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

The conceptus loss in Mangalarga Marchador mares of different reproductive status after artificial insemination and embryo transfer

Foram realizados dois estudos para avaliar em éguas da raça Mangalarga Marchador, os fatores que influenciam a perda do concepto após a inseminação artificial (IA), considerando a faixa etária, o status reprodutivo e o período de gestação, bem como, as taxas de prenhez e perda embrionária de éguas em diferentes status reprodutivos utilizadas como receptoras em programas de transferência de embriões (TE). No primeiro estudo, foram monitoradas 320 gestações entre os anos de 2003 e 2006 compreendendo fêmeas nulíparas (n = 52), pluríparas não lactantes (n = 112) e pluríparas lactantes (n = 156). Os animais possuíam idade entre 4 e 16 anos. O diagnóstico de gestação por ultra-sonografia foi realizado no 15o dia pós-ovulação, repetindo os exames no 20o, 30o e 45o dia de prenhez. O índice total de perda do concepto foi de 9,06% (29/320). Com relação à faixa etária, as perdas de 8,06% (5/62), 6,58% (10/152) e 13,21% (14/106) para fêmeas com menos de 5 anos, de 5 a 10 anos e de 11 a 16 anos, respectivamente, não evidenciaram diferenças significativas (P > 0,05). Quanto ao status reprodutivo, perdas de 5,77% (3/52), 9,82% (11/112) e 9,61% (15/156) para fêmeas nulíparas, pluríparas não lactantes e pluríparas lactantes, respectivamente, também não mostraram diferenças significativas (P > 0,05). No que se refere ao período gestacional, o índice de perda do concepto foi mais significativo (P 0,05) entre os índices de perdas do concepto das éguas inseminadas no cio do potro 8,97% (7/78) e daqueles inseminadas no cio subseqüente 10,26% (8/78). Com base nos dados deste estudo foi possível concluir que o status reprodutivo e a faixa etária não influenciam as taxas de perdas do concepto, porém, noperíodo entre a 2ª e 3ª semana de gestação, as éguas estão mais susceptíveis a essas perdas. No segundo estudo, entre os anos de 2004 e 2005, foram utilizadas 10 éguas pluríparas como doadoras de embriões e como receptoras, 21 fêmeas nulíparas, 20 pluríparas lactantes e 20 pluríparas não lactantes. As colheitas embrionárias foram realizadas no 8o dia após a ovulação das doadoras e os embriões imediatamente transferidos para as receptoras. Os diagnósticos de gestação por ultra-sonografia foram realizados no 7o dia após as TE, repetindo os exames nosdias 20, 25 e 30 da gestação. O total de prenhez diagnosticada no 7o dia após a TE e de perda embrionária no 30o dia de gestação foram 67,21% (41/61) e 39,02% (16/41), respectivamente. Com relação ao status reprodutivo, as taxas de prenhez e de perda embrionária, não evidenciaram diferenças significativas (P > 0,05). Quanto à faixa etária, as fêmeas com mais de 11 anos exibiram taxa de prenhez menor (P 0,05). Os dados obtidos neste estudo permitem concluir que éguas da raça Mangalarga Marchador independente do status reprodutivo podem ser utilizadas com êxito como receptoras em programas de TE, porém, não é recomendável, que fêmeas com idade acima de 11 anos sejam utilizadas para essa função.Two studies were performed to evaluate in Mangalarga Marchador mares, the factors that influence the concepts loss after artificial insemination (AI), considering the group age, the reproductive status and the gestational period and the rates of pregnancy and embryonic loss of mares in different reproductive condition used as recipients in programs for embryo transfer (ET). In the first study, was performed between the years 2003 and 2006 were monitored the pregnancies of 320 mares, including nulliparous female (n = 52), not lactating pluriparous (n = 112) and pluriparous in lactation (n = 156) aged between 4 and 16 years. The diagnosis of pregnancy by ultrasound was conducted by the 15th day after ovulation, repeating the tests on the 20th, 30th and 45th day of pregnancy. The total of conceptus loss was 9.06% (29/320). Concerning the age group, losses of 8.06% (5/62), 6.58% (10/152) and 13.21% (14/106) for females under the age of 5, 5 to 10 years and 11 to 16 years respectively showed no significant differences (P > 0.05). Concerning the reproductive status, loss of 5.77% (3/52), 9.82% (11/112) and 9.61% (15/156) for females nulliparous, pluriparous non lactants and pluriparous in lactation, respectively, also showed no significant differences (P > 0.05). Considering the gestational period, the concept loss was more significant (P 0.05)between the pregnancy rates loss of the mares inseminated in the foal heat 8.97% (7/78) and those inseminated in subsequent estrus 10.25% (8/78). Based on data from this study were unable to conclude that the reproductive status and age group did not influence the rates of theconcept loss, but, in the period between 2nd and 3rd week of gestation, the mares are more susceptible to these losses. In the second study, between the years 2004 and 2005 have been used pluriparous 10 mares as donors of embryos and recipients, 21 nulliparous females, 20 pluriparous in lactation and 20 not lactating pluriparous. On The 8th day after ovulation were performed the embryos recovered of the donors and immediate transfer to the recipients. The diagnosis of pregnancy by ultrasound was conducted by the 7th day after the ET, repeating the tests on days 20, 25 and 30 of pregnancy. The total pregnancy diagnosed in the 7th day afterET and embryo loss in the 30th day of gestation was 67.21% (41/61) and 39.02% (16/41), respectively. With regard to the reproductive status, the rates of pregnancy and embryonic loss, did not show significant differences (P > 0.05). As for the age group, females with more than 11 years showed lower pregnancy rate (P 0.05). Data obtained in this study suggests that Mangalarga Marchador mares regardless of reproductive status can be used successfully as recipients in programs for ET, but, is not recommended that females aged over 11 years are used for this function

