Nutrição hiperproteica em recém-nascidos com muito baixo peso e evolução de índices antropométricos até a alta hospitalar: ensaio clínico randomizado

Apesar de diversos estudos sobre nutrição de prematuros terem sido realizados, ainda não existe consenso sobre a melhor estratégia nutricional a ser adotada. Atualmente a taxa de crescimento dessa população não é semelhante àquela encontrada no ambiente intrauterino. O presente estudo tem por objetivo avaliar se o maior aporte proteico enteral durante a internação hospitalar promove melhora dos índices antropométricos na alta hospitalar. Realizou-se um ensaio clínico randomizado com 117 prematuros nascidos entre janeiro de 2009 e julho de 2013 com peso ≤ 1500 gramas e idade gestacional≤32 semanas em uma unidade terciária de saúde, excluídos os nascidos com malformações graves, aferindo-se os índices antropométricos ao nascimento e na alta hospitalar. Randomizou-se os prematuros por meio de sorteio em dois grupos. O grupo 1 (n=53), foi submetido a um aporte protéico enteral diário de 4,5 gramas/kg/dia, enquanto o grupo 2 (n=64), recebeu 3,5 gramas/kg/dia. Avaliou-se se a nutrição enteral com aporte protéico maior que o comumente utilizado em unidades de terapia intensiva neonatais e também descrito na literatura, promove diferenças antropométricas na alta hospitalar. Na análise dos resultados, verificou-se diferença estatisticamente significativa para retorno ao peso de nascimento (p=0,02), crescimento de escore-Z em relação ao peso de nascimento (p=0,03) e crescimento escore-Z em relação ao comprimento de nascimento (p=0,02) quando comparados o grupo 1 ao 2. Não houve diferenças estatisticamente significativas nas incidências de enterocolite necrotizante (p=0,70, RR 0,88), déficit ponderal na alta (p=0,27, RR 0,70), restrição de crescimento na alta (p= 0,39, RR 0,82) e déficit de perímetro cefálico na alta (p=0,45, RR 0,67). Concluiu-se, apesar das limitações metodológicas do estudo, que os participantes do grupo 1 apresentaram menor decréscimo de escores-Z em relação ao peso de nascimento e ao comprimento de nascimento quando comparados ao grupo 2, além de necessidade de menor tempo para recuperação do peso de nascimento. Não houve diferença entre os grupos para tempo de internação hospitalar, assim como para intercorrências de interesse (enterocolite necrotizante, déficit ponderal na alta, restrição de crescimento na alta e déficit de perímetro cefálico na alta).

Moradia como Liberdade

A habitação de interesse social decorre da existência do déficit habitacional que não é passível de ser enfrentado pela lógica do mercado imobiliário. Conforme aponta omainstreamda economia regional, a cidade é foco do crescimento mundial devido ao fluxo de informações e conhecimento; é nas cidades que o déficit habitacional se concentra e por isso o acesso a ela se torna tão relevante. O déficit habitacional urbano confirma a teoria de que habitar no centro urbano é algo que se valorize, deste modo o acesso à cidade é significativo para a expansão da liberdade. Não obstante, nossas observações confirmam que a maioria dos investimentos do Minha Casa Minha Vida do município do Rio de Janeiro são nas periferias urbanas, com infraestrutura precária, o que dificulta o acesso à cidade e ao trabalho, o pode ser um entrave para o desenvolvimento socioeconômico do Brasil. Desse modo, este trabalho analisa a moradia pela abordagem seniana das capacidades. Esta abordagem se faz relevante por considerar fatores sociológicos importantes para a superação da condição de privação econômica e social dos cidadãos. A pesquisa consiste na mensuração do déficit habitacional com a utilização dos dados do Censo Demográfico 2010 do IBGE. O trabalho consiste num esforço para delinear a satisfação e do acesso a cidade dos moradores do Rio de Janeiro que foram beneficiados pelo Programa Minha Casa Minha Vida. Este trabalho ressalta a importância do acesso à cidade bem como da moradia para a expansão das liberdades e para o desenvolvimento do país.

