| 51. |
- Machado, Carla G., et al.
(författare)
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Industrial engineering, operations management and sustainability : Overview
- 2012
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Ingår i: Brazilian Journal of Operations & Production Management. - : Brazilian Association of Production Engineering (ABEPRO). - 2237-8960 .- 1679-8171. ; 9:2, s. 51-74
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Tidskriftsartikel (refereegranskat)abstract
- Several authors have been dedicating their efforts to understand and map topics and themes in the field of Industrial Engineering (IE), particularly those related to Operations Management (OM), with special regard to sustainability. Bibliometric analyses were performed by using information collected from 495 selected papers in nine OM-related international databases, based on the keywords “Sustainability” and “Operations Management”. Results pointed out to the evolution of the subject over the past two decades, the relationship among authors in their network of research, its effect on productivity and the related research topics. The results also indicated the main developing issues, authors, institutions and journals most devoted to the subject and the contribution of the study by establishing OM as a discipline in Industrial Engineering. Finally, the current paper will offer an overview of the trends for further research on sustainability into the OM field.
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| 52. |
- Marcos-Pérez, Diego, et al.
(författare)
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Association of inflammatory mediators with frailty status in older adults : results from a systematic review and meta-analysis
- 2020
-
Ingår i: GeroScience. - : Springer Science and Business Media LLC. - 2509-2715 .- 2509-2723. ; 42:6, s. 1451-1473
-
Forskningsöversikt (refereegranskat)abstract
- Frailty is a geriatric syndrome defined as a status of extreme vulnerability to stressors, leading to a higher risk of negative health-related outcomes. “Inflammaging”, an age-related state of low-grade chronic inflammation, is characterized by an increased concentration of pro-inflammatory cytokines and acute phase proteins. Inflammaging has been postulated as an underlying mechanism of frailty, and several studies tested the relationship between frailty and concentration of inflammatory mediators. The aim of this systematic review and meta-analysis was to test whether inflammatory mediators are overproduced in frail older adults. Among the 758 articles identified in the literature search, 50 were included in the systematic review, and 39 in the three meta-analyses, i.e., C-reactive protein (CRP), interleukin 6 (IL6), and tumor necrosis factor α. To reduce heterogeneity, meta-analyses were restricted to studies identifying frailty by the Fried et al. [1] [J. Gerontol. A. Biol. Sci. Med. Sci. 56, M146–56] phenotypic criteria. Quantitative analyses measuring the association between frailty and biomarker concentrations showed significant differences when frail subjects were compared to non-frail and pre-frail subjects for CRP and IL6. This work established strong association between inflammatory biomarkers and frailty, confirming the role of age-related chronic inflammation in frailty development.
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| 53. |
- Marcos-Pérez, Diego, et al.
(författare)
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Low vitamin d levels and frailty status in older adults : A systematic review and meta-analysis
- 2020
-
Ingår i: Nutrients. - : MDPI AG. - 2072-6643. ; 12:8
-
Forskningsöversikt (refereegranskat)abstract
- Serum vitamin D deficiency is widespread among older adults and is a potential modifiable risk factor for frailty. Moreover, frailty has been suggested as an intermediate step in the association between low levels of vitamin D and mortality. Hence, we conducted a systematic review of the literature and meta-analysis to test the possible association of low concentrations of serum 25-hydroxyvitamin D (25(OH)D), a marker of vitamin D status, with frailty in later life. We reviewed cross-sectional or longitudinal studies evaluating populations of older adults and identifying frailty by a currently validated scale. Meta-analyses were restricted to cross-sectional data from studies using Fried’s phenotype to identify frailty. Twenty-six studies were considered in the qualitative synthesis, and thirteen studies were included in the meta-analyses. Quantitative analyses showed significant differences in the comparisons of frail (standardized mean difference (SMD)—1.31, 95% confidence interval (CI) (−2.47, −0.15), p = 0.0271) and pre-frail (SMD—0.79, 95% CI (−1.58, −0.003), p = 0.0491) subjects vs. non-frail subjects. Sensitivity analyses reduced heterogeneity, resulting in a smaller but still highly significant between-groups difference. Results obtained indicate that lower 25(OH)D levels are significantly associated with increasing frailty severity. Future challenges include interventional studies testing the possible benefits of vitamin D supplementation in older adults to prevent/palliate frailty and its associated outcomes.
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| 54. |
- Mariscal-Munoz, Eduardo, et al.
