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

Análise da água em assentamentos rurais: um diálogo da universidade com a sociedade

It's undeniable the importance of water for the existence of life, universal solvent it participates in several reactions in the body. However the water can be carrier of various pathogens, it representing a threat to the population. In the countryside, where lacks a sewage treatment system, the water is susceptible to contamination from external sources microorganism. On this information, this study aimed to evaluate the quality water consumed in two settlements in the Northwest Paulista, in the period April to August 2015. We collected 41 water samples from wells and ponds semi-artesian, these eight samples received physical analysis -chemical and bacteriological, these samples showed unacceptable values established by A Portaria N°2.914, de 12 de dezembro de 2011 do Ministério da Saúde for the nitrate parameter and coliforms total and Escherichia coli. Overall, the 41 samples analyzed, 51% had total coliforms and 37% for Escherichia coli and only 12% is deemed fit for consumption.É inegável a importância da água para a existência da vida, solvente universal ela participa de diversas reações no organismo. No entanto a água pode ser carreadora de vários patógenos, representando uma ameaça para a população. Na zona rural, onde não conta com um sistema de tratamento de esgoto, a água está suscetível a contaminação por microrganismo de origem externa. Diante dessa informação, este trabalho buscou avaliar a qualidade da água consumida em dois assentamentos no Noroeste Paulista, no período de abril a agosto de 2015. Foram coletadas 41 amostras de água, de poços cacimbas e semiartesianos, dessas amostras oito receberam análises físico-químicos e bacteriológicas, essas amostras apresentaram valores não aceitáveis estabelecido pela A Portaria N°2.914, de 12 de dezembro de 2011 do Ministério da Saúde para o parâmetro nitrato e para coliformes totais e Escherichia coli. No geral das 41 amostras analisadas, 51% apresentaram coliformes totais e 37% para Escherichia coli e somente 12% é considerada própria para o consumo

Synthesis and characterization of poly-o-toluidine: kinetic and structural aspects

Poly(o-methylaniline) (poly-o-toluidine, PTOL) was synthesized by chemical oxidation of o-toluidine with ammonium peroxydisulfate in an aqueous 1.0 mol L-1 HCl solution. The progress of polymerization was followed by measuring the open-circuit potential (OCP) of a Pt electrode immersed in the reaction medium with the polymerization time. The chemical synthesis of PTOL was carried out at different monomer:oxidant (M:O) molar ratios (4:1, 2:1, 1.5:1, 1:1, and 0.66:1), and the products obtained were characterized by infrared spectroscopy, gel permeation chromatography, and X-ray diffraction. The molecular weight and percentage of crystallinity of PTOL are higher for samples synthesized in an excess of the monomer, i.e. at higher M:O ratios. However, the yield of PTOL prepared at higher M:O ratios is considerably low, in particular at a 4:1 M:O ratio, which is the M:O ratio most commonly used in the literature to synthesize polyaniline and its derivatives

Cursinho da Unesp: para muito além das aulas

The Cursinho Diferencial is a pre-college course , and is housed in Unesp Ilha Solteira as a project of social inclusion. The aim of it is mainly include the low-income students , coming from deficient public education and thus provide greater possibilities they enroll in a higher education. The teachers from Cursinho are University’s students who have the desire to contribute in some way to this important project in the society in which it is inserted because despite the difficulty in keeping students motivated there is a common quest in an attempt to stimulate them to study and seek a better future. Some work done has been decreasing dropout of students and at the same time increasing the number of approvals , which brings a positive result for the project.O Cursinho Diferencial é um Cursinho Pré- vestibular Popular, e está inserido na Unesp de Ilha Solteira como um projeto de inclusão social. O intuito dele é principalmente incluir os alunos de baixa renda, que vem do ensino público deficitário e, dessa forma, proporcionar maiores possibilidades deles ingressarem em um Ensino Superior. O corpo docente do Cursinho é composto por alunos da Universidade que possuem a vontade de contribuir de alguma forma para esse projeto tão importante na sociedade na qual ele está inserido, pois apesar da dificuldade em manter os alunos motivados existe uma busca frequente na tentativa de estimulá-los a estudar e buscar um futuro melhor. Alguns trabalhos realizados vêm diminuindo a evasão dos alunos e ao mesmo tempo aumentando o número de aprovações, o que traz um resultado positivo para o projeto

Realização da semana diferencial no combate à evasão no cursinho diferencial: unidade Ilha Solteira

This work has as main objective to evaluate the realization of Semana Diferencial, created to reduce the evasion of students in Cursinho Diferencial cram in weeks following the UNESP entrance exam, critical period due to stress caused by the preparation and holding of entrance examinations. For this study, we applied a questionnaire to the course participants, which dealt with the realization of activity in isolation and the quality of each. In addition, it included questions about the skills worked in the background of activities such as the union of the group, interaction between teacher and student, among others. Added to this, there was a statistical comparison with the presence of student rates in the period after the entrance exam of the UNESP in 2014 and 2015. The results are satisfactory, with all the activities presenting rates of 74% or greater of excellent / good. In addition, the loss in the period decreased from 37.3% in 2014 to 19.4% in the same period in 2015, and may consider as well, achieving Semana Diferencial a success and repeatable in the coming occasions.Este trabalho tem como objetivo principal avaliar a realização da Semana Diferencial, criada para a diminuição da evasão dos cursistas no Cursinho Diferencial em semanas seguintes ao vestibular da Unesp, período crítico devido ao estresse causado pela preparação e realização de exames vestibulares. Para a realização deste estudo, aplicou-se um questionário aos cursistas, o qual abordava a realização das atividade de maneira isolada e da qualidade de cada uma delas. Além disso, incluiu-se questões sobre as competências trabalhadas em segundo plano nas atividades, como a união do grupo, interação entre docente e cursista, entre outras. Somado a isso, realizou-se uma comparação estatística com os índices de presença dos cursista no período após o vestibular da Unesp de 2014 e 2015. Os resultados obtidos são satisfatórios, com todas as atividades apresentando índices de 74% ou maiores de ótimo/bom. Ademais, a evasão no período reduziu de 37,3% em 2014, para 19,4% na mesma época em 2015, podendo considerar, assim, a realização da Semana Diferencial um sucesso e passível de repetição nas próximas ocasiões

Proposta para sensibilização sobre a importância da graduação

Conselho Nacional de Desenvolvimento Ciêntífico e Tecnológico (CNPq

A prática pedagógica do professor universitário: momentos de reflexão no espaço de uma oficina de estudos e práticas pedagógicas

Conselho Nacional de Desenvolvimento Ciêntífico e Tecnológico (CNPq