112 resultados para CBR


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This work deals with the continuation of Scientific Initiation research initiated by Tamura (2012), which draws up a mixture of soil and recycled aggregate analysis for paving of low traffic volume roads using local materials from the Vale do Paraíba region. The main steps of the process were the soil and recycled aggregate characterization, along with grading tests and California Bearing Ratio (CBR) applied to the soil, the recycled aggregate and the mixture of soil and recycled aggregate; aiming their use as base and sub-base in paving urban roads. The results are discussed, emphasizing the mechanical behavior. The current results are compared with the results of IC Tamura research, taking decisions over this job to the final product best result. For a greater understanding of the work in general were described paving, its structure, its components and its physical behavior. It has been intended to emphasize the importance of the mixture of soil and recycled aggregate to meet the quality requirements and compliance with the specifications of current technical standards, in the context of durability, natural materials economy, decreases volume in landfills and cost reduction

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This work deals with the continuation of Scientific Initiation research initiated by Tamura (2012), which draws up a mixture of soil and recycled aggregate analysis for paving of low traffic volume roads using local materials from the Vale do Paraíba region. The main steps of the process were the soil and recycled aggregate characterization, along with grading tests and California Bearing Ratio (CBR) applied to the soil, the recycled aggregate and the mixture of soil and recycled aggregate; aiming their use as base and sub-base in paving urban roads. The results are discussed, emphasizing the mechanical behavior. The current results are compared with the results of IC Tamura research, taking decisions over this job to the final product best result. For a greater understanding of the work in general were described paving, its structure, its components and its physical behavior. It has been intended to emphasize the importance of the mixture of soil and recycled aggregate to meet the quality requirements and compliance with the specifications of current technical standards, in the context of durability, natural materials economy, decreases volume in landfills and cost reduction

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Acute kidney injury (AKI) is classically described as a rapid loss of kidney function. AKI affects more than 15% of all hospital admissions and is associated with elevated mortality rates. Although many advances have occurred, intermittent or continuous renal replacement therapies are still considered the best options for reversing mild and severe AKI syndrome. For this reason, it is essential that innovative and effective therapies, without side effects and complications, be developed to treat AKI and the end-stages of renal disease. Mesenchymal stem cell (MSC) based therapies have numerous advantages in helping to repair inflamed and damaged tissues and are being considered as a new alternative for treating kidney injuries. Numerous experimental models have shown that MSCs can act via differentiation-independent mechanisms to help renal recovery. Essentially, MSCs can secrete a pool of cytokines, growth factors and chemokines, express enzymes, interact via cell-to-cell contacts and release bioagents such as microvesicles to orchestrate renal protection. In this review, we propose seven distinct properties of MSCs which explain how renoprotection may be conferred: 1) anti-inflammatory; 2) pro-angiogenic; 3) stimulation of endogenous progenitor cells; 4) anti-apoptotic; 5) anti-fibrotic; 6) anti-oxidant; and 7) promotion of cellular reprogramming. In this context, these mechanisms, either individually or synergically, could induce renal protection and functional recovery. This review summarises the most important effects and benefits associated with MSC-based therapies in experimental renal disease models and attempts to clarify the mechanisms behind the MSC-related renoprotection. MSCs may prove to be an effective, innovative and affordable treatment for moderate and severe AKI. However, more studies need to be performed to provide a more comprehensive global understanding of MSC-related therapies and to ensure their safety for future clinical applications.

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Community research fatigue has been understudied within the context of community-university relationships and knowledge production. Community-based research (CBR), often occurring within a limited geography and population, increases the possibility that community members feel exhausted or over-whelmed by university research —particularly when they do not see tangible results from research activities. Prompted by informal stories of research fatigue from community members, a small graduate student team sought to understand the extent to which community members experienced research fatigue, and what factors contributed to or relieved feelings of research fatigue. In order to explore these dimensions of research fatigue, semi-structured, face-to-face interviews were conducted with 21 participants, including community members (n = 9), staff and faculty (n = 10), and students (n = 2). The objective of the research was to identify university practices that contribute to research fatigue and how to address the issue at the university level. Qualitative data analysis revealed several important actionable findings: the structure and conduct of community-based research, structured reciprocity and impact, and the role of trust in research. This study’s findings are used to assess the quality of Clark University’s research relationship with its adjacent community. Recommendations are offered; such as to improve partnerships, the impact of CBR, and to develop clear principles of practice.

