177 resultados para CVC


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Creació d'un entorn web que consisteix en un sistema per fer consultes en línia a bases de dades d'imatges. Aquestes consultes es fan per contingut, a partir de mètodes creats pel grup de recerca CAT (Color and Texture) del CVC (Centre de Visió per Computador). L'aplicació web permet afegir nous mètodes que els membres del grup han programat amb Matlab.

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Objectiu: Avaluar una intervenció dirigida a la reducció d‘infeccions relacionades amb els catèters venosos centrals (IRC). Mètodes: Estudi pre-postintervenció, 2004-2006. Població d'estudi: pacients portadors de catèter venós central (CVC). La intervenció va consistir en conèixer la situació bassal, identificar factors de risc, i en el segon període realitzar diverses intervencions. Resultats: Es van analitzar 175 i 200 CVC en el període pre i postintervenció, respectivament. Es va observar una incidència de IRC de 20% durant el període preintervenció i de 5,5% en el període post-intervenció (p&0,001). Conclusió: La aplicació de mesures de prevenció ha aconseguit una disminució d’aquestes del 72,5%.

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Biofilm production is an important mechanism that allows microbes to escape host defences and antimicrobial therapy. Vancomycin has been used largely for the treatment of methicillin-resistant staphylococcal infections. Here, we determined the minimal inhibitory concentration (MIC) and minimal biofilm eradication concentration (MBEC) for 82 Staphylococcus species isolated from central venous catheters (CVC). Our results showed that the 41 strong and moderate-biofilm-producing isolates presented a higher MBEC/MIC ratio for vancomycin than the 24 weak-biofilm-producing isolates, illustrating the importance of biofilm production ability and the difficulty in treating biofilm-related infections. The MBEC was significantly higher in moderate-biofilm-producing isolates than in weak-biofilm-producing isolates (p < 0.001) and in strong-biofilm-producing isolates than in weak-biofilm-producing isolates (p = 0.001). The correlation between the MIC and the MBEC was poor. Based on our results, we recommend that bacterial biofilms be suspected in all cases of CVC infection.

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La peau est sujette à un vieillissement intrinsèque (processus naturel et chronologique) et extrinsèque (processus induit par l'environnement et notamment les rayons UV). Plusieurs études ont montré que le vieillissement cutané s'accompagne d'une réduction de la densité capillaire au sein du derme et d'une dégradation de plusieurs protéines de la matrice extracellulaire. Cette atteinte morphologique est associée à une diminution de la capacité vasodilatatrice maximale de la microcirculation dermique et en particulier, de la réponse maximale du flux sanguin cutané à un échauffement local de la surface cutanée à des températures avoisinant les 43-44°C. Cette réponse, appelée hyperémie locale induite par la chaleur (local thermal hyperemia), est facilement mesurable par des investigations non invasives, telles que le laser Doppler. Nous avons entrepris cette étude afin d'investiguer les effets de l'âge sur la réactivité de la microcirculation dermique dans des zones cutanées exposées différemment aux rayons UV. Pour ce faire, nous avons étudié, chez des patients jeunes (18 à 30 ans, n=13) et des patients âgés (> 60 ans, n=13), la vasodilatation cutanée induite par réchauffement local de la peau, au niveau de 3 sites anatomiques différents (la cuisse, l'avant- bras et le front). Les mesures ont été effectuées au moyen d'un laser Doppler. Pour chaque sujet et chaque site, la température cutanée fut tout d'abord amenée à 34°C par 2 corps de chauffe (A et B), disposés de manière adjacente sur la peau. La température fut ensuite augmentée à 39°C (corps de chauffe A) et à 41°C (corps de chauffe B) pour une durée de 30 minutes, dans l'optique d'induire une vasodilatation sous- maximale. Ensuite, la température fut augmentée à 43 °C (corps de chauffe A et B) pour 15 minutes supplémentaires. Enfin, la vasodilatation maximale a été induite par un échauffement local à 44°C pour 15 minutes supplémentaires (corps de chauffe A et B). L'enregistrement séquentiel du flux sanguin cutané, effectué chaque minute par laser Doppler imager, donne des images sur lesquelles peut être calculé le flux sanguin cutané (unités de perfusion, PU). Par la suite, nous avons calculé les conductances vasculaires cutanées (CVC), en divisant le flux sanguin (PU) par la tension artérielle moyenne (mmHg), afin de permettre une normalisation entre les différents sujets. Les CVC, évaluées au temps de départ (température 34°C) et après vasodilatation maximale (température 44°C), étaient plus hautes au niveau du front qu'au niveau des 2 autres sites anatomiques. Sur les 3 sites, la CVC maximale (température 44°C) diminuait avec l'âge mais de façon moins importante au niveau du front, en comparaison avec les 2 autres sites. La réponse aux températures sous-maximales (température 39 et 41°C), exprimée en pourcentage de la CVC maximale, ne variait pas avec l'âge ni en fonction du site anatomique étudié. En conclusion, cette étude est la première à étudier simultanément l'hyperémie locale induite par la chaleur sur 3 sites ayant une exposition différente aux rayons UV. Le processus utilisé (laser Doppler imager) est également unique dans la littérature concernant les altérations de la microcirculation cutanée en lien avec l'âge. Cette étude confirme ainsi que le vieillissement cutané intrinsèque et/ou extrinsèque réduit la capacité vasodilatatrice maximale de la microcirculation dermique. Par contre, la réactivité à réchauffement local à des températures moindres ne semble pas être affectée.

