995 resultados para Non-nutritive suction habits


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Con riferimento alla realizzazione di tunnel per servizi interrati, l’incertezza che contraddistingue il quadro geologico, oltre che incidere sui costi, riveste un ruolo chiave nella progettazione preliminare. Sebbene un’approfondita caratterizzazione geotecnica e geologica del volume di terreno inerente l’opera di scavo sia generalmente parte integrante del progetto, non è comunque possibile eliminare del tutto tali incertezze per via dell’estensione del volume interessato oltre che per la disomogeneità che sempre contraddistingue il terreno. Generalmente, investigazioni in corso d’opera e interventi di stabilizzazione devono essere previsti per contenere i costi di perforazione ed ottimizzare la progettazione. Ad esempio, tra i metodi di esplorazione geotecnica figurano i tunnel pilota, i quali sono in grado di garantire un’ottimale caratterizzazione del quadro geotecnico del sottosuolo. Con riferimento agli interventi di stabilizzazione del terreno, adottabili laddove una perforazione tradizionale non consentirebbe il tunnelling, vi è un vasta gamma di scelta. Pertanto, da una prima analisi delle problematiche connesse al tunnelling emerge che la stabilizzazione delle facce di scavo riveste un’importanza e un risconto applicativo di prim’ordine. Questa tesi si inserisce all’interno di un progetto che promuove un’innovativa ed economica tecnica di stabilizzazione dei tunnel per suzione tenendo quindi conto dell’influenza della suzione sulla coesione non drenata.

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INTRODUCTION: This case report describes the anaesthetic management of exploratory thoracoscopy and alternating one lung ventilation (OLV) in a dog with a pulmonary bulla, and the application of continuous positive airway pressure (CPAP) to the non-ventilated lung for preventing and treating hypoxia. CASE HISTORY: A 6-year-old, male castrated Border collie was scheduled for exploratory thoracoscopy to investigate spontaneous pnemothorax that had not resolved with repeated suction. Specific requirements for the thoracoscopy were alternating OLV to allow the surgical access to the right middle lobe and its removal, and the examination of the left hemithorax to rule out the presence of other lesions. DIAGNOSIS AND MANAGEMENT: Selective lung ventilation was performed with a double lumen endobronchial tube (DLT), inserted under endoscopic guidance. After a short period of two lung ventilation during preparation of the surgical field, alternating OLV was performed, combining CPAP, provided to the non-ventilated lung via a Mapleson D breathing system, and positive end-expiratory pressure (PEEP) applied to the ventilated lung. Left OLV occurred first and resection of the right middle pulmonary lobe was successfully performed; right OLV followed to allow the examination of the left hemithorax. DISCUSSION AND CONCLUSIONS: The combination of CPAP and PEEP resulted in a satisfactory intra-operative management of hypoxemia. Alternating OLV can be performed successfully by using a DLT. CPAP, commonly employed in human medicine, should be considered an important tool in the anaesthetic management of OLV in small animals.

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The aim of the study was to assess sleep-wake habits and disorders and excessive daytime sleepiness (EDS) in an unselected outpatient epilepsy population. Sleep-wake habits and presence of sleep disorders were assessed by means of a clinical interview and a standard questionnaire in 100 consecutive patients with epilepsy and 90 controls. The questionnaire includes three validated instruments: the Epworth Sleepiness Scale (ESS) for EDS, SA-SDQ for sleep apnea (SA), and the Ullanlinna Narcolepsy Scale (UNS) for narcolepsy. Sleep complaints were reported by 30% of epilepsy patients compared to 10% of controls (p=0.001). The average total sleep time was similar in both groups. Insufficient sleep times were suspected in 24% of patients and 33% of controls. Sleep maintenance insomnia was more frequent in epilepsy patients (52% vs. 38%, p=0.06), whereas nightmares (6% vs. 16%, p=0.04) and bruxism (10% vs. 19%, p=0.07) were more frequent in controls. Sleep onset insomnia (34% vs. 28%), EDS (ESS >or=10, 19% vs. 14%), SA (9% vs. 3%), restless legs symptoms (RL-symptoms, 18% vs. 12%) and most parasomnias were similarly frequent in both groups. In a stepwise logistic regression model loud snoring and RL-symptoms were found to be the only independent predictors of EDS in epilepsy patients. In conclusion, sleep-wake habits and the frequency of most sleep disorders are similar in non-selected epilepsy patients as compared to controls. In epilepsy patients, EDS was predicted by a history of loud snoring and RL-symptoms but not by SA or epilepsy-related variables (including type of epilepsy, frequency of seizures, and number of antiepileptic drugs).

