993 resultados para enteral nutritional support
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Otto-von-Guericke-Universität Magdeburg, Fakultät für Maschinenbau, Univ., Dissertation, 2015
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Report for the scientific stay at the California Institute of Technology during the summer of 2005. ByoDyn is a tool for simulating the dynamical expression of gene regulatory networks (GRNs) and for parameter estimation in uni- and multicellular models. A software support was carried out describing GRNs in the Systems Biology Markup Language (SBML). This one is a computer format for representing and storing computational models of biochemical pathways in software tools and databases. Supporting this format gives ByoDyn a wide range of possibilities to study the dynamical properties of multiple regulatory pathways.
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Estudio elaborado a partir de una estancia en el Institut fur Vogelforschung. El objeto de la estancia fue participar en la campaña de campo en la colonia de Charrán común (Sterna hirundo) situada en Wilhelmshaven (Alemania), entre los meses de mayo y agosto de 2005. Esta participación se llevó a cabo bajo la dirección del Prof. Dr. Peter H. Becker y junto a su equipo. Se participó en la recogida rutinaria de datos de la colonia así como en distintas técnicas relacionadas con el presente proyecto, como el marcaje de pollos, su observación directa desde escondites y la recogida de distintas muestras biológicas. El objetivo principal era continuar con la obtención de datos para el trabajo de investigación sobre la influencia de la calidad y la condición parental en la manipulación adaptativa de la razón de sexos y la asignación por sexos. La obtención de datos se basa en la implantación de transponders en pollos, que permiten la identificación de cada charrán de por vida. La combinación de esta información con la observación directa de cebas hace de la colonia un lugar excepcional, lo que permite conocer los factores que influyen en las tendencias que existan. Sin embargo, el objetivo específico de la campaña se centraba en investigar la variabilidad individual de la respuesta inmune en los pollos de charrán en relación a un número de atributos de los propios pollos (sexo, tamaño, tasa de crecimiento, proteínas en plasma, hematocrito, carga parasitaria, carotenos en plasma, isótopos de las plumas), de los padres (fecha y tamaño de puesta, calidad parental) y de las condiciones de cría (orden de eclosión, densidad de la sub-colonia). Los resultados de estos datos obtenidos durante la campaña respaldan que existe una influencia de la condición nutricional y la calidad parental en la respuesta immune de los pollos, debida probablemente a un esfuerzo reproductivo diferencial.
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En este trabajo analizaremos en primer lugar la presencia i la importancia de los alimentos que caracterizan la dieta mediterránea en los sistemas alimentarios españoles del siglo XIX. Veremos como evoluciona esta presencia y el su peso a la dieta dentro del proceso de transición nutricional moderna española, contemplando dos períodos: desde finales del XIX hasta la década de 1930, y la segunda mitad del XX, períodos caracterizados por un aumento de la ingesta de alimentos, cereales y patatas primer, y de productos de origen animal después, y por la progresiva convergencia con las dietes de les sociedades desarrolladas, que diluirían o minimizarían progresivamente las características diferenciales mediterráneos. Situaremos los cambios que se producen a España en el contexto europeo, i finalmente, analizaremos en que medida, en la etapa inicial, la dieta seguida se ajustaba a les necesidades de la población y a la dieta actualmente recomendada, y si se produjeron cambios significativos en el curso de la transición alimentaria.
