Desfechos tardios de sobreviventes de ensaio clínico randomizado controlado (protocolo ARDSnet vs. Open Lung Approach para o manejo ventilatório da síndrome do desconforto respiratório agudo moderado-grave)

Apesar da utilização da ventilação mecânica protetora como estratégia para o tratamento da síndrome do desconforto respiratório agudo, ao menos um quarto dos pacientes com essa síndrome ainda apresentam redução na função pulmonar após 6 meses de seguimento. Não se sabe se esta redução está relacionada com a gravidade da síndrome ou associada com a forma de ventilar o paciente. Nosso objetivo neste trabalho foi avaliar a associação entre alterações funcionais e estruturais do pulmão com parâmetros de gravidade clínica e de ventilação mecânica. Foi realizada uma análise secundária dos dados obtidos em estudo randomizado e controlado que incluiu pacientes com síndrome do desconforto respiratório agudo moderada/grave, internados em seis unidades de terapia intensiva em um hospital terciário da cidade de São Paulo. Foram analisados dados de pacientes que tinham ao menos um teste de função pulmonar no seguimento. O teste funcional incluiu a medida da capacidade vital forçada, volumes pulmonares e a capacidade de difusão do monóxido de carbono após 1, 2 e 6 meses de seguimento. Foram considerados variáveis independentes o volume corrente, a pressão de distensão e a pressão positiva ao final da expiração (todos medidos após 24 horas da randomização) e um sistema de classificação de prognóstico (APACHE II), a relação PaO2/FIO2 e a complacência respiratória estática (todos medidos antes da randomização). Também foi realizada tomografia de alta resolução do tórax juntamente com os testes de função pulmonar, e posterior análise quantitativa das imagens. Na avaliação de 6 meses também foi realizado teste de caminhada de 6 minutos e um questionário de qualidade de vida (SF-36). Um total de 21 pacientes realizaram o teste de função pulmonar após 1 mês e 15 pacientes realizaram após 2 e 6 meses de seguimento. A capacidade vital forçada foi relacionada inversamente com a pressão de distensão na avaliação de 1, 2 e 6 meses (p < 0,01). A capacidade de difusão do monóxido de carbono relacionou-se inversamente com a pressão de distensão e com o APACHE II (ambos p < 0,01) na avaliação de 1 e 2 meses. Após 6 meses de seguimento, houve correlação inversa entre a pressão de distensão e a capacidade vital forçada independente do volume corrente, da pressão de platô e da complacência estática respiratória após ajustes (R2 = 0,51, p = 0,02). A pressão de distensão também se relacionou com o volume pulmonar total, a densidade pulmonar media e a porcentagem de volume pulmonar não aerado ou pobremente aerado medidos através da análise quantitativa da tomografia computadorizada de tórax realizada na avaliação de 6 meses. Também foi observada relação entre a qualidade de vida após 6 meses de seguimento e a pressão de distensão considerando o domínio estado geral de saúde. Nós concluímos que mesmo em pacientes ventilados com reduzido volume corrente e pressão de platô limitada, maiores valores de pressão de distensão relacionaram-se com menores valores de função pulmonar no seguimento de longo prazo

Thames Tunnel, London, England, 1827 (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: Plan of the roads and main objects on the eastern part of London : as connected with the tunnel excavating under the Thames from Rotherhithe to Wapping, projected by M.I. Brunel, C.E. F.R.S., 1827. It was published by H. Teape & Son in 1827. Scale [ca. 1:48,000]. The image inside the map neatline is georeferenced to the surface of the earth and fit to the British National Grid coordinate system (British National Grid, Airy Spheroid OSGB (1936) Datum). All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as roads, docks, drainage, canals, selected buildings, and more. Includes text, advertisement, and engravings: View of the Thames River -- View of the Interior of the Thames Tunnel -- View of the iron shield compartments for workers. This layer is part of a selection of digitally scanned and georeferenced historic maps from The Harvard Map Collection as part of the Imaging the Urban Environment project. Maps selected for this project represent major urban areas and cities of the world, at various time periods. These maps typically portray both natural and manmade features at a large scale. The selection represents a range of regions, originators, ground condition dates, scales, and purposes.

