Valorization of pumpkin residue by supercritical extraction of added-value compounds

Dissertação para a obtenção do Grau de Mestre em Engenharia Química e Bioquímica

Experimental high-throughput adsorption unit for multi-evaluation of adsorbents for gas capture, storage and separation applications

Dissertação para obtenção do grau de Mestre em Engenharia Química e Bioquímica

Malnutrição em idosos na admissão hospital actuação perante a sua elevado prevalência

RESUMO: Ao longo das últimas décadas a redistribuição etária da população mundial tem vindo a apresentar um aumento do número de pessoas com 65 ou mais anos, integrando um grupo populacional comummente designado por população idosa. Importa aprofundar mecanismos fisiológicos que conduzem ao envelhecimento e de que forma podem condicionar não só aspetos clínicos, como também nutricionais, entre outros, com a perspetiva da sua origem no aparecimento de doenças crónicas. Com esse enfoque, a desnutrição na pessoa idosa é hoje considerada pela European Nutrition for Health Alliance(ENHA) um problema de saúde pública. Está descrito que a sua prevalência ronda os 60% a nível de instituições hospitalares, 40% em unidades residenciais e 5 a 10% na pessoa idosa a residir em domicílio próprio ou de familiares, e na sua maioria permanece por diagnosticar e tratar. Assim, foi objetivo deste estudo caracterizar e estimar a prevalência da desnutrição e do risco de desnutrição na pessoa idosa, nas primeiras 72 horas de admissão hospitalar. Aplicou-se um estudo observacional, analítico, transversal, quantitativo e correlacional, cujos dados foram recolhidos por entrevista ao próprio e por observação. O estudo desenvolveu-se em duas vertentes de investigação, uma focada na caracterização da desnutrição em pessoas idosas institucionalizadas em hospitais portugueses da zona centro e sul do Continente e Madeira, nos períodos de julho/agosto de 2009, abril/junho de 2010, maio/julho de 2011, através do MNA®. A outra, uma avaliação nutricional detalhada, efetuada no Centro Hospitalar de Lisboa Central – Hospital de Santa Marta, EPE, entre o início de janeiro de 2009 e o fim de janeiro de 2010, sendo a amostra recrutada de entre os idosos de ambos os sexos, internados. Foram estudados dados sociodemográficos, de saúde e feita uma avaliação nutricional extensa. A avaliação nutricional constou de colheita de parâmetros laboratoriais (hematológicos e bioquímicos) e antropométricos (índice de massa corporal (IMC), prega cutânea tricipital(PCT), prega cutânea subescapular (PCSE), perímetro braquial (PB), adequação do perímetro braquial (APB), área muscular braquial (AMB) e perímetro Geminal (PG), análise da composição corporal (Massa Gorda Corporal (MGC), Massa Isenta de Gordura (MIG)),caracterização de um dia alimentar tipo e questionário Mini Nutritional Assessment Long Form®– MNA LF®. Dos dados obtidos em hospitais portugueses, destaca-se que dos 402 idosos avaliados, 53% eram do sexo masculino, tinham uma idade média de 75,8 + 6,52 (65 – 100) e segundo o MNA® 57,5% encontravam-se Desnutridos ou em Risco de Desnutrição.Na amostra, dos dados obtidos, a nível sociodemográfico salienta-se que 50% dos doentes eram do sexo masculino, a idade média rondava os 75,5 + 7,22 (65 – 100) anos, 55% eram naturais de Lisboa e 80% residiam em Lisboa e Vale do Tejo, 38% não tiveram estudos formais e 43% fizeram-no apenas até ao 4º ano de escolaridade. Em relação aos dados de saúde, a maioria dos doentes foi admitida através do Serviço de Urgência do Centro Hospitalar de Lisboa Central – Hospital de São José e foram internados no Serviço de Medicina (38%) e no Serviço de Cardiologia (30%), por patologia médica (38%) e patologia do sistema circulatório (56%). Nos hábitos de vida, quanto à mobilidade, um terço dos doentes estavam acamados e os restantes deambulavam ou tinham uma mobilidade normal, 74% não apresentaram hábitos etanólicos regulares, 19% apresentavam um consumo elevado (> 30g de etanol/dia); 95% dos doentes não apresentavam hábitos tabágicos. Relativamente à caracterização nutricional, os valores médios encontrados em relação aos parâmetros laboratoriais revelaram-se inferiores aos valores padrão para a idade e sexo e eram inferiores no sexo feminino. Na caracterização antropométrica verificaram-se os seguintes achados: o cálculo do IMC mostrou-se pouco sensível na identificação de doentes desnutridos; a PCT e a PCSE revelaram valores de massa gorda dentro do intervalo considerado normal;segundo o PB, 88% não apresentavam valor indicativo de desnutrição e 8% estavam desnutridos; a APB identificou 50% de doentes desnutridos; a AMB, revelou que 97% dos homens e 95% das mulheres apresentavam deficit da