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O objetivo deste estudo foi avaliar as práticas de prevenção e controle de infecção da corrente sanguínea associada ao cateter venoso central (ICS-ACVC) de curta permanência, por meio da aplicação de indicadores clínicos processuais. A amostra foi constituída por 5.877 avaliações distribuídas entre as práticas selecionadas. Obteve-se ampla variação de conformidade: 91,6% - registro de indicação e tempo de permanência do CVC; 51,5% - cuidados e manutenção do curativo da inserção do CVC e seus dispositivos; 10,7% - higienização das mãos na realização de procedimentos de cuidado e manutenção do CVC; 0,0% - inserção do cateter venoso central (CVC). Os resultados demonstram necessidade de elaboração de novas estratégias que assegurem conformidade duradoura para a maioria das práticas de prevenção e controle de ICS-ACVC avaliadas. Conclui-se pela vantagem na aplicação de avaliação processual, pela possibilidade de não somente identificar seus índices de conformidade em relação à melhor prática esperada, como também favorecer, sobremaneira, reconhecimento das situações específicas que contribuíram para os valores encontrados.

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Este estudo objetivou traduzir e adaptar culturalmente a Management of Aggression and Violence Attitude Scale – MAVAS – para uso no Brasil. As etapas metodológicas seguiram as diretrizes internacionais para adaptação cultural de escalas psicométricas: equivalência conceitual, equivalência semântica, equivalência de itens e equivalência operacional. A validade de conteúdo realizada por um grupo de juízes resultou numa escala composta por 23 itens divididos em quatro fatores com Coeficientes de Validade de Conteúdo (CVC) satisfatórios nos parâmetros avaliados: (0,88) para clareza de linguagem, 0,91 pertinência prática e 0,92 para relevância teórica. Os dados foram coletados no ano de 2011, em Londrina, PR, Brasil. Concluiu-se que a MAVAS-BR está traduzida e adaptada culturalmente para uso no Brasil e que o instrumento traduzido e adaptado apresenta validade de conteúdo satisfatória. Estudos futuros relacionados à MAVAS-BR são sugeridos, dentre eles a avaliação de suas qualidades psicométricas, como a validade de construto e a confiabilidade do instrumento.

