rates. RESULTS: A total of 126 patients were studied. Eighty-seven patients (69%) received antimicrobials on the day of study, 72 (57%) for treatment, and 15 (12%) for prophylaxis. Community-acquired infection occurred in 15 patients (20.8%), non- intensive care unit nosocomial infection in 24 (33.3%), and intensive care unit-acquired infection in 22 patients (30.6%). Eleven patients (15.3%) had no defined type. The most frequently reported infections were respiratory (58.5%). The most frequently isolated bacteria were Enterobacteriaceae (33.8%), Pseudomonas aeruginosa (26.4%), and Staphylococcus aureus (16.9%; [100% resistant to methicillin]). Multivariate regression analysis revealed 3 risk factors for intensive care unit-acquired infection: age > 60 years (p = 0.007), use of a nasogastric tube (p = 0.017), and postoperative status (p = 0.017). At the end of 4 weeks, overall mortality was 28.8%. Patients with infection had a mortality rate of 34.7%. There was no difference between mortality rates for infected and noninfected patients (p=0.088). CONCLUSION: The rate of nosocomial infection is high in intensive care unit patients, especially for respiratory infections. The predominant bacteria were Enterobacteriaceae, Pseudomonas aeruginosa, and Staphylococcus aureus (resistant organisms). Factors such as nasogastric intubation, postoperative status, and age ³60 years were significantly associated with infection. This study documents the clinical impression that prevalence rates of intensive care unit-acquired infections are high and suggests that preventive measures are important for reducing the occurrence of infection in critically ill patients.

Going Public: Conservation of Contemporary Artworks. Between Backstage and Frontstage in Contemporary Art Museums

In museum studies and history of art, what happens behind the scenes of museums stays relatively unseen and unspoken about. In the arts, generally speaking, what is dismissed as irrelevant (e.g. the realm of practices) is deliberately detached from what is thought to really matter; theory, discourse, content and meaning. Up till recently, backstage activities such as conservation practices are merely discussed among specialists and museum professionals. Only the outcomes of these discussions are sometimes – if at all – explicitly communicated to a larger public. Studies into the practices of contemporary art conservation however show that practices behind the scenes play an important role in the perpetuation of these artworks. What happens behind the scenes in terms of conservation has, in several ways, important effects on the ongoing life of these artworks in a museum context. Conservation practices, I argue, should therefore become a necessary part of museum studies and history of art. How can the working practices of conservators become more visible and transparent to a diversity of audiences, including researchers? And what does this mean in terms of research methodology?

The perfect paint in modern art conservation: a comparative study of 21st century vinyl emulsions

Contemporary painting places, and will continue to place, several questions about its meaning, its chemical nature, its durability and the best way to preserve it. This research aims at putting together comprehensive data on vinyl based paints, including their components, their properties, their aging behavior and their response to selected cleaning products. In this project degradation mechanisms of vinyl binders and formulations used in the 20th and 21st century were studied. Stability over time of selected vinyl polymers was assessed through natural indoor and artificially aging. The objective was to enhance knowledge and understanding of vinyl emulsion formulations and their performance over time. Overall conservation state of pictorial layers namely, adhesion, cohesion and discoloration of selected case studies from the Portuguese artist Julião Sarmento (b.1948) was correlated with the observed molecular level changes studied in laboratory experiments. Sarmento’s paintings were chosen due to conservation concerns (discoloration) on some of his works from the 90’s. Besides, research was carried out to start increasing the knowledge of what can be expected of PVAc based paints in terms of response to conservation treatments namely, surface cleaning. Artificial aging showed that the most recent formulations which are based on a poly(vinyl acetate), poly(vinyl chloride) and polyethylene terpolymer are less stable when compared to some homopolymer formulations. From the four pigments studied, titanium dioxide rutile and a carbon based black proved to be stabilizers for both types of polymer. The mixture lithopone plus calcium carbonate has showed to have a photocatalytic effect on the binders. The studied paintings showed to be in an overall good state of conservation except for the paintings created in the 90’s with white glue and a mixture of white lithoponeand calcium carbonate. Discoloration of this white paint seems to be irreversible and ongoing and is still a major concern. The disapearance of the plasticizer was the only change detected. The current works created by Sarmento are expected to be more stable as they were painted using the rutile titanium dioxide. Immersion/cleaning tests showed that vinyl based paints can be susceptible to water and organic solvents like ethanol as some evidences point to the removal/diffusion of additives from the paint. The observations made point to the need to further proceed in this research field.

Lightweight concrete masonry units based on processed granulate of corn cob as aggregate

A research work was performed in order to assess the potential application of processed granulate of corn cob (PCC) as an alternative lightweight aggregate for the manufacturing process of lightweight concrete masonry units (CMU). Therefore, CMU-PCC were prepared in a factory using a typical lightweight concrete mixture for non-structural purposes. Additionally, lightweight concrete masonry units based on a currently applied lightweight aggregate such as expanded clay (CMU-EC) were also manufactured. An experimental work allowed achieving a set of results that suggest that the proposed building product presents interesting material properties within the masonry wall context. Therefore, this unit is promising for both interior and exterior applications. This conclusion is even more relevant considering that corn cob is an agricultural waste product.

