50 research outputs found
Substituição de copa do cupuaçuzeiro utilizando clones resistentes - alternativa para controle integrado da vassoura de bruxa.
A produtividade média do cupuaçuzeiro no Estado do Pará, tem declinado nos últimos anos, em função, entre outros, de danos causados pelo fungo Moniliophthora perniciosa (Stahel) Singer. A substituição de copas de plantas susceptíveis por clones resistentes passou a ser uma estratégia interessante para convivência com essa doença. Esta pesquisa teve por objetivo verificar a performance de três cultivares resistentes na recuperação de plantas doentes de um pomar de cupuaçuzeiro. O experimento foi instalado em um pomar comercial, localizado no município de Tomé Açu, que se encontrava altamente atacado com M. perniciosa, o que inviabilizava o prosseguimento do cultivo. As plantas foram induzidas a emitir brotações novas (chupões) na porção basal da copa. Nessas brotações era realizada a enxertia, do tipo garfagem em fenda cheia. Verificou-se que após um ano da realização da enxertia a copa já se encontrava restabelecida e na safra seguinte começava a produção de frutos. Plantas com copa própria, deixadas como testemunha, que no início do trabalho já não frutificavam, apresentaram uma sensível recuperação devido à diminuição da fonte de inoculo dentro da quadra, apesar de ainda terem sido afetadas pela doença. No tocante as variáveis de produção, a cultivar Manacapuru foi a que teve o melhor desempenho nessas primeiras safras, acompanhada da cultivar Codajás. As três cultivares testadas ficaram livres da vassoura de bruxa.PIBIC-2011
Di-ureasil hybrids doped with LiBF4: attractive candidates as electrolytes for "Smart Windows"
The sol-gel process has been used to prepare hybrid electrolytes composed of a poly(oxyethylene) (POE)/siloxane hybrid network doped with lithium tetrafluoroborate (LiBF4) with compositions of n between ∞ and 2.5. In this context the lithium salt concentration is expressed in terms of the number of oxyethylene units in the organic component of the network per Li+ ion. Electrolyte samples with n ≥ 20 are thermally stable up to approximately 250 ºC. All the materials synthesized are semi-crystalline: in the composition range n ≥ 15 free crystalline POE exists and at 60 ≥ n ≥ 2.5 evidence of the presence of a crystalline POE/LiBF4 compound has been found. At n = 2.5 this latter crystalline phase coexists with free salt. The room temperature conductivity maximum of this electrolyte system is located at n = 10 (1.5x10-5 S cm-1 at 22 ºC). The electrochemical stability domain of the sample with n = 15 spans about 5.5 V versus Li/Li+. This new series of materials represents a promising alternative to the LiTFSI- and LiClO4-doped POE and POE/siloxane analogues. Preliminary tests performed with a prototype electrochromic device (ECD) comprising the sample with n = 8 as electrolyte and WO3 as cathodically coloring layer are extremely encouraging. The device exhibits switching time around 50 s, an optical density change of 0.13, open circuit memory of about 4 months and high coloration efficiency (106 cm2C-1 in the 3rd cycle).Fundação para a Ciência e a Tecnologi
The Spanish society of Parenteral and Enteral Nutrition (SENPE) and its relation with healthcare authorities
Está muy bien documentado en la literatura médica
que la desnutrición es un problema común en todos los
niveles de atención sanitaria, desde atención primaria a
especializada y en centros de atención geriátrica. Este
problema no se limita a países con pocos recursos económicos
o con limitado desarrollo social y económico. También
es un problema universal en Europa. La desnutrición
aumenta las cifras de morbilidad, mortalidad,
ingresos hospitalarios y duración de la estancia. Estas
cifras más elevadas suponen lógicamente un aumento del
uso de recursos sanitarios. A pesar de esto, el problema de
la desnutrición a menudo puede pasar desapercibido y el
paciente no recibir el tratamiento necesario. Este problema
requiere la cooperación de múltiples agentes tales
como los Gobiernos de los Estados, los profesionales de la
salud y los mismos ciudadanos. El VIII Foro de Debate
concluye con la necesidad de establecer un claro plan de
actuación (a semejanza de la European Alliance for
Health Nutrition) y la creación de una plataforma (coalición)
que reúna las voces de asociaciones de profesionales
sanitarios, instituciones, colegios profesionales, asociaciones
de pacientes, industria y entidades aseguradoras. Los
fines de esta plataforma consistirán en informar de la
extensión del problema, identificar y potenciar líderes
que transmitan los fines de esta iniciativa ante las autoridades
autonómicas y nacionales, propuesta de soluciones
y colaboración en su puesta en marcha y finalmente, evaluación/
control de las acciones desarrolladasIt has been well documented in medical literature that
hyponutrition is a common issue at all healthcare levels,
from primary to specialized health care, as well as geria -
tric healthcare facilities. This problem is not limited to
countries with scarce economic resources or limited social
development; it is also a universal issue in Europe.