(författare)
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Osteoblast differentiation is enhanced by a nano-to-micro hybrid titanium surface created by Yb:YAG laser irradiation
- 2016
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Ingår i: Clinical Oral Investigations. - : Springer. - 1432-6981 .- 1436-3771. ; 20:3, s. 503-511
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to analyze the capacity of a new modified laser surface to stimulate calvarial osteoblasts isolated from neonatal mouse bones to differentiate and form mineralized nodules. Titanium discs were subjectezd or not to laser irradiation according to specific parameters and characterized. Osteoblasts isolated from neonatal mouse calvaria were cultured over the discs, and the capacity of these cells to proliferate (MTT assay), form mineralized nodules (Alizarin red assay), and enhance alkaline phosphatase activity (ALPase activity) was analyzed. Real-time PCR was used for quantification of gene expression. Laser-irradiated titanium discs (L) presented a rough nano-to-micrometric oxidized surface contrasting with the smooth pattern on polished discs (P). The R-a on the micrometric level increased from 0.32 +/- 0.01 mu m on P surfaces to 10.57 +/- 0.39 mu m on L surfaces. When compared with P, L promoted changes in osteoblast morphology, increased mineralized nodule formation in osteoblasts cultured on the surfaces for 14 days, and enhanced ALPase activity at days 7 and 14. Transcription factors triggering osteoblast differentiation (Runx2 and Sp7) and genes encoding the bone extracellular matrix proteins collagen type-1 (Col1a1), osteopontin (Spp1), and osteocalcin (Bglap) were upregulated in cells on L surfaces compared with those on P surfaces at days 1-14. Laser treatment of titanium surfaces created a rough surface that stimulated osteoblast differentiation. Laser treatment of titanium generates a reproducible and efficient surface triggering osteoblast differentiation that can be of importance for osteointegration.
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| 55. |
- Massad, Eduardo, et al.
(författare)
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Two complementary model-based methods for calculating the risk of international spreading of a novel virus from the outbreak epicentre. The case of COVID-19
- 2020
-
Ingår i: Epidemiology and Infection. - : Cambridge University Press. - 0950-2688 .- 1469-4409. ; 148
-
Tidskriftsartikel (refereegranskat)abstract
- We present two complementary model-based methods for calculating the risk of international spread of the novel coronavirus SARS-CoV-2 from the outbreak epicentre. One model aims to calculate the number of cases that would be exported from an endemic country to disease-free regions by travellers. The second model calculates the probability that an infected traveller will generate at least one secondary autochthonous case in the visited country. Although this paper focuses on the data from China, our methods can be adapted to calculate the risk of importation and subsequent outbreaks. We found an averageR(0)= 5.31 (ranging from 4.08 to 7.91) and a risk of spreading of 0.75 latent individuals per 1000 travellers. In addition, one infective traveller would be able to generate at least one secondary autochthonous case in the visited country with a probability of 23%.
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| 56. |
- Morais, Caio C. A., et al.
(författare)
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High Positive End-Expiratory Pressure Renders Spontaneous Effort Noninjurious
- 2018
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Ingår i: American Journal of Respiratory and Critical Care Medicine. - : AMER THORACIC SOC. - 1073-449X .- 1535-4970. ; 197:10, s. 1285-1296
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Tidskriftsartikel (refereegranskat)abstract
- Rationale: In acute respiratory distress syndrome (ARDS), atelectatic solid-like lung tissue impairs transmission of negative swings in pleural pressure (Ppl) that result from diaphragmatic contraction. The localization of more negative Ppl proportionally increases dependent lung stretch by drawing gas either from other lung regions (e.g., nondependent lung [pendelluft]) or from the ventilator. Lowering the level of spontaneous effort and/or converting solid-like to fluid-like lung might render spontaneous effort noninjurious.Objectives: To determine whether spontaneous effort increases dependent lung injury, and whether such injury would be reduced by recruiting atelectatic solid-like lung with positive end-expiratory pressure (PEEP).Methods: Established models of severe ARDS (rabbit, pig) were used. Regional histology (rabbit), inflammation (positron emission tomography; pig), regional inspiratory Ppl (intrabronchial balloon manometry), and stretch (electrical impedance tomography; pig) were measured. Respiratory drive was evaluated in 11 patients with ARDS.Measurements and Main Results: Although injury during muscle paralysis was predominantly in nondependent and middle lung regions at low (vs. high) PEEP, strong inspiratory effort increased injury (indicated by positron emission tomography and histology) in dependent lung. Stronger effort (vs. muscle paralysis) caused local overstretch and greater tidal recruitment in dependent lung, where more negative Ppl was localized and greater stretch was generated. In contrast, high PEEP minimized lung injury by more uniformly distributing negative Ppl, and lowering the magnitude of spontaneous effort (i.e., deflection in esophageal pressure observed in rabbits, pigs, and patients).Conclusions: Strong effort increased dependent lung injury, where higher local lung stress and stretch was generated; effort-dependent lung injury was minimized by high PEEP in severe ARDS, which may offset need for paralysis.