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BACKGROUND: Elderly individuals who provide care to a spouse suffering from dementia bear an increased risk of coronary heart disease (CHD). OBJECTIVE: To test the hypothesis that the Framingham CHD Risk Score would be higher in dementia caregivers relative to non-caregiving controls. METHODS: We investigated 64 caregivers providing in-home care for their spouse with Alzheimer's disease and 41 gender-matched non-caregiving controls. All subjects (mean age 70 +/- 8 years, 75% women, 93% Caucasian) had a negative history of CHD and cerebrovascular disease. The original Framingham CHD Risk Score was computed adding up categorical scores for age, blood lipids, blood pressure, diabetes, and smoking with adjustment made for sex. RESULTS: The average CHD risk score was higher in caregivers than in controls even when co-varying for socioeconomic status, health habits, medication, and psychological distress (8.0 +/- 2.9 vs. 6.3 +/- 3.0 points, p = 0.013). The difference showed a medium effect size (Cohen's d = 0.57). A relatively higher blood pressure in caregivers than in controls made the greatest contribution to this difference. The probability (area under the receiver operator curve) that a randomly selected caregiver had a greater CHD risk score than a randomly selected non-caregiver was 65.5%. CONCLUSIONS: Based on the Framingham CHD Risk Score, the potential to develop overt CHD in the following 10 years was predicted to be greater in dementia caregivers than in non-caregiving controls. The magnitude of the difference in the CHD risk between caregivers and controls appears to be clinically relevant. Clinicians may want to monitor caregiving status as a routine part of standard evaluation of their elderly patients' cardiovascular risk.

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INTRODUCTION: The simple bedside method for sampling undiluted distal pulmonary edema fluid through a normal suction catheter (s-Cath) has been experimentally and clinically validated. However, there are no data comparing non-bronchoscopic bronchoalveolar lavage (mini-BAL) and s-Cath for assessing lung inflammation in acute hypoxaemic respiratory failure. We designed a prospective study in two groups of patients, those with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) and those with acute cardiogenic lung edema (ACLE), designed to investigate the clinical feasibility of these techniques and to evaluate inflammation in both groups using undiluted sampling obtained by s-Cath. To test the interchangeability of the two methods in the same patient for studying the inflammation response, we further compared mini-BAL and s-Cath for agreement of protein concentration and percentage of polymorphonuclear cells (PMNs). METHODS: Mini-BAL and s-Cath sampling was assessed in 30 mechanically ventilated patients, 21 with ALI/ARDS and 9 with ACLE. To analyse agreement between the two sampling techniques, we considered only simultaneously collected mini-BAL and s-Cath paired samples. The protein concentration and polymorphonuclear cell (PMN) count comparisons were performed using undiluted sampling. Bland-Altman plots were used for assessing the mean bias and the limits of agreement between the two sampling techniques; comparison between groups was performed by using the non-parametric Mann-Whitney-U test; continuous variables were compared by using the Student t-test, Wilcoxon signed rank test, analysis of variance or Student-Newman-Keuls test; and categorical variables were compared by using chi-square analysis or Fisher exact test. RESULTS: Using protein content and PMN percentage as parameters, we identified substantial variations between the two sampling techniques. When the protein concentration in the lung was high, the s-Cath was a more sensitive method; by contrast, as inflammation increased, both methods provided similar estimates of neutrophil percentages in the lung. The patients with ACLE showed an increased PMN count, suggesting that hydrostatic lung edema can be associated with a concomitant inflammatory process. CONCLUSIONS: There are significant differences between the s-Cath and mini-BAL sampling techniques, indicating that these procedures cannot be used interchangeably for studying the lung inflammatory response in patients with acute hypoxaemic lung injury.