Hyponutrition increases the rates of morbidity, mortality,
hospital admissions, and hospital stay. These higher
figures also represent a higher use of healthcare
resources. In spite of this, hyponutrition may often go
undetected and the patient may not receive the necessary
treatment. This problem requires the cooperation of multiple
agents such as the Governments, the healthcare professionals,
and the citizens themselves. The VIII Discussion
Forum concludes on the need to establish a clear-cut
plant for action (similar to the European Alliance for
Health Nutrition) and the creation of a platform (coalition)
encompassing the voices of healthcare professionals
associations, institutions, professional colleges, patients
associations, the pharmaceutical companies, and insurance
companies. The goals of this platform will be to
inform about the extent of this issue, to identity and promote
leaders that will convey the aims of this initiative to
regional and national healthcare authorities, to present
solutions and to collaborate in their implementation, and
finally to assess/control the actions take
Predicting high risk of exacerbations in bronchiectasis: the E-FACED score
BACKGROUND: Although the FACED score has demonstrated a great prognostic capacity in bronchiectasis, it does not include the number or severity of exacerbations as a separate variable, which is important in the natural history of these patients. OBJECTIVE: Construction and external validation of a new index, the E-FACED, to evaluate the predictive capacity of exacerbations and mortality. METHODS: The new score was constructed on the basis of the complete cohort for the construction of the original FACED score, while the external validation was undertaken with six cohorts from three countries (Brazil, Argentina, and Chile). The main outcome was the number of annual exacerbations/hospitalizations, with all-cause and respiratory-related deaths as the secondary outcomes. A statistical evaluation comprised the relative weight and ideal cut-off point for the number or severity of the exacerbations and was incorporated into the FACED score (E-FACED). The results obtained after the application of FACED and E-FACED were compared in both the cohorts. RESULTS: A total of 1,470 patients with bronchiectasis (819 from the construction cohorts and 651 from the external validation cohorts) were followed up for 5 years after diagnosis. The best cut-off point was at least two exacerbations in the previous year (two additional points), meaning that the E-FACED has nine points of growing severity. E-FACED presented an excellent prognostic capacity for exacerbations (areas under the receiver operating characteristic curve: 0.82 for at least two exacerbations in 1 year and 0.87 for at least one hospitalization in 1 year) that was statistically better than that of the FACED score (0.72 and 0.78, P<0.05, respectively). The predictive capacities for all-cause and respiratory mortality were 0.87 and 0.86, respectively, with both being similar to those of the FACED. CONCLUSION: E-FACED score significantly increases the FACED capacity to predict future yearly exacerbations while maintaining the score’s simplicity and prognostic capacity for death
Análisis de la relevancia y factibilidad de indicadores de calidad en las unidades de nutrición
Introducción: La evaluación de la calidad en las actividades
sanitarias exige la elección de unos indicadores
acordes con los resultados que queremos medir. De todos
los posibles, debemos priorizar aquellos que nos permitan
obtener la información más relevante sin sobrecargar el
trabajo habitual de nuestras Unidades.
Objetivo: Conocer la opinión de los socios de SENPE
respecto a la relevancia y la viabilidad del uso de una
selección de indicadores de calidad para su aplicación en
nutrición clínica.
Métodos: Encuesta remitida mediante correo electrónico
a los socios de SENPE solicitando a los mismos su
opinión sobre 12 indicadores de calidad, valorándose
cada uno en cuanto a su relevancia y factibilidad de la
aplicación en su medio.