massa magra e segundo o PG, 18% apresentavam um valor inferior a 31cm descritor de desnutrição. Na análise da composição corporal verificou-se que ambos os sexos apresentavam uma percentagem de MGC classificada como demasiado alta e que esta era superior nas mulheres em relação aos homens. Ao analisar a ingestão nutricional verificou-se que esta era inferior às Dietary Reference Intakes (DRIs) para a ingestão hídrica (p=0,00), energética (p=0,00), proteica (p=0,00), lipídica (p=0,01), MUFA (p=0,00), PUFA (p=0,00), e glícidos (p=0,00), fibra (p=0,02), potássio (p=0,00), cálcio (p=0,00), magnésio (p=0,00), fósforo (p=0,00), zinco (p=0,00), vitamina D (p=0,00), vitamina E (p=0,00) e folato (p=0,00). No que diz respeito ao MNA®, a sua aplicação permitiu identificar 62% de situações de risco nutricional ou de desnutrição já instalada. Valores de MNA® indicativos de desnutrição ou risco estavam associados a níveis de escolaridade mais baixos (r=0,32; p=0,00). Verificou-se correlação entre o MNA® e a PCT (r=0,30;p=0,00), PCSE (r=0,19;p=0,03) e PG (r=0,27;p=0,00). Na análise da amostra por sexo e escalão etário, apenas se distinguiram as mulheres mais velhas, que apresentaram situação de IMC indicador de risco de desnutrição (IMC <23,5 + 2,9, (r=0,42;p=0,02)), e de valores médios de PB de 25,6+3,84cm (r=0,42;p=0,01), em situações de menor mobilidade caraterizados pelo MNA®. Os homens maisvelhos apresentaram correlação entre o MNA® e PCSE (r=0,41;p=0,02), APMB (r=0,57;p=0,00)e PG (r=0,55;p=0,00), e as mulheres mais velhas apenas com a PCT (r=0,39;p=0,02). A análise multivariada do MNA® em função do sexo e do escalão etário, revelou que estes são independentes. Os homens apresentaram valores médios de MNA® superiores às mulheres e à medida que a idade aumenta, os valores de MNA® em ambos os sexos diminuem, sendo indicativos de risco de desnutrição. Consideramos que, tendo em conta a natureza e objetivos do presente estudo, foi possível caracterizar e estimar a prevalência da desnutrição e do risco de desnutrição em pessoas idosas nas primeiras 72 horas de admissão hospitalar. Os resultados obtidos sinalizam a sua elevada prevalência e alertam para a necessidade de procedimentos protocolados de avaliação e intervenção nutricional da população idosa na admissão hospitalar. Para este efeito a aplicação do MNA® provou a sua aplicabilidade, assim como a medição e cálculo da AMB, que poderão ser muito precocemente aplicados e contribuir para potenciar melhorias do estado de saúde e diminuir o tempo de internamento, nomeadamente de pessoas idosas. Em relação ao padrão alimentar, este estudo contribuiu para uma chamada de atenção dos profissionais de saúde que a população idosa pode apresentar carências nutricionais na admissão, e que estas se não forem devidamente sinalizadas e colmatadas tendem a agravar-se durante o internamento podendo contribuir para o aumento da morbilidade.-------------ABSTRACT:Over the last decades the age redistribution group of the population worldwide has been presenting an increasing number of people aged 65 years or more, incorporating a population group commonly referred to as the elderly population. It´s important to further analyze the physiological mechanisms that lead to aging and how they might influence not only clinical aspects, but also nutritional, among others, with the perspective of their origin in the onset of chronic diseases. With this approach, malnutrition in the elderly is now considered by the European Nutrition for Health Alliance (ENHA) a public health problem. It is reported that its prevalence is around 60% at the level of hospital units, 40% in residential units and 5 to 10% in the elderly living in their own home or family's, and mostly remains to diagnose and treat. The aim of this study was to characterize and estimate the prevalence of malnutrition and risk of malnutrition in the elderly, in the first 72 hours of hospital admission. We applied an observational, analytical, cross-sectional and correlacional quantitative type of study and data were collected by interview and observation itself. The study was developed in two lines of research: one focused on the characterization of malnutrition in elderly institutionalized in Portuguese hospitals, in the central and southern mainland and Madeira, in the periods between July - August 2009, April - June 2010, May - July 2011, through the MNA®; and the other: a detailed nutritional assessment, conducted in Hospital Lisbon Center - Hospital de Santa Marta, EPE, between early January 2009 and late January 2010, and the sample was recruited from among the elderly of both sexes at hospital admission. We studied intensively sociodemographic, health