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OBJECTIVES To identify potential prognostic factors affecting outcome in septic peritonitis caused by gastrointestinal perforation in dogs and cats. METHODS A retrospective study. Animals operated on for septic peritonitis because of gastrointestinal perforation were evaluated. Risk factors assessed included age, duration of clinical signs, recent prior abdominal surgery, recent prior anti-inflammatory drug administration, placement of a closed-suction drain and location of perforation. RESULTS Fifty-five animals (44 dogs and 11 cats) were included. The overall mortality was 63·6%. No association was found between age, duration of clinical signs or prior abdominal surgery and outcome. Animals with a history of prior anti-inflammatory drugs were significantly (P=0·0011) more likely to have perforation of the pylorus (73·3%). No significant difference in outcome was found between animals treated with closed-suction drains and those treated with primary closure or between pyloric perforation and perforation at other gastrointestinal sites. CLINICAL SIGNIFICANCE Administration of anti-inflammatory drugs in dogs and cats is a significant risk factor for pyloric perforation. Pyloric perforation was not associated with a poorer outcome than perforation at other gastrointestinal sites. Placement of a closed suction drain did not improve outcome compared to primary closure.

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One non bt-corn hybrid (Pioneer 3489) and three btcorn hyrids (Pioneer 34RO7, Novartis NX6236, and Novartis N64-Z4) were planted in replicated 7.1-acre fields. After grain harvest, fields were stocked with 3 mature cows in midgestation to be strip-grazed as four paddocks over 126 days. Six similar cows were allotted to replicated drylots. All cows were fed hay as necessary to maintain a condition score of 5 on a 9-point scale. Cows were condition-scored biweekly and weighed monthly. Forage yield and weathering losses were determined by sampling one 4-m2 location per grazed or ungrazed paddock in each field with a minimum total of 2 locations of grazed or ungrazed forage per field. To measure forage selection during grazing, samples of grazed forage were collected from the rumen of one fistulated steer that grazed for 2 hours after ruminal evacuation. Non-bt-corn hybrids had greater (P<.05) infestation of corn borers in the upper stalk, lower stalk and ear shank than bt-corn hybrids. However, there were no differences in grain yields or dropped grain between hybrids. Crop residue dry matter, organic matter and in vitro digestible dry matter yields at the initiation of grazing did not differ between corn hybrids. Dry matter, organic matter and in vitro digestible dry matter losses tended (P<.10) to be greater from the NX6236 and N64-Z4 hybrids than from the 3489 and 34RO7 hybrids and were greater (P<.05) from grazed than non-grazed areas of the fields. At the initiation of grazing, dry matter concentrations of the crop residues from the NX6236 and N64-Z4 hybrids tended to be lower than those from the 3489 and 34RO7 hybrids. Crop residues from the NX6236 and N64-74 hybrids had lower concentrations of acid detergent fiber (P<.05) and acid detergent lignin (P=.07) and higher concentrations of in vitro digestible organic matter than the 3489 and 34RO7 hybrids. Over the grazing season, corn hybrid did not affect mean rates of change in forage composition. The concentration of in vitro digestible organic matter in forage selected by steers after two weeks of grazing did not differ. However, steers grazing corn crop residues consumed forage with higher (P<.05) concentrations of neutral detergent fiber, acid detergent fiber, and acid detergent insoluble nitrogen than steers fed hay. The acid detergent fiber concentration of forage selected by steers grazing the 3489 and N64-Z4 hybrids was lower (P < .05) than concentrations from the 34RO7 and NX6236 hybrids. In order to maintain similar body condition score changes, cows grazing crop residues from the 3489, 34RO7, NX6236, and N64-Z4 hybrids required 650, 628, 625, and 541 kg hay DM/cow compared with a hay requirement of 1447 kg hay DM/cow for cows maintained in a drylot.

