Sequential Modulation of Cardiac Autonomic Control Induced by Cardiopulmonary and Arterial Baroreflex Mechanisms

Background—Nonhypotensive lower body negative pressure (LBNP) induces a reflex increase in forearm vascular resistance and muscle sympathetic neural discharge without affecting mean heart rate. We tested the hypothesis that a reflex change of the autonomic modulation of heartbeat might arise during low intensity LBNP without changes of mean heart rate.Methods and Results—Ten healthy volunteers underwent plasma catecholamine evaluation and a continuous recording of ECG, finger blood pressure, respiratory activity, and central venous pressure (CVP) during increasing levels of LBNP up to −40 mm Hg. Spectrum and cross-spectrum analyses assessed the changes in the spontaneous variability of R-R interval, respiration, systolic arterial pressure (SAP), and CVP and in the gain (αLF) of arterial baroreflex control of heart rate. Baroreceptor sensitivity was also evaluated by the SAP/R-R spontaneous sequences technique. LBNP began decreasing significantly: CVP at −10, R-R interval at −20, SAP at −40, and the indexes αLFand baroreceptor sensitivity at −30 and −20 mm Hg, compared with baseline conditions. Plasma norepinephrine increased significantly at −20 mm Hg. The normalized low-frequency component of R-R variability (LFR-R) progressively increased and was significantly higher than in the control condition at −15 mm Hg.Conclusions—Nonhypotensive LBNP elicits a reflex increase of cardiac sympathetic modulation, as evaluated by LFR-R, which precedes the changes in the hemodynamics and in the indexes of arterial baroreflex control

The MRI Sepsis Score: An Innovative Tool for the Evaluation of Septic Peritonitis in Mice Using 7-Tesla Small Animal MRI

Background: Magnetic resonance imaging (MRI) techniques are rarely used in the context of abdominal sepsis and in sepsis research. This study investigates the impact of MRI for monitoring septic peritonitis in an animal model (colon ascendens stent-induced peritonitis, CASP). The CASP model closely mimics that of human disease and is highly standardized. The most frequently employed readout parameter in mouse CASP studies is prolonged or decreased rate of survival. Monitoring the progression of peritonitis via MRI could provide a helpful tool in the evaluation of severity. The use of alternative readout systems could very well reduce the number of research animals. Perspectively, clinical improvement after certain treatment could be classified. Methods: This study describes for the first time MRI findings following the induction of septic peritonitis in mice using the CASP model. Two sublethal groups of mice with septic peritonitis were investigated. Each had received one of two differing stent diameters in order to control the leakage of feces into the abdominal cavity. Each mouse served as its own control. Imaging and analyses were performed blinded. Gut diameters, stomach volume, abdominal organ wall diameters, and volume of the adrenal glands were measured. Serum corticosterone levels were detected using ELISA. Serum IL-6, TNF-α, IL-1β, and IL-10 levels were screened by cytometric bead array. Statistical analysis was performed using the Mann-Whitney U test for nonparametric probes and the Kruskal-Wallis and t tests. Results: Using a 7-tesla MRI scanner 24 and 48 h after induction of septic peritonitis, interenteric fluid, organ swelling of spleen and adrenal glands, as well as dilatation of the stomach were compared to nonseptic conditions. Swelling of adrenal glands resulted in an increased serum corticosterone level. In addition, the wall of the intestine bowel was thickened. Based upon these findings, an MRI score (MRI sepsis score, MSS) for abdominal sepsis in mice was established. Reduced stent sizes led to reduced severity of the abdominal sepsis, which could be reproduced in the MSS, which is described here for the first time. Conclusions: Intraabdominal variations during septic peritonitis are detectable by MRI techniques. MRI methods should become a more important tool for the evaluation of abdominal peritonitis. MSS could provide an interesting tool for the evaluation of therapeutic strategies

The MRI Sepsis Score: An Innovative Tool for the Evaluation of Septic Peritonitis in Mice Using 7-Tesla Small Animal MRI