and nutritional assessment done extensive. Nutritional evaluation consisted of harvesting different parameters: hematological, biochemical and anthropometric (body mass index (BMI), triceps skinfold (TSF), sub-scapular skinfold (SSF), arm circumference (AC), arm muscle area (AMA), geminal perimeter (GP), analysis of body composition (Fat Mass (FM), Fat Free Mass (FFM)), characterization of a daily food type and Mini Nutritional Assessment Long Form® questionnaire - MNA LF®. Form the data obtained in Portuguese hospitals, it is noteworthy that of the 402 patients included, 53% were male, had a mean age of 75,8 + 6,52 (65 - 100) and, according to the MNA®, 57,5% were malnourished or at risk of malnutrition. In the sample, from the sociodemographic data obtained, we saw that 50% of patients were male, the average age was around 75,5 + 7,22 years (65-100), 55% were from Lisbon and 80 %lived in Lisbon, 38% had no formal education and 43% did so only until the 4th grade. Regarding health data, the majorities of patients were admitted through the ER of Hospital Lisbon Center - S. José Hospital - and were admitted to the Medicine Unit (38%) and to the Cardiology Unit (30%), by medical pathology (38%) and circulatory system disease (56%). In regard to lifestyle, and considering mobility, one third of patients were bedridden and the rest were ambulating or had a normal mobility. 74% had no regular ethanol habits, 19% had a high intake (> 30 g ethanol / day); 95% of the patients had no smoking habits. Regarding nutritional assessment, the mean values for laboratory parameters proved inferior to standard values for age and sex and were lower in females. In anthropometric assessment these were the findings: BMI calculation showed to be scarcely sensitive in the identification of undernourished patients; the TSF and SSF revealed values of fat mass within the normal range; in AC, 88% did not have an indicative value of malnutrition and 8% were malnourished; in AMA, 97% of men and 95% women had a deficit of lean mass and in GP, 18% had a value of less than the 31cm malnutrition descriptor. In body composition analysis found that both sexes showed a percentage of FM ranked too high and this was higher in women compared to men. By analyzing the nutritional intake was found that this was less than the Dietary Reference Intakes (DRIs) for water intake (p=0,00), energy (p=0,00), protein (p=0,00), lipid (p=0,01), MUFA (p=0,00), PUFA (p=0,00), carbohydrates (p=0,00), fiber (p=0,02), potassium (p=0,00), calcium (p=0,00), magnesium (p=0,00), phosphorus (p=0,00), zinc (p=0,00), vitamin D (p=0,00), vitamin E (p=0,00) and folate (p=0,00). Regarding MNA®, its application identified 62% of cases of nutritional risk or malnutrition already installed. MNA® values indicative of malnutrition or risk were associated with lower levels of education (r=0,32; p=0,00). There was a correlation between the MNA ® and TSF (r =0,30, p = 0,00), SFF (r = 0,19, p = 0,03) and GP (r=0,27, p = 0,00). In the analysis of the sample by gender and age group, the highlight was in older women who had BMI status indicator of malnutrition risk (BMI <23,5 + 2,9 (r=0,42;p=0,02)) and mean values of AC 25,6 +3,84cm (r=0,42; p=0,01), in situations characterized by low mobility MNA®. Older men showed a correlation between the MNA® and SFF (r = 0,41; p = 0,02), AMA (r = 0,57; p = 0,00) and GP (r=0,55;p=0,00), and in older women only TSF showed a correlation(r = 0,39; p =0,02). Multivariate analysis of the MNA® by gender and age group, revealed that they are independent. The men had MNA® mean superior to women, and as the age increases, the values of MNA® in both sexes declined, being indicative of risk of malnutrition. We believe that, given the nature and objectives of the present study, it allowed us to characterize and estimate the prevalence of risk of malnutrition and malnutrition in older people during the first 72 hours of hospital admission. The results indicate a high prevalence and point to the need for protocol procedures of nutritional assessment and intervention in the elderly population at hospital admission. For this purpose the application of MNA® has proved its applicability, as well as measuring and calculating AMA, which may be applied in early stages thus contributing to enhance health state improvements and to shorten the time of hospitalization, particularly in elderly people. In relation to dietary pattern, this study contributed to call of attention from health professionals that the elderly may have nutritional deficiencies on admission, and that these are not properly marked and addressed tend to worsen during hospitalization may contribute to increased morbidity.