Design e Marketing: uma relação de sinergia para a Sustentabilidade

Esta dissertação aborda os princípios do Design, os fundamentos do Marketing e as condições que ambas as atividades podem, em parceria, gerar ambientes criativos para a Sustentabilidade. Acredita-se que tanto Design quanto Marketing são campos de saber parceiros, complementares e transversais, tendo deste modo um natural potencial de sinergia para a construção de projetos consistentes e duráveis. A insistência nesta ideia se deve, em parte, à vivência profissional nesses setores de gestão de projeto, e também ao desenvolvimento de exames, através da pesquisa bibliográfica, sobre os sentidos de termos, conceitos e objetivos para a organização de dados, a análise e alinhamento conceitual e a verificação de tangências entre esses campos. Este trabalho objetiva contribuir para a interação e a integração de saberes, em cursos de nível superior, também com a sugestão de ferramenta criativo-analítica e criativo-gerativa para o desenvolvimento de soluções mais sustentáveis. A crescente necessidade de atuações adequadas e eficazes dos campos estudados nos setores produtivos, a necessidade de profissionais capazes de se adequarem estas demandas, e a oferta deficitária de pesquisas com esta abordagem reforçam a crença na utilidade desta investigação. Os saberes em foco têm em comum relações multidisciplinares, sistêmicas e interdependentes.

Annual estimates of the unobserved incidental kill of pantropical spotted dolphin (Stenella attenuata attenuata) calves in the tuna purse-seine fishery of the eastern tropical Pacific

We estimated the total number of pantropical spotted dolphin (Stenella attenuata) mothers killed without their calves (“calf deficit”) in all tuna purse-seine sets from 1973– 90 and 1996–2000 in the eastern tropical Pacific. Estimates were based on a tally of the mothers killed as reported by color pattern and gender, several color-pattern-based frequency tables, and a weaning model. Over the time series, there was a decrease in the calf deficit from approximately 2800 for the western-southern stock and 5000 in the northeastern stock to about 60 missing calves per year. The mean deficit per set decreased from approximately 1.5 missing calves per set in the mid-1970s to 0.01 per set in the late-1990s. Over the time series examined, from 75% to 95% of the lactating females killed were killed without a calf. Under the assumption that these orphaned calves did not survive without their mothers, this calf deficit represents an approximately 14% increase in the reported kill of calves, which is relatively constant across the years examined. Because the calf deficit as we have defined it is based on the kill of mothers, the total number of missing calves that we estimate is potentially an underestimate of the actual number killed. Further research on the mechanism by which separation of mother and calf occurs is required to obtain better estimates of the unobserved kill of dolphin calves in this fishery.

The effect of an upstream turbine on a low-aspect ratio vane

The interaction between a high-pressure rotor and a downstream vane is dominated by vortex-blade interaction. Each rotor blade passing period two co-rotating vortex pairs, the tip-leakage and upper passage vortex and the lower passage and trailing shed vortex, impinge on, and are cut by, the vane leading edge. In addition to the streamwise vortex the tip-leakage flow also contains a large velocity deficit. This causes the interaction of the tip-leakage flow with a downstream vane to differ from typical vortex blade interaction. This paper investigates the effect these interaction mechanisms have on a downstream vane. The test geometry considered was a low aspect ratio second stage vane located within a S-shaped diffuser with large radius change mounted downstream of a shroudless high-pressure turbine stage. Experimental measurements were conducted at engine-representative Mach and Reynolds numbers, and data was acquired using a fast-response aerodynamic probe upstream and downstream of the vane. Time-resolved numerical simulations were undertaken with and without a rotor tip gap in order to investigate the relative magnitude of the interaction mechanisms. The presence of the upstream stage is shown to significantly change the structure of the secondary flow in the vane and to cause a small drop in its performance.