A study on the performance of technology transfer units

Universities are increasingly institutionalizing activities related to technology transfer and one of the main institutional mechanisms that has emerged is the “technology transfer unit” (TTU). Many of them are focusing their activities on the management of the university intellectual property. Studies have investigated factors that seem to affect their performance, but few have looked in detail at internal procedures and techniques that are used in their processes related to technology evaluation and licensing. The aim of this paper is to provide a comprehensive overview of some of the several steps that comprises the processes regarding technology evaluation and licensing, providing an analysis of the critical issues that affect each step of the process. A review of the literature was made, complemented with interviews to seven university TTUs, which was used as a check and a complement to the literature review and as way of perceiving from an insider perspective, the problems and issues that this paper wants to emphasize and to state clearly.

Cost-effective and lightweight mobile units for MixAR: A comparative trial among different setups

Cultural heritage has arousing the interest of the general public (e.g. tourists), resulting in the increasing number of visitations to archaeological sites. However, many buildings and monuments are severely damaged or completely destroyed, which doesn’t allow to get a full experience of “travelling in time”. Over the years, several Augmented Reality (AR) approaches were proposed to overcome these issues by providing three-dimensional visualization of reconstructed ancient structures in situ. However, most of these systems were made available through heavy and expensive technological bundles. Alternatively, MixAR intends to be a lightweight and cost-effective Mixed Reality system which aims to provide the visualization of virtual ancient buildings reconstructions in situ, properly superimposed and aligned with real-world ruins. This paper proposes and compares different AR mobile units setups to be used in the MixAR system, with low-cost and lightweight requirements in mind, providing different levels of immersion. It was propounded four different mobile units, based on: a laptop computer, a single-board computer (SBC), a tablet and a smartphone, which underwent a set of tests to evaluate their performances. The results show that mobile units based on laptop computer and SBC reached a good overall performance while mobile units based on tablet and smartphone did not meet such a satisfactory result even though they are acceptable for the intended use.

Using the GPU to design complex profile extrusion dies

In the present work the benefits of using graphics processing units (GPU) to aid the design of complex geometry profile extrusion dies, are studied. For that purpose, a3Dfinite volume based code that employs unstructured meshes to solve and couple the continuity, momentum and energy conservation equations governing the fluid flow, together with aconstitutive equation, was used. To evaluate the possibility of reducing the calculation time spent on the numerical calculations, the numerical code was parallelized in the GPU, using asimple programing approach without complex memory manipulations. For verificationpurposes, simulations were performed for three benchmark problems: Poiseuille flow, lid-driven cavity flow and flow around acylinder. Subsequently, the code was used on the design of two real life extrusion dies for the production of a medical catheter and a wood plastic composite decking profile. To evaluate the benefits, the results obtained with the GPU parallelized code were compared, in terms of speedup, with a serial implementation of the same code, that traditionally runs on the central processing unit (CPU). The results obtained show that, even with the simple parallelization approach employed, it was possible to obtain a significant reduction of the computation times.

Step towards a patient timeline in intensive care units

In Intensive Medicine, the presentation of medical information is done in many ways, depending on the type of data collected and stored. The way in which the information is presented can make it difficult for intensivists to quickly understand the patient's condition. When there is the need to cross between several types of clinical data sources the situation is even worse. This research seeks to explore a new way of presenting information about patients, based on the timeframe in which events occur. By developing an interactive Patient Timeline, intensivists will have access to a new environment in real-time where they can consult the patient clinical history and the data collected until the moment. The medical history will be available from the moment in which patients is admitted in the ICU until discharge, allowing intensivist to examine data regarding vital signs, medication, exams, among others. This timeline also intends to, through the use of information and models produced by the INTCare system, combine several clinical data in order to help diagnose the future patients’ conditions. This platform will help intensivists to make more accurate decision. This paper presents the first approach of the solution designed

Intelligent decision support to predict patient barotrauma risk in intensive care units

The occurrence of Barotrauma is identified as a major concern for health professionals, since it can be fatal for patients. In order to support the decision process and to predict the risk of occurring barotrauma Data Mining models were induced. Based on this principle, the present study addresses the Data Mining process aiming to provide hourly probability of a patient has Barotrauma. The process of discovering implicit knowledge in data collected from Intensive Care Units patientswas achieved through the standard process Cross Industry Standard Process for Data Mining. With the goal of making predictions according to the classification approach they several DM techniques were selected: Decision Trees, Naive Bayes and Support Vector Machine. The study was focused on identifying the validity and viability to predict a composite variable. To predict the Barotrauma two classes were created: “risk” and “no risk”. Such target come from combining two variables: Plateau Pressure and PCO2. The best models presented a sensitivity between 96.19% and 100%. In terms of accuracy the values varied between 87.5% and 100%. This study and the achieved results demonstrated the feasibility of predicting the risk of a patient having Barotrauma by presenting the probability associated.