Upgrade of an experimental volumetric unit for gas adsorption equilibrium studies

In this work, a volumetric unit previously assembled by the research group was upgraded. This unit revamping was necessary due to the malfunction of the solenoid valves employed in the original experimental setup, which were not sealing the gas properly leading to erroneous adsorption equilibrium measurements. Therefore, the solenoid valves were substituted by manual ball valves. After the volumetric unit improvement its operation was validated. For this purpose, the adsorption equilibrium of carbon dioxide (CO2) at 323K and 0 - 20 bar was measured on two different activated carbon samples, in the of extrudates (ANG6) and of a honeycomb monolith (ACHM). The adsorption equilibrium results were compared with data previously measured by the research group, using a high-pressure microbalance from Rubotherm GmbH (Germany) – gravimetric. The results obtained using both apparatuses are coincident thus validating the good operation of the volumetric unit upgraded in this work. Furthermore, the adsorption equilibrium of CO2 at 303K and 0 - 10 bar on Metal-Organic Frameworks (MOFs) Cu-BTC and Fe-BTC was also studied. The CO2 adsorption equilibrium results for both MOFs were compared with the literature results showing good agreement, which confirms the good quality of the experimental results obtained in the new volumetric unit. Cu-BTC sample showed significantly higher CO2 adsorption capacity when compared with the Fe-BTC sample. The revamping of the volumetric unit included a new valve configuration in order to allow testing an alternative method for the measurement of adsorption equilibrium. This new method was employed to measure the adsorption equilibrium of CO2 on ANG6 and ACHM at 303, 323 and 353K within 0-10 bar. The good quality of the obtained experimental data was testified by comparison with data previously obtained by the research group in a gravimetric apparatus.

Differences in ERP use and value across Iberian Manufacturing and Services SMEs

Enterprise Resource Planning (ERP) system literature reports very little research on post-adoption stages, that is, actual usage and value. Even fewer studies focus on the specificities of an industry analysis. Based on the Technology-Organizational-Environment (TOE) framework and the Resource-Based View (RBV) theory, we develop a research model to measure and examine determinants of ERP use and value and their impact in the Iberian region (Portugal and Spain) across Manufacturing and Services industries in Small and Medium Enterprises (SMEs). The empirical test was conducted through structural equation modelling, using data from 261 firms in the peninsula in the Manufacturing and Service industries. Results show that amongst ERP use determinants, Training is the most important determinant for Service firms and Compatibility for Manufacturing firms. Firm size, Analytics, and Collaboration contribute to ERP Value in both industries, with Analytics being more important for the Service industry. The paper provides insight into which determinants contribute to ERP use and ERP value in Iberian Manufacturing and Services SMEs, offering managerial and academic implications.

Thomsen-Friedenreich antigens in bladder cancer: evaluation of their prognostic value

