Estudos e criação em hipermídia : hiperedifício/sintopia

15

Arquiteias ou poesia para arquitetos

12

Do Urbanet ao Civitas : aplicação de teorias urbanas na geração de simulador de cidade virtual

12

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Construção e abertura : diálogos Christopher Alexander - Jean Piaget

Construção e abertura: diálogos Alexander-Piaget examina a construção do conhecimento, no campo da Arquitetura e Urbanismo, através da articulação das abordagens dos dois autores destacados no título da tese, na perspectiva de esboçar elementos para uma teoria e uma pedagogia do processo de projeto. Neste sentido, o trabalho organiza-se em duas partes: Aberturas – contexto teórico Para compreender os processos cognitivos envolvidos na concepção do projeto arquitetural no âmbito do ateliê pedagógico, a investigação busca estabelecer um diálogo teórico que encontra pontos de contato entre a tradição da Epistemologia Genética iniciada por Jean Piaget, e o pensamento do arquiteto austro-americano Christopher Alexander. Desde o construtivismo piagetiano, interessa, em especial, a noção dos possíveis, passando pelas formulações referentes à percepção e representação espacial, pelos processos de tomada de consciência no percurso entre o fazer e o compreender, e pelos fundamentos de uma lógica de significações. Desde a abordagem de Alexander, tomam-se, em especial, as noções de linguagem de padrões e de totalidades crescentes para explicar as relações entre os sujeitos do processo projetual e o ambiente construído, na emergência de uma ordem espacial coerente através de contínuos ajustes entre forma e contexto. O espaço de encontro entre os dois pensadores se explicita através de uma abordagem epistemológica apoiada no conceito de sistema, e no princípio cibernético de equilibração. No caso de Piaget, isto implica estados majorantes de assimilação na interação entre sujeito e objeto de conhecimento; na abordagem de Alexander, isso se revela através da analogia entre sistemas ambientais construídos pelo homem e organismos vivos, que pode ser descrita na forma de um conjunto de princípios projetuais bem definidos. Construções – contexto pedagógico No plano pedagógico, foi elaborado um experimento, oferecido a estudantes de graduação e, Arquitetura e Urbanismo, procedentes de diferentes etapas do curso, objetivando: i) a reflexão em torno do quadro teórico apresentado, ii) a exploração de tecnologias de simulação gráfica; iii) o agenciamento de meios de trabalho cooperativo, presencial e à distância, e; iv) o desenvolvimento de exercícios de projeto apoiados nas reflexões derivadas de (i), (ii) e (iii), no sentido de promover desequilíbrios cognitivos, sugerindo percursos de trabalho diferentes daqueles com os quais os estudantes estão familiarizados. O experimento estrutura-se em três exercícios, correspondentes, grosso modo, às etapas de concepção, desenvolvimento e aperfeiçoamento de um projeto arquitetônico ou urbanístico. Casa tomada, baseado no conto homônimo do argentino Julio Cortázar, aborda a pedagogia da metáfora, propondo uma transcrição da narrativa ficcional para o espaço arquitetônico, reconstituindo topologicamente a trama urdida pelo escritor. Cidade das palavras reflete o âmbito denominado pedagogia do linguajar, e propõe o desenvolvimento de narrativas "genéticas" construídas através do trabalho cooperativo, em escalas de organização de crescente complexidade. Desenho e canteiro especula sobre uma pedagogia da precisão, inspirando-se na reflexão do arquiteto brasileiro Sérgio Ferro sobre os processos de produção da arquitetura, sendo os estudantes desafiados a simular, com ferramentas digitais, elementos construtivos tomados dos exercícios iniciais, promovendo reequilibrações no processo de aprendizagem. As “pedagogias” da metáfora, do linguajar e da precisão, integradas na reflexão sobre o fazer e o compreender, buscam constituir uma "ecologia" que enlaça sujeitos, conceitos e tecnologias. O trabalho conclui com um conjunto de crônicas que examinam diferentes aspectos do percurso realizado.Construção e abertura: diálogos Alexander-Piaget (Construction and overture: dialogues Alexander-Piaget) examines the construction of knowledge in the field of Architecture and Planning, through the combination of the approaches of two prominent authors detached in the title of the thesis, aiming outlines elements for a theory and a pedagogy of the design process. In this sense, the work is organized into two parts: Overtures – theoretical context To realize cognitive processes involved in the architectural design within the pedagogic studio, the research seeks to establish a theoretical dialogue that finds points of contact between the tradition by Genetic Epistemology started by Jean Piaget, and the theories of Austro-American architect Christopher Alexander. Since Piaget's constructivism, interests, in particular, the notion of the possibles, through the formulation on the perception and spatial representation, through the processes of awareness on the route between to do and to understand, and the foundations for a logic of meanings. Since the approach of Alexander, detaching, especially, the notions of Pattern Language and the growing wholes, to explain relations between subjects of the design process and the built environment, in the emergence of a coherent ordered space through continuous fitness between form and context. The space of encounter between the two thinkers is explained through an epistemological approach based on the concept of system, and the cybernetic principle of balance. In the case of Piaget, this implies upper bounds states of assimilation in the interaction between subject and object of knowledge; from the approach of Alexander, it is revealed through the analogy between manmade environmental systems and living organisms, which can be described as a well defined set of design principles. Constructions – pedagogic context In terms of pedagogy, an experiment was designed, and offered to undergraduate students of Architecture and Planning from different stages of the course, aiming to: i) discussions around the theoretical context, ii) the exploration of technologies for graphic simulation; iii) the arrangement of means of cooperative work, in classroom and in distance learning environment, and iv) the development of design exercises supported the reflections derived from (i), (ii) and (iii) to promote cognitive imbalances, suggesting work journeys than those with which students are familiar. The experiment is a set of three exercices, corresponding roughly to the stages of conceiving, developing and refining an architectural or urban design. Casa Tomada (House taken over) based on the tale by the Argentinian Julio Cortázar, addresses the pedagogy of metaphor, proposing a transcript of fictional narrative to the architectural space, topologically reconstructing the plot hatched by the writer. Cidade das palavras (City of words) reflects the scope of pedagogy named speech and proposes the development of "genetic" narratives constructed through the cooperative work on scales of organization of increasing complexity. Desenho e canteiro (Design and construction site) speculates about a pedagogy of precision, drawing on the reflection of Brazilian architect Sergio Ferro on the production processes of architecture, and students are challenged to simulate, with digital tools, building elements taken from the initial exercises in promoting a feedback for learning process. The "pedagogies" of metaphor, speech and precision, integrated into thinking about doing and understanding, seek to constitute an "ecology" that links subjects, concepts and technologies. The thesis concludes with a set of chronicles that examines different aspects of the journey undertaken