Disfunção dos músculos respiratórios de pacientes críticos sob ventilação mecânica por insuficiência respiratória aguda: revisão de literatura

Impairment of breathing muscles is one of many consequences of mechanical ventilation in critical patients. In some cases, muscle weakness is due to patients’ disease itself. According to experimental studies conducted with animals, diaphragm force decreases after 12 hours of controlled mechanical ventilation. However, many factors might be responsible for such breathing muscles dysfunction and consequent difficulty in weaning from mechanical ventilation. The aim of the present review was to search for the causes of breathing muscle alterations in patients who present acute respiratory failure. The search in main electronic databases led to selecting experimental and review studies published in the last 10 years, most of which were conducted with animal models. According to the reviewed studies, impairment of breathing muscles is multi-factorial and might be related to sepsis, medicine consumption, nutrition deprivation, and to the controlled mechanical ventilation itself. It is mandatory to identify each of these factors since, either isolated or associated, they increase respiratory muscle dysfunction.A disfunção dos músculos respiratórios é uma das conseqüências daventilação mecânica em paciente crítico. Em alguns casos a fraqueza muscular é decorrente de sua doença de base. Nota-se a redução da força diafragmática após 12 h de ventilação mecânica controlada de acordo com estudos experimentais em modelos animais. Entretanto, há vários fatores que podem ser responsáveis pela disfunção muscular respiratória e conseqüente dificuldade no desmame da VM. O objetivo desta revisão foi verificar as causas das alterações dos músculos respiratórios em pacientes que apresentam insuficiência respiratória aguda. A busca nas principais bases de dados eletrônicas resultou na seleção de estudos experimentais e de revisão dos últimos 10 anos, sendo a maioria realizada em modelos animais. Observou-se que a disfunção muscular respiratória é multifatorial, podendo estar relacionada à sepse, ao uso de medicamentos, à desnutrição e à própria ventilação mecânica controlada. É necessário identificar cada um desses fatores, visto que, isolados ou associados, potencializam a disfunção muscular respiratória

Relação entre as Teorias Bayesiana e de Dempster-Shafer

Este artigo aborda o estudo comparativo entre duas teorias paramodelagem da incerteza em sistemas especialistas fornecendo consideraçõessobre a utilização do formalismo matemático de Dempster-Shafer e da lógicabayesiana

Representação da Teoria de Dempster-Shafer a partir de uma Rede Bayesiana de Lombalgia

Este artigo aborda o estudo de uma teoria para modelagem daincerteza em sistemas especialistas fornecendo considerações sobre autilização do formalismo matemático de Dempster-Shafer e seus métodos deinferência

Representação da Teoria de Dempster-Shafer a partir de uma Rede Bayesiana de Lombalgia

Este artigo aborda o estudo de uma teoria para modelagem daincerteza em sistemas especialistas fornecendo considerações sobre autilização do formalismo matemático de Dempster-Shafer e seus métodos deinferência

Avaliação da melhoria de desempenho da frota de transporte e carregamento de uma mineradora aliando ferramentas estatísticas ao software de despacho eletrônico / Improvement in the logistic performance of a mining machine with the use of statistical tools and electronic office software

A avaliação do desempenho do setor produtivo mineral é realizada por meio de índices que medem a eficiência de um processo. Ferramentas de engenharia, como gráficos de controle, monitoram a variabilidade e a estabilidade de um processo, avaliando se este está de acordo com o esperado, ou não, por intermédio de indicadores desempenho. Neste trabalho, utilizou-se a combinação da importação do banco de dados do software de despacho (Smartmine®) de uma mineradora juntamente com o Power BI, que é um serviço gratuito para análise de negócios fornecido pela Microsoft, na produção de indicadores de desempenho para embasar os denominados relatórios simultâneos, que auxiliaram os gestores na avaliação de performance industrial, para a tomada de decisão, pela equipe gestora mineradora, na manutenção, troca de equipamentos e reformulação de estratégias de manutenção.

Ferramenta para desenvolvimento de Sistemas Inteligentes Baseada em Teorias para Modelagem da Incerteza

Este artigo apresenta a proposta de desenvolvimento de umaferramenta para modelagem da incerteza utilizando três teorias: fatores decerteza, Dempeter-Shafer e redes bayesianas. Portanto, é uma proposta deunificação de diferentes teorias em um único ambiente de desenvolvimento,visando propiciar a criação de sistemas inteligentes bem como o ensino deinteligência artificial

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status

Growing knowledge: an overview of Seed Plant diversity in Brazil

Abstract An updated inventory of Brazilian seed plants is presented and offers important insights into the country's biodiversity. This work started in 2010, with the publication of the Plants and Fungi Catalogue, and has been updated since by more than 430 specialists working online. Brazil is home to 32,086 native Angiosperms and 23 native Gymnosperms, showing an increase of 3% in its species richness in relation to 2010. The Amazon Rainforest is the richest Brazilian biome for Gymnosperms, while the Atlantic Rainforest is the richest one for Angiosperms. There was a considerable increment in the number of species and endemism rates for biomes, except for the Amazon that showed a decrease of 2.5% of recorded endemics. However, well over half of Brazillian seed plant species (57.4%) is endemic to this territory. The proportion of life-forms varies among different biomes: trees are more expressive in the Amazon and Atlantic Rainforest biomes while herbs predominate in the Pampa, and lianas are more expressive in the Amazon, Atlantic Rainforest, and Pantanal. This compilation serves not only to quantify Brazilian biodiversity, but also to highlight areas where there information is lacking and to provide a framework for the challenge faced in conserving Brazil's unique and diverse flora