Floristic, edaphic and structural characteristics of flooded and unflooded forests in the lower Rio Purús region of central Amazonia, Brazil

Despite a natural history interest in the early 1900s, relatively little ecological research has been carried out in the Rio Purús basin of central Amazonia, Brazil. Here we describe a new study area in the region of Lago Uauaçú with an emphasis on the climate, forest structure and composition, and soil characteristics between adjacent unflooded (terra firme) and seasonally inundated forests; situated within both the white-water (várzea) and black-water (igapó) drainage systems that dominate the landscape. The climate was found to be typical of that of the central Amazon. Várzea forest soils had high concentrations of nutrients, while terra firme and igapó soils were comparatively nutrient-poor. Terra firme forests were the most floristically diverse forest type, whereas várzea was intermediate, and igapó the most species-poor. The Lecythidaceae was the most important family in terra firme while the Euphorbiaceae was the most important in both várzea and igapó. There were significant differences between forest types in terms of number of saplings, canopy cover and understorey density. In contrasting our results with other published information, we conclude that the Lago Uauaçú region consists of a typical central Amazonian forest macro-mosaic, but is a unique area with high conservation value due to the intimate juxtaposition of terra firme, várzea and igapó forests.

Diversity of the land resources in the Amazonian State of Rondônia, Brazil

Conflicting opinions are recorded in the literature concerning the suitability of Amazon lands for sustainable agriculture following deforestation. This article has been written to shed light on this question by summarizing climate, landform, soil and vegetation features from the findings of a land resource study of the Brazilian state of Rondônia in south-west Amazonia. The work, which followed the World Soils and Terrain Digital Database (SOTER) methodology, was financed by the World Bank. During the course of the survey special emphasis was given to studying soils; 2914 profiles were analyzed and recorded. The study identified a complex pattern of land units with clear differences in climate, landform, soils and native vegetation. Forested areas mosaic with lesser areas of natural savannas. The latter occur on both poorly-drained and well-drained, albeit nutrient deficient sandy soils. The tallest and most vigorous forests or their remnants were seen growing on well-drained soils formed from nutrient-rich parent materials. Many of these soils could, or are being used for productive agriculture. Soils developed on nutrient-poor parent materials support forests that are significantly lower in height, and would require large lime and fertilizer inputs for agriculture. Low forests with high palm populations and minor areas of wet land savannas cover the poorly drained soils. It is evident that forest clearing in the past was indiscriminant; this cannot be condoned. The diversity of land conditions found throughout Rondônia would suggest that many past studies in the Amazon have simply been too broad to identify significant soil differences.

Mosaic maternal ancestry in the Great Lakes region of East Africa

The Great Lakes lie within a region of East Africa with very high human genetic diversity, home of many ethno-linguistic groups usually assumed to be the product of a small number of major dispersals. However, our knowledge of these dispersals relies primarily on the inferences of historical, linguistics and oral traditions, with attempts to match up the archaeological evidence where possible. This is an obvious area to which archaeogenetics can contribute, yet Uganda, at the heart of these developments, has not been studied for mitochondrial DNA (mtDNA) variation. Here, we compare mtDNA lineages at this putative genetic crossroads across 409 representatives of the major language groups: Bantu speakers and Eastern and Western Nilotic speakers. We show that Uganda harbours one of the highest mtDNA diversities within and between linguistic groups, with the various groups significantly differentiated from each other. Despite an inferred linguistic origin in South Sudan, the data from the two Nilotic-speaking groups point to a much more complex history, involving not only possible dispersals from Sudan and the Horn but also large-scale assimilation of autochthonous lineages within East Africa and even Uganda itself. The Eastern Nilotic group also carries signals characteristic of West-Central Africa, primarily due to Bantu influence, whereas a much stronger signal in the Western Nilotic group suggests direct West-Central African ancestry. Bantu speakers share lineages with both Nilotic groups, and also harbour East African lineages not found in Western Nilotic speakers, likely due to assimilating indigenous populations since arriving in the region ~3000 years ago.

Ex situ collection of Limonium spp.: cytogenetic and reproductive characterization for the conservation of rare species

Dissertação mestrado em Biologia Molecular, Biotecnologia e Bioempreendedorismo em Plantas

Pervasive patient timeline for intensive care units

This research work explores a new way of presenting and representing information about patients in critical care, which is the use of a timeline to display information. This is accomplished with the development of an interactive Pervasive Patient Timeline able to give to the intensivists an access in real-time to an environment containing patients clinical information from the moment in which the patients are admitted in the Intensive Care Unit (ICU) until their discharge This solution allows the intensivists to analyse data regarding vital signs, medication, exams, data mining predictions, among others. Due to the pervasive features, intensivists can have access to the timeline anywhere and anytime, allowing them to make decisions when they need to be made. This platform is patient-centred and is prepared to support the decision process allowing the intensivists to provide better care to patients due the inclusion of clinical forecasts.