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| 57. |
- Naghavi, Mohsen, et al.
(författare)
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Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013
- 2015
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Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 385:9963, s. 117-171
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Tidskriftsartikel (refereegranskat)abstract
- Background Up-to-date evidence on levels and trends for age-sex-specifi c all-cause and cause-specifi c mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries. Methods We estimated age-sex-specifi c all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specifi c causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age-sex-country-year group to sum to all-cause mortality based on draws from the uncertainty distributions. Findings Global life expectancy for both sexes increased from 65.3 years (UI 65.0-65.6) in 1990, to 71.5 years (UI 71.0-71.9) in 2013, while the number of deaths increased from 47.5 million (UI 46.8-48.2) to 54.9 million (UI 53.6-56.3) over the same interval. Global progress masked variation by age and sex: for children, average absolute diff erences between countries decreased but relative diff erences increased. For women aged 25-39 years and older than 75 years and for men aged 20-49 years and 65 years and older, both absolute and relative diff erences increased. Decomposition of global and regional life expectancy showed the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa. For most communicable causes of death both numbers of deaths and age-standardised death rates fell whereas for most non-communicable causes, demographic shifts have increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10.7%, from 4.3 million deaths in 1990 to 4.8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100 000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS, pancreatic cancer, atrial fibrillation and flutter, drug use disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus for lower respiratory infections. Country-specific probabilities of death over three phases of life were substantially varied between and within regions. Interpretation For most countries, the general pattern of reductions in age-sex specifi c mortality has been associated with a progressive shift towards a larger share of the remaining deaths caused by non-communicable disease and injuries. Assessing epidemiological convergence across countries depends on whether an absolute or relative measure of inequality is used. Nevertheless, age-standardised death rates for seven substantial causes are increasing, suggesting the potential for reversals in some countries. Important gaps exist in the empirical data for cause of death estimates for some countries; for example, no national data for India are available for the past decade.
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| 58. |
- Neckel, Itamar T., et al.
(författare)
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Unveiling Center-Type Topological Defects on Rosettes of Lead Zirconate Titanate Associated to Oxygen Vacancies
- 2021
-
Ingår i: Annalen der Physik. - : Wiley. - 0003-3804 .- 1521-3889.
-
Tidskriftsartikel (refereegranskat)abstract
- Understanding the formation of topological defects in ferroelectric materials can provide access to their unusual physics, invaluable for possible applications of domain engineering in nanoelectronics. The present study shows the spontaneous formation of center-type topological defects in lead zirconate titanate (PZT) films, characterized by a strong in-plane radial electromechanical response on rosette-like structures, as revealed by piezoelectric response force microscopy. Multi-modal electron and X-ray based techniques provide a comprehensive set of tools for delving at atomic scale the local chemistry, electronic, and crystalline structures. The elemental surface-sensitivity of soft X-ray absorption shows chemical segregation and drastic changes in the titanium electronic structure, which have been associated to oxygen vacancies, leading to a mechanism that describe the polarization symmetry on the rosettes. X-ray nanofluorescence experiments revealed titanium segregation, corroborating with the absorption and low energy electron microscopy images. Taking advantage of a nanobeam, 2D nanodiffraction maps probed the complex microstructure of the domains, revealing its mosaicity and lattice strain at the nanoscale. This study highlights a complex topological structure and provides, by the simultaneous application of a set of analytical tools, a broad comprehension of the formation of center-type ferroelectric topological defects in PZT.
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| 59. |
- Ntalla, Ioanna, et al.