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This dissertation concerns two types of wh-constructions – interrogative and relative clauses – of Cape Verdean Creole (CVC), a Portuguese-based Creole language spoken on the archipelago of Cape Verde, specifically the variety spoken on Santiago Island, in the coast of West Africa. Chapter 2 focus on some aspects of the syntax of CVC, claiming that the possibilities of S-V inversion are very limited and that verbs stay in Vº, except for the Present tense form of the copula verb e ‘to be’, which is the spell out of the formal feature [Present] of T. It is proposed that CVC exhibits a clause functional structure that is similar to English: [CP [TP [NegP [AspP [VP … ]]]]]. In this chapter, it is also suggested that a non Split-CP, based on the formal features [±D, ±V, ±Q, ±Wh, ±T], correctly accounts for the distribution of the complementizers in CVC. Chapter 3 presents the wh-question formation strategies exhibited by CVC, showing that some of them involve Move, while others do not. Considering CVC data, it is said that the language has two clausal typing processes: an ambiguous complementizer ki ([±Q, ±Wh]), whose checking domain is strictly local; and an unambiguous complementizer Ø ([+Q, +Wh]), whose checking domain is not strictly local. The first one derives fronted wh-questions and the second one accounts for wh-in- -situ. Chapter 4 describes the relativization strategies displayed by CVC, focusing on the fact that PP pied-piping is ruled out and that resumption is possible both inside and outside syntactic islands. It is suggested a revision of Bianchi’s (2002a) head raising analysis for the structure of relative clauses. Chapter 5 discusses the properties of the defective copy strategy ([wh[+PL] … el]) and presents evidence in favor of a distinction between this type of wh-strategy and resumption ([wh[+PL] … es]). It is argued that the language requires an overt pronominal form (3SG) to occur in the complement position of the preposition because CVC types the clause with a complementizer ki [uCat +D] and does not allow for preposition incorporation. The set of formal features of the lower copy is ‘shrinked’, i.e. the features are deleted but not erased, being accessible to PF. This analysis of the defective copy xiv strategy predicts that it only applies to PPs and that it is an autonomous process involving wh-movement, which is distinct from resumption.