Resultados: Contestaron 40 encuestados de 40 centros
diferentes de 12 comunidades autónomas. En general, los
indicadores fueron considerados más relevantes que factibles.
Los indicadores mejor puntuados fueron: “identificación
en las bolsas de nutrición artificial”, “posición
semi-incorporada del paciente con nutrición enteral por
sonda nasogástrica” y “protocolos clínicos básicos”. Considerando
los indicadores por grupos (de estructura, proceso
o resultado) los mejor valorados fueron: “identificación
del paciente en las bolsas de nutrición artificial”
(estructura), “posición semi-incorporada” y “protocolos
clínicos básicos” (proceso), y “cumplimiento del objetivo
calórico” (resultado).
Conclusión: Los resultados de la encuesta permiten
seleccionar indicadores prioritarios para su aplicación en
las Unidades de NutriciónIntroduction: The quality assessment in health activities
requires the choice of indicators in line with the
results we want to measure. Of all possible, we should prioritize
those that allow us to obtain the most relevant
information without overloading the regular work of our
units.
Objective: To determine the opinion of the members of
SENPE regarding the relevance and feasibility of using a
selection of quality indicators designed for use in clinical
nutrition.
Methods: E-mail survey sent to members of SENPE
asking them their views on 12 quality indicators, evaluating
each in terms of their relevance and feasibility of
implementation in their environment.
Results: 40 respondents answered from 40 centers in 12
different regions. In general, the indicators were considered
more relevant than feasible. The indicators best
rated were: “identification in artificial nutrition bags,
“semi-recumbent position in patient with nasogastric
tube feeding” and “basic clinical protocols”. Considering
the type of indicator: “patient identification in the bags of
artificial nutrition (structure),” a semi-incorporated
“and” basic clinical protocols (process), and “fulfillment
of the caloric goal” (result).
Conclusion: The results of the survey can make a selection
of indicators that could be considered for first-line
introduction in a Nutrition Uni
The European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC):experiences from a successful ERS Clinical Research Collaboration
In contrast to airway diseases like chronic obstructive pulmonary disease or asthma, and rare diseases such as cystic fibrosis, there has been little research and few clinical trials in bronchiectasis. Guidelines are primarily based on expert opinion and treatment is challenging because of the heterogeneous nature of the disease. In an effort to address decades of underinvestment in bronchiectasis research, education and clinical care, the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) was established in 2012 as a collaborative pan-European network to bring together bronchiectasis researchers. The European Respiratory Society officially funded EMBARC in 2013 as a Clinical Research Collaboration, providing support and infrastructure to allow the project to grow. EMBARC has now established an international bronchiectasis registry that is active in more than 30 countries both within and outside Europe. Beyond the registry, the network participates in designing and facilitating clinical trials, has set international research priorities, promotes education and has participated in producing the first international bronchiectasis guidelines. This manuscript article the development, structure and achievements of EMBARC from 2012 to 2017. EDUCATIONAL AIMS: To understand the role of Clinical Research Collaborations as the major way in which the European Respiratory Society can stimulate clinical research in different disease areasTo understand some of the key features of successful disease registriesTo review key epidemiological, clinical and translational studies of bronchiectasis contributed by the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) project in the past 5 yearsTo understand the key research priorities identified by EMBARC for the next 5 years
Reference values of whole-blood fatty acids by age and sex from European children aged 3-8 years
OBJECTIVES: To establish reference values for fatty acids (FA) especially for n-3 and n-6 long-chain polyunsaturated FAs (LC PUFA) in whole-blood samples from apparently healthy 3-8-year-old European children. The whole-blood FA composition was analysed and the age-and sex-specific distribution of FA was determined.
DESIGN AND SUBJECTS: Blood samples for FA analysis were taken from 2661 children of the IDEFICS (identification and prevention of dietary-and lifestyle-induced health effects in children and infants) study cohort. Children with obesity (n = 454) and other diseases that are known to alter the FA composition (n = 450) were excluded leaving 1653 participants in the reference population.