Cellular slabs with and without insulation submitted to fire conditions

The wooden cellular slabs are lightweight structures, easy to assemble, and with excellent architectural features, as good thermal and acoustic conditions. The wooden cellular slabs with perforations are typical and very common engineering solutions, used in the ceiling or flooring to improve the acoustic absorption of compartments, and also have a good insulation and relevant architectonic characteristics. However, the high vulnerability of wooden elements submitted to fire conditions requires the evaluation of its structural behaviour with accuracy. The main objective of this work is to present a numerical model to assess the fire resistance of wooden cellular slabs with different perforations. Also the thermal behaviour of the wooden slabs will be compared considering material insulation inside the cavities. The time-temperature history and the residual cross-section of wooden slabs were numerically measured and analysed.

Wooden cellular slabs with and without insulation submitted to fire conditions

The wooden cellular slabs are lightweight structures, easy to assemble, and with excellent architectural features, as thermal and acoustic conditions. The wooden cellular slabs with perforations are typical and very common engineering solutions, used in the ceiling or flooring plates to improve the acoustic absorption of compartments, and also have a good insulation and relevant architectonic characteristics. However, the high vulnerability of wooden elements submitted to fire conditions requires the evaluation of its structural behavior with accurately. The main objective of this work is to present a numerical model to assess the fire resistance of wooden cellular slabs with different perforations. Also the thermal behavior of the wooden slabs will be compared considering material insulation inside the cavities

Thermal model for charring rate calculation in wooden cellular slabs under fire

Wood is a natural and traditional building material, as popular today as ever, and presents advantages. Physically, wood is strong and stiff, but compared with other materials like steel is light and flexible. Wood material can absorb sound very effectively and it is a relatively good heat insulator. But dry wood burns quite easily and produces a great deal of heat energy. The main disadvantage is the high level of combustion when exposed to fire, where the point at which it catches fire is from 200–400°C. After fire exposure, is need to determine if the charred wooden structures are safe for future use. Design methods require the use of computer modelling to predict the fire exposure and the capacity of structures to resist those action. Also, large or small scale experimental tests are necessary to calibrate and verify the numerical models. The thermal model is essential for wood structures exposed to fire, because predicts the charring rate as a function of fire exposure. The charring rate calculation of most structural wood elements allows simple calculations, but is more complicated for situations where the fire exposure is non-standard and in wood elements protected with other materials. In this work, the authors present different case studies using numerical models, that will help professionals analysing woods elements and the type of information needed to decide whether the charred structures are adequate or not to use. Different thermal models representing wooden cellular slabs, used in building construction for ceiling or flooring compartments, will be analysed and submitted to different fire scenarios (with the standard fire curve exposure). The same numerical models, considering insulation material inside the wooden cellular slabs, will be tested to compare and determine the fire time resistance and the charring rate calculation.

Carcinoma da tiróide

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Rôle de l'isoforme p35 de la chaîne invariante humaine dans la formation et le transport de complexes de CMH II

La présentation antigénique par les molécules de classe II du complexe majeur d’histocompatibilité (CMH II) est un mécanisme essentiel au contrôle des pathogènes par le système immunitaire. Le CMH II humain existe en trois isotypes, HLA-DP, DQ et DR, tous des hétérodimères composés d’une chaîne α et d’une chaîne β. Le CMH II est entre autres exprimé à la surface des cellules présentatrices d’antigènes (APCs) et des cellules épithéliales activées et a pour fonction de présenter des peptides d’origine exogène aux lymphocytes T CD4+. L’oligomérisation et le trafic intracellulaire du CMH II sont largement facilités par une chaperone, la chaîne invariante (Ii). Il s’agit d’une protéine non-polymorphique de type II. Après sa biosynthèse dans le réticulum endoplasmique (ER), Ii hétéro- ou homotrimérise, puis interagit via sa région CLIP avec le CMH II pour former un complexe αβIi. Le complexe sort du ER pour entamer son chemin vers différents compartiments et la surface cellulaire. Chez l’homme, quatre isoformes d’Ii sont répertoriées : p33, p35, p41 et p43. Les deux isoformes exprimées de manière prédominante, Iip33 et p35, diffèrent par une extension N-terminale de 16 acides aminés portée par Iip35. Cette extension présente un motif de rétention au réticulum endoplasmique (ERM) composé des résidus RXR. Ce motif doit être masqué par la chaîne β du CMH II pour permettre au complexe de quitter le ER. Notre groupe s’est intéressé au mécanisme du masquage et au mode de sortie du ER des complexes αβIi. Nous montrons ici que l’interaction directe, ou en cis, entre la chaîne β du CMH II et Iip35 dans une structure αβIi est essentielle pour sa sortie du ER, promouvant la formation de structures de haut niveau de complexité. Par ailleurs, nous démontrons que NleA, un facteur de virulence bactérien, permet d’altérer le trafic de complexes αβIi comportant Iip35. Ce phénotype est médié par l’interaction entre p35 et les sous-unités de COPII. Bref, Iip35 joue un rôle central dans la formation des complexes αβIi et leur transport hors du ER. Ceci fait d’Iip35 un régulateur clef de la présentation antigénique par le CMH II.