(författare)
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Multi-ancestry GWAS of the electrocardiographic PR interval identifies 202 loci underlying cardiac conduction
- 2020
-
Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 11:1
-
Tidskriftsartikel (refereegranskat)abstract
- The electrocardiographic PR interval reflects atrioventricular conduction, and is associated with conduction abnormalities, pacemaker implantation, atrial fibrillation (AF), and cardiovascular mortality. Here we report a multi-ancestry (N=293,051) genome-wide association meta-analysis for the PR interval, discovering 202 loci of which 141 have not previously been reported. Variants at identified loci increase the percentage of heritability explained, from 33.5% to 62.6%. We observe enrichment for cardiac muscle developmental/contractile and cytoskeletal genes, highlighting key regulation processes for atrioventricular conduction. Additionally, 8 loci not previously reported harbor genes underlying inherited arrhythmic syndromes and/or cardiomyopathies suggesting a role for these genes in cardiovascular pathology in the general population. We show that polygenic predisposition to PR interval duration is an endophenotype for cardiovascular disease, including distal conduction disease, AF, and atrioventricular pre-excitation. These findings advance our understanding of the polygenic basis of cardiac conduction, and the genetic relationship between PR interval duration and cardiovascular disease. On the electrocardiogram, the PR interval reflects conduction from the atria to ventricles and also serves as risk indicator of cardiovascular morbidity and mortality. Here, the authors perform genome-wide meta-analyses for PR interval in multiple ancestries and identify 141 previously unreported genetic loci.
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| 60. |
- Pereira, David I. O., et al.
(författare)
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A Review Content Analysis Between Industry 4.0 and Sustainable Manufacturing
- 2020
-
Ingår i: Lecture Notes on Multidisciplinary Industrial Engineering. - Cham : Springer International Publishing. - 2522-5022 .- 2522-5030. ; Part F201, s. 12-23, s. 12-23
-
Konferensbidrag (refereegranskat)abstract
- Manufacturing companies have been facing a dynamic environment due the Industry 4.0 and sustainable development phenomena and, consequently, a greatest attention from researchers has been attracted to investigate how the 4th Industrial Revolution interact or influence sustainable manufacturing. Therefore, the purpose of this paper is to investigate the academic progress regarding Industry 4.0 and Sustainable Manufacturing simultaneously, offering as the main result a review content analysis. More specifically, a bibliometric analysis provides a list of prominent journals and popular conferences and the summary of the main authors and their institutions. Moreover, a content analysis presents a semantic network, illustrating current research efforts and suggesting future research directions, identified by topics. In sum, the first topic suggests the need to explore and comprehend the interaction between the areas. The second topic brings the importance to analyse and understand requirements needed to successfully implement. The last topic shows the different ways to implement and assess the sustainable manufacturing in the context of Industry 4.0.
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| 61. |
- Pinheiro de Lima, Edson, et al.
(författare)
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Framing operations and performance strategic management system design process
- 2008
-
Ingår i: Brazilian Journal of Operations & Production Management. - 1679-8171. ; 5:1, s. 23-46
-
Tidskriftsartikel (refereegranskat)abstract
- The increasing competitive pressure resulting from operations activities and marketglobalization are forcing enterprises to reorient their strategies, operations systemsand processes. Specifically, organizations are paying closer attention to the changingnature of operations systems performance, to the point where operations strategicmanagement system used in enterprise performance evaluation becomes the main focusof redesign projects. This study explores the process rationality behind operations strategymanagement systems design, taking into account a content definition established by astructural specification of the management system and the integration of life cycle andimplementation models. This research proposes a framework that represents reconciliationbetween research and practice, contributing to the development and test of practicalsolutions for operations strategic management system design, implementation andmanagement. The main result is a synthesis of three frameworks that each addresses thedesign process in different levels: the performance management system life cycle model;the process approach for guiding design and implementation issues; and recommendationsthat synthesizes the design task. The study also discusses methodological choices inapproaching the design, implementation and use of an operations strategic managementsystem. Doing so, the study develops the discussion on structural and process aspects ofstrategic performance measurement system design.
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| 62. |
- Pinheiro de Lima, Edson, et al.
(författare)
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Operations strategy and performance measurement roles
- 2010
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Ingår i: Proceedings of the 21<sup>th</sup> Annual Production and Operations Management Society Conference. ; , s. 015-0710-
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Konferensbidrag (refereegranskat)abstract
- Companies’ environment and global competition are forcing them to revise the way theydesign and implement their strategies and management systems. Business and functionalmanagement systems should develop specific capabilities to deal with a changing andcomplex environment, that is, strategic and operational plans should be continuouslyassed and updated. This paper frame a discussion based on operations strategyframework. The main issue is to interrelate operations strategy with performancemeasurement in a strategic management framework. Performance measurement roles arerevised in order to assess their alignment with new design requirements for operationsstrategic management. Based on a set of updated performance measurement systemsroles, a case study protocol is developed and applied to two engineering servicecompanies. Although classical roles as performance control is still the main focus ofoperations performance measurement systems, the evidences collected show a growinguse of operations strategic management systems for continuous improvement management.
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| 63. |
- Pinheiro de Lima, Edson, et al.