RESUMO: Introdução. O cancro de bexiga é uma patologia comum que representa o 6° e o 5° cancro mais incidente em Portugal e na Itália, respetivamente. Em mais de metade dos casos ocorre reincidência durante o primeiro ano, requerendo acompanhamento clínico ao longo da vida. A instilação intravesical de Bacillus Calmette-Guérin (BCG) (uma estirpe atenuada do Mycobacterium bovis) representa uma imunoterapia eficaz no combate ao cancro de bexiga, no entanto, muitos aspetos da interação de BCG com as células tumorais bem como com as células do sistema imunitário permanecem por desvendar. As células tumorais de bexiga expressam frequentemente as formas sialiladas dos antigénios de Thomsen-Friedenreich (TF), i.e., sialil-T (sT) e sialil-Tn (sTn). Contudo ainda se desconhece o significado da sua expressão na malignidade tumoral e se afeta a eficácia da terapêutica BCG. Objetivo do estudo. Investigar o papel dos antigénios sT e sTn no fenótipo maligno de células de cancro de bexiga bem como na resposta mediada pelo sistema imunitário à terapia com BCG. Metodologia. Para tal, foram utilizadas as linhas celulares de cancro da bexiga HT1376 e MCR, geneticamente modificadas por transdução com vetores codificantes para as sialiltransferases ST3GAL1 ou ST6GALNAC1, de forma a expressar homogeneamente os antigénios sT ou sTn respetivamente. Estes modelos celulares foram estudados após confronto com BCG. O nível de BCG internalizado foi avaliado por citometria de fluxo. O perfil global de expressão genética dos modelos celulares antes e após incubação com BCG foi analisado pela tecnologia de microarray. O perfil de citocinas secretadas pelos modelos celulares após incubação com BCG, bem como de macrófagos estimulados pelo secretoma de células de cancro de bexiga que por sua vez foram estimuladas previamente por BCG, foi estudado pelo sistema multiplex de “imuno-esferas”. Resultados. A análise do transcritoma dos modelos celulares revelou que grupos de genes envolvidos em funções específicas foram modulados em paralelo nos dois modelos celulares, após transdução, independentemente da sialiltransferase expressa. Ou seja, em células que expressavam a sialiltransferase ST3GAL1 ou ST6GALNAC1, os genes envolvidos na regulação da segregação cromossómica e na reparação do DNA foram consistentemente regulados negativamente. Genes descritos na literatura como marcadores para o cancro de bexiga foram também modulados. A incubação com BCG resultou numa tendência ao aumento da expressão de genes relevantes na preservação e estabilidade genómica e menor malignidade, no entanto, apenas em células que expressavam sT ou sTn. Entre as dez citocinas testadas, apenas a IL-6 e IL-8 foram expressas pelas linhas celulares de cancro da bexiga, com indução destas após estimulação com BCG, e principalmente em células que expressavam ST3GAL1 ou ST6GALNAC1. Em macrófagos, citocinas inflamatórias, tais como IL-1β, IL-6 e TNFα, e a citocina anti-inflamatória IL-10, foram induzidas apenas pelo secretoma de células de cancro da bexiga confrontadas com BCG, com maior relevância quando estas expressavam ST3GAL1 ou ST6GALNAC1, prevendo a estimulação de macrófagos semelhantes aos de tipo M1 e uma melhor resposta à terapia com BCG. Conclusões. O efeito geral da expressão destas sialiltransferases e dos produtos enzimáticos sT ou sTn nas células de cancro de bexiga conduz a um fenótipo de maior malignidade. Contudo, a maior avidez de estas na produção de citocinas inflamatórias após confronto com BCG, bem como a maior capacidade de estimulação de macrófagos, predirá uma resposta à terapia com BCG mais eficaz em tumores que expressem os antigénios de TF sialilados. Tais conclusões são totalmente concordantes com os nossos mais recentes dados clínicos obtidos em colaboração, que mostram que em doentes com cancro de bexiga que expressam sTn respondem melhor a terapia BCG. ----------ABSTRACT: Background. Bladder cancer is a common malignancy representing the 6th and the 5th most incident cancer in Portugal and in Italy, respectively. More than half of the cases relapse within one year, requiring though a lifelong follow-up. Intravesical instillation of Bacillus Calmette-Guérin (BCG) (an attenuated strain of Mycobacterium bovis) represents an effective immunotherapy of bladder cancer, although many aspects of the interaction of BCG with cancer cells and host immune cells remain obscure. Bladder cancer cells often express the sialylated forms of the Thomsen-Friedenreich (TF), i.e., sialil-T (sT) e sialil-Tn (sTn). However, it’s still unknown the sense of such expression in tumour malignancy and in the BCG therapy efficacy. Aim of the study. To investigate the role of the sT and sTn antigens on the malignant phenotype of bladder cancer cells and the immune mediated response to BCG therapy. Experimental. We have utilized populations of the bladder cancer cell lines HT1376 and MCR, genetically modified by transduction with the sialyltransferases ST3GAL1 or ST6GALNAC1 to express homogeneously sT or sTn antigens. The level of BCG internalized was assessed by flow cytometry. The whole gene expression profile of BCG-challenged or unchallenged bladder cancer cell lines was studied by microarray technology. The profile of cytokines secreted by BCG-challenged bladder cancer cells and that of macrophages challenged by the secretome of BCG-challenged bladder cancer cells was studied by multiplex immune-beads assay. Results. Transcriptome analysis of the sialyltransferase-transduced cells revealed that groups of genes involved in specific functions were regulated in parallel in the two cell lines, regardless the sialyltransferase expressed. Namely, in sialyltransferase-expressing cells, genes involved in the proper chromosomal segregation and in the DNA repair were consistently down-regulated, while genes reported in literature as markers for bladder cancer were modulated. BCG-challenging induced a tendency to up-regulation of the genes preserving genomic stability and reducing malignancy, but only in cells expressing either sT or sTn. Among the ten cytokines tested, only IL-6 and IL-8 were expressed by bladder cancer cell lines and up-regulated by BCG-challenging, mainly in sialyltransferases-expressing cells. In macrophages, inflammatory cytokines, such as IL-1β, IL-6 and TNFα, and the antinflammatory IL-10 were induced only by the secretome of BCG-challenged bladder cancer cells, particularly when expressing either sialyltransferase, predicting the stimulation of M1-like macrophages and a better response to BCG therapy. Conclusions. The general effect of the expression of the two sialyltransferases and their products in the bladder cancer cells is toward a more malignant phenotype. However, the stronger ability of sialyltransferase expressing cells to produce inflammatory cytokines upon BCG-challenging and to stimulate macrophages predicts a more effective response to BCG in tumours expressing the sialylated TF antigens. This is fully consistent with our recent clinical data obtained in collaboration, showing that patients with bladder cancer expressing sTn respond better to BCG therapy.