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One of the key emphases of these three essays is to provide practical managerial insight. However, good practical insight, can only be created by grounding it firmly on theoretical and empirical research. Practical experience-based understanding without theoretical grounding remains tacit and cannot be easily disseminated. Theoretical understanding without links to real life remains sterile. My studies aim to increase the understanding of how radical innovation could be generated at large established firms and how it can have an impact on business performance as most businesses pursue innovation with one prime objective: value creation. My studies focus on large established firms with sales revenue exceeding USD $ 1 billion. Usually large established firms cannot rely on informal ways of management, as these firms tend to be multinational businesses operating with subsidiaries, offices, or production facilities in more than one country. I. Internal and External Determinants of Corporate Venture Capital Investment The goal of this chapter is to focus on CVC as one of the mechanisms available for established firms to source new ideas that can be exploited. We explore the internal and external determinants under which established firms engage in CVC to source new knowledge through investment in startups. We attempt to make scholars and managers aware of the forces that influence CVC activity by providing findings and insights to facilitate the strategic management of CVC. There are research opportunities to further understand the CVC phenomenon. Why do companies engage in CVC? What motivates them to continue "playing the game" and keep their active CVC investment status. The study examines CVC investment activity, and the importance of understanding the influential factors that make a firm decide to engage in CVC. The main question is: How do established firms' CVC programs adapt to changing internal conditions and external environments. Adaptation typically involves learning from exploratory endeavors, which enable companies to transform the ways they compete (Guth & Ginsberg, 1990). Our study extends the current stream of research on CVC. It aims to contribute to the literature by providing an extensive comparison of internal and external determinants leading to CVC investment activity. To our knowledge, this is the first study to examine the influence of internal and external determinants on CVC activity throughout specific expansion and contraction periods determined by structural breaks occurring between 1985 to 2008. Our econometric analysis indicates a strong and significant positive association between CVC activity and R&D, cash flow availability and environmental financial market conditions, as well as a significant negative association between sales growth and the decision to engage into CVC. The analysis of this study reveals that CVC investment is highly volatile, as demonstrated by dramatic fluctuations in CVC investment activity over the past decades. When analyzing the overall cyclical CVC period from 1985 to 2008 the results of our study suggest that CVC activity has a pattern influenced by financial factors such as the level of R&D, free cash flow, lack of sales growth, and external conditions of the economy, with the NASDAQ price index as the most significant variable influencing CVC during this period. II. Contribution of CVC and its Interaction with R&D to Value Creation The second essay takes into account the demands of corporate executives and shareholders regarding business performance and value creation justifications for investments in innovation. Billions of dollars are invested in CVC and R&D. However there is little evidence that CVC and its interaction with R&D create value. Firms operating in dynamic business sectors seek to innovate to create the value demanded by changing market conditions, consumer preferences, and competitive offerings. Consequently, firms operating in such business sectors put a premium on finding new, sustainable and competitive value propositions. CVC and R&D can help them in this challenge. Dushnitsky and Lenox (2006) presented evidence that CVC investment is associated with value creation. However, studies have shown that the most innovative firms do not necessarily benefit from innovation. For instance Oyon (2007) indicated that between 1995 and 2005 the most innovative automotive companies did not obtain adequate rewards for shareholders. The interaction between CVC and R&D has generated much debate in the CVC literature. Some researchers see them as substitutes suggesting that firms have to choose between CVC and R&D (Hellmann, 2002), while others expect them to be complementary (Chesbrough & Tucci, 2004). This study explores the interaction that CVC and R&D have on value creation. This essay examines the impact of CVC and R&D on value creation over sixteen years across six business sectors and different geographical regions. Our findings suggest that the effect of CVC and its interaction with R&D on value creation is positive and significant. In dynamic business sectors technologies rapidly relinquish obsolete, consequently firms operating in such business sectors need to continuously develop new sources of value creation (Eisenhardt & Martin, 2000; Qualls, Olshavsky, & Michaels, 1981). We conclude that in order to impact value creation, firms operating in business sectors such as Engineering & Business Services, and Information Communication & Technology ought to consider CVC as a vital element of their innovation strategy. Moreover, regarding the CVC and R&D interaction effect, our findings suggest that R&D and CVC are complementary to value creation hence firms in certain business sectors can be better off supporting both R&D and CVC simultaneously to increase the probability of generating value creation. III. MCS and Organizational Structures for Radical Innovation Incremental innovation is necessary for continuous improvement but it does not provide a sustainable permanent source of competitiveness (Cooper, 2003). On the other hand, radical innovation pursuing new technologies and new market frontiers can generate new platforms for growth providing firms with competitive advantages and high economic margin rents (Duchesneau et al., 1979; Markides & Geroski, 2005; O'Connor & DeMartino, 2006; Utterback, 1994). Interestingly, not all companies distinguish between incremental and radical innovation, and more importantly firms that manage innovation through a one-sizefits- all process can almost guarantee a sub-optimization of certain systems and resources (Davila et al., 2006). Moreover, we conducted research on the utilization of MCS along with radical innovation and flexible organizational structures as these have been associated with firm growth (Cooper, 2003; Davila & Foster, 2005, 2007; Markides & Geroski, 2005; O'Connor & DeMartino, 2006). Davila et al. (2009) identified research opportunities for innovation management and provided a list of pending issues: How do companies manage the process of radical and incremental innovation? What are the performance measures companies use to manage radical ideas and how do they select them? The fundamental objective of this paper is to address the following research question: What are the processes, MCS, and organizational structures for generating radical innovation? Moreover, in recent years, research on innovation management has been conducted mainly at either the firm level (Birkinshaw, Hamel, & Mol, 2008a) or at the project level examining appropriate management techniques associated with high levels of uncertainty (Burgelman & Sayles, 1988; Dougherty & Heller, 1994; Jelinek & Schoonhoven, 1993; Kanter, North, Bernstein, & Williamson, 1990; Leifer et al., 2000). Therefore, we embarked on a novel process-related research framework to observe the process stages, MCS, and organizational structures that can generate radical innovation. This article is based on a case study at Alcan Engineered Products, a division of a multinational company provider of lightweight material solutions. Our observations suggest that incremental and radical innovation should be managed through different processes, MCS and organizational structures that ought to be activated and adapted contingent to the type of innovation that is being pursued (i.e. incremental or radical innovation). More importantly, we conclude that radical can be generated in a systematic way through enablers such as processes, MCS, and organizational structures. This is in line with the findings of Jelinek and Schoonhoven (1993) and Davila et al. (2006; 2007) who show that innovative firms have institutionalized mechanisms, arguing that radical innovation cannot occur in an organic environment where flexibility and consensus are the main managerial mechanisms. They rather argue that radical innovation requires a clear organizational structure and formal MCS.

