Relationship of arterial and exhaled CO2 during elevated artificial pneumoperitoneum pressure for introduction of the first trocar.

The present study evaluated the correlation between arterial CO2 and exhaled CO2 during brief high-pressure pneumoperitoneum. Patients were randomly distributed into two groups: P12 group (n=30) received a maximum intraperitoneal pressure of 12mmHg, and P20 group (n=37) received a maximum intraperitoneal pressure of 20mmHg. Arterial CO2 was evaluated by radial arterial catheter and exhaled CO2 was measured by capnometry at the following time points: before insufflation, once intraperitoneal pressure reached 12mmHg , 5 minutes after intraperitoneal pressure reached 12mmHg for the P12 group or 20mmHg for the P20 group, and 10 minutes after intraperitoneal pressure reached 12mmHg for the P12 group or when intraperitoneal pressure had decreased from 20mmHg to 12mmHg, for the P20 group. During brief durations of very high intraperitoneal pressure (20mmHg), there was a strong correlation between arterial CO2 and exhaled CO2. Capnometry can be effectively used to monitor patients during transient increases in artificial pneumoperitoneum pressure

Invasive monitoring of the clinical effects of high intra-abdominal pressure for insertion of the first trocar.

Background: To analyze the effects of transitory, high intra-abdominal pressure on clinical, hemodynamic, blood gas and metabolic parameters.

Methods: Sixty-seven laparoscopic patients were divided into groups P12 (n = 30, maximum intra-abdominal pressure of 12 mmHg) and P20 (n = 37, maximum intra-abdominal pressure of 20 mmHg). Through radial artery cannulation, mean arterial pressure (MAP) was assessed and blood gas analysis – pH, arterial oxygen tension (PaO2), arterial carbon dioxide tension (PaCO2), bicarbonate (HCO3) and base excess (BE) – was performed. These parameters were evaluated in both groups at time point zero, before CO2 insufflation; at time point one (TP1), when intra-abdominal pressure of 12 mmHg was reached in both groups; at time point two (TP2), 5 minutes after reaching intra-abdominal pressure of 12 mmHg in group P12 and of 20 mmHg in group P20; and at time point three (TP3), 10 minutes after reaching intra-abdominal pressure of 12 mmHg in group P12 and 10 minutes after TP1 in group P20, when intra-abdominal pressure decreased from 20 mmHg to 12 mmHg. Values out of the normal range or the occurrence of atypical phenomena suggestive of organic disease indicated clinical changes.

Results: Significant variations in MAP, pH, HCO3 and BE were observed in group P20; these changes, however, were within normal limits. Clinical changes were also within normal limits, and no pathological phenomena were observed.

Conclusions: Brief, intra-abdominal hypertension for the insertion first trocar insertion causes variations in MAP, pH, HCO3 and BE without adverse effects, and it may protect from iatrogenic injury

Identification of differentially expressed genes in pathways of cerebral neurotransmission of anovulatory mice

Polycystic ovary syndrome is the classic example of loss of functional cyclicity and anomalous feedback. In this case, the excessive extra-glandular production and conversion of androgens to estrogens are the pathophysiological basis of the chronic anovulation. The literature describes an experimental model of the polymicrocystic ovary in obese diabetic mice with insulin resistance. The fact that these animals exhibit obesity, insulin resistance, and infertility demonstrates their skill as an experimental model for polycystic ovary. A recent study using long protocol for up to 40 weeks showed that anovulatory and obese mice transplanted with adipose tissue from animals with normal weight have multiple changes in their phenotype. These changes include reduction of body weight, prevention of obesity, insulin level normalization, and insulin tolerance tests, preventing the elevation of steroids and especially the reversal of fertility restoration with anovulation. Considering that there are close relationships between the ovulation process and the central nervous system, we propose to evaluate the gene expression levels of 84 different genes involved in neurotransmission and insulin pathways in addition to examining the neurolipidosis differential murine brain before and after reversal of anovulation. The present study showed changes in gene expression of molecular markers in brain tissue of animals for brain neurotransmission pathways as well as pathways for insulin. GABAergic genes, muscarinic, serotonin receptors, receptor tyrosine kinase, and genes of interleukin 6 showed overexpression profile. There was also a change in the lipid content in anovulatory brain, obesity, and insulin resistant mice (Ob-/Ob-) compared with controls. The re-introduction of leptin in these animals appears to reverse, at least in part, this profile.Univ Fed Sao Paulo, Lab Ginecol Mol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Lab Ginecol Mol, Sao Paulo, SP, BrazilWeb of Scienc