Masking odour when regrouping rabbit does: Effect on aggression, stress and lesions.

Regrouping female rabbits (Oryctolagus cuniculus) in group housing systems is a common management practice in Swiss rabbit breeding which may, however, induce agonistic interactions resulting in social stress and severe lesions. On farms using artificial insemination, does are usually kept singly for 12 days after parturition to avoid pseudopregnancy and fighting for nests. The integration of new group members usually occurs after this isolation phase. This study was conducted with 128 gravid does of the Hycole hybrid, housed in pens covering a floor area of 5.7 m2 that was bedded with straw and furnished with elevated areas, hiding places and eight compartments with nest boxes. In the experiment, the fur of 16 groups of 8 does each was sprayed with either alcohol or vinegar to mask the pre-existing group odours, or with water (control groups) shortly before regrouping. Lesion scores, stress parameters (body temperature and blood glucose level) and behaviour were assessed before and after the isolation phase. Effects of treatment and time on all collected parameters were analysed using mixed models. On the second day after regrouping 43% of the does showed new lesions. In the first five days after regrouping, new lesions occurred in 60% of the does; 32% had severe lesions. After regrouping, more agonistic interactions were observed and body temperature and blood glucose levels were higher than before regrouping (P<0.001 each). Body temperature increased less in groups treated with vinegar compared to the other two treatments on the first day after regrouping (P=0.017). In all other parameters no influence of the treatment with alcohol or vinegar was found. These findings suggest that masking the group odours with alcohol or vinegar had little effect on lesions, stress and agonistic interactions. Therefore, alternative management procedures need to be developed to reduce lesions and stress caused by aggressive behaviour.

Influence of nitrogen deficiency on senescence and the amounts of RNA and proteins in wheat leaves

Senescence-associated coordination in amounts of enzymes localized in different cellular compartments were determined in attached leaves of young wheat (Triticum aestivum L. cv. Arina) plants. Senescence was initiated at the time of full leaf elongation based on declines in total RNA and soluble protein. Removal of N from the growth medium just at the time of full leaf elongation enhanced the rate of senescence. Sustained declines in the amount of ribulose-1,5-bisphosphate carboxylase/oxygenase (Rubisco, EC 4.1.1.39), and a marked decrease in the rbcS transcripts, just after full leaf elongation indicated that Rubisco synthesis/degradation was very sensitive to the onset of senescence. Rubisco activase amount also declined during senescence but the proportion of rca transcript relative to the total poly A RNA pool increased 3-fold during senescence. Thus, continued synthesis of activase may be required to maintain functional Rubisco throughout senescence. N stress led to declines in the amount of proteins located in the chloroplast, the peroxisome and the cytosol. Transcripts of the Clp protease subunits also declined in response to N stress, indicating that Clp is not a senescence-specific protease. In contrast to the other proteins, mitochondrial NADH-glutamate dehydrogenase (EC 1.4.1.2) was relatively stable during senescence and was not affected by N stress. During natural senescence with adequate plant nitrate supply the amount of nitrite reductase (EC 1.7.7.1) increased, and those of glutamine synthetase (EC 1.4.7.1) and glutamate synthase (EC 6.3.1.2) were stable. These results indicated that N assimilatory capacity can continue or even increase during senescence if the substrate supply is maintained. Differential stabilities of proteins, even within the same cellular compartment, indicate that proteolytic activity during senescence must be highly regulated.