MEASUREMENTS: The FA composition of whole blood was analysed from blood drops by a rapid, validated gas chromatographic method.
RESULTS: Pearson correlation coefficients showed an age-dependent increase of C18:2n-6 and a decrease of C18:1n-9 in a subsample of normal weight boys and girls. Other significant correlations with age were weak and only seen either in boys or in girls, whereas most of the FA did not show any age dependence. For age-dependent n-3 and n-6 PUFA as well as for other FA that are correlated with age (16:0, C18:0 and C18:1n-9) percentiles analysed with the general additive model for location scale and shape are presented. A higher median in boys than in girls was observed for C20:3n-6, C20:4n-6 and C22:4n-6.
CONCLUSIONS: Given the reported associations between FA status and health-related outcome, the provision of FA reference ranges may be useful for the interpretation of the FA status of children in epidemiological and clinical studies
Obeticholic acid for the treatment of non-alcoholic steatohepatitis: interim analysis from a multicentre, randomised, placebo-controlled phase 3 trial
BACKGROUND
Non-alcoholic steatohepatitis (NASH) is a common type of chronic liver disease that can lead to cirrhosis. Obeticholic acid, a farnesoid X receptor agonist, has been shown to improve the histological features of NASH. Here we report results from a planned interim analysis of an ongoing, phase 3 study of obeticholic acid for NASH.
METHODS
In this multicentre, randomised, double-blind, placebo-controlled study, adult patients with definite NASH, non-alcoholic fatty liver disease (NAFLD) activity score of at least 4, and fibrosis stages F2-F3, or F1 with at least one accompanying comorbidity, were randomly assigned using an interactive web response system in a 1:1:1 ratio to receive oral placebo, obeticholic acid 10 mg, or obeticholic acid 25 mg daily. Patients were excluded if cirrhosis, other chronic liver disease, elevated alcohol consumption, or confounding conditions were present. The primary endpoints for the month-18 interim analysis were fibrosis improvement (≥1 stage) with no worsening of NASH, or NASH resolution with no worsening of fibrosis, with the study considered successful if either primary endpoint was met. Primary analyses were done by intention to treat, in patients with fibrosis stage F2-F3 who received at least one dose of treatment and reached, or would have reached, the month 18 visit by the prespecified interim analysis cutoff date. The study also evaluated other histological and biochemical markers of NASH and fibrosis, and safety. This study is ongoing, and registered with ClinicalTrials.gov, NCT02548351, and EudraCT, 20150-025601-6.
FINDINGS
Between Dec 9, 2015, and Oct 26, 2018, 1968 patients with stage F1-F3 fibrosis were enrolled and received at least one dose of study treatment; 931 patients with stage F2-F3 fibrosis were included in the primary analysis (311 in the placebo group, 312 in the obeticholic acid 10 mg group, and 308 in the obeticholic acid 25 mg group). The fibrosis improvement endpoint was achieved by 37 (12%) patients in the placebo group, 55 (18%) in the obeticholic acid 10 mg group (p=0·045), and 71 (23%) in the obeticholic acid 25 mg group (p=0·0002). The NASH resolution endpoint was not met (25 [8%] patients in the placebo group, 35 [11%] in the obeticholic acid 10 mg group [p=0·18], and 36 [12%] in the obeticholic acid 25 mg group [p=0·13]). In the safety population (1968 patients with fibrosis stages F1-F3), the most common adverse event was pruritus (123 [19%] in the placebo group, 183 [28%] in the obeticholic acid 10 mg group, and 336 [51%] in the obeticholic acid 25 mg group); incidence was generally mild to moderate in severity. The overall safety profile was similar to that in previous studies, and incidence of serious adverse events was similar across treatment groups (75 [11%] patients in the placebo group, 72 [11%] in the obeticholic acid 10 mg group, and 93 [14%] in the obeticholic acid 25 mg group).
INTERPRETATION
Obeticholic acid 25 mg significantly improved fibrosis and key components of NASH disease activity among patients with NASH. The results from this planned interim analysis show clinically significant histological improvement that is reasonably likely to predict clinical benefit. This study is ongoing to assess clinical outcomes.
FUNDING
Intercept Pharmaceuticals