(författare)
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Relying on the past and predicting the future : interrelating perspectives in Operations Strategic Management Systems
- 2007
-
Ingår i: Proceedings of the 18<sup>th</sup> Annual Production and Operations Management Society Conference.
-
Konferensbidrag (refereegranskat)abstract
- The complexity and dynamics of nowadays enterprises’ environments and operationssystems are demanding an integral approach for designing and implementing theiroperations’ strategic management and control systems. This integral approach should becapable to deal with the short and long term perspectives, helping the enterprises tomanage their positions, processes and paths for a sustainable development. This paper isa theoretical construction based on Operations Management and General Systems theory,intending to discuss and propose a new “architecture” for the strategic managementsystem of the operations function. The findings of the research project related in thispaper show the systemic representation of the functionalities and features that a strategicmanagement system for the operations function should develop to accomplish the relatedtask. The developed framework as theoretical construction is willing to review thecognitive and mental models that the operations managers are using for managing theoperations systems.
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| 64. |
- Pinotti, Felipe Eduardo, et al.
(författare)
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Use of a Non-Crosslinked Collagen Membrane During Guided Bone Regeneration Does Not Interfere With the Bone Regenerative Capacity of the Periosteum
- 2018
-
Ingår i: Journal of oral and maxillofacial surgery (Print). - : Elsevier. - 0278-2391 .- 1531-5053. ; 76:11
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To assess whether the use of a non-crosslinked porcine collagen type I and III bi-layered membrane inter-positioned between the periosteum and a bone defect would interfere with the bone regenerative capacity of the periosteum. MATERIALS AND METHODS: Sixty rats, each with 1 critical-size calvarial defect (CSD; diameter, 5 mm) in the parietal bone, were randomly allocated to 1 of 3 equal-size groups after CSD creation: 1) the periosteum was excised and the flap was repositioned without interposition of a membrane (no-periosteum [NP] group); 2) the flap including the periosteum was repositioned (periosteum [P] group); and 3) a non-crosslinked collagen membrane was inter-positioned between the flap, including the periosteum, and the bone defect (membrane [M] group). Micro-computed tomography, qualitative histology, immunohistochemistry, and reverse transcription real-time quantitative polymerase chain reaction were performed at 3, 7, 15, and 30 days postoperatively. RESULTS: A markedly increased radiographic residual defect length was observed in the NP group compared with the P group at 30 days. The NP group also presented a smaller radiographic bone fill area than the P group at 15 and 30 days and then the M group at 30 days. The P and M groups exhibited considerably greater expression of bone morphogenetic protein-2 and osteocalcin than the NP group at 7 days; expression of transforming growth factor-beta1 was considerably greater in the NP group at 15 days. Further, the P group presented considerably higher gene expression levels of Runx2 and Jagged1 at 7 days and of alkaline phosphatase at 3 and 15 days compared with the M and NP groups. CONCLUSION: Interposition of this specific non-crosslinked collagen membrane between the periosteum and the bone defect during guided bone regeneration interferes only slightly, if at all, with the bone regenerative capacity of the periosteum.
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| 65. |
- Reske, Andreas W., et al.
(författare)
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Bedside Estimation of Nonaerated Lung Tissue Using Blood Gas Analysis
- 2013
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Ingår i: Critical Care Medicine. - 0090-3493 .- 1530-0293. ; 41:3, s. 732-743
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Studies correlating the arterial partial pressure of oxygen to the fraction of nonaerated lung assessed by CT shunt yielded inconsistent results. We systematically analyzed this relationship and scrutinized key methodological factors that may compromise it. We hypothesized that both physiological shunt and the ratio between PaO2 and the fraction of inspired oxygen enable estimation of CT shunt at the bedside. Design: Prospective observational clinical and laboratory animal investigations. Setting: ICUs (University Hospital Leipzig, Germany) and Experimental Pulmonology Laboratory (University of Sao Paulo, Brazil). Patients, Subjects and Interventions: Whole-lung CT and arterial blood gases were acquired simultaneously in 77 patients mechanically ventilated with pure oxygen. A subgroup of 28 patients was submitted to different FIO2. We also studied 19 patients who underwent repeat CT. Furthermore we studied ten pigs with acute lung injury at multiple airway pressures, as well as a theoretical model relating PaO2 and physiological shunt. We logarithmically transformed the PaO2/FIO2 to change this nonlinear relationship into a linear regression problem. Measurements and Main Results: We observed strong linear correlations between Riley's approximation of physiological shunt and CT shunt (R-2 = 0.84) and between logarithmically transformed PaO2/FIO2 and CT shunt (R-2 = 0.86), allowing us to construct a look-up table with prediction intervals. Strong linear correlations were also demonstrated within-patients (R-2 = 0.95). Correlations were significantly improved by the following methodological issues: measurement of PaO2/FIO2 during pure oxygen ventilation, use of logarithmically transformed PaO2/FIO2 instead of the "raw" PaO2/FIO2, quantification of nonaerated lung as percentage of total lung mass and definition of nonaerated lung by the [-200 to +100] Hounsfield Units interval, which includes shunting units within less opacified lung regions. Conclusion: During pure oxygen ventilation, logarithmically transformed PaO2/FIO2 allows estimation of CT shunt and its changes in patients during systemic inflammation. Relevant intrapulmonary shunting seems to occur in lung regions with CT numbers between [-200 and +100] Hounsfield Units.