Pulmonary hypoplasia and anasarca syndrome in Cika cattle

BACKGROUND: Hydrops foetalis is defined as excessive fluid accumulation within the foetal extravascular compartments and body cavities. It has been described in human and veterinary medicine, but despite several descriptive studies its aetiology is still not fully clarified. Pulmonary hypoplasia and anasarca (PHA) syndrome is a rare congenital abnormality in cattle that is characterised by hydrops foetalis including extreme subcutaneous oedema (anasarca) and undeveloped or poorly formed lungs (pulmonary hypoplasia). Until now, sporadic cases of PHA were reported in cattle breeds like Australian Dexter, Belted Galloway, Maine-Anjou, and Shorthorn. This report describes the first known cases of PHA syndrome in Slovenian Cika cattle. CASE PRESENTATION: A 13-year-old cow aborted a male calf in the seventh month of pregnancy, while a male calf was delivered by caesarean section on the due date from a 14-year-old cow. The pedigree analysis showed that the calves were sired by the same bull, the dams were paternal half-sisters and the second calf was the product of a dam-son mating. Gross lesions were similar in both cases and characterized by severe anasarca, hydrothorax, hydropericardium, ascites, hypoplastic lungs, absence of lymph nodes, and an enlarged heart. The first calf was also athymic. Histopathology of the second affected calf confirmed severe oedema of the subcutis and interstitium of the organs, and pulmonary hypoplasia. The lymph vessels in the subcutis and other organs were severely dilated. Histopathology of the second calf revealed also lack of bronchus associated lymphoid tissue and adrenal gland hypoplasia. CONCLUSIONS: The findings were consistent with known forms of the bovine PHA syndrome. This is the first report of the PHA syndrome occurring in the local endangered breed of Cika cattle. Observed inbreeding practice supports that this lethal defect most likely follows an autosomal recessive mode of inheritance. In the light of the disease phenotype it is assumed that a mutation causing an impaired development of lymph vessels is responsible for the hydrops foetalis associated malformations in bovine PHA.

Gut content of holothurians from the NE Atlantic

This paper describes inter-specific differences in the distribution of sediment in the gut compartments and in the enzyme and bacterial profiles along the gut of abyssal holothurian species - Oneirophanta mutabilis, Psychropotes longicauda and Pseudostichopus villosus sampled from a eutrophic site in the NE Atlantic at different times of the year. Proportions of sediments, relative to total gut contents, in the pharynx, oesophagus, anterior and posterior intestine differed significantly in all the inter-species comparisons, but not between inter-seasonal comparisons. Significant differences were also found between the relative proportions of sediments in both the rectum and cloaca of Psychropotes longicauda and Oneirophanta mutabilis. Nineteen enzymes were identified in either gut-tissue or gut-content samples of the holothurians studied. Concentrations of the enzymes in gut tissues and their contents were highly correlated. Greater concentrations of the enzymes were found in the gut tissues suggesting that they are the main source of the enzymes. The suites of enzymes recorded were broadly similar in each of the species sampled collected regardless of the time of the year, and they were similar to those described previously for shallow-water holothurians. Significant inter-specific differences in the gut tissue concentrations of some of the glycosidases suggest dietary differences. For example, Psychropotes longicauda and Pseudostichopus villosus contain higher levels of chitobiase than Oneirophanta mutabilis. There were no seasonal changes in bacterial activity profiles along the guts of O. mutabilis and Pseudostichopus villosus. In both these species bacterial activity and abundance declined between the pharynx/oesophagus and anterior intestine, but then increased along the gut and became greatest in the rectum/cloaca. Although the data sets were more limited for Psychropotes longicauda, bacterial activity increased from the anterior to the posterior intestine but then declined slightly to the rectum/cloaca. These changes in bacterial activity and densities probably reflect changes in the microbial environment along the guts of abyssal holothurians. Such changes suggest that there is potential for microbial breakdown of a broader range of substrates than could be otherwise be achieved by the holothurian itself. However, the present study found no evidence for sedimentary (microbial) sources of hydrolytic enzymes.

