10 research outputs found

    COMPARAÇÃO ENTRE O MÉTODO REEQUILÍBRIO TORACOABDOMINAL E A TÉCNICA DE DRENAGEM AUTÓGENA ASSISTIDA SOBRE OS PARÂMETROS FISIOLÓGICOS E DESCONFORTO RESPIRATÓRIO EM RECÉM-NASCIDOS PRÉ-TERMO:ENSAIO CLÍNICO RANDOMIZADO

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    Assisted Autogenous Drainage (DAA) and the Thoracoabdominal Rebalancing (RTA) method assist in the synergism of abdominal muscles and breathing, which facilitates bronchial hygiene and improves respiratory mechanics. The aim of this study was to compare the RTA method with the DAA on physiological parameters and respiratory distress in preterm newborns (PTNB). This is a randomized clinical trial in which 30 PTNB participated, allocated in two groups (DAA and RTA group), submitted to a treatment protocol that used DAA or RTA. The variables analyzed were peripheral oxygen saturation (SpO₂), respiratory rate (RR) and heart rate (HR) in addition to respiratory distress (DR) by the Silverman Andersen Bulletin (BSA). Data were collected in 2 moments: before randomization and immediately after the end of the protocol. The HR of PTNBs, immediately after, submitted to AAD decreased significantly in relation to the RTA group (p = 0.040). For the variables SpO₂, RR and BSA score, there was no difference between the experimental groups in any of the evaluated moments. On the other hand, in the intra-group comparison, SpO₂ increased (DAA: p = 0.002; RTA: p = 0.004) and FR decreased (DAA: p = 0.015; RTA: p = 0.017) significantly. Thus, the data show that the RTA and DAA do not differ with respect to the variables analyzed in this study, but are safe and have beneficial results in the SpO₂ and RF of PTNBA Drenagem Autógena Assistida (DAA) e o método Reequilíbrio Toracoabdominal (RTA) auxiliam no sinergismo da musculatura abdominal e da respiração, o que facilita a higiene brônquica e melhora da mecânica respiratória. O objetivo deste trabalho foi comparar o método de RTA com a DAA sobre os parâmetros fisiológicos e desconforto respiratório no recém-nascido pré-termo (RNPT). Trata-se de um ensaio clínico randomizado do qual participaram 30 RNPT, alocados em dois grupos (grupo DAA e RTA), submetidos a um protocolo de tratamento que utilizou a DAA ou o RTA. As variáveis analisadas foram a saturação periférica de oxigênio (SpO₂), frequência respiratória (FR) e cardíaca (FC) além do desconforto respiratório (DR) pelo Boletim de Silverman Andersen (BSA). Os dados foram coletados em 2 momentos: antes da randomização e imediatamente após o término do protocolo. A FC dos RNPT, no momento imediatamente após, submetidos à DAA diminuiu significativamente em relação ao grupo RTA (p=0,040). Para as variáveis SpO₂, FR e escore do BSA, não houve diferença entre os grupos experimentais em nenhum dos momentos avaliados. Por outro lado, na comparação intragrupo, a SpO₂ aumentou (DAA: p=0,002; RTA: p=0,004) e a FR diminuiu (DAA: p=0,015; RTA: p=0,017) significativamente. Desta forma, os dados mostram que o RTA e DAA não diferem entre si no que se refere as variáveis analisadas neste estudo, mas se mostram seguros e apresentam resultados benéficos na SpO₂ e FR dos RNPT

    Carbon-sensitive pedotransfer functions for plant available water

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    Currently accepted pedotransfer functions show negligible effect of management-induced changes to soil organic carbon (SOC) on plant available water holding capacity (θAWHC), while some studies show the ability to substantially increase θAWHC through management. The Soil Health Institute\u27s North America Project to Evaluate Soil Health Measurements measured water content at field capacity using intact soil cores across 124 long-term research sites that contained increases in SOC as a result of management treatments such as reduced tillage and cover cropping. Pedotransfer functions were created for volumetric water content at field capacity (θFC) and permanent wilting point (θPWP). New pedotransfer functions had predictions of θAWHC that were similarly accurate compared with Saxton and Rawls when tested on samples from the National Soil Characterization database. Further, the new pedotransfer functions showed substantial effects of soil calcareousness and SOC on θAWHC. For an increase in SOC of 10 g kg–1 (1%) in noncalcareous soils, an average increase in θAWHC of 3.0 mm 100 mm–1 soil (0.03 m3 m–3) on average across all soil texture classes was found. This SOC related increase in θAWHC is about double previous estimates. Calcareous soils had an increase in θAWHC of 1.2 mm 100 mm–1 soil associated with a 10 g kg–1 increase in SOC, across all soil texture classes. New equations can aid in quantifying benefits of soil management practices that increase SOC and can be used to model the effect of changes in management on drought resilience