IoT Registration and Authentication in Smart City Applications with Blockchain

The advent of 5G will bring a massive adoption of IoT devices across our society. IoT Applications (IoT Apps) will be the primary data collection base. This scenario leads to unprecedented scalability and security challenges, with one of the first areas for these applications being Smart Cities (SC). IoT devices in new network paradigms, such as Edge Computing and Fog Computing, will collect data from urban environments, providing real-time management information. One of these challenges is ensuring that the data sent from Edge Computing are reliable. Blockchain has been a technology that has gained the spotlight in recent years, due to its robust security in fintech and cryptocurrencies. Its strong encryption and distributed and decentralized network make it potential for this challenge. Using Blockchain with IoT makes it possible for SC applications to have security information distributed, which makes it possible to shield against Distributed Denial of Service (DDOS). IoT devices in an SC can have a long life, which increases the chance of having security holes caused by outdated firmware. Adding a layer of identification and verification of attributes and signature of messages coming from IoT devices by Smart Contracts can bring confidence in the content. SC Apps that extract data from legacy and outdated appliances, installed in inaccessible, unknown, and often untrusted urban environments can benefit from this work. Our work's main contribution is the development of API Gateways to be used in IoT devices and network gateway to sign, identify, and authorize messages. For this, keys and essential characteristics of the devices previously registered in Blockchain are used. We will discuss the importance of this implementation while considering the SC and present a testbed that is composed of Blockchain Ethereum and real IoT devices. We analyze the transfer time, memory, and CPU impacts during the sending and processing of these messages. The messages are signed, identified, and validated by our API Gateways and only then collected for an IoT data management application

MATURAÇÃO NUCLEAR IN VITRO E MORTE CELULAR POR APOPTOSE EM OÓCITOS DE CAPRINOS NOS PERÍODOS SECO E CHUVOSO

This study aimed to determine the in vitro nuclear maturation and cell death by apoptosis in goat oocytes. The ovaries of goats were collected during the dry (October-March) and rainy (April-September) seasons in slaughterhouses and transported to the Laboratory of Reproductive Biotechniques of UFRPE. Twelve repetitions were performed and cumulus oophorus were collected from follicles of 2-6 mm diameter using the technique of "slicing" and selected based on morphology. The experiment contained two groups: Group-1 (not matured), evaluated immediately after collection, and Group-2 (matured in vitro), assessed after 24 hours of maturation in a CO2 incubator, in which 25 oocytes per drop were placed in alkaline maturation (MBM). After collecting the oocytes from G-1 and G-2, the quality was determined by testing the enzyme activity of caspases and DNA fragmentation (TUNEL), using PhiPhiLux-G1D2 reagent, and in group G-2 the quality was only determined after nuclear maturation. During nuclear maturation stages, germinal vesicle, germinal vesicle breakdown and metaphase I and II were evaluated and no significant differences were found (P> 0.05). There was also no significant difference (P> 0.05) in enzymes activity of caspase and DNA fragmentation of oocytes matured and not matured in vitro. Based on the data obtained, it was concluded that rainy and dry seasons have no effect on in vitro nuclear maturation and apoptosis of goat oocytes

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.13Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data