Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Creación de una Empresa Distribuidora de Vino en la Ciudad de Montería

El presente trabajo consiste en el desarrollo de un estudio de factibilidad donde se muestra como la Distribuidora Imporvinos S.A.S establecerá su Sede en la Ciudad de Montería, en el Departamento de Córdoba, con el propósito de ofrecer su producto vino M&L, con el que busca generar una experiencia única y novedosa en los consumidores, a través de su excelente sabor, atención al cliente y precios en el mercado. La oferta del Vino es verdaderamente innovadora para los consumidores tradicionales y no tradicionales de este, ya que el Vino contara con un servicio de asesoría personalizada, siendo este el fuerte o valor agregado donde se quiere destacar por encima de la competencia, esto es donde el asesor informa al cliente el mejor tipo de Vino, su Procedencia, Calidad, Cosecha, con el fin de que este consuma nuestro Vino para la ocasión que lo requiera como por ejemplo: Matrimonios, Celebraciones de Quince Años, Reuniones Sociales, Empresariales, entradas, entre otras ocasiones, donde lo que interesa es que el cliente se vaya totalmente satisfecho del producto que acaba de adquirir. La estrategia de distribución del Vino inicialmente será a través de canales directos (Supermercados y Tienda Especializada) y se desarrollarán otros canales más rentables conforme el producto se posicione en el mercado. Además de lo anteriormente descrito, la distribuidora Imporvinos S.A.S traerá consigo grandes beneficios en materia de empleabilidad para la población aledaña del sector donde se ubique, ya que se requerirá mano de obra Técnica y Profesional para cargos tales como asesores de venta, siendo estos la cara de presentación de la Empresa ante los clientes.Introducción ...........................................................................................................................11 Referente teórico y conceptual..........................................................................................31.1 Clasificación por edad: ..............................................................................................41.2 Producción del Vino...................................................................................................41.3 Industria del Vino.......................................................................................................51.4 Creación de Empresa..................................................................................................51.4.1 Estudio de Mercado ............................................................................................61.4.2 Estudio Técnico...................................................................................................61.4.3 Estudio Administrativo........................................................................................71.4.4 Estudio Financiero ..............................................................................................71.4.5 Evaluación del Proyecto .....................................................................................72 Módulo de Mercado..........................................................................................................82.1 Producto....................................................................................................................82.1.1 Características del Producto................................................................................82.1.2 Usos del Producto.............................................................................................102.2 Descripción de productos sustitutos.........................................................................102.3 Descripción de productos complementarios.............................................................102.4 Usuarios o consumidores.........................................................................................112.5 Delimitación del Área Geográfica..............................................................................112.6 Análisis de la demanda ............................................................................................112.6.1 Cálculo del tamaño de la muestra .....................................................................112.6.2 Instrumento para recolectar la información.......................................................122.6.3 Cálculo de la demanda actual ...........................................................................122.6.4 Proyección de la Demanda ...............................................................................142.7 Análisis de la oferta.................................................................................................142.8 Determinación del tipo de demanda.........................................................................142.8.1 Tipo de demanda ..............................................................................................142.8.2 Proyección de la demanda insatisfecha .............................................................152.9 Análisis de Precios...................................................................................................152.10 Canales de comercialización ................................................................................162.11 Mercado de insumos ............................................................................................173 Módulos Técnico y Organizacional...................................................................................183.1 Tamaño del Proyecto ...............................................................................................183.2 Localización ............................................................................................................193.2.1 Estudio de localización a nivel Macro...............................................................193.2.2 Estudio de localización a nivel Micro................................................................193.3 Distribución en Planta..............................................................................................203.4 Proceso de comercialización....................................................................................213.4.1 Descripción del proceso....................................................................................213.5 Naturaleza Jurídica ..................................................................................................223.6 Misión.....................................................................................................................243.7 Visión......................................................................................................................243.8 Organigrama............................................................................................................253.9 Manual de funciones................................................................................................263.10 Imagen Corporativa ..............................................................................................343.11 Eslogan................................................................................................................344 Módulo de Impacto Social, Económico y Ambiental.........................................................354.1 Impacto Social .........................................................................................................354.2 Impacto Económico .................................................................................................354.3 Impacto Ambiental ...................................................................................................365 Módulo Financiero ..........................................................................................................385.1 Inversiones..............................................................................................................385.2 Costos operacionales ...............................................................................................395.3 Calculo del Punto de Equilibrio................................................................................455.4 Proyecciones financieras..........................................................................................465.5 Flujo del Proyecto....................................................................................................486 Fuentes de financiación ..................................................................................................507 Conclusiones..................................................................................................................518 Recomendaciones...........................................................................................................529 Referencias Bibliográficas...............................................................................................5310 Anexos........................................................................................................................56Creación de empresaPregradoAdministrador(a) en Finanzas y Negocios Internacionale

Analysis of Surgical Mortality for Congenital Heart Defects Using RACHS-1 Risk Score in a Brazilian Single Center

ABSTRACT Introduction: Risk Adjustment for Congenital Heart Surgery 1 (RACHS-1) score is a simple model that can be easily applied and has been widely used for mortality comparison among pediatric cardiovascular services. It is based on the categorization of several surgical palliative or corrective procedures, which have similar mortality in the treatment of congenital heart disease. Objective: To analyze the in-hospital mortality in pediatric patients (<18 years) submitted to cardiac surgery for congenital heart disease based on RACHS-1 score, during a 12-year period. Methods: A retrospective date analysis was performed from January 2003 to December 2014. The survey was divided in two periods of six years long each, to check for any improvement in the results. We evaluated the numbers of procedures performed, complexity of surgery and hospital mortality. Results: Three thousand and two hundred and one surgeries were performed. Of these, 3071 were able to be classified according to the score RACHS-1. Among the patients, 51.7% were male and 47.5% were younger than one year of age. The most common RACHS-1 category was 3 (35.5%). The mortality was 1.8%, 5.5%, 14.9%, 32.5% and 68.6% for category 1, 2, 3, 4 and 6, respectively. There was a significant increase in the number of surgeries (48%) and a significant reduction in the mortality in the last period analysed (13.3% in period I and 10.4% in period II; P=0.014). Conclusion: RACHS-1 score was a useful score for mortality risk in our service, although we are aware that other factors have an impact on the total mortality

Orientações TCC e Iniciação Científica

Trabalhos dos orientandos da Profa. Denny Thame e materiais para pesquisa de Direito da Informática, da Comunicação, Internacional e Ambiental

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field