Background: Magnetic resonance imaging (MRI) techniques are rarely used in the context of abdominal sepsis and in sepsis research. This study investigates the impact of MRI for monitoring septic peritonitis in an animal model (colon ascendens stent-induced peritonitis, CASP). The CASP model closely mimics that of human disease and is highly standardized. The most frequently employed readout parameter in mouse CASP studies is prolonged or decreased rate of survival. Monitoring the progression of peritonitis via MRI could provide a helpful tool in the evaluation of severity. The use of alternative readout systems could very well reduce the number of research animals. Perspectively, clinical improvement after certain treatment could be classified. Methods: This study describes for the first time MRI findings following the induction of septic peritonitis in mice using the CASP model. Two sublethal groups of mice with septic peritonitis were investigated. Each had received one of two differing stent diameters in order to control the leakage of feces into the abdominal cavity. Each mouse served as its own control. Imaging and analyses were performed blinded. Gut diameters, stomach volume, abdominal organ wall diameters, and volume of the adrenal glands were measured. Serum corticosterone levels were detected using ELISA. Serum IL-6, TNF-α, IL-1β, and IL-10 levels were screened by cytometric bead array. Statistical analysis was performed using the Mann-Whitney U test for nonparametric probes and the Kruskal-Wallis and t tests. Results: Using a 7-tesla MRI scanner 24 and 48 h after induction of septic peritonitis, interenteric fluid, organ swelling of spleen and adrenal glands, as well as dilatation of the stomach were compared to nonseptic conditions. Swelling of adrenal glands resulted in an increased serum corticosterone level. In addition, the wall of the intestine bowel was thickened. Based upon these findings, an MRI score (MRI sepsis score, MSS) for abdominal sepsis in mice was established. Reduced stent sizes led to reduced severity of the abdominal sepsis, which could be reproduced in the MSS, which is described here for the first time. Conclusions: Intraabdominal variations during septic peritonitis are detectable by MRI techniques. MRI methods should become a more important tool for the evaluation of abdominal peritonitis. MSS could provide an interesting tool for the evaluation of therapeutic strategies

A Crossover Trial Using High‐Fidelity Cardiovascular Phenotyping

Background Sympathetic and parasympathetic influences on heart rate (HR), which are governed by baroreflex mechanisms, are integrated at the cardiac sinus node through hyperpolarization‐activated cyclic nucleotide–gated channels (HCN4). We hypothesized that HCN4 blockade with ivabradine selectively attenuates HR and baroreflex HR regulation, leaving baroreflex control of muscle sympathetic nerve activity intact. Methods and Results We treated 21 healthy men with 2×7.5 mg ivabradine or placebo in a randomized crossover fashion. We recorded electrocardiogram, blood pressure, and muscle sympathetic nerve activity at rest and during pharmacological baroreflex testing. Ivabradine reduced normalized HR from 65.9±8.1 to 58.4±6.2 beats per minute (P<0.001) with unaffected blood pressure and muscle sympathetic nerve activity. On ivabradine, cardiac and sympathetic baroreflex gains and blood pressure responses to vasoactive drugs were unchanged. Ivabradine aggravated bradycardia during baroreflex loading. Conclusions HCN4 blockade with ivabradine reduced HR, leaving physiological regulation of HR and muscle sympathetic nerve activity as well as baroreflex blood pressure buffering intact. Ivabradine could aggravate bradycardia during parasympathetic activation