In situ pore water oxygen microprofiles from the Polar Front, Southern South Atlantic Ocean

Without doubt, global climate change is directly linked to the anthropogenic release of greenhouse gases such as carbon dioxide (CO2) and methane (UN IPCC-Report 2007). Therefore, research efforts to comprehend the global carbon cycle have increased during the last years. In the context of the observed changes, it is of particular interest to decipher the role of the hydro-, bio- and atmospheres and how the different compartments of the earth system are affected by the increase of atmospheric CO2. Due to its huge carbon inventory, the marine carbon cycle represents the most important component in this respect. Numerous findings suggest that the Southern Ocean plays a key role in terms of oceanic CO2 uptake. However, an exact quantification of such fluxes of material is hard to achieve for large areas, not least on account of the inaccessibility of this remote region. In particular, there exist so far only few accurate data for benthic carbon fluxes. The latter can be derived from high resolution pore water oxygen profiles, as one possible method. However the ex situ flux determinations carried out on sediment cores, tend to suffer from temperature and pressure artefacts. Alternatively, oxygen microprofiles can be measured in situ, i.e. at the seafloor. Until now, no such data have been published for the Southern Ocean. During the Antarctic Expedition ANT-XXI/4, within the framework of this thesis, in situ and ex situ oxygen profiles were measured and used to derive benthic organic carbon fluxes. Having both types of measurements from the same locations, it was possible to establish a depth-related correction function which was applied subsequently to revise published and additional unpublished carbon fluxes to the seafloor. This resulted in a consistent data base of benthic carbon inputs covering many important sub-regions of the Southern Ocean including the Amundsen and Bellingshausen Seas (southern Pacific), Scotia and Weddell Seas (southern South Atlantic) as well as the Crozet Basin (southern Indian Ocean). Including additional locations on the Antarctic Shelf, there are now 134 new and revised measurement locations, covering almost 180° of the Southern Ocean, for which benthic organic carbon fluxes and sedimentary oxygen penetration depth values are available. Further, benthic carbon fluxes were empirically related to dominant diatom distributions in surface sediments as well as to long-term remotely sensed chlorophyll-a estimates. The comparison of these results with benthic carbon fluxes of the entire Atlantic Ocean reveals significantly higher export efficiencies for the Southern Ocean than have previously been assumed, especially for the area of the opal belt.

Seawater carbonate chemistry and accumulation of radiotracers in squid, Loligo vulgaris during experiments, 2011

The anthropogenic release of carbon dioxide (CO2) into the atmosphere leads to an increase in the CO2 partial pressure (pCO2) in the ocean, which may reach 950 ?atm by the end of the 21st century. The resulting hypercapnia (high pCO2) and decreasing pH ("ocean acidification") are expected to have appreciable effects on water-breathing organisms, especially on their early-life stages. For organisms like squid that lay their eggs in coastal areas where the embryo and then paralarva are also exposed to metal contamination, there is a need for information on how ocean acidification may influence trace element bioaccumulation during their development. In this study, we investigated the effects of enhanced levels of pCO2 (380, 850 and 1500 ?atm corresponding to pHT of 8.1, 7.85 and 7.60) on the accumulation of dissolved 110mAg, 109Cd, 57Co, 203Hg, 54Mn and 65Zn radiotracers in the whole egg strand and in the different compartments of the egg of Loligo vulgaris during the embryonic development and also in hatchlings during their first days of paralarval life. Retention properties of the eggshell for 110mAg, 203Hg and 65Zn were affected by the pCO2 treatments. In the embryo, increasing seawater pCO2 enhanced the uptake of both 110mAg and 65Zn while 203Hg showed a minimum concentration factor (CF) at the intermediate pCO2. 65Zn incorporation in statoliths also increased with increasing pCO2. Conversely, uptake of 109Cd and 54Mn in the embryo decreased as a function of increasing pCO2. Only the accumulation of 57Co in embryos was not affected by increasing pCO2. In paralarvae, the CF of 110mAg increased with increasing pCO2, whereas the 57Co CF was reduced at the highest pCO2 and 203Hg showed a maximal uptake rate at the intermediate pCO2. 54Mn and 65Zn accumulation in paralarvae were not significantly modified by hypercapnic conditions. Our results suggest a combined effect of pH on the adsorption and protective properties of the eggshell and of hypercapnia on the metabolism of embryo and paralarvae, both causing changes to the accumulation of metals in the tissues of L. vulgaris.

Crashworthiness analysis of the UMTA state-of-the-art cars. Final report.

Transportation Systems Center, Cambridge, Mass.

Ingress clearance requirements and seat positioning for automatic belt systems. Final report.

Mode of access: Internet.