Investigation of Absolute Refractory Period Pacing to Prevent Lethal Arrhythmias in Humans

Sudden cardiac death (SCD) is a major health issue, being the commonest cause of natural death in the industrialised world. SCD frequently results from the development of erratic heart rhythms which are usually preceded by repolarisation alternans (RA). Previous studies suggest that the abolishment of RA may prevent the onset of arrhythmia. In a recent swine study, absolute refractory period pacing (ARPP) showed promising results in RA modulation. However, the cellular mechanisms underlying this therapy and its efficiency in human patients remains unclear. Single cell in silico modelling showed that ARPP might be used to both increase or decrease action potential duration (APD) with the degree of modulation depending mainly on stimulus duration, magnitude and coupling interval. ICaL, IKr and IK1 were the main currents involved, and conductance of Ito and ICaL strongly influenced results. APD alternans was successfully reduced in a population of alternating models. In vivo results obtained using an epicardial sock during cardiac surgery showed significant changes in repolarisation when applying ARPP. However, elevated morphological signal alterations led to question the results’ validity. The investigation of signal processing methodology led to the acknowledgement of high-pass filter interference in signal morphology due to the ARPP artefact, resulting in altered markers. Further in vivo data showed no significant effect of ARPP on local RT at the whole heart level. Small effects on RT, spectral method and Tend markers close to the pacing site were observed, suggesting a localised effect. One dimensional in silico modelling showed a rapid decline of the ARPP effect, being limited to around 10mm from the pacing site, correlating with the in vivo results. These results provide important new knowledge regarding the effects of ARPP in the human ventricle at the cellular and organ level. It also provides relevant information for further development, analysis and translation of pacing based therapies

Implementação de dois pilares da metodologia TPM numa empresa de cortiça

Esta dissertação foi realizada num contexto industrial, numa empresa que utiliza e reutiliza a cortiça, assim como outros materiais para criar novos produtos, dando aos mesmos uma nova utilidade. Devido à elevada necessidade de uma maior produtividade e eficiência dos equipamentos, o objetivo principal deste trabalho foi implementar dois pilares da metodologia TPM na empresa em questão. Dada a elevada dimensão da empresa, foi decidido que inicialmente apenas seria necessário focar em duas áreas. O trabalho desenvolvido dividiu-se em várias etapas. Inicialmente foi realizada uma análise das criticidades dos equipamentos de cada linha, e posteriormente foram analisadas as solicitações entre julho de 2017 e julho de 2019, de forma a retirar os problemas mais recorrentes dos equipamentos críticos. Após esta análise, foi possível perceber que as manutenções autónomas e preventivas não estavam a ser realizadas pelos operadores, tendo por isso que ser alteradas e melhoradas, sendo esta efetuada em conjunto com a direção de cada área, com o objetivo de demonstrar às mesmas a importância e as melhorias que poderiam trazer a cada uma destas, diminuindo os tempos de paragem, o que consequentemente promove a um incremento da produção. Devido à implementação do SAP, não foi possível obter dados referentes à época atual na fábrica, de forma a comparar com os obtidos durante este trabalho. Contudo, conseguiu-se verificar quais as avarias que seriam referentes à falta de intervenções, sendo associado um custo indireto de paragem das linhas devido a essas avarias, concluindo-se que, no total, as principais máquinas de cada linhas, durante um ano, trouxeram um elevado prejuízo, como ficou demonstrado. Sendo assim, foram criados novos planos de manutenção autónoma e preventiva, específicos para os equipamentos mais importantes de cada área, e foram também criadas OPL’s - One Point Lessons, ou seja, procedimentos que ilustram as Operações Standard, de manutenção preventiva, padronizando e facilitando as intervenções nos equipamentos críticos. No final do estágio, também foi necessário iniciar a implementação do TPM na Oficina Auto, local de manutenção dos equipamentos utilizados para transportar material. Aqui, iniciou-se para implementação dos 5S e foram discutidas diversas ideias de como melhorar e organizar o local.This dissertation was carried out in an industrial context, in a company that uses and reuses cork and other materials to create new products, giving them a new use. Due to the high need for greater productivity and equipment efficiency, the main objective of this work was to implement two pillars of the TPM methodology in the company in question. Given the large size of the company, it was decided that, initially, it would only be necessary to focus on two areas. The work developed was divided into several stages. Initially, an analysis of the criticalities of the equipment on each line was performed, and then the requests between July 2017 and July 2019 were analyzed in order to remove the most recurrent breakdowns of the critical equipment. After this analysis, it was possible to realize that the autonomous and preventive maintenance was not being carried out by the operators, and therefore had to be changed and improved. This was done in conjunction with the management of each area, with the goal of demonstrating to them the importance and the improvements that could bring to each of them, reducing downtime, which consequently increases production. Due to the implementation of SAP, it was not possible to obtain data for the current time in the factory in order to compare with those obtained between July 2017 and July 2019, however, it was possible to verify which breakdowns would be related to the lack of interventions, being associated with an indirect cost of stopping the lines due to these breakdowns, concluding that in total the main machines of each line, during a year, brought a great loss, as it will be shown. That way, new autonomous and preventive maintenance plans were created, specific for the most important equipment in each area and OPL's - One Point Lessons - were also created, i.e., procedures that illustrate the Standard Operations of preventive maintenance, standardizing and facilitating interventions in critical equipment. At the end of the internship, it was also necessary to start the implementation of TPM in the Auto Workshop, place of maintenance of the equipment used to transport material. Here, we started to implement the 5S and discussed several ideas on how to improve and organize the site