Nosocomial infections in a Brazilian neonatal intensive care unit: a 4-year surveillance study

INTRODUCTION: Report the incidence of nosocomial infections, causative microorganisms, risk factors associated with and antimicrobial susceptibility pattern in the NICU of the Uberlândia University Hospital. METHODS: Data were collected through the National Healthcare Safety Network surveillance from January 2006 to December 2009. The patients were followed five times/week from their birth to their discharge or death. RESULTS: The study included 1,443 patients, 209 of these developed NIs, totaling 293 NI episodes, principally bloodstream infections (203; 69.3%) and conjunctivitis (52; 17.7%). Device-associated infection rates were as follows: 17.3 primary bloodstream infections per 1,000 central line-days and 3.2 pneumonias per 1000 ventilator-days. The mortality rate in neonates with NI was 11.9%. Mechanical ventilation, total parenteral nutrition, orogastric tube, previous antibiotic therapy, use of CVC and birth weight of 751-1,000g appeared to be associated with a significantly higher risk of NI (p < 0.05). In multiple logistic regression analysis for NI, mechanical ventilation and the use of CVC were independent risk factors (p < 0.05). Coagulase- negative Staphylococcus (CoNS) (36.5%) and Staphylococcus aureus (23.6%) were the most common etiologic agents isolated from cultures. The incidences of oxacillin-resistant CoNS and S. aureus were 81.8% and 25.3%, respectively. CONCLUSIONS: Frequent surveillance was very important to evaluate the association of these well-known risk factors with NIs and causative organisms, assisting in drawing the attention of health care professionals to this potent cause of morbidity.

40 K Liquid Neon Energy Storage Unit

A thermal Energy Storage Unit (ESU) could be used to attenuate inherent temperature fluctuations of a cold finger, either from a cryocooler working or due to sudden income heat bursts. An ESU directly coupled to the cold source acts as a thermal buffer temporarily increasing its cooling capacity and providing a better thermal stability of the cold finger (“Power Booster mode”). The energy storage units presented here use an enthalpy reservoir based on the high latent heat of the liquid-vapour transition of neon in the temperature range 38 - 44 K to store up to 900 J, and that uses a 6 liters expansion volume at RT in order to work as a closed system. Experimental results in the power booster mode will be described: in this case, the liquid neon cell was directly coupled to the cold finger of the working cryocooler, its volume (12 cm3) allowing it to store 450 J at around 40 K. 10 W heat bursts were applied, leading to liquid evaporation, with quite reduced temperature changes. The liquid neon reservoir can also work as a temporary cold source to be used after stopping the cryocooler, allowing for a vibration-free environment. In this case the enthalpy reservoir implemented (24 cm3) was linked to the cryocooler cold finger through a gas gap heat switch for thermal coupling/decoupling of the cold finger. We will show that, by controlling the enthalpy reservoir’s pressure, 900 J can be stored at a constant temperature of 40 K as in a triple-point ESU.