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PURPOSE: To evaluate the effects of palliative chemotherapy with gemcitabine plus capecitabine (GemCap) on patient-reported outcomes measured using clinical benefit response (CBR) and quality-of-life (QOL) measures in patients with advanced biliary tract cancer. PATIENTS AND METHODS: Patients had to manifest symptoms of advanced biliary tract cancer and have at least one of the following: impaired Karnofsky performance score (60 to 80), average analgesic consumption >or= 10 mg of morphine equivalents per day, and average pain intensity score of >or= 20 mm out of 100 mm. Treatment consisted of oral capecitabine 650 mg/m(2) twice daily on days 1 through 14 plus gemcitabine 1,000 mg/m(2) as a 30-minute infusion on days 1 and 8 every 3 weeks until progression. The primary end point was the number of patients categorized as having a CBR or stable CBR (SCBR) during the first three treatment cycles. RESULTS: Forty-four patients were enrolled (bile duct cancer, n = 36; gallbladder cancers, n = 8). The main grade 3 or 4 adverse events included hematologic toxicity and fatigue. After three cycles, 36% of patients achieved a CBR, and 34% achieved an SCBR. Over the full course of treatment, 57% of patients achieved a CBR, and 18% achieved an SCBR. Improved QOL was observed in patients with a CBR or SCBR. The objective response rate was 25%. Median time to progression and overall survival times were 7.2 months and 13.2 months, respectively. CONCLUSION: Chemotherapy with GemCap is well tolerated and effective and leads to a high CBR rate. Patient-reported outcomes are useful for evaluating the effects of palliative chemotherapy in patients with biliary tract cancer.

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The monoclonal antibody anti-CD66 labeled with (99m)Tc is widely used as Scintimun((R)) granulocyte for bone marrow immunoscintigraphy. Further, recently performed clinical radioimmunotherapy studies with [(90)Y]Y-anti-CD66 proved to be suitable for the treatment of hematologic malignancies. Before radioimmunotherapy with [(90)Y]Y-anti-CD66, dosimetric estimations are required to minimize radiotoxicity and determine individual applicable activities. Planar imaging, using gamma-emitting radionuclides, is conventionally carried out to estimate the absorbed organ doses. In contrast, immuno-PET (positron emission tomography) enables the quantification of anti-CD66 accumulation and provides better spatial and temporal resolution. Therefore, in this study, a semiautomated radiosynthesis of [(18)F] F-anti-CD66 was developed, using the (18)F-acylation agent, N-succinimidyl-4-[(18)F]fluorobenzoate ([(18)F]SFB). As a proof of concept, an intraindividual comparison between PET and conventional scintigraphy, using (18)F- and (99m)Tc-labeled anti-CD66 in 1 patient with high-risk leukemia, is presented. Both labeled antibodies displayed a similar distribution pattern with high preferential uptake in bone marrow. Urinary excretion of [(18)F] F-anti-CD66 was increased and bone marrow uptake reduced, in comparison to [(99m)Tc]Tc-anti-CD66. Nevertheless, PET-based dosimetry with [(18)F] F-anti-CD66 could provide additional information to support conventional scintigraphy. Moreover, [(18)F]F-anti-CD66 is ideally suited for bone marrow imaging using PET.

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To compare clinical benefit response (CBR) and quality of life (QOL) in patients receiving gemcitabine (Gem) plus capecitabine (Cap) versus single-agent Gem for advanced/metastatic pancreatic cancer.