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| 66. |
- Retamal, Jaime, et al.
(författare)
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Does Regional Lung Strain Correlate With Regional Inflammation in Acute Respiratory Distress Syndrome During Nonprotective Ventilation? : An Experimental Porcine Study
- 2018
-
Ingår i: Critical Care Medicine. - 0090-3493 .- 1530-0293. ; 46:6, s. e591-e599
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: It is known that ventilator-induced lung injury causes increased pulmonary inflammation. It has been suggested that one of the underlying mechanisms may be strain. The aim of this study was to investigate whether lung regional strain correlates with regional inflammation in a porcine model of acute respiratory distress syndrome.DESIGN: Retrospective analysis of CT images and positron emission tomography images using [18F]fluoro-2-deoxy-D-glucose.SETTING: University animal research laboratory.SUBJECTS: Seven piglets subjected to experimental acute respiratory distress syndrome and five ventilated controls.INTERVENTIONS: Acute respiratory distress syndrome was induced by repeated lung lavages, followed by 210 minutes of injurious mechanical ventilation using low positive end-expiratory pressures (mean, 4 cm H2O) and high inspiratory pressures (mean plateau pressure, 45 cm H2O). All animals were subsequently studied with CT scans acquired at end-expiration and end-inspiration, to obtain maps of volumetric strain (inspiratory volume - expiratory volume)/expiratory volume, and dynamic positron emission tomography imaging. Strain maps and positron emission tomography images were divided into 10 isogravitational horizontal regions-of-interest, from which spatial correlation was calculated for each animal.MEASUREMENTS AND MAIN RESULTS: The acute respiratory distress syndrome model resulted in a decrease in respiratory system compliance (20.3 ± 3.4 to 14.0 ± 4.9 mL/cm H2O; p < 0.05) and oxygenation (PaO2/FIO2, 489 ± 80 to 92 ± 59; p < 0.05), whereas the control animals did not exhibit changes. In the acute respiratory distress syndrome group, strain maps showed a heterogeneous distribution with a greater concentration in the intermediate gravitational regions, which was similar to the distribution of [18F]fluoro-2-deoxy-D-glucose uptake observed in the positron emission tomography images, resulting in a positive spatial correlation between both variables (median R2 = 0.71 [0.02-0.84]; p < 0.05 in five of seven animals), which was not observed in the control animals.CONCLUSION: In this porcine acute respiratory distress syndrome model, regional lung strain was spatially correlated with regional inflammation, supporting that strain is a relevant and prominent determinant of ventilator-induced lung injury.
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| 67. |
- Retamal, Jaime, et al.
(författare)
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Regional pulmonary deformation is positively correlated with regional lung inflammation assessed by 18F-FDG positron emission tomography / computed tomography
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objective: Lung deformation beyond of physiological capacity is associated with cell death and inflammation. Lung strain has been estimated as a global strain, but uneven strain distribution may lead to regional stress concentrations and lung damage. Local lung inflammation can be estimated using PET imaging of [18F]fluoro-2-deoxy-D-glucose. We hypothesized that local lung deformation correlates well with local inflammation. The aim of this study was to assess local tidal deformations by using a new mathematical model of finite-elements to analyze CT images, and to correlate them with local inflammation in a porcine experimental model of early acute respiratory distress syndrome.Design: Retrospective images analysis, laboratory investigation.Setting: University animal research laboratory.Subjects: Seven piglets submitted to experimental ventilator-induced lung injury and five healthy ventilated controls.Intervention: Lung injury was induced by repeated lung lavages and 210 minutes of injurious mechanical ventilation using low positive end-expiratory pressure and high inspiratory pressures. All animals were subsequently studied with dynamic PET imaging of [18F]fluoro-2-deoxy-D-glucose. CT scans were acquired at end expiration and end inspiration. Then maps of deformation were constructed and regional deformation was estimated. We divided the lung parenchyma in 10 horizontal ROIs, and correlations of local volumetric strain and [18F]fluoro-2-deoxy-D-glucose uptake were analyzed in each ROI.Measurements and Main Results: The deformation maps showed a heterogeneous distribution with a greater concentration in the intermediate gravitational regions. We found a strong correlation between local strain and inflammation (R2 > 0.5) for the whole lung, when we eliminate the 3/10 dorsal ROIs R2 increased until>0.8.Conclusion: the present findings suggest that the greater local stretches were mainly concentrated in the intermediate gravitational zones of injured heterogeneous lungs. Additionally, local lung deformations correlated well with local inflammation in this experimental model of VILI. And the new proposed image-based estimation of regional volumetric strain based on finite element interpolations has the potential to give new insights of local pathogenic mechanisms of VILI and how best design protective-ventilations strategies.
