Prevalence of aac(6')-Ib-cr plasmid-mediated and chromosome-encoded fluoroquinolone resistance in Enterobacteriaceae in Italy

The spread of aac(6')-Ib-cr plasmid-mediated quinolone resistance determinants was evaluated in 197 enterobacterial isolates recovered in an Italian teaching hospital. The aac(6')-Ib-cr gene was found exclusively in Escherichia coli strains. The gene was located on a plasmid which presented additional ESBL genes. Most of the clinical strains were clonally related and displayed three point mutations at the topoisomerase level which conferred high resistance to fluoroquinolones

Influence of the degree of hydrolysis of poly(vinyl alcohol) on the physical properties of films based on blends of gelatin and poly(vinyl alcohol) plasticized with glycerol

O objetivo deste trabalho foi o estudo do efeito do Grau de Hidrólise (GH) do poli(vinil álcool) (PVA) nas propriedades dos filmes à base de blendas de gelatina suína e PVA com dois GH. Os filmes foram produzidos com soluções com 2 g de macromoléculas/100 g de solução, contendo 23,1 g de PVA.100 g-1 de macromoléculas e 25 g de glicerol/100 g de macromoléculas. As propriedades mecânicas e térmicas, cor, opacidade, umidade e solubilidade, além de espectros de infravermelho com transformada de Fourier (FTIR) dos filmes, foram estudadas. As soluções foram analisadas por reometria dinâmica. Os filmes produzidos com o PVA de menor GH foram mais higroscópicos e mais solúveis. Mas o tipo de PVA não afetou a cor, afetando a opacidade e o brilho dos filmes. O PVA com maior GH proporcionou filmes mais resistentes, e o PVA de menor GH produziu filmes mais resistentes à tração, embora menos deformáveis na perfuração. O GH do PVA não afetou a temperatura de transição vítrea dos filmes, determinada na primeira varredura, mas a afetou na segunda varredura. Os resultados das análises de FTIR corroborraram com esses resultados. As propriedades viscoelásticas das soluções não foram afetadas pelo GH do PVA, muito possivelmente por se tratar de soluções diluídas.The aim of this work was to study the effect of the Degree of Hydrolysis (DH) of poly(vinyl alcohol) (PVA) on the properties of films based on blends of pigskin gelatin and PVA with two DH. The films were made with solutions with 2 g macromolecules/100 g solution, containing 23.1 g PVA.100 g-1 macromolecules and 25 g glycerol/100 g macromolecules. The mechanical and thermal properties, color, opacity, moisture and solubility of the films were studied, as well as Fourier Transform Infrared (FTIR) spectra. The solutions were analyzed by dynamic rheometry. The films containing PVA with lower DH were more hygroscopic and more soluble. However, the type of PVA did not affect color, but affected the opacity and the gloss of the films. The PVA of higher DH produced films which were more resistant to puncture and stress, and the PVA of lower DH produced films which were more deformable upon stress, although less deformable upon puncture. The DH of PVA did not affect the first scan glass transition temperature of the films, but did affect this property in the second scan. The results from the FTIR analysis were in conformity with the results of the thermal analysis. The viscoelastic properties of the solutions determined by rheometry were not affected by the DH of PVA, possibly because the solutions studied were diluted.FAPESPCNP

Evaluation of a NIR handheld device and PLS-DA for discrimination of six similar amazonian wood species

Supervising wood exploitation can be very challenging due to the existence of many similar species and the reduced number of wood identification experts to meet the demand. There is evidence that valuable endangered wood species are being smuggled disguised as other species. Near infrared spectroscopy (NIRS) and chemometrics has been successfully used to discriminate between Amazonian wood species using high resolution instruments. In this study, a handheld spectrometer was evaluated for the discrimination of six visually similar tropical wood species using PLS-DA. Woods of mahogany (Swietenia macrophylla) and cedar (Cedrela odorata), both high value tropical timber species included in Appendixes II and III of the CITES, respectively; crabwood (Carapa guianensis); cedrinho (Erisma uncinatum); curupixá (Micropholis melinoniana); and jatobá (Hymenea coubaril). The data for model development and validation take into account both laboratory and field measurements. Outlier exclusion was performed based on Hotelling T2, residuals Q and errors in the estimated class values. The efficiency rates were higher than 90% for all species, showing that the handheld NIR combined with PLS-DA succeeded in discriminate between these species. These results stimulate the application of handheld NIR spectrometers in the supervision of wood exploitation, which can contribute to the species preservation

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

Sui fondamenti della composizione

Il problema del progetto di architettura sta tutto nella definizione della forma che con maggiore efficacia possa permettere all’opera di partecipare, di assumere un ruolo nel processo di composizione dello spazio dell’abitare. Nel momento in cui si va diffondendo un’arbitrarietà che alimenta il piacere ultimo della trasgressione non autentica, espressione di un mondo che ha mescolato a tal punto i meccanismi del desiderio da renderli inutilizzabili, i contributi di questo libro, riflettendo sui fondamenti disciplinari dell’architettura, provano a delineare percorsi che, in risposta alla precarietà come condizione, si misurano con la necessità di recuperare sicurezza, nell’attendibile convinzione di essere capaci, come Dedalo, di controllare il labirinto della complessità contemporanea