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BACKGROUND Vitamin D deficiency is prevalent in HIV-infected individuals and vitamin D supplementation is proposed according to standard care. This study aimed at characterizing the kinetics of 25(OH)D in a cohort of HIV-infected individuals of European ancestry to better define the influence of genetic and non-genetic factors on 25(OH)D levels. These data were used for the optimization of vitamin D supplementation in order to reach therapeutic targets. METHODS 1,397 25(OH)D plasma levels and relevant clinical information were collected in 664 participants during medical routine follow up visits. They were genotyped for 7 SNPs in 4 genes known to be associated with 25(OH)D levels. 25(OH)D concentrations were analyzed using a population pharmacokinetic approach. The percentage of individuals with 25(OH)D concentrations within the recommended range of 20-40ng/ml during 12 months of follow up and several dosage regimens were evaluated by simulation. RESULTS A one-compartment model with linear absorption and elimination was used to describe 25(OH)D pharmacokinetics, while integrating endogenous baseline plasma concentrations. Covariate analyses confirmed the effect of seasonality, body mass index, smoking habits, the analytical method, darunavir/r and the genetic variant in GC (rs2282679) on 25(OH)D concentrations. 11% of the interindividual variability in 25(OH)D levels was explained by seasonality and other non-genetic covariates and 1% by genetics. The optimal supplementation for severe vitamin D deficient patients was 300000 IU two times per year. CONCLUSIONS This analysis allowed identifying factors associated with 25(OH)D plasma levels in HIV-infected individuals. Improvement of dosage regimen and timing of vitamin D supplementation is proposed based on those results.

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Food primes and thought suppression have been identified as factors influencing poor eating choices. Primes affect people non-consciously by activating thoughts of food. Suppression of food thoughts leads to a preoccupation with food that is often followed by a hyperaccessibility of food thoughts and increased binging. The current study paired these two processes to examine their interactional effects. We manipulated exposure to food primes and instructions to suppress thoughts of a tasty snack food (M&Ms) for 76 college-aged women. We hypothesized that participants both primed with food images and asked to suppress would consume the most M&Ms at the end of the study. Contrary to predictions, results showed no effects for the manipulations. Perceived weight category, however, did interact with the manipulations, with overweight participants eating more when they got either the food prime or the suppression (but not both together). These findings have important implications for weight-loss strategies.

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Some experiments have been performed to investigate the cyclic freeze-thaw deterioration of concrete, using traditional and non-traditional techniques. Two concrete mixes, with different pore structure, were tested in order to compare the behavior of a freeze-thaw resistant concrete from one that is not. One of the concretes was air entrained, high content of cement and low w/c ratio, and the other one was a lower cement content and higher w/c ratio, without air-entraining agent. Concrete specimens were studied under cyclic freeze-thaw conditions according to UNE-CENT/TS 12390-9 test, using 3% NaCl solution as freezing medium (CDF test: Capillary Suction, De-icing agent and Freeze-thaw Test). The temperature and relative humidity were measured during the cycles inside the specimens using embedded sensors placed at different heights from the surface in contact with the de-icing agent solution. Strain gauges were used to measure the strain variations at the surface of the specimens. Also, measurements of ultrasonic pulse velocity through the concrete specimens were taken before, during, and after the freeze-thaw cycles. According to the CDF test, the failure of the non-air-entraining agent concrete was observed before 28 freeze-thaw cycles; contrariwise, the scaling of the air-entraining agent concrete was only 0.10 kg/m 2 after 28 cycles, versus 3.23 kg/m 2 in the deteriorated concrete, after 28 cycles. Similar behavior was observed on the strain measurements. The residual strain in the deteriorated concrete after 28 cycles was 1150 m versus 65 m, in the air-entraining agent concrete. By means of monitoring the changes of ultrasonic pulse velocity during the freeze-thaw cycles, the deterioration of the tested specimens were assessed

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Swarm colonies reproduce social habits. Working together in a group to reach a predefined goal is a social behaviour occurring in nature. Linear optimization problems have been approached by different techniques based on natural models. In particular, Particles Swarm optimization is a meta-heuristic search technique that has proven to be effective when dealing with complex optimization problems. This paper presents and develops a new method based on different penalties strategies to solve complex problems. It focuses on the training process of the neural networks, the constraints and the election of the parameters to ensure successful results and to avoid the most common obstacles when searching optimal solutions.