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| 68. |
- Rodrigues Meurer, Ywlliane da Silva, et al.
(författare)
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Postnatal exposure to fluoxetine led to cognitive-emotional alterations and decreased parvalbumin positive neurons in the hippocampus of juvenile Wistar rats
- 2021
-
Ingår i: International Journal of Developmental Neuroscience. - : John Wiley & Sons. - 0736-5748 .- 1873-474X. ; 81:7, s. 616-632
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Tidskriftsartikel (refereegranskat)abstract
- The exposure to selective serotonin reuptake inhibitors (SSRIs) during development results in behavioural impairment in adulthood in humans and animal models. Indeed, serotonergic overexpression in early life leads to structural and functional changes in brain circuits that control cognition and emotion. However, the effects of developmental exposure to these substances on the behaviour of adolescent rats are conflicting and remain poorly characterised. We performed a behavioural screening to investigate the effects of postnatal exposure to fluoxetine on memory and behaviours related to anxiety, anhedonia, and depression, as well we evaluate the parvalbumin expression in hippocampus of juvenile (similar to PND45) female and male rats. Fluoxetine (daily 20 mg/kg s.c. injections from PND7-PND21)- or vehicle-treated adolescent rats went through several behavioural tasks (from PND 38 to PND52) and were subject to transcardial perfusion and brain removal for immunohistochemical analysis (PND53). We found that postnatal exposure to fluoxetine increased anxiety- and depression-like behaviours in the open field and sucrose preference and forced swimming tests, respectively. In addition, this treatment induced working memory and short-term (but not long-term) recognition memory impairments, and reduced parvalbumin-positive inter-neurons in the hippocampus. In addition, the results revealed developmental sex-dependent effects of fluoxetine postnatal treatment on adolescent rats' behaviour. These outcomes indicate that affective disorders and mnemonic alterations caused by SSRIs perinatal exposure can be present at adolescence.
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| 69. |
- Scotti-Campos, Paula, et al.
(författare)
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Antioxidative ability and membrane integrity in salt-induced responses of Casuarina glauca Sieber ex Spreng. in symbiosis with N-2-fixing Frankia Thr or supplemented with mineral nitrogen
- 2016
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Ingår i: Journal of plant physiology (Print). - : Elsevier BV. - 0176-1617 .- 1618-1328. ; 196-197, s. 60-69
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Tidskriftsartikel (refereegranskat)abstract
- The actinorhizal tree Casuarina glauca tolerates extreme environmental conditions, such as high salinity. This species is also able to establish a root-nodule symbiosis with N-2-fixing bacteria of the genus Frankia. Recent studies have shown that C. glauca tolerance to high salt concentrations is innate and linked to photosynthetic adjustments. In this study we have examined the impact of increasing NaCl concentrations (200, 400 and 600 mM) on membrane integrity as well as on the control of oxidative stress in branchlets of symbiotic (NOD+) and non-symbiotic (KNO3+) C. glauca. Membrane selectivity was maintained in both plant groups at 200 mM NaCl, accompanied by an increase in the activity of antioxidative enzymes (superoxide dismutase, ascorbate peroxidase, glutathione reductase and catalase). Regarding cellular membrane lipid composition, linolenic acid (C18:3) showed a significant decline at 200 mM NaCl in both NOD+ and KNO3+ plants. In addition, total fatty acids (TFA) and C18:2 also decreased in NOD+ plants at this salt concentration, resulting in malondialdehyde (MDA) production. Such initial impact at 200 mM NaCl is probably due to the fact that NOD+ plants are subjected to a double stress, i.e., salinity and low nitrogen availability. At 400 mM NaCl a strong reduction of TFA and C18:3 levels was observed in both plant groups. This was accompanied by a decrease in the unsaturation degree of membrane lipids in NOD+. However, in both NOD+ and KNO3+ lipid modifications were not reflected by membrane leakage at 200 or 400 mM, suggesting acclimation mechanisms at the membrane level. The fact that membrane selectivity was impaired only at 600 mM NaCl in both groups of plants points to a high tolerance of C. glauca to salt stress independently of the symbiotic relation with Frankia.
