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

Ecos de la academia: Revista de la Facultad de Educación, Ciencia y Tecnología - FECYT Nro 6

Ecos de la academia, Revista de la Facultad de Educación Ciencia y Tecnología es una publicación científica de la Universidad Técnica del Norte, con revisión por pares a doble ciego que publica artículos en idioma español, quichua, portugués e inglés. Se edita con una frecuencia semestral con dos números por año.En ella se divulgan trabajos originales e inéditos generados por los investigadores, docentes y estudiantes de la FECYT, y contribuciones de profesionales de instituciones docentes e investigativas dentro y fuera del país, con calidad, originalidad y relevancia en las áreas de ciencias sociales y tecnología aplicada.Modelos multidimensionales del bienestar en contextos de enseñanza- aprendizaje: una revisión sistemática. Nuevas tendencias para el área académica de la Publicidad en la zona 1 del Ecuador. Propuesta de un curso de escritura académica bajo la base de modelos experienciales. Aproximación al estudio de las emociones. Seguimiento a egresados y graduados para actualizar el perfil de egreso y profesional. Impacto de la Gerencia de Calidad en el clima organizacional en Educación Básica. Comunicación efectiva del gerente educativo orientada al manejo de conflictos en el personal docente. Meritocracia: Democratización o exclusión en el acceso a la educación superior en Ecuador. Asertividad y desempeño académico en estudiantes universitarios. La creatividad en la formación profesional. Aspectos metodológicos en el proceso de enseñanza- aprendizaje de la gimnasia en estudiantes de Educación Física. English Language Learning Interaction through Web 2.0 Technologies. La sistematización de la práctica educativa y su relación con la metodología de la investigación. El ozono y la oxigenación hiperbárica: una vía para mejorar la recuperación en lesiones deportivas. La labor tutorial: Independencia del aprendizaje en el contexto universitario. Motivación hacia la profesión docente en la Enseñanza Secundaria. El uso académico de Facebook y WhatsApp en estudiantes universitarios... La educación superior en Ecuador: situación actual y factores de mejora de la calidad. El Proyecto de Investigación “Imbabura Étnica”

Crescimento e produção de brócolis em sistema orgânico em função de doses de composto Growth and yield of broccoli on organic production system as a function of compost dosages

A utilização de composto orgânico na produção de olerícolas resulta em efeitos diversos e complexos. Embora seja crescente a pesquisa voltada para a produção orgânica de olerícolas, os efeitos do composto orgânico sobre o crescimento e a produção dessas culturas são ainda pouco conhecidos cientificamente. Objetivou-se com este trabalho avaliar o crescimento e a produção de brócolis cultivado com composto orgânico e determinar a variável não destrutiva com maior correlação com o acúmulo de matéria seca. O experimento foi conduzido em Viçosa, MG (20º 45' sul 42º 51' oeste). O delineamento experimental foi o de blocos casualizados com quatro repetições em parcelas subdivididas no tempo para as variáveis de crescimento. Os tratamentos consistiram em doses de composto orgânico: 5, 10, 15, 20, 25 t ha-1 em base de massa seca, fornecidos à cultura do brócolis híbrido 'Domador'. A maior produção, 564 g planta-1, correspondente a 12,53 t ha-1, foi obtida com a dose de 25 t ha-1 de composto. A área do dossel foi a variável de maior correlação com o rendimento comercial e com o acúmulo de massa seca, sendo a mais indicada para a avaliação do crescimento por método não destrutivo. O período inicial de maior acúmulo de massa seca varia com as doses de composto, sendo que na dose de 25 t ha-1 ,este período ocorreu entre 28 e 56 dias após o transplantio. As mais altas taxas de crescimento relativo foram verificadas entre a segunda e a quarta semana após o transplante.<br>The use of organic compost on vegetable crops production results in complex and diverse effects. Although the research on organic vegetable production has been increasing, the effects of organic compost on the growth and yield of these crops are still poorly scientifically known. This work aimed to evaluate the growth and yield of broccoli grown on organic compost, besides determining the non-destructive parameter with higher correlation to dry mass accumulation. The experiment was carried out in Viçosa, MG (20º 45' S 42º 51' W). The experiment was set up in a randomized block design with four replicates in split-plot (time) design for growth parameters. The treatments consisted of doses of organic compost: 5, 10 15 20 and 25 t ha-1 on a dry matter basis, supllied to hybrid "domador". The highest broccoli yield, 564 g plant-1, corresponds to 12,53 t ha-1, and was obtained with the 25 t ha-1 compost dose. Canopy area presented the highest correlation with both commercial yield and dry mass accumulation and it is the best non-destructive parameter for growth evaluation. The initial period of higher dry mass accumulation varies according to the compost dose, So that the 25 t ha-1 dose, this period was between 28 and 56 days after transplant. The highest relative growth rates happened between the second and fourth week after transplant