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Abstract OBJECTIVE Determining which is the most effective solution (heparin flush compared to 0.9% saline flush) for reducing the risk of occlusions in central venous catheters (CVC) in adults. METHOD The systematic review followed the principles proposed by the Cochrane Handbook; critical analysis, extraction and synthesis of data were performed by two independent researchers; statistical analysis was performed using the RevMan program 5.2.8. RESULTS Eight randomized controlled trials and one cohort study were included and the results of the meta-analysis showed no difference (RR=0.68, 95% CI=0.41-1.10; p=0.12). Analysis by subgroups showed that there was no difference in fully deployed CVC (RR=1.09, CI 95%=0.53-2.22;p=0.82); Multi-Lumen CVC showed beneficial effects in the heparin group (RR=0.53, CI 95%=0.29-0.95; p=0.03); in Double-Lumen CVC for hemodialysis (RR=1.18, CI 95%=0.08-17.82;p=0.90) and Peripherally inserted CVC (RR=0.14, CI 95%=0.01-2.60; p=0.19) also showed no difference. CONCLUSION Saline solution is sufficient for maintaining patency of the central venous catheter, preventing the risks associated with heparin administration.

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Although the Santiago variety of Cape Verdean Creole (CVC) has been the subject of numerous linguistic works, the second major variety of the language, i.e. the São Vicente variety of CVC (CVSV), has hardly been described. Nevertheless this lack of studies and given its striking differences, on all linguistic levels, from the variety of Santiago (CVST), the implicit explanation for such divergences, echoed for decades in the literature on CVC, has been the presumably decreolized character of CVSV. First, this study provides a comprehensive fieldwork-based synchronic description of CVSV major morpho-syntactic categories in the intent to document the variety. Second, it aims to place the study of CVSV within a broader scope of contact linguistics in the quest to explain its structure. Based on analyses of historical documents and studies, it reconstructs the sociohistorical scenario of the emergence and development of CVSV in the period of 1797- 1975. From the comparison of the current structures of CVSV and CVST, the examination of linguistic data in historical texts and the analysis of sociohistorical facts it becomes clear that the contemporary structure of CVSV stems from the contact-induced changes that occurred during the intensive language and dialect contact on the island of São Vicente in the early days of its settlement in the late 18th and ensuing early 19th century development, rather than from modern day pressure of Portuguese. Although this dissertation argues for multiple explanations rather than a single theory, by showing that processes such as languages shift among the first Portuguese settlers, L2 acquisition, migration of the Barlavento speakers and subsequent dialect leveling as well as language borrowing at a later stage were at stake, it demonstrates the usefulness of partial-restructuring model proposed by Holm (2004).

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INTRODUCTION. Multimodal strategy targeted at prevention of catheter-related infection combine education to general measures of hygiene with specific guidelines for catheter insertion and dressing (1). OBJECTIVES. In this context, we tested the introduction of chlorhexidine(CHX)-impregnated sponges (2). METHODS. In our 32-beds mixed ICU, prospective surveillance of primary bacteremia and of microbiologically documented catheter-related bloodstream infections (CRBSI) is performed according to standardized definitions. New guidelines for central venous catheter (CVC) dressing combined a CHX-impregnated sponge (BioPatch_) with a transparent occlusive dressing (Tegaderm _) and planning for refection every 7 days. To contain costs, Biopatch_ was used only for internal jugular and femoral sites. Other elements of the prevention were not modified (overall compliance to hand hygiene 65-68%; non coated catheters except for burned patients [173 out of 9,542 patients];maximal sterile barriers for insertion; alcoholic solution ofCHXfor skin disinfection). RESULTS. Median monthly CVC-days increased from 710, to 749, 855 and 965 in 2006, 2007, 2008 and 2009, respectively (p\0.01). Following introduction of the new guidelines (4Q2007), the average monthly rate of infections decreased from 3.7 (95% CI: 2.6-4.8) episodes/1000 CVC-days over the 24 preceding months to 2.2 (95% CI: 1.5-2.8) over the 24 following months (p = 0.031). Dressings needed to be changed every 3-4 days. The decrease of catheter-related infections we observed in all consecutive admitted patients is comparable to that recently showed in a placeborandomized trial2. Further generalization to all CVC and arterial catheters access may be justified. CONCLUSIONS. Our data strongly suggest that combined with occlusive dressings, CHXimpregnated sponges for dressing of all CVC catheters inserted in internal jugular and/or femoral sites, significantly reduces the rate of primary bacteremia and CRBSI. REFERENCES. (1) Eggimann P, Harbarth S, Constantin MN, Touveneau S, Chevrolet JC, Pittet D. Impact of a prevention strategy targeted at vascular-access care on incidence of infections acquired in intensive care. Lancet 2000; 355:1864-1868. (2) Timsit JF, Schwebel C, Bouadma L, Geffroy A, Garrouste-Org, Pease S et al. Chlorhexidine- impregnated sponges and less frequent dressing changes for prevention of catheter-related infections in critically ill adults: a randomized controlled trial. JAMA 2009; 301(12):1231-1241.