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OBJECTIVES Clinical benefit response (CBR), based on changes in pain, Karnofsky performance status, and weight, is an established palliative endpoint in trials for advanced gastrointestinal cancer. We investigated whether CBR is associated with survival, and whether CBR reflects a wide-enough range of domains to adequately capture patients' perception. METHODS CBR was prospectively evaluated in an international phase III chemotherapy trial in patients with advanced pancreatic cancer (n = 311) in parallel with patient-reported outcomes (PROs). RESULTS The median time to treatment failure was 3.4 months (range: 0-6). The majority of the CBRs (n = 39) were noted in patients who received chemotherapy for at least 5 months. Patients with CBR (n = 62) had longer survival than non-responders (n = 182) (hazard ratio = 0.69; 95% confidence interval: 0.51-0.94; p = 0.013). CBR was predicted with a sensitivity and specificity of 77-80% by various combinations of 3 mainly physical PROs. A comparison between the duration of CBR (n = 62, median = 8 months, range = 4-31) and clinically meaningful improvements in the PROs (n = 100-116; medians = 9-11 months, range = 4-24) showed similar intervals. CONCLUSION CBR is associated with survival and mainly reflects physical domains. Within phase III chemotherapy trials for advanced gastrointestinal cancer, CBR can be replaced by a PRO evaluation, without losing substantial information but gaining complementary information.

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Case-based reasoning (CBR) is a unique tool for the evaluation of possible failure of firms (EOPFOF) for its eases of interpretation and implementation. Ensemble computing, a variation of group decision in society, provides a potential means of improving predictive performance of CBR-based EOPFOF. This research aims to integrate bagging and proportion case-basing with CBR to generate a method of proportion bagging CBR for EOPFOF. Diverse multiple case bases are first produced by multiple case-basing, in which a volume parameter is introduced to control the size of each case base. Then, the classic case retrieval algorithm is implemented to generate diverse member CBR predictors. Majority voting, the most frequently used mechanism in ensemble computing, is finally used to aggregate outputs of member CBR predictors in order to produce final prediction of the CBR ensemble. In an empirical experiment, we statistically validated the results of the CBR ensemble from multiple case bases by comparing them with those of multivariate discriminant analysis, logistic regression, classic CBR, the best member CBR predictor and bagging CBR ensemble. The results from Chinese EOPFOF prior to 3 years indicate that the new CBR ensemble, which significantly improved CBRs predictive ability, outperformed all the comparative methods.

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O trabalho aqui apresentado é resultado de uma pesquisa onde se procurou caracterizar os solos da Região Metropolitana de Fortaleza (RMF). Inicialmente, o objetivo deixou de ser principal devido às limitações desse método quando aplicado aos solos da RMF. O objetivo principal do trabalho passou a ser estudar mais detalhadamente os solos que ocorrem na Região Metropolitana de Fortaleza à luz de métodos convencionais e não convencionais, para aplicação na engenharia rodoviária. Para tanto, foram estudados sessenta solos pertencentes às classes pedológicas que ocorrem na RMF. Esses solos foram submetidos a um programa experimental que envolveu a execução de ensaios \"convencionais\" e \"não convencionais\". A partir dos resultados experimentais foram estabelecidas correlações entre os valores de algumas propriedades de interesse à pavimentação realizadas em cilindro convencional e miniatura. Tentou-se determinar o valor de CBR de um solo, dispondo das cargas calculadas no ensaio mini-CBR, mas essa tarefa não logrou êxito. As amostras foram classificadas pelas classificações HBR e MCT para verificação da qualidade da previsão das propriedades dos solos obtidas por esses métodos e aqueles resultantes da execução dos ensaios de laboratório. Foi proposto, a partir da execução de ensaio de adsorção de azul de metileno, a inclusão no ábaco de três zonas para se caracterizar o comportamento dos solos da RMF. Os resultados experimentais permitiram, também, concluir que pode-se identificar os materiais com potencial de uso na pavimentação de sua classe pedológica.