Analysis of Survival Data with Multiple Events

An important aim in biomedical studies is to study how an intermediate event and prognostic factors influence the course of disease of a patient. In most cases, the effect of the intermediate event is considered a timedependent covariate and studied using extensions of the Cox proportional hazards model. Additionally, many of these studies often involve several endpoints, making the traditional approaches much more complicated. In such cases, multi-state models provide a useful tool to describe the survival process. This article aims to illustrate how multi-state models can be used as an alternative to traditional approaches. It also aims to offer guidelines for the correct use of these approaches through the analysis of survival data of patients with breast cancer. Several analyses were performed, and methods to evaluate the effect of covariates on transition intensities and to test some usual assumptions are discussed. Tree-based survival models, like the Cox proportional hazards models, are popular methods for constructing a prediction model in the field of medical research. We also present the results obtained by applying some tree-based models to the breast cancer data while showing their interpretation and utility. An overview of available software and software developed by the authors is provided to aid researchers in choosing an appropriate software tool for their purposes. © 2022 World Scientific and Engineering Academy and Society. All rights reserved.Acknowledgements: This work received financial support from the Portuguese Foundation for Science and Technology (“Fundação para a Ciên-cia e a Tecnologia”), references UIDB/00013/2020, UIDP/00013/2020 and EXPL/MAT-STA/0956/2021

O papel e os desafios do fórum no enfoque do desenvolvimento territorial.

neste artigo apresenta a discussão, os objetivos, o resultado e o funcionamento do fórum como espaço de novas governanças nos territórios, o qual se constitui um dos eixos no projeto desenvolvido pela Embrapa, Cirad e Fao, em quatro município do Piauí e Pernambuco

The determinants of risk reporting during the period of adoption of Basel II Accord: Evidence from the Portuguese commercial banks

The purpose of this paper to analyze the risk reporting practices and its determinants of commercial banks during the period of the adoption of the Basel II Accord in Portugal. The paper conducts a content analysis of the risk and risk management sections included in the management reports and the notes of the annual reports of Portuguese commercial banks, for the years 2007, 2010 and 2013. Findings show that theoretical frameworks underpinned in agency and legitimacy theories continue to provide valid explanations for risk reporting by Portuguese banks. More specifically, findings indicate that agency costs, public visibility and reputation are crucial drivers of risk reporting. Findings also indicate that younger banks with lower risk management skills use risk reporting either as an informational process or as a channel to manage organizational legitimacy. The content analysis does not allow readily for in-depth qualitative inquiry. The coding instrument is subject to coder bias. Information about risk can be provided in sources other than annual reports. Additionally, not all banks disclose information on corporate governance-related variables that could also influence risk reporting. The current research setting has never been studied hitherto. In this sense, this study seems to be of great relevance given the scarcity of literature on the subject in Portugal.info:eu-repo/semantics/publishedVersio

Gettering of Pd to implantation-induced nanocavities in Si

The gettering of Pd to nanocavities in Si for implantation doses ranging from 5×10¹³ to 1×10¹⁵ cm¯² and annealing temperatures ranging from 750 to 1050 °C was investigated using Rutherford backscattering and cross-sectional transmission electron microscopy. For a given annealing temperature, the gettering efficiency increased as the dose decreased. For a given dose, maximum gettering efficiency was achieved at the intermediate temperatures studied. Competition between silicide formation and nanocavity gettering limited gettering efficiency.The authors thank the Australian Research Council for their financial support. G.deM.A. acknowledges the Brazilian agency CNPq ~Conselho Nacional de Desenvolvimento Cientı´fico e Tecnolo´gico! for a postdoctoral fellowship

Pressure and chemical substitution effects in the local atomic structure of BaFe2As2

The effects of K and Co substitutions and quasi-hydrostatic applied pressure (P<9 GPa) in the local atomic structure of BaFe2As2, Ba(Fe{0.937}Co{0.063})2As2 and Ba{0.85}K{0.15}Fe2As2 superconductors were investigated by extended x-ray absorption fine structure (EXAFS) measurements in the As K absorption edge. The As-Fe bond length is found to be slightly reduced (<~ 0.01 Angstroms) by both Co and K substitutions, without any observable increment in the corresponding Debye Waller factor. Also, this bond is shown to be compressible (k = 3.3(3)x10^{-3} GPa^{-1}). The observed contractions of As-Fe bond under pressure and chemical substitutions are likely related with a reduction of the local Fe magnetic moments, and should be an important tuning parameter in the phase diagrams of the Fe-based superconductors.Comment: 7 pages, 6 figure