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| 70. |
- Souza, João Paulo, et al.
(författare)
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Moving beyond essential interventions for reduction of maternal mortality (the WHO Multicountry Survey on Maternal and Newborn Health) : a cross-sectional study
- 2013
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Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 381:9879, s. 1747-1755
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We report the main findings of the WHO Multicountry Survey on Maternal and Newborn Health (WHOMCS), which aimed to assess the burden of complications related to pregnancy, the coverage of key maternal health interventions, and use of the maternal severity index (MSI) in a global network of health facilities.METHODS: In our cross-sectional study, we included women attending health facilities in Africa, Asia, Latin America, and the Middle East that dealt with at least 1000 childbirths per year and had the capacity to provide caesarean section. We obtained data from analysis of hospital records for all women giving birth and all women who had a severe maternal outcome (SMO; ie, maternal death or maternal near miss). We regarded coverage of key maternal health interventions as the proportion of the target population who received an indicated intervention (eg, the proportion of women with eclampsia who received magnesium sulphate). We used areas under the receiver operator characteristic curves (AUROC) with 95% CI to externally validate a previously reported MSI as an indicator of severity. We assessed the overall performance of care (ie, the ability to produce a positive effect on health outcomes) through standardised mortality ratios.RESULTS: From May 1, 2010, to Dec 31, 2011, we included 314,623 women attending 357 health facilities in 29 countries (2538 had a maternal near miss and 486 maternal deaths occurred). The mean period of data collection in each health facility was 89 days (SD 21). 23,015 (7.3%) women had potentially life-threatening disorders and 3024 (1.0%) developed an SMO. 808 (26.7%) women with an SMO had post-partum haemorrhage and 784 (25.9%) had pre-eclampsia or eclampsia. Cardiovascular, respiratory, and coagulation dysfunctions were the most frequent organ dysfunctions in women who had an SMO. Reported mortality in countries with a high or very high maternal mortality ratio was two-to-three-times higher than that expected for the assessed severity despite a high coverage of essential interventions. The MSI had good accuracy for maternal death prediction in women with markers of organ dysfunction (AUROC 0.826 [95% CI 0.802-0.851]).INTERPRETATION: High coverage of essential interventions did not imply reduced maternal mortality in the health-care facilities we studied. If substantial reductions in maternal mortality are to be achieved, universal coverage of life-saving interventions need to be matched with comprehensive emergency care and overall improvements in the quality of maternal health care. The MSI could be used to assess the performance of health facilities providing care to women with complications related to pregnancy.
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| 71. |
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| 72. |
- Young, William J., et al.
(författare)
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Genetic analyses of the electrocardiographic QT interval and its components identify additional loci and pathways
- 2022
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Ingår i: Nature Communications. - : Springer Nature. - 2041-1723. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- The QT interval is a heritable electrocardiographic measure associated with arrhythmia risk when prolonged. Here, the authors used a series of genetic analyses to identify genetic loci, pathways, therapeutic targets, and relationships with cardiovascular disease. The QT interval is an electrocardiographic measure representing the sum of ventricular depolarization and repolarization, estimated by QRS duration and JT interval, respectively. QT interval abnormalities are associated with potentially fatal ventricular arrhythmia. Using genome-wide multi-ancestry analyses (>250,000 individuals) we identify 177, 156 and 121 independent loci for QT, JT and QRS, respectively, including a male-specific X-chromosome locus. Using gene-based rare-variant methods, we identify associations with Mendelian disease genes. Enrichments are observed in established pathways for QT and JT, and previously unreported genes indicated in insulin-receptor signalling and cardiac energy metabolism. In contrast for QRS, connective tissue components and processes for cell growth and extracellular matrix interactions are significantly enriched. We demonstrate polygenic risk score associations with atrial fibrillation, conduction disease and sudden cardiac death. Prioritization of druggable genes highlight potential therapeutic targets for arrhythmia. Together, these results substantially advance our understanding of the genetic architecture of ventricular depolarization and repolarization.
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