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A presente dissertação procura contribuir para avaliar a utilidade de três equipamentos ligeiros na caracterização in situ de materiais de pavimentação de infraestruturas de transporte. Aquele tipo de avaliação visa o controlo de qualidade dos materiais durante o processo construtivo, embora possa contribuir também para estimar o comportamento previsível dos materiais utilizados. O estudo centrou-se principalmente na utilização do Defletómetro de Impacto Ligeiro (DIL), do GeoGauge (GG) e do Densímetro Elétrico (DE). No entanto, realizaramse complementarmente ensaios com o Cone de Penetração Dinâmica (CPD), com o Gamadensímetro (GD) e com o Indicador de Qualidade de Pavimentos (IQP). O GG e o DIL foram concebidos com o objetivo de medirem o módulo de deformabilidade de camadas constituídas por solo ou por materiais granulares. O DE destina-se a avaliar a qualidade da compactação de camadas de solo. Numa fase inicial do trabalho, fez-se uma recolha bibliográfica sobre as características, os princípios de funcionamento e o modo operatório de cada um dos equipamentos, de modo a apoiar o estudo de caso que se realizou mais tarde no âmbito do trabalho. O estudo bibliográfico centrou-se ainda na procura dos parâmetros que é possível medir com cada um dos equipamentos estudados, bem como na procura de relações entre aqueles parâmetros. Para a realização da campanha de ensaios previamente estabelecida, o estudo incluiu a construção de um modelo físico de pavimento. O pavimento construído, com dimensões em planta da ordem de 2 1,5 m2, é constituído por duas estruturas diferentes, assentes sobre a mesma fundação, com uma espessura total de 29 cm: uma formada por uma camada granular e uma camada betuminosa; a outra constituída por uma camada de solo estabilizado com cimento e uma camada betuminosa. Os materiais constituintes do modelo foram caracterizados em laboratório e/ou in situ com recurso a ensaios convencionais. Nalguns casos recorreu-se às fichas de produto para recolher as propriedades necessárias. Na fundação estudou-se a utilização do DIL, do GG e do DE. Adicionalmente, avaliou-se o solo, com o CPD e com o GD. Nas camadas granular e de solo estabilizado estudou-se a utilização do DIL, do GG e do GD. Na camada betuminosa efetuaram-se ensaios com o DIL e com o IQP. Em cada um dos materiais colocados foi estudada a utilização dos equipamentos individualmente, de modo a obter os parâmetros caracterizadores dos materiais: o CBR (com o CPD), o módulo de deformabilidade (com o DIL, o GG e o CPD), a baridade seca e o teor em água (com o GD e o DE), a baridade (com o IQP). Quando se revelou útil, compararam-se resultados obtidos com os diferentes equipamentos para cada um dos materiais. Em termos gerais, pode afirmar-se que a utilização dos equipamentos testados pode contribuir de forma útil para avaliar os materiais in situ. Contudo, foram detetadas fragilidades no processo de caracterização, particularmente no que diz respeito à análise de sistemas multicamada com o DIL. O processo de calibração necessário à obtenção de resultados fiáveis com o DE revelou-se pouco prático. Além disso, o GG permitiu obter resultados com baixa variabilidade, embora geralmente bastante diferentes dos obtidos com o DIL. Os equipamentos complementares estudados neste trabalho mostraram ser úteis na avaliação dos materiais. Em suma, para que o controlo de qualidade seja efetivo, é necessário estabelecer, através de estudos mais alargados, quais os materiais em os equipamentos estudados podem ser utilizados com propriedade, e quais os critérios de aceitação/rejeição dos materiais que devem ser considerados em cada caso.