Compressor wake/leading-edge interactions at off design incidences

In this paper, the effects of wake/leading-edge interactions were studied at off-design conditions. Measurements were performed on the stator-blade suction surface at midspan. The leading-edge flow-field was investigated using hotwire micro-traverses, hotfilm surface shear-stress sensors and pressure micro-tappings. The trailing-edge flow-field was investigated using hotwire boundary-layer traverses. Unsteady CFD calculations were also performed to aid the interpretation of the results. At low flow coefficients, the time-averaged momentum thickness of the leading-edge boundary layer was found to rise as the flow coefficient was reduced. The time-resolved momentum-thickness rose due to the interaction of the incoming rotor wake. As the flow coefficient was reduced, the incoming wakes increased in pitch-wise extent, velocity deficit and turbulence intensity. This increased both the time-resolved rise in the momentum thickness and the turbulent spot production within the wake affected boundary-layer. Close to stall, a drop in the leading-edge momentum thickness was observed in-between wake events. This was associated with the formation of a leading-edge separation bubble in-between wake events. The wake interaction with the bubble gave rise to a shedding phenomenon, which produced large length scale disturbances in the surface shear stress. Copyright © 2008 by ASME.

Architectural research and its enemies

Like the Research Assessment Exercise (RAE) that preceded it, the UK government's proposed Research Excellence Framework (REF) is a means of allocating funding in higher education to support research. As with any method for the competitive allocation of funds it creates winners and losers and inevitably generates a lot of emotion among those rewarded or penalised. More specifically, the 'winners' tend to approve of the method of allocation and the 'losers' denigrate it as biased against their activities and generally unfair. An extraordinary press campaign has been consistently waged against research assessment and its methods by those involved in architectural education, which I will track over a decade and a half. What follows will question whether this campaign demonstrates the sophistication and superior judgment of those who have gone into print, or conversely whether its mixture of misinformation and disinformation reveals not just disenchantment and prejudice, but a naivety and a depth of ignorance about the fundamentals of research that is deeply damaging to the credibility of architecture as a research-based discipline. With the recent consultation process towards a new cycle of research assessment, the REF, getting under way, I aim to draw attention to the risk of repeating past mistakes. Copyright © Cambridge University Press 2010.

Economic analysis of carp based culture technologies in selected areas of Bangladesh

Six carp based culture technologies such as, carp-pangas, carp polyculture, carp-golda, pangas monoculture, golda monoculture and nursery have been selected to determine the cost and returns of respective technologies in Bangladesh. The sample farmers selected for these technologies were 55, 100, 65, 50, 51 and 55 respectively and thus the total sample size stood at 376. The study covered 7 districts of Bangladesh, namely, Mymensingh, Bogra, Noakhali, Comilla, Jessore, Khulna and Bagerhat. Both primary and secondary data were used for this study. It was found that farmers used a good number of feeds for the selected technologies and they maintained no standard doses for them. Remarkable differences were found among the prices of different feeds and other inputs used for different technologies in different locations. Prices of all inputs were found to be increasing and this increase was more in recent years compared to previous years. Though all the technologies were found to be profitable, the feed situation was not satisfactory. Except rice polish all the local feeds showed deficit in supply to meet the national demand for the country. If this situation persists and no proper measures are taken to secure the local feed supply, the present development of supplementary feed-based aquaculture would be fully dependent on imported feeds and would not be sustainable in future. This study strongly suggests the corresponding authority to handle the matter with proper attention considering its significant livelihood impact on the economy of the country.

Evidence of positive selection acting at the human dopamine receptor D4 gene locus

Associations have been reported of the seven-repeat (7R) allele of the human dopamine receptor D4 (DRD4) gene with both attention-deficit/hyperactivity disorder and the personality trait of novelty seeking. This polymorphism occurs in a 48-bp tandem repea

Can the occurrence of rare insertion/deletion polymorphisms in human mtDNA be verified from phylogeny?

