Sedation overuse is frequent and possibly associated with poor outcomes in the intensive care unit (ICU) patients. However, the association of early oversedation with clinical outcomes has not been ...thoroughly evaluated. The aim of this study was to assess the association of early sedation strategies with outcomes of critically ill adult patients under mechanical ventilation (MV).
A secondary analysis of a multicenter prospective cohort conducted in 45 Brazilian ICUs, including adult patients requiring ventilatory support and sedation in the first 48 hours of ICU admissions, was performed. Sedation depth was evaluated after 48 hours of MV. Multivariate analysis was used to identify variables associated with hospital mortality.
A total of 322 patients were evaluated. Overall, ICU and hospital mortality rates were 30.4% and 38.8%, respectively. Deep sedation was observed in 113 patients (35.1%). Longer duration of ventilatory support was observed (7 (4 to 10) versus 5 (3 to 9) days, P = 0.041) and more tracheostomies were performed in the deep sedation group (38.9% versus 22%, P = 0.001) despite similar PaO2/FiO2 ratios and acute respiratory distress syndrome (ARDS) severity. In a multivariate analysis, age (Odds Ratio (OR) 1.02; 95% confidence interval (CI) 1.00 to 1.03), Charlson Comorbidity Index >2 (OR 2.06; 95% CI, 1.44 to 2.94), Simplified Acute Physiology Score 3 (SAPS 3) score (OR 1.02; CI 95%, 1.00 to 1.04), severe ARDS (OR 1.44; CI 95%, 1.09 to 1.91) and deep sedation (OR 2.36; CI 95%, 1.31 to 4.25) were independently associated with increased hospital mortality.
Early deep sedation is associated with adverse outcomes and constitutes an independent predictor of hospital mortality in mechanically ventilated patients.
ABSTRACT Recent researches have shown promising results for the use of orbital data using the Normalized Difference Vegetation Index (NDVI) to monitor and predict soybean grain yield. The objective ...of this work was to evaluate propositions of multiple linear regression models to predict soybean grain yield using NDVI. The research was carried out at the Celeiro Farm, in Monte Alegre do Piauí, PI, Brazil, in an area of 200 ha. Five images were collected during the soybean crop cycle: one from the Landsat 8 and four from the Sentinel 2. Regression analyses were carried out between grain yield data (predicted variable) extracted from harvest maps and spectral data (predictor variables) from NDVI of soybean crops at different developmental stages. The promising models were selected by the Akaike Information Criterion (AIC). The models were validated using Root Mean Square Error (RMSE) and Normalized Root Mean Square Error (nRMSE), considering the mean of soybean yield of the plot. The linear regression models developed with NDVI for the V5-V6 and R2 developmental stages showed promising results for the prediction of soybean grain yield, with mean error of predictions of 153.9 kg ha-1, representing 4.2% when compared to the data from field measures.
RESUMO Pesquisas recentes apontam resultados promissores da integração de dados orbitais utilizando o índice de vegetação NDVI, para monitorar e estimar a produtividade da soja. O objetivo do trabalho foi avaliar a proposição de modelos de regressão linear múltipla para estimativa da produtividade de grãos com uso do índice NDVI. A pesquisa foi realizada na Fazenda Celeiro, município de Monte Alegre do Piauí, PI, sendo a área de estudo de 200 ha. Foram utilizadas cinco imagens durante o ciclo de cultivo da soja, sendo uma do Landsat 8 e quatro do Sentinel 2. Efetuou-se análises de regressão entre dados de produtividade de grãos (variável predita), extraídos dos mapas de colheita, e dados espectrais de (variáveis preditoras) oriundos dos índices de vegetação (NDVI) de diferentes estádios de desenvolvimento da soja. A seleção dos modelos promissores foi efetuada pelo critério de informação de Akaike (AIC). Para validação dos modelos utilizou-se a raiz quadrada do erro quadrado médio (RMSE) e a raiz quadrada do erro quadrado médio normalizado (nRMSE) pela média da produtividade da soja no talhão. O modelo de regressão linear gerado com o índice de vegetação NDVI nos estádios de desenvolvimento V5-V6 e R2, mostrou-se promissor na predição da produtividade de grãos de soja, com erro médio de estimativa da ordem de 153,9 kg ha-1, o que representa 4,2% em relação aos dados medidos em campo.