40 K Neon liquid energy storage unit

Cryocoolers have been progressively replacing the use of the stored cryogens in cryogenic chains used for detector cooling, thanks to their higher and higher reliability. However, the mechanical vibrations, the electromagnetic interferences and the temperature fluctuations inherent to their functioning could reduce the sensor’s sensitivity. In order to minimize this problem, compact thermal energy storage units (ESU) are studied, devices able to store thermal energy without significant temperature increase. These devices can be used as a temporary cold source making it possible to turn the cryocooler OFF providing a proper environment for the sensor. A heat switch is responsible for the thermal decoupling of the ESU from the cryocooler’s temperature that increases when turned OFF. In this work, several prototypes working around 40 K were designed, built and characterized. They consist in a low temperature cell that contains the liquid neon connected to an expansion volume at room temperature for gas storage during the liquid evaporation phase. To turn this system insensitive to the gravity direction, the liquid is retained in the low temperature cell by capillary effect in a porous material. Thanks to pressure regulation of the liquid neon bath, 900 J were stored at 40K. The higher latent heat of the liquid and the inexistence of triple point transitions at 40 K turn the pressure control during the evaporation a versatile and compact alternative to an ESU working at the triple point transitions. A quite compact second prototype ESU directly connected to the cryocooler cold finger was tested as a temperature stabilizer. This device was able to stabilize the cryocooler temperature ((≈ 40K ±1 K) despite sudden heat bursts corresponding to twice the cooling power of the cryocooler. This thesis describes the construction of these devices as well as the tests performed. It is also shown that the thermal model developed to predict the thermal behaviour of these devices, implemented as a software,describes quite well the experimental results. Solutions to improve these devices are also proposed.

40 K neon liquid energy storage unit

Cryocoolers have been progressively replacing the use of the stored cryogens in cryogenic chains used for detector cooling, thanks to their higher and higher reliability. However, the mechanical vibrations, the electromagnetic interferences and the temperature fluctuations inherent to their functioning could reduce the sensor’s sensitivity. In order to minimize this problem, compact thermal energy storage units (ESU) are studied, devices able to store thermal energy without significant temperature increase. These devices can be used as a temporary cold source making it possible to turn the cryocooler OFF providing a proper environment for the sensor. A heat switch is responsible for the thermal decoupling of the ESU from the cryocooler’s temperature that increases when turned OFF. In this work, several prototypes working around 40 K were designed, built and characterized. They consist in a low temperature cell that contains the liquid neon connected to an expansion volume at room temperature for gas storage during the liquid evaporation phase. To turn this system insensitive to the gravity direction, the liquid is retained in the low temperature cell by capillary effect in a porous material. Thanks to pressure regulation of the liquid neon bath, 900 J were stored at 40K. The higher latent heat of the liquid and the inexistence of triple point transitions at 40 K turn the pressure control during the evaporation a versatile and compact alternative to an ESU working at the triple point transitions. A quite compact second prototype ESU directly connected to the cryocooler cold finger was tested as a temperature stabilizer. This device was able to stabilize the cryocooler temperature ((≈ 40K ±1 K) despite sudden heat bursts corresponding to twice the cooling power of the cryocooler. This thesis describes the construction of these devices as well as the tests performed. It is also shown that the thermal model developed to predict the thermal behaviour of these devices,implemented as a software, describes quite well the experimental results. Solutions to improve these devices are also proposed.