Moche: propuestas y perspectivas

Entre el 12 y 16 de abril de 1993 se realizó en la ciudad de Trujillo el Primer Coloquio sobre la Cultura Moche, organizado por la Facultad de Ciencias Sociales y el Provecto Arqueológico Huaca de la Luna de la Universidad Nacional de Trujillo, y gracias al apoyo de el Instituto Francés de Estudios Andinos (IFFA), la Fundación Ford, la Sociedad Cervecera de Trujillo y la Asociación Peruana de Fomento a las Ciencias Sociales (FOMCIENCIAS). Se reunieron veintiocho especialistas sobre la cultura Moche, con la finalidad de presentar y debatir las investigaciones realizadas durante las últimas dos décadas, así como hacer una evaluación de las investigaciones primigenias y proponer líneas de trabajo para el futuro. Este libro contiene los resultados de estas deliberaciones. Está organizado en cuatro partes con un total de 16 ponencias, además de un estudio introductorio y Otro de conclusiones y recomendaciones. La primera parte, titulada Nuevas Investigaciones, contiene ocho informes de campo que presentan datos nuevos producto de excavaciones realizadas durante los últimos seis años. Fa segunda parte, titulada Nuevas interpretaciones, incluye cuatro contribuciones (que tienen por común denominador el ofrecer principalmente revisiones críticas y de síntesis sobre la cultura Moche. La tercera parte. Ideología y poder, contiene tres artículos que tratan sobre la parte ideológica del mundo Moche. La cuarta incluye una ponencia sobre la importante tarea de conservación del patrimonio cultural, con especial énfasis en los murales polícromos de barro. Culmina el libro con una recopilación completa de la Bibliografía existente sobre la cultura Moche en sus diversos aspectos. Los trabajos que este libro contiene significan -sin duda alguna- un estado de la cuestión de nuestros conocimientos sobre la cultura Moche, y proporciona nuevos lineamentos que orientarán las investigaciones futuras. Por tanto, será un libro de interés tanto para los científicos como para el público en general. El libro consta de 550 páginas, con 228 ilustraciones en blanco y negro, 4 encartes, lo láminas con 40 lotos a color y 18 cuadros

Las plantas medicinales en el inventario español sobre los conocimientos Tradicionales relativos al patrimonio natural y a la biodiversidad

En las últimas décadas las organizaciones internacionales han puesto de manifiesto la importancia de los conocimientos ecológicos tradicionales para la conservación y el uso sostenible de la diversidad biológica, como se refleja en el Convenio sobre la Diversidad Biológica (CBD 1992). En España, el marco jurídico que recoge las normas y recomendaciones de esta estrategia es la Ley de Patrimonio Natural y Biodiveresidad 42/2007 que establece la creación del Inventario Español de Conocimientos Tradicionales (IECT) relevantes para la conservación y el uso sostenible de la biodiversidad y geodiversidad. Desde hace más de un año un equipo de más de 60 investigadores, incluyendo botánicos, zoólogos, antropólogos, ecólogos y geólogos de más de 20 centros de investigación y universidades del estado español, están trabajando en el IEDT, con el objetivo de recopilar y difundir la información publicada sobre los conocimientos tradicionales relativos a la flora, fauna, geodiversidad y el manejo de los ecosistemas

The GenTree Platform:growth traits and tree-level environmental data in 12 European forest tree species

Abstract Background: Progress in the field of evolutionary forest ecology has been hampered by the huge challenge of phenotyping trees across their ranges in their natural environments, and the limitation in high-resolution environmental information. Findings: The GenTree Platform contains phenotypic and environmental data from 4,959 trees from 12 ecologically and economically important European forest tree species: Abies alba Mill. (silver fir), Betula pendula Roth. (silver birch), Fagus sylvatica L. (European beech), Picea abies (L.) H. Karst (Norway spruce), Pinus cembra L. (Swiss stone pine), Pinus halepensis Mill. (Aleppo pine), Pinus nigra Arnold (European black pine), Pinus pinaster Aiton (maritime pine), Pinus sylvestris L. (Scots pine), Populus nigra L. (European black poplar), Taxus baccata L. (English yew), and Quercus petraea (Matt.) Liebl. (sessile oak). Phenotypic (height, diameter at breast height, crown size, bark thickness, biomass, straightness, forking, branch angle, fructification), regeneration, environmental in situ measurements (soil depth, vegetation cover, competition indices), and environmental modeling data extracted by using bilinear interpolation accounting for surrounding conditions of each tree (precipitation, temperature, insolation, drought indices) were obtained from trees in 194 sites covering the species’ geographic ranges and reflecting local environmental gradients. Conclusions: The GenTree Platform is a new resource for investigating ecological and evolutionary processes in forest trees. The coherent phenotyping and environmental characterization across 12 species in their European ranges allow for a wide range of analyses from forest ecologists, conservationists, and macro-ecologists. Also, the data here presented can be linked to the GenTree Dendroecological collection, the GenTree Leaf Trait collection, and the GenTree Genomic collection presented elsewhere, which together build the largest evolutionary forest ecology data collection available

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