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A methodological framework for conducting a systematic, mostly qualitative, meta-synthesis of community-based rehabilitation (CBR) project evaluation reports is described. Developed in the course of an international pilot study, the framework proposes a systematic review process in phases which are strongly collaborative, methodologically rigorous and detailed. Through this suggested process, valuable descriptive data about CBR practice, strategies and outcomes may be synthesized. It is anticipated that future application of this methodology will contribute to an improved evidence base for CBR, which will facilitate the development of more appropriate policy and practice guidelines for disability service delivery in developing countries. The methodology will also have potential applications in areas beyond CBR, which are similarly. evidence poor' (lacking empirical research) but 'data rich' (with plentiful descriptive and evaluative reports).

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In vitro binding of the iodinated imidazopyri dine, N',N'-dimethyl-6-methyl-(4'-[I-123]iodophenyl)imidazo[1,2-a]pyridine-3-acetamide [I-123]IZOL to benzodiazepine binding sites on brain cortex, adrenal and kidney membranes is reported. Saturation experiments showed that [I-123]IZOL, bound to a single class of binding site (n(H)=0.99) on adrenal and kidney mitochondrial membranes with a moderate affinity (K-d=30 nM). The density of binding sites was 22 +/- 6 and 1.2 +/- 0.4 pmol/mg protein on adrenal and kidney membranes, respectively. No specific binding was observed in mitochondrial-synaptosomal membranes of brain cortex. In biodistribution studies in rats, the highest uptake of [I-123]IZOL was found 30 min post injection in adrenals (7.5% ID/g), followed by heart, kidney, lung (1% ID/g) and brain (0.12% ID/g), consistent with the distribution of peripheral benzodiazepine binding sites. Pre-administration of unlabelled IZOL and the specific PBBS drugs, PK 11195 and Ro 5-4864 significantly reduced the uptake of [I-123]IZOL by 30% (p < 0.05) in olfactory bulbs and by 51-86% (p < 0.01) in kidney, lungs, heart and adrenals, while it increased by 30% to 50% (p < 0.01) in the rest of the brain and the blood. Diazepam, a mixed CBR-PBBS drug, inhibited the uptake in kidney, lungs, heart, adrenals and olfactory bulbs by 32% to 44% (p < 0.01) but with no effect on brain uptake and in blood concentration. Flumazenil, a central benzodiazepine drug and haloperidol (dopamine antagonist/sigma receptor drug) displayed no effect in [I-123]IZOL in peripheral organs and in the brain. [I-123]IZOL may deserve further development for imaging selectively peripheral benzodiazepine binding sites. (c) 2006 Elsevier Inc. All rights reserved.

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Objective: To describe the workload profile in a network of Australian skin cancer clinics. Design and setting: Analysis of billing data for the first 6 months of 2005 in a primary-care skin cancer clinic network, consisting of seven clinics and staffed by 20 doctors, located in the Northern Territory, Queensland and New South Wales. Main outcome measures: Consultation to biopsy ratio (CBR); biopsy to treatment ratio (BTR); number of benign naevi excised per melanoma (number needed to treat [NNT]). Results: Of 69780 billed activities, 34 622 (49.6%) were consultations, 19 358 (27.7%) biopsies, 8055 (11.5%) surgical excisions, 2804 (4.0%) additional surgical repairs, 1613 (2.3%) non-surgical treatments of cancers and 3328 (4.8%) treatments of premalignant or non-malignant lesions. A total of 6438 cancers were treated (116 melanomas by excision, 4709 non-melanoma skin cancers [NMSCs] by excision, and 1613 NMSCs non-surgically); 5251 (65.2%) surgical wounds were repaired by direct suture, 2651 (32.9%) by a flap (of which 44.8% were simple flaps), 42 (0.5%) by wedge excision and 111 (1.4%) by grafts. The CBR was 1.79, the BTR was 3.1 and the NNT was 28.6. Conclusions: In this network of Australian skin cancer clinics, one in three biopsies identified a skin cancer (BTR, 3.1), and about 29 benign lesions were excised per melanoma (NNT, 28.6). The estimated NNT was similar to that reported previously in general practice. More data are needed on health outcomes, including effectiveness of treatment and surgical repair.