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The objective of this work was to construct linkage maps of 'Pêra' sweet orange [Citrus sinensis (L.) Osbeck] and 'Cravo' mandarin (Citrus reticulata Blanco) using RAPD markers and the pseudo-testcross strategy. The parents were chosen according to the resistance/susceptibility to citrus variegate chlorosis (CVC). The segregation of 176 markers was analyzed in 94 progeny of F1 hybrids, which were obtained from controlled crossings. The linkage map of 'Pêra' sweet orange had 117 markers defined by 12 linkage groups, which spanned 612.1 cM. Only six markers could not be linked to the linkage group and 48.7% of the markers showed segregation distortion. The linkage map of 'Cravo' mandarin had 51 markers defined by 12 linkage groups, which spanned 353.3 cM. Only two markers did not link to the groups and 15.7% showed segregation distortion. The construction of linkage maps is relevant to future mapping studies of the inheritance of CVC, citrus canker and leprosis.

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O objetivo deste trabalho foi caracterizar a comunidade bacteriana endofítica de plantas assintomáticas (escapes) e afetadas pela clorose variegada dos citros (CVC) por meio de isolamento em meio de cultura, técnica de gradiente desnaturante em gel de eletroforese (DGGE) e detecção de Methylobacterium mesophilicum e Xyllela fastidiosa por meio de PCR específico, para estudar esta comunidade e sua relação com a ocorrência da CVC. A análise da comunidade bacteriana via DGGE permitiu a detecção de X. fastidiosa, bem como Klebsiella sp. e Acinetobacter sp. como endófitos de citros. Foram observados também Curtobacterium sp., Pseudomonas sp., Enterobacter sp. e Bacillus spp. Utilizando primers específicos, Methylobacterium mesophilicum e X. fastidiosa também foram observadas, reforçando hipóteses de que estas bactérias podem estar interagindo no interior da planta hospedeira.

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O objetivo deste trabalho foi avaliar os efeitos da clorose variegada dos citros (CVC), no fluxo de seiva, trocas gasosas e atividade fotoquímica em laranjeira 'Natal', com e sem CVC, em condição de campo. O curso diário do fluxo de seiva, potencial da água na folha, assimilação de CO2, transpiração, condutância estomática e eficiência quântica máxima e efetiva do fotossistema II foram avaliados. O delineamento experimental foi em blocos ao acaso com cinco repetições. O fluxo de seiva foi 1,9 vez superior nas plantas sadias em relação às doentes. Em plantas doentes ocorreu queda de 43, 28 e 33% na assimilação de CO2, condutância estomática e transpiração, respectivamente. As plantas com CVC apresentaram fotoinibição dinâmica. Uma vez que a eficiência quântica efetiva apresentou um padrão de resposta semelhante, durante o dia, em ambos os tratamentos, o efeito protetor da fotorrespiração no aparato fotoquímico em plantas com CVC é discutido. As quedas de assimilação de CO2, transpiração e de fluxo de seiva, nas plantas com CVC, foram decorrentes do menor valor da condutância estomática, possivelmente causado pela colonização dos vasos do xilema pela Xylella fastidiosa.

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O objetivo deste trabalho foi obter plantas transgênicas de laranja 'Valência' com o gene cecropin MB39 controlado pelo promotor do gene da fenilalanina-amônia-liase de citros, visando a expressão gênica específica nos vasos do xilema. A transformação genética foi realizada via Agrobacterium tumefaciens por meio do co-cultivo de segmentos de epicótilo. Onze plantas transgênicas foram identificadas por PCR, pela amplificação do fragmento esperado de 189 pb, as quais foram aclimatizadas em casa de vegetação. A integração do transgene foi confirmada em três plantas pela análise de transferência de Southern.