A (Re) existência da Política de Ações Afirmativas na UFRB diante das movimentações contrárias à educação

O artigo pretende levantar uma discussão política acerca da permanência dos estudantes negros no Ensino Superior. Diante da atual conjuntura que envolve diretamente a (re)existência de uma reivindicação que foi construída historicamente pelos movimentos negros. Com movimentações que cumpriram um papel importante para educar a sociedade sobre as desigualdades raciais e adentrar nos cursos superiores com uma demanda por educação. O estudo investiga o Programa de Permanência Qualificada da Universidade Federal do Recôncavo da Bahia com um trabalho de campo realizado na Pró - Reitoria de Políticas Afirmativas e Assuntos Estudantis de forma qualitativa pesquisando o dados que envolvam perfis dos estudantes beneficiários, envolvendo raça e gênero, quantidade de atingidos pelo programa. O objetivo é avançar na defesa da permanência destas políticas com a proposta de aprofundar ainda mais o programa pela discussão da permanência simbólica. Dentre muitos elementos, considera se um dos fatores importantes para a garantia do percurso universitário estudantil as organizações sociais e políticas como um movimento atuante no espaço educativo de ensino superior

ERAS em Obstetrícia Da evidência à vivência da Maternidade

Introdução : The mission of ERAS Society is to develop perioperative care and to improve recovery through research, education, audit, and implementation of evidence-based practice.info:eu-repo/semantics/draf

Premature or small for gestational age discrimination: international multicenter trial protocol for classification of the low-birth-weight newborn through the optical properties of the skin

© Zilma Reis, Gabriela Vitral, Rodney Guimarães, Juliano Gaspar, Enrico Colosimo, Sergio Taunde, Nilza Mussagy, Rita Rosado Santos, Diogo Ayres-De-Campos, Roberta Romanelli. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 14.07.2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included.Background: A low birth weight is an independent risk factor for adverse infant outcomes and a predictor of chronic disease in adulthood. In these situations, differentiating between prematurity and small for gestational age (SGA) or simultaneous conditions is essential to ensuring adequate care. Such diagnoses, however, depend on reliable pregnancy dating, which can be challenging in developing countries. A new medical optoelectronic device was developed to estimate gestational age (GA) at birth based on newborn skin reflection. Objective: This study will aim to evaluate the device's ability to detect prematurity or SGA, or both conditions simultaneously as well as predict short-term pulmonary complications in a cohort of low-birth-weight newborns. Methods: This study protocol was designed for a multicenter cohort including referral hospitals in Brazil and Mozambique. Newborns weighing 500-2500 g will be eligible for inclusion with the best GA available, considering the limited resources of low-income countries. Comparator-GA is based on reliable last menstrual period dating or ultrasound assessment before 24 weeks' gestation. Estimated GA at birth (Test-GA) will be calculated by applying a novel optoelectronic device to the newborn's skin over the sole. The average difference between Test-GA and Comparator-GA will be analyzed, as will the percentage of newborns who are correctly diagnosed as preterm or SGA. In addition, in a nested case-control study, the accuracy of skin reflection in the prediction of prematurity-related respiratory problems will be evaluated. The estimated required sample size is 298 newborns. Results: Teams of health professionals were trained, and standard operating procedures were developed following the good practice guidelines for the clinical investigation of medical devices for human participants. The first recruitment started in March 2019 in Brazil. Data collection is planned to end in December 2020, and the results should be available in March 2021. Conclusions: The results of this clinical study have the potential to validate a new device to easily assess postnatal GA, supporting SGA identification when pregnancy dating is unreliable or unknown.This research was supported by a Grand Challenges Exploration grant from the Bill & Melinda Gates Foundation (Grant No. OPP1128907, Contract; http://www.gatesfoundation.org/) and the Fundação de Amparo a Pesquisa de Minas Gerais, Brazil (Grant Nos AUC-00032-15 and PPM 0247/16; http://www.fapemig.br/en/; nonprofit sector). This study is funded by Fundação Oswaldo Cruz – Rio de Janeiro, Brazil, Grand Challenges Canada’s programs, Government of Canada – Toronto, Canada (Grant No. R-ST-POC-1807-13515).info:eu-repo/semantics/publishedVersio