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The aim of this paper is to explain the chloride concentration profiles obtained experimentally from control samples of an offshore platform after 25 years of service life. The platform is located 12 km off the coast of the Brazilian province Rio Grande do Norte, in the north-east of Brazil. The samples were extracted at different orientations and heights above mean sea level. A simple model based on Fick’s second law is considered and compared with a finite element model which takes into account transport of chloride ions by diffusion and convection. Results show that convective flows significantly affect the studied chloride penetrations. The convection velocity is obtained by fitting the finite element solution to the experimental data and seems to be directly proportional to the height above mean sea level and also seems to depend on the orientation of the face of the platform. This work shows that considering solely diffusion as transport mechanism does not allow a good prediction of the chloride profiles. Accounting for capillary suction due to moisture gradients permits a better interpretation of the material’s behaviour.

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Chemical composition and correlations between chemical analyses and protein quality of 454 batches of SBM of 3 different origins (USA, n=168; Brazil (BRA), n=139, and Argentine (ARG), n=147) were studied. Samples were collected during a 6-yr period. SBM from USA had more CP, sucrose and stachyose and less NDF (P<0.001) than SBM from ARG and BRA. CP content was negatively related (P<0.001) with sucrose for USA meals and with NDF for ARG and BRA meals. Also, P content was positively related (P<0.01) with CP content of the meals. PDI and KOH solubility were higher (P<0.001) for USA than for ARG or BRA SBM, values that were positively related (P<0.001) with trypsin inhibitor activity of the meals. In addition, USA meals had more lys, met+cys, thr, and trp than BRA and ARG meals (P < 0.001). Per unit of CP, lys content was negatively related (P<0.001) with CP content for USA, positively for BRA, and no relations was found for ARG meals. It is concluded that nutritive values and protein quality of the meals varied widely among soybean origins. Consequently, the origin of the beans should be considered in the evaluation of the nutritive value of commercial SBM for non-ruminant animals.

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A model for chloride transport in concrete is proposed. The model accounts for transport several transport mechanisms such as diffusion, advection, migration, etc. This work shows the chloride transport equations at the macroscopic scale in non-saturated concrete. The equations involve diffusion, migration, capillary suction, chloride combination and precipitation mechanisms. The material is assumed to be infinitely rigid, though the porosity can change under influence of chloride binding and precipitation. The involved microscopic and macroscopic properties of the materials are measured by standardized methods. The variables which must be imposed on the boundaries are temperature, relative humidity and chloride concentration. The output data of the model are the free, bound, precipitated and total chloride ion concentrations, as well as the pore solution content and the porosity. The proposed equations are solved by means of the finite element method (FEM) implemented in MATLAB (classical Galerkin formulation and the streamline upwind Petrov-Galerkin (SUPG) method to avoid spatial instabilities for advection dominated flows).

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The aim of this paper is to explain the chloride concentration profiles obtained experimentally from control samples of an offshore platform after 25 years of service life. The platform is located 12 km off the coast of the Brazilian province Rio Grande do Norte, in the north-east of Brazil. The samples were extracted at different orientations and heights above mean sea level. A simple model based on Fick’s second law is considered and compared with a finite element model which takes into account transport of chloride ions by diffusion and convection. Results show that convective flows significantly affect the studied chloride penetrations. The convection velocity is obtained by fitting the finite element solution to the experimental data and seems to be directly proportional to the height above mean sea level and also seems to depend on the orientation of the face of the platform. This work shows that considering solely diffusion as transport mechanism does not allow a good prediction of the chloride profiles. Accounting for capillary suction due to moisture gradients permits a better interpretation of the material’s behaviour