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Purpose: In extreme situations, such as hyperacute rejection of heart transplant or major bleeding per-operating complications, an urgent heart explantation might be the only means of survival. The aim of this experimental study was to improve the surgical technique and the hemodynamics of an Extracorporeal Membrane Oxygenation (ECMO) support through a peripheral vascular access in an acardia model. Methods: An ECMO support was established in 7 bovine experiments (59±6.1 kg) by the transjugular insertion to the caval axis of a self-expanded cannula, with return through a carotid artery. After baseline measurements of pump flow and arterial and central venous pressure, ventricular fibrillation was induced (B), the great arteries were clamped, the heart was excised and right and left atria remnants, containing the pulmonary veins, were sutured together leaving an atrial septal defect (ASD) over the cannula in the caval axis. Measurements were taken with the pulmonary artery (PA) clamped (C) and anastomosed with the caval axis (D). Regular arterial and central venous blood gases tests were performed. The ANOVA test for repeated measures was used to test the null hypothesis and a Bonferroni t method for assessing the significance in the between groups pairwise comparison of mean pump flow. Results: Initial pump flow (A) was 4.3±0.6 L/min dropping to 2.8±0.7 L/min (P B-A= 0.003) 10 minutes after induction of ventricular fibrillation (B). After cardiectomy, with the pulmonary artery clamped (C) it augmented not significantly to 3.5±0.8 L/min (P C-B= 0.33, P C-A= 0.029). Finally, PA anastomosis to the caval axis was followed by an almost to baseline pump flow augmentation (4.1±0.7 L/min, P D-B= 0.009, P D-C= 0.006, P D-A= 0.597), permitting a full ECMO support in acardia by a peripheral vascular access. Conclusions: ECMO support in acardia is feasible, providing new opportunities in situations where heart must urgently be explanted, as in hyperacute rejection of heart transplant. Adequate drainage of pulmonary circulation is pivotal in order to avoid pulmonary congestion and loss of volume from the normal right to left shunt of bronchial vessels. Furthermore, the PA anastomosis to the caval axis not only improves pump flow but it also permits an ECMO support by a peripheral vascular access and the closure of the chest.
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Aquest projecte es basa en l'estudi de l'oferiment de qualitat de servei en xarxes wireless i satel·litals. Per això l'estudi de les tècniques de cross-layer i del IEEE 802.11e ha sigut el punt clau per al desenvolupament teòric d’aquest estudi. Usant el simulador de xarxes network simulator, a la part de simulacions es plantegen tres situacions: l'estudi de la xarxa satel·lital, l'estudi del mètode d'accés HCCA i la interconnexió de la xarxa satel·lital amb la wireless. Encara que aquest últim punt, incomplet en aquest projecte, ha de ser la continuació per a futures investigacions.
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OBJECTIVE: The study tests the hypothesis that a low daily fat intake may induce a negative fat balance and impair catch-up growth in stunted children between 3 and 9y of age. DESIGN: Randomized case-control study. SETTING: Three rural villages of the West Kiang District, The Gambia. SUBJECTS: Three groups of 30 stunted but not wasted children (height for age z-score < or = -2.0, weight for height z-score > or = -2.0) 3-9 y of age were selected by anthropometric survey. Groups were matched for age, sex, village, degree of stunting and season. INTERVENTION: Two groups were randomly assigned to be supplemented five days a week for one year with either a high fat (n = 29) or a high carbohydrate biscuit (n = 30) each containing approximately 1600 kJ. The third group was a non supplemented control group (n = 29). Growth, nutritional status, dietary intake, resting energy expenditure and morbidity were compared. RESULTS: Neither the high fat nor the high carbohydrate supplement had an effect on weight or height gain. The high fat supplement did slightly increase adipose tissue mass. There was no effect of supplementation on resting energy expenditure or morbidity. In addition, the annual growth rate was not associated with a morbidity score. CONCLUSIONS: Results show that neither a high fat nor a high carbohydrate supplement given during 12 months to stunted Gambian children induced catch-up growth. The authors suggest that an adverse effect of the environment on catch-up growth persists despite the nutritional interventions.
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The algorithmic approach to data modelling has developed rapidly these last years, in particular methods based on data mining and machine learning have been used in a growing number of applications. These methods follow a data-driven methodology, aiming at providing the best possible generalization and predictive abilities instead of concentrating on the properties of the data model. One of the most successful groups of such methods is known as Support Vector algorithms. Following the fruitful developments in applying Support Vector algorithms to spatial data, this paper introduces a new extension of the traditional support vector regression (SVR) algorithm. This extension allows for the simultaneous modelling of environmental data at several spatial scales. The joint influence of environmental processes presenting different patterns at different scales is here learned automatically from data, providing the optimum mixture of short and large-scale models. The method is adaptive to the spatial scale of the data. With this advantage, it can provide efficient means to model local anomalies that may typically arise in situations at an early phase of an environmental emergency. However, the proposed approach still requires some prior knowledge on the possible existence of such short-scale patterns. This is a possible limitation of the method for its implementation in early warning systems. The purpose of this paper is to present the multi-scale SVR model and to illustrate its use with an application to the mapping of Cs137 activity given the measurements taken in the region of Briansk following the Chernobyl accident.