Due to its specific characteristics, such as maternal inheritance and absence of recombination, each mtDNA belongs to certain monophyletic clade in the rooted mtDNA tree (haplogroup) according to the mutations it harbors. Rare mutation (excluding parallel mutation) occurring at multiple times in different haplogroups could thus be a potential reading error according to the mtDNA phylogeny. This experience has been widely used in double-checking the credibility of the rare mutations in human mtDNA sequences. However, no test has been performed so far for the feasibility of applying this strategy to the rare insertion/deletion (indel) events in mtDNA sequences. In this study, we attempted to relate the rare indels in mtDNAs to their haplogroup status in a total of 2352 individuals from 50 populations in China. Our results show that the insertion of A at position 16259 is restricted to a subclade of haplogroup C and can be verified. The other indel polymorphisms, which occur in the repeat of the deleted or inserted nucleotide(s), may not be distinguished from phantom mutations from a phylogenetic point of view. Independently and multiply sequencing the fragment with the indel is the best and the most reliable way for confirmation.

Efficient truncation scheme for modeling deepwater mooring lines

This paper is aimed at enabling the confident use of existing model test facilities for ultra deepwater application without having to compromise on the widely accepted range of scales currently used by the floating production industry. Passive line truncation has traditionally been the preferred method of creating an equivalent numerical model at reduced depth; however, these techniques tend to suffer in capturing accurately line dynamic response and so reproducing peak tensions. In an attempt to improve credibility of model test data the proposed truncation procedure sets up the truncated model, based on line dynamic response rather than quasi-static system stiffness. The upper sections of each line are modeled in detail, capturing the wave action zone and all coupling effects with the vessel. These terminate to an approximate analytical model that aims to simulate the remainder of the line. Stages 1 & 2 are used to derive a water depth truncation ratio. Here vibration decay of transverse elastic waves is assessed and it is found that below a certain length criterion, the transverse vibrational characteristics for each line are inertia driven, hence with respect to these motions the truncated model can assume a linear damper whose coefficient depends on the local line properties and vibration frequency. Stage 3 endeavors to match the individual line stiffness between the full depth and truncated models. In deepwater it is likely that taut polyester moorings will be used which are predominantly straight and have high axial stiffness that provides the principal restoring force to static and low frequency vessel motions. Consequently, it means that the natural frequencies of axial vibrations are above the typical wave frequency range allowing for a quasi-static solution. In cases of exceptionally large wave frequency vessel motions, localized curvature at the chain seabed segment and tangential skin drag on the polyester rope can increase dynamic peak tensions considerably. The focus of this paper is to develop an efficient scheme based on analytic formulation, for replicating these forces at the truncation. The paper will close with an example case study of a single mooring under extreme conditions that replicates exactly the static and dynamic characteristics of the full depth line. Copyright © 2012 by the International Society of Offshore and Polar Engineers (ISOPE).

The night purging of a two-storey atrium building

We examine the fluid mechanics of night purging in a two-storey naturally ventilated atrium building. We develop a mathematical model of a simplified atrium building and focus on the rate at which warm air purges from each storey and the atrium by displacement ventilation into a still cool night environment of a constant temperature. To develop a first insight into how the geometry of the building influences the rate at which warm air purges from each storey via the atrium we neglect heat exchange with the fabric (so there is no thermal buffering) and furthermore assume that the warm air layers in each storey and the atrium are of uniform temperature. The plumes of warm air that rise from the storeys into the atrium, causing the atrium to fill with warm air, have a very strong influence on the night purge. Modelling these as axisymmetric turbulent plumes, we identify three forms of purging behaviour. Each purge is characterised by five key times identified in the progression of the night purge and physical rationale for these differing behaviours is given. An interface velocity deficit and volumetric purge deficit are introduced as measures of the efficiency of a night purge. © 2010 Elsevier Ltd.

