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

Synthesis, characterization and applications of BODIPY-derived fluorophores

O desenvolvimento de técnicas analíticas, espectroscópicas e de imagem baseadas na detecção da fluorescência está associado com a necessidade por marcadores fluorescentes com variadas características e aplicabilidades. Dentre os diversos marcadores fluorescentes disponíveis, os derivados de borodipirrometenos (BODIPY), descobertos no final da década de 1960, passaram a ser amplamente utilizados desde o final da década de 1980. Esta tese de doutorado se trata de um estudo pioneiro no Brasil, envolvendo a síntese, modificação química e caracterização fotofísica de BODIPYs. Na primeira etapa do projeto métodos de obtenção de BODIPYs foram estabelecidos e aplicados na síntese de uma biblioteca de sondas fluorescentes. O estudo fotofísico dessa biblioteca de fluoróforos nos possibilitou identificar e estudar particularidades de alguns fluoróforos, como o solvatocromismo, halocromismo e ionocromismo. A segunda etapa do projeto envolveu o estabelecimento de métodos de modificação química de BODIPYs visando a diversificação fotofísica e estrutural da biblioteca de compostos. Foram sintetizados BODIPYs reativos que foram submetidos a reações de substituição nucleofílica, Suzuki, Sonogashira, Knoevenagel e arilação direta, levando à obtenção de compostos com propriedades ópticas diversas. Por fim, na terceira etapa do projeto, está descrito o desenvolvimento de novos métodos de modificação química de fluoróforos BODIPY. Foi desenvolvido um método simples de tiocianação direta dessa classe de compostos com bons rendimentos, baseado na utilização de tiocianato de amônio e oxone ®. O escopo e as limitações do novo método de tiocianação foi estudado em BODIPYs com propriedades eletrônicas diversas. Foi mostrada ainda a conversão de BODIPYs tiocianados a derivados tioalquilados com características ópticas particulares. Em conclusão, com esta tese de doutorado foi estabelecida uma linha de pesquisa inovadora envolvendo a síntese e modificação química de uma classe de compostos com ampla aplicação tecnológica.The development of fluorescence-based analytical, spectroscopic and image techniques is associated with the necessity of fluorescent probes with diverse properties and applications. Among the available fluorescent probes, borondipyrromethene (BODIPY) derivatives, discovered in the late 1960`s, became widely applied since the late 1980`s. This PhD thesis is a pioneering study in Brazil, concerning the synthesis, chemical modification and photophysical characterization of BODIPYs. In the first stage of the project some methods for the synthesis of BODIPYs were stablished and then applied in the development of a library of fluorescent probes. The photophysical study of this fluorophore library enabled us to identify and further study particularities of some fluorophores, such as solvatochromism, halochromism and ionochromism. The second stage of the project involved the establishment of methods for the chemical modification BODIPYs, aiming at the photophysical and structural diversification of the library. Reactive BODIPYs were synthesized and subjected to reactions such as nucleophilic substitution, Suzuki, Sonogashira, Knoevenagel and direct arylation, resulting in the obtainment of compounds with diverse optical properties. Finally, in the third stage of the project, it is described the development of new methods for the chemical modification of BODIPY fluorophores. It was developed a simple and high yielding method for the direct thiocyanation of this class of compounds, based on the use of ammonium thiocyanate and oxone ®. The scope and limitations of the new thiocyanation method has been studied in BODIPYs with different electronic properties. It was also shown the conversion of thiocyanated BODIPYs to thioalkylated derivatives bearing particular optical characteristics. In conclusion, in this PhD thesis an innovative research line involving the synthesis and chemical modification of a class of compounds with broad technological application has been established

Thiocyanation of BODIPY dyes and their conversion to thioalkylated derivatives

A high-yielding method for the direct thiocyanation of BODIPY dyes is described. In 1,3-dimethyl BODIPYs, the thiocyanato group adds at position 2, whereas the insertion occurs at position 5 in 3-amino BODIPYs. The transformation of the thiocyanato group enables the synthesis of thioalkylated BODIPYs. 2-Thioalkylated BODIPYs and 3-thiocyanato-5-piperidino BODIPYs exhibit interesting spectroscopical features. Hence, the described synthetic methodology can be used for the photophysical tuning of BODIPY dyes.crosscheck: This document is CrossCheck deposited related_data: Supplementary Information identifier: Lucas Cunha Dias de Rezende (ORCID) copyright_licence: The Royal Society of Chemistry has an exclusive publication licence for this journal copyright_licence: The accepted version of this article will be made freely available in the Chemical Sciences Article Repository after a 12 month embargo period history: Received 12 March 2015; Accepted 23 April 2015; Accepted Manuscript published 23 April 2015; Advance Article published 6 May 2015; Version of Record published 19 May 2015status: publishe

Epidemiological characterization and risk evaluation associated with the presence of Megninia spp. in posture farms

ABSTRACT: This study was accomplished with the aim to evaluate and to characterize the risks for the presence of Megninia spp. in poultry farms from Minas Gerais, using for that Correspondence Analysis (CA). A secondary database was used and adapted for this study, with information from 402 chicken houses of 42 laying hens commercial properties. Variables used to compose the correspondence model were selected through tests of Qui-square being considered the significant result of P≤0,05. A risk index was built to the presence of Megninia spp. starting from variables considered as risk factors for the presence of those ectoparasites. The CA graph produced for the epidemiological characterization of the presence of Megninia spp. presented an accumulated qui-square value of 58,55%. There was an association of the risk index with the age ranges of the poultry, among the presence Megninia spp. and the use of mineral oil and acaricide in the ration and; finally, an association between the ruddy ground-dove (Columbina talpacoti) presence and the absence of mites of the Megninia genus. The results supply knowledge on the epidemiology of Megninia spp. In addition, these information can contribute in the decision, reducing the risks of possible infestations in poultry farms and the negative effects of that parasitism

Seminário de Dissertação (2024)

Página da disciplina de Seminário de Dissertação (MPPP, UFPE, 2022) Lista de participantes == https://docs.google.com/spreadsheets/d/1mrULe1y04yPxHUBaF50jhaM1OY8QYJ3zva4N4yvm198/edit#gid=