Importância do auditor para a continuidade das empresas - setor do calçado

Esta versão contém as críticas e sugestões dos elementos do júriO pressuposto de continuidade tem ganho cada vez mais importância nos dias de hoje, devido aos escândalos, tanto internacionais como nacionais, que ocorreram nos últimos anos, como por exemplo, nas entidades Xerox, Enron, Worldcom e BES. Os escândalos levaram a pôr em causa o trabalho do Revisor Oficial de Contas (ROC) bem como a sua independência. A crise financeira que afetou Portugal, levou a que diversas empresas, nomeadamente, as que pertenciam ao setor do calçado, encerrassem a sua atividade. Desde então, o nosso país tem vindo a apresentar taxas de crescimento positivas relativamente ao mesmo setor. A presente dissertação tem como objetivo verificar qual a importância que o auditor tem quando emite uma opinião sobre a continuidade, na ótica dos administradores/gerentes e dos auditores, em específico, nas empresas que pertencem ao setor do calçado situadas no distrito de Aveiro. Assim, após a realização de uma pesquisa bibliográfica relacionada com os temas Auditoria, Continuidade e o Setor de Calçado em Portugal, foram realizados dois questionários, um destinado às empresas do Setor do Calçado (com ou sem ROC), situadas no distrito de Aveiro e, outro, destinado aos Auditores Externos (ROC e não ROC). Os questionários ocorreram entre os dias 06 de junho de 2020 e 15 de agosto de 2020. Após a obtenção das respostas aos questionários e análise dos dados, foi possível concluir que o trabalho do auditor tem uma grande importância nas entidades do setor do calçado, uma vez que a sua opinião tem influência perante os utilizadores das demonstrações financeiras. A grande maioria das empresas de calçado afirma que o trabalho do auditor pode ser uma mais-valia para as empresas. E, ambos os inquiridos acreditam que o órgão de gestão tem medo de informar quando existe incerteza material quanto à continuidade das empresas.Nowadays, the going concern assumption has become more and more relevant because of the international and national scandals that occurred in the last years, for example, Xerox, Eron, Worldcom and BES’s entities. These scandals have called into question the work of the Statutory Auditors (SA) as well as its independence. The financial crisis that affected Portugal led to several companies, namely those belonging to the Footwear Sector, to close their activity. Since this, our country has been showing positive growth rates in what concerns the Footwear Sector. This dissertation aims to verify how important the auditor is, in the perspective of administrators/ managers and the auditors, when giving an opinion about the going concern, in specific, the companies belonging to the Footwear Sector located in the Aveiro district. So, after executing a bibliographic research related to the topics of Audit, Going Concern and Footwear in Portugal, two questionnaires were made, one for the Footwear Sector Companies (with and without SA) located in the Aveiro district and another for External Auditors (SA and non-SA). The questionnaires were made available between 6th June 2020 and 15th August 2020. After obtaining the answers to the questionnaires and analysing the data, it was possible to conclude that the work of auditors plays an important role in the Footwear Sector entities, once their opinion has an influence on financial statements users. Most Footwear Sector entities consider that the auditor’s work can be an asset to companies and both respondents believe that managements are afraid of informing when there is material uncertainty about the going concern of companies

Effects of Daily Centrifugation on Segmental Fluid Distribution in Bed-rested Subjects

The effect of daily centrifugation on segmental fluid distribution have been studied during 21 days of 6 degree head down bedrest. One group (N=7) underwent no countermeasure while the other (N=8) received a daily, one hour, dose (2.5 gz at the foot, decreasing to 1.0 gz at the heart) of artificial gravity (AG) training on the Johnson Space Center short radius centrifuge. Fluid shifts of thoracic(VTO), abdominal (VAB), thigh (VTH), and calf (VCA) regions were measured by the tetrapolar segmental body impedance technique. Untrained subjects reduced their total volume from 18.9 plus or minus 0.5L to 17.9 plus or minus 0.9L (MN plus or minus SE, P less than 0.05) while trained subjects maintained their total volume. In untrained, control, subjects after bed rest, there was a trend toward reduced volume in all segments, with significant reductions in thigh and calf (fig, P less than 0.05). Trained subjects maintained volume in all segments. Our data indicate that artificial gravity treatment counteracts bed rest-induced hypovolemia

Reflexos da judicialização de demandas por justiça social no Brasil a partir da atuação das Assessorias Jurídicas Populares Universitárias

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Reflexos da judicialização de demandas por justiça social no Brasil a partir da atuação das Assessorias Jurídicas Populares Universitárias

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