Enteric parasites in HIV-1/AIDS-infected patients from a Northwestern São Paulo reference unit in the highly active antiretroviral therapy era

INTRODUCTION: We describe the epidemiology of intestinal parasites in patients from an AIDS reference service in Northeastern São Paulo, Brazil. METHODS: Retrospective evaluation was done for all HIV-1/AIDS-positive patients whose Hospital de Base/São José do Rio Preto laboratorial analysis was positive for enteroparasites after diagnosis of HIV-1 infection, from January 1998 to December 2008. Statistical analysis was performed using the R statistical software version 2.4.1. The level of significance adopted was 5%. RESULTS: The most frequent protozoan was Isospora belli (4.2%), followed by Giardia lamblia (3.5%), Entamoeba coli (2.8%), and Cryptosporidium parvum (0.3%). Ancylostoma duodenale (1.4%) was the most frequently detected helminth, while Taenia saginata and Strongiloides stercoralis were found in 0.7% of the samples. The results showed that diarrhea was significantly associated with giardiasis and isosporiasis. However, no association was observed between CD4+ cell counts, viral load, and the characteristics of any particular parasite. CONCLUSIONS: Our data may be useful for further comparisons with other Brazilian regions and other developing countries. The data may also provide important clues toward improving the understanding, prevention, and control of enteric parasites around the world.

Reduction of catheter-associated bloodstream infections through procedures in newborn babies admitted in a university hospital intensive care unit in Brazil

INTRODUCTION: Catheter-associated bloodstream infection (CA-BSI) is the most common nosocomial infection in neonatal intensive care units. There is evidence that care bundles to reduce CA-BSI are effective in the adult literature. The aim of this study was to reduce CA-BSI in a Brazilian neonatal intensive care unit by means of a care bundle including few strategies or procedures of prevention and control of these infections. METHODS: An intervention designed to reduce CA-BSI with five evidence-based procedures was conducted. RESULTS: A total of sixty-seven (26.7%) CA-BSIs were observed. There were 46 (32%) episodes of culture-proven sepsis in group preintervention (24.1 per 1,000 catheter days [CVC days]). Neonates in the group after implementation of the intervention had 21 (19.6%) episodes of CA-BSI (14.9 per 1,000 CVC days). The incidence of CA-BSI decreased significantly after the intervention from the group preintervention and postintervention (32% to 19.6%, 24.1 per 1,000 CVC days to 14.9 per 1,000 CVC days, p=0.04). In the multiple logistic regression analysis, the use of more than 3 antibiotics and length of stay >8 days were independent risk factors for BSI. CONCLUSIONS: A stepwise introduction of evidence-based intervention and intensive and continuous education of all healthcare workers are effective in reducing CA-BSI.

Fair value measurement: Is the debate around level II and level III assets and liabilities relevant

Double Degree. A Work Project presented as part of the requirements for the Award of a Masters Degree in Finance from the NOVA- School of Business and Economics and a Masters Degree in Business Engineering from Louvain school of Management

Relationship between antibiotic consumption, oropharyngeal colonization, and ventilator-associated pneumonia by Staphylococcus aureus in an intensive care unit of a Brazilian teaching hospital

INTRODUCTION: his study evaluated the consumption of major classes of antibiotics, the colonization of the oropharynx of patients on mechanical ventilation, and the risk of ventilator-associated pneumonia (VAP) caused by Staphylococcus aureus in an intensive care unit for adults. METHODS: A case-control study was carried out using colonized patients (cases) by oxacillin-resistant S. aureus (ORSA) and (controls) oxacillin-sensitive S. aureus (OSSA) from May 2009 to August 2010. The occurrence of VAP by S. aureus was also evaluated in the same period. Antibiotic consumption was expressed as the number of defined daily doses (DDD)/1,000 patient-days for glycopeptides, carbapenems, and extended-spectrum cephalosporins. RESULTS: Three hundred forty-six (56.1%) patients underwent mechanical ventilation with a frequency of oropharyngeal colonization of 36.4%, corresponding to 63.5% for ORSA and 36.5% for OSSA. The risk of illness for this organism was significant (p<0.05), regardless of whether colonization/infection was by ORSA or OSSA. The consumption of antibiotics was high, mainly for broad-spectrum cephalosporins (551.26 DDDs/1,000 patient-days). The high density of use of glycopeptides (269.56 DDDs/1,000 patient-days) was related to colonization by ORSA (Pearson r=0.57/p=0.02). Additionally, age >60 years, previous antibiotic therapy, and previous use of carbapenems were statistically significant by multivariate analysis. CONCLUSIONS: There was a significant relationship between the colonization of the oropharyngeal mucosa and the risk of VAP by both phenotypes. The use of glycopeptides was related to colonization by ORSA.

Should Unilever JM export Cornettos to emergent countries?

Field Lab in Entrepreneurial Innovative Ventures