    Carbon-sensitive pedotransfer functions for plant available water

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    Currently accepted pedotransfer functions show negligible effect of management-induced changes to soil organic carbon (SOC) on plant available water holding capacity (θAWHC), while some studies show the ability to substantially increase θAWHC through management. The Soil Health Institute\u27s North America Project to Evaluate Soil Health Measurements measured water content at field capacity using intact soil cores across 124 long-term research sites that contained increases in SOC as a result of management treatments such as reduced tillage and cover cropping. Pedotransfer functions were created for volumetric water content at field capacity (θFC) and permanent wilting point (θPWP). New pedotransfer functions had predictions of θAWHC that were similarly accurate compared with Saxton and Rawls when tested on samples from the National Soil Characterization database. Further, the new pedotransfer functions showed substantial effects of soil calcareousness and SOC on θAWHC. For an increase in SOC of 10 g kg–1 (1%) in noncalcareous soils, an average increase in θAWHC of 3.0 mm 100 mm–1 soil (0.03 m3 m–3) on average across all soil texture classes was found. This SOC related increase in θAWHC is about double previous estimates. Calcareous soils had an increase in θAWHC of 1.2 mm 100 mm–1 soil associated with a 10 g kg–1 increase in SOC, across all soil texture classes. New equations can aid in quantifying benefits of soil management practices that increase SOC and can be used to model the effect of changes in management on drought resilience

    Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

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    Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

    Spatial organization and social dynamics of geoffroy's cat in the Brazilian pampas

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    Geoffroy´s cat (Leopardus geoffroyi) is a small Neotropical felid whose social behavior remains poorly understood. We used simultaneous radiotelemetry (4 males and 3 females) and camera trapping to examine the spatial structure and dynamics of a population of this species in the Brazilian pampas (part of the Uruguayan Savannah ecoregion), including assessment of interindividual genetic relatedness. Home ranges (HRs) and core areas of males were larger than those of females. Males were significantly heavier than females, and linear regression analyses indicated that body mass of males significantly influenced HR size, whereas the relationship was not significant for females. When we performed a joint analysis comparing our data to those reported previously for other study sites, we observed the same patterns. We detected extensive HR and core area overlap among most of our monitored individuals, with no clear sex-based pattern. Moreover, our molecular data indicated that most of the sampled individuals were unrelated, and that the levels of HR and core area overlap were not significantly influenced by genetic relatedness. These results suggest that some interindividual tolerance and relaxation in territoriality may occur in Geoffroy´s cat. We detected only minor changes in HR and core area size and overlap between seasons, indicating that the spatial structure we observed was temporally stable. On a broader perspective, our cross-site comparisons illustrate the usefulness of performing multiple ecological studies employing comparable methods at different locations to better understand the ecology of wild felid populations.Fil: Tirelli, Flávia P.. Pontificia Universidade Católica do Rio Grande do Sul; Brasil. University of Oxford; Reino UnidoFil: Trigo, Tatiane C.. Fundação Zoobotânica do Rio Grande do Sul; BrasilFil: Trinca, Cristine S.. Pontificia Universidade Católica do Rio Grande do Sul; BrasilFil: Albano, Ana Paula N.. Universidade Federal de Pelotas; BrasilFil: Mazim, Fábio D.. Ka’aguy Consultoria Ambiental; BrasilFil: Queirolo, Diego. Universidad de la República; UruguayFil: Espinosa, Caroline da C.. Pontificia Universidade Católica do Rio Grande do Sul; BrasilFil: Soares, José Bonifácio. Ka’aguy Consultoria Ambiental; BrasilFil: Pereira, Javier Adolfo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Museo Argentino de Ciencias Naturales Bernardino Rivadavia; ArgentinaFil: Crawshaw, Peter G.. Centro Nacional de Pesquisa e Conservação de Mamíferos Carnívoros; BrasilFil: Macdonald, David .W. University of Oxford; Reino UnidoFil: Lucherini, Mauro. Universidad Nacional del Sur. Departamento de Biología, Bioquímica y Farmacia; ArgentinaFil: Eizirik, Eduardo. Pontificia Universidade Católica do Rio Grande do Sul; Brasi
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