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Critically ill patients depend on artificial nutrition for the maintenance of their metabolic functions and lean body mass, as well as for limiting underfeeding-related complications. Current guidelines recommend enteral nutrition (EN), possibly within the first 48 hours, as the best way to provide the nutrients and prevent infections. EN may be difficult to realize or may be contraindicated in some patients, such as those presenting anatomic intestinal continuity problems or splanchnic ischemia. A series of contradictory trials regarding the best route and timing for feeding have left the medical community with great uncertainty regarding the place of parenteral nutrition (PN) in critically ill patients. Many of the deleterious effects attributed to PN result from inadequate indications, or from overfeeding. The latter is due firstly to the easier delivery of nutrients by PN compared with EN increasing the risk of overfeeding, and secondly to the use of approximate energy targets, generally based on predictive equations: these equations are static and inaccurate in about 70% of patients. Such high uncertainty about requirements compromises attempts at conducting nutrition trials without indirect calorimetry support because the results cannot be trusted; indeed, both underfeeding and overfeeding are equally deleterious. An individualized therapy is required. A pragmatic approach to feeding is proposed: at first to attempt EN whenever and as early as possible, then to use indirect calorimetry if available, and to monitor delivery and response to feeding, and finally to consider the option of combining EN with PN in case of insufficient EN from day 4 onwards.
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Continuous respiratory exchange measurements were performed on 10 healthy young women for 1 h before, 3 h during, and 3 h after either parenteral (iv) or intragastric (ig) administration of a nutrient mixture (52% glucose, 18% amino acid, and 30% lipid energy) infused at twice the postabsorptive resting energy expenditure (REE). REE rose from 0.98 +/- 0.02 (iv) and 0.99 +/- 0.02 kcal/min (ig) postabsorptively to 1.13 +/- 0.03 (iv) and 1.13 +/- 0.02 kcal/min (ig), resulting in nutrient-induced thermogenesis of 10 +/- 0.6 and 9.3 +/- 0.9%, respectively, when related to the metabolizable energy. The respiratory quotient rose from preinfusion values of 0.81 +/- 0.02 (iv) and 0.80 +/- 0.01 (ig) to 0.86 +/- 0.01 (iv) and 0.85 +/- 0.01 (ig). After nutrient administration the respiratory quotient fell significantly to below the preinfusion values. Plasma glucose and insulin concentrations rose during nutrient administration but were higher during the intravenous route. It is concluded that, although the response time to intragastric administration was delayed, the thermic effects and overall substrate oxidations were comparable during intravenous or intragastric administration, albeit, at lower plasma glucose and insulin concentrations via the intragastric route.
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Energy balance is the difference between metabolizable energy intake and total energy expenditure. Energy intake is difficult to measure accurately; changes in body weight, for example, are not a good measure of the adequacy of energy intake, because fluctuations in body weight are common even if the overall trend is toward weight loss. It is now customary to assess energy requirements indirectly from total energy expenditure. Total energy expenditure consists of basal metabolism, postprandial thermogenesis, and physical activity. Energy expenditure is related to both body weight and body composition. A reduction in total energy expenditure accompanies weight loss, because basal metabolic rate decreases with the loss of lean tissue mass. Similarly, with weight gain, there is an increase in basal metabolic rate, because lean tissue mass grows to support the increase in fat tissue mass. Excess energy intake over energy expenditure causes weight gain and an accompanying increase in total energy expenditure. Following a period of adaptation, total energy expenditure will match energy intake and body weight will stabilize at a higher level. This same relationship holds for weight loss. Respiratory quotient (measured in steady state) is an indication of the proportion of energy expenditure derived from fat and carbohydrate oxidation. Over long periods of time, fat balance is equivalent to energy balance, as an excess of fat intake over fat oxidation causes fat storage.