A Novel System for Reducing Turbo-Lag by Injection of Compressed Gas into the Exhaust Manifold

A key challenge in achieving good transient performance of highly boosted engines is the difficulty of accelerating the turbocharger from low air flow conditions (“turbo lag”). Multi-stage turbocharging, electric turbocharger assistance, electric compressors and hybrid powertrains are helpful in the mitigation of this deficit, but these technologies add significant cost and integration effort. Air-assist systems have the potential to be more cost-effective. Injecting compressed air into the intake manifold has received considerable attention, but the performance improvement offered by this concept is severely constrained by the compressor surge limit. The literature describes many schemes for generating the compressed gas, often involving significant mechanical complexity and/or cost. In this paper we demonstrate a novel exhaust assist system in which a reservoir is charged during braking. Experiments have been conducted using a 2.0 litre light-duty Diesel engine equipped with exhaust gas recirculation (EGR) and variable geometry turbine (VGT) coupled to an AC transient dynamometer, which was controlled to mimic engine load during in-gear braking and acceleration. The experimental results confirm that the proposed system reduces the time to torque during the 3rd gear tip-in by around 60%. Such a significant improvement was possible due to the increased acceleration of turbocharger immediately after the tip-in. Injecting the compressed gas into the exhaust manifold circumvents the problem of compressor surge and is the key enabler of the superior performance of the proposed concept.

The Effect of Motivation on Movement: A Study of Bradykinesia in Parkinson's Disease

Background: Bradykinesia is a cardinal feature of Parkinson's disease (PD). Despite its disabling impact, the precise cause of this symptom remains elusive. Recent thinking suggests that bradykinesia may be more than simply a manifestation of motor slowness, and may in part reflect a specific deficit in the operation of motivational vigour in the striatum. In this paper we test the hypothesis that movement time in PD can be modulated by the specific nature of the motivational salience of possible action-outcomes. Methodology/Principal Findings: We developed a novel movement time paradigm involving winnable rewards and avoidable painful electrical stimuli. The faster the subjects performed an action the more likely they were to win money (in appetitive blocks) or to avoid a painful shock (in aversive blocks). We compared PD patients when OFF dopaminergic medication with controls. Our key finding is that PD patients OFF dopaminergic medication move faster to avoid aversive outcomes (painful electric shocks) than to reap rewarding outcomes (winning money) and, unlike controls, do not speed up in the current trial having failed to win money in the previous one. We also demonstrate that sensitivity to distracting stimuli is valence specific. Conclusions/Significance: We suggest this pattern of results can be explained in terms of low dopamine levels in the Parkinsonian state leading to an insensitivity to appetitive outcomes, and thus an inability to modulate movement speed in the face of rewards. By comparison, sensitivity to aversive stimuli is relatively spared. Our findings point to a rarely described property of bradykinesia in PD, namely its selective regulation by everyday outcomes. © 2012 Shiner et al.

Dopamine and performance in a reinforcement learning task: evidence from Parkinson's disease.

The role dopamine plays in decision-making has important theoretical, empirical and clinical implications. Here, we examined its precise contribution by exploiting the lesion deficit model afforded by Parkinson's disease. We studied patients in a two-stage reinforcement learning task, while they were ON and OFF dopamine replacement medication. Contrary to expectation, we found that dopaminergic drug state (ON or OFF) did not impact learning. Instead, the critical factor was drug state during the performance phase, with patients ON medication choosing correctly significantly more frequently than those OFF medication. This effect was independent of drug state during initial learning and appears to reflect a facilitation of generalization for learnt information. This inference is bolstered by our observation that neural activity in nucleus accumbens and ventromedial prefrontal cortex, measured during simultaneously acquired functional magnetic resonance imaging, represented learnt stimulus values during performance. This effect was expressed solely during the ON state with activity in these regions correlating with better performance. Our data indicate that dopamine modulation of nucleus accumbens and ventromedial prefrontal cortex exerts a specific effect on choice behaviour distinct from pure learning. The findings are in keeping with the substantial other evidence that certain aspects of learning are unaffected by dopamine lesions or depletion, and that dopamine plays a key role in performance that may be distinct from its role in learning.