Design, synthesis and biologival evaluation of novel isoniazid derivatives with potente antitubercular activity

The disturbing emergence of multidrug-resistant strains of Mycobacterium tuberculosis (Mtb) has been driving the scientific community to urgently search for new and efficient antitubercular drugs. Despite the various drugs currently under evaluation, isoniazid is still the key and most effective component in all multi-therapeutic regimens recommended by the WHO. This paper describes the QSAR-oriented design, synthesis and in vitro antitubercular activity of several potent isoniazid derivatives (isonicotinoyl hydrazones and isonicotinoyl hydrazides) against H37Rv and two resistant Mtb strains. QSAR studies entailed RFs and ASNNs classification models, as well as MLR models. Strict validation procedures were used to guarantee the models' robustness and predictive ability. Lipophilicity was shown not to be relevant to explain the activity of these derivatives, whereas shorter N-N distances and lengthy substituents lead to more active compounds. Compounds I, 2, 4, 5 and 6, showed measured activities against H37Rv higher than INH (i.e., MIC <= 0.28 mu M), while compound 9 exhibited a six fold decrease in MIC against the katG (S315T) mutated strain, by comparison with INH (Le., 6.9 vs. 43.8 mu M). All compounds were ineffective against H37Rv(INH) (Delta katG), a strain with a full deletion of the katG gene, thus corroborating the importance of KatG in the activation of INH-based compounds. The most potent compounds were also shown not to be cytotoxic up to a concentration 500 times higher than MIC. (C) 2014 Elsevier Masson SAS. All rights reserved

Studying nanotoxic effects of CdTe quantum dots in Trypanosoma cruzi

Semiconductor nanoparticles, such as quantum dots (QDs), were used to carry out experiments in vivo and ex vivo with Trypanosoma cruzi. However, questions have been raised regarding the nanotoxicity of QDs in living cells, microorganisms, tissues and whole animals. The objective of this paper was to conduct a QD nanotoxicity study on living T. cruzi protozoa using analytical methods. This was accomplished using in vitro experiments to test the interference of the QDs on parasite development, morphology and viability. Our results show that after 72 h, a 200 &#956;M cadmium telluride (CdTe) QD solution induced important morphological alterations in T. cruzi, such as DNA damage, plasma membrane blebbing and mitochondrial swelling. Flow cytometry assays showed no damage to the plasma membrane when incubated with 200 &#956;M CdTe QDs for up to 72 h (propidium iodide cells), giving no evidence of classical necrosis. Parasites incubated with 2 &#956;M CdTe QDs still proliferated after seven days. In summary, a low concentration of CdTe QDs (2 &#956;M) is optimal for bioimaging, whereas a high concentration (200 &#956;M CdTe) could be toxic to cells. Taken together, our data indicate that 2 &#956;M QD can be used for the successful long-term study of the parasite-vector interaction in real time.15816

CONSTRUÇÃO DE UMA TECNOLOGIA EDUCATIVA SOBRE VIOLÊNCIA OBSTÉTRICA PARA AS GESTANTES

Objetivo: construir uma tecnologia educativa na modalidade de cartilha direcionada às mulheres sobre os direitos da gestante durante o trabalho de parto e situações que caracterizam violência obstétrica. Método: pesquisa metodológica, qualitativa, foram realizadas entrevistas semiestruturada com 14 enfermeiros residentes do programa de Residência de Enfermagem Obstétrica da Universidade Federal do Pará. A análise de conteúdo foi utilizada para identificar significado, seguida pela elaboração textual, seleção das ilustrações e finalização da cartilha. Resultados: a violência obstétrica caracteriza-se como física, psicológica, negligência, discriminação, podendo acontecer no pré-natal, parto, puerpério e abortamento. A informação como alicerce para o conhecimento de mulheres por meio da cartilha pode contribuir de forma efetiva para o empoderamento e protagonismo de mulheres. Considerações finais: o processo de construção da cartilha, desenvolvida de forma participativa e dialógica, foi enriquecedor e oportunizou a disseminação de informação com embasamento científico para atuação junto à população-alvo. Descritores: Gestação. Educação em Saúde. Violência Obstétrica. Tecnologia Educacional. Internato e Residência