Contemporary information on mechanical ventilation (MV) use in emerging countries is limited. Moreover, most epidemiological studies on ventilatory support were carried out before significant ...developments, such as lung protective ventilation or broader application of non-invasive ventilation (NIV). We aimed to evaluate the clinical characteristics, outcomes and risk factors for hospital mortality and failure of NIV in patients requiring ventilatory support in Brazilian intensive care units (ICU).
In a multicenter, prospective, cohort study, a total of 773 adult patients admitted to 45 ICUs over a two-month period requiring invasive ventilation or NIV for more than 24 hours were evaluated. Causes of ventilatory support, prior chronic health status and physiological data were assessed. Multivariate analysis was used to identifiy variables associated with hospital mortality and NIV failure.
Invasive MV and NIV were used as initial ventilatory support in 622 (80%) and 151 (20%) patients. Failure with subsequent intubation occurred in 54% of NIV patients. The main reasons for ventilatory support were pneumonia (27%), neurologic disorders (19%) and non-pulmonary sepsis (12%). ICU and hospital mortality rates were 34% and 42%. Using the Berlin definition, acute respiratory distress syndrome (ARDS) was diagnosed in 31% of the patients with a hospital mortality of 52%. In the multivariate analysis, age (odds ratio (OR), 1.03; 95% confidence interval (CI), 1.01 to 1.03), comorbidities (OR, 2.30; 95% CI, 1.28 to 3.17), associated organ failures (OR, 1.12; 95% CI, 1.05 to 1.20), moderate (OR, 1.92; 95% CI, 1.10 to 3.35) to severe ARDS (OR, 2.12; 95% CI, 1.01 to 4.41), cumulative fluid balance over the first 72 h of ICU (OR, 2.44; 95% CI, 1.39 to 4.28), higher lactate (OR, 1.78; 95% CI, 1.27 to 2.50), invasive MV (OR, 2.67; 95% CI, 1.32 to 5.39) and NIV failure (OR, 3.95; 95% CI, 1.74 to 8.99) were independently associated with hospital mortality. The predictors of NIV failure were the severity of associated organ dysfunctions (OR, 1.20; 95% CI, 1.05 to 1.34), ARDS (OR, 2.31; 95% CI, 1.10 to 4.82) and positive fluid balance (OR, 2.09; 95% CI, 1.02 to 4.30).
Current mortality of ventilated patients in Brazil is elevated. Implementation of judicious fluid therapy and a watchful use and monitoring of NIV patients are potential targets to improve outcomes in this setting.
ClinicalTrials.gov NCT01268410.
O artigo objetiva discutir como a patrimonialização do Terreiro Casa Branca e a sua negra resistência contribuiu para ressignificar o instituto do tombamento, dando abertura para dessacralizá-lo. ...Considerando o instituto como o mais tradicional instrumento do Direito Administrativo a serviço da proteção de bens culturais no Brasil, o tombamento tem sua história marcada pela transplantação de um modelo português, o qual, não raras vezes, foi utilizado como discurso para negar proteção a bens culturais que denotam nítido caráter de brasilidade. Desse modo, o uso do tombamento para a proteção de um terreiro de candomblé serviu para demonstrar que o instituto é mais maleável do que se pensa, estando sujeito às relações de poder vigentes e o discurso negador geralmente se vale de uma suposta inadequação do instituto para a proteção dos novos patrimônios, como forma de fortalecer apenas patrimonialidades tradicionais. Como conclusão, demonstra-se que o Direito está relacionado às questões de poder, inclusive às raciais, sendo necessário tomar-se consciência dessa relação, a fim de não se criarem bloqueios aos patrimônios dos sujeitos subalternizados. A inadequação ou não do instituto do tombamento para os novos patrimônios parece ser muito mais uma invenção decorrente das relações de poder que se firmaram no âmbito do patrimônio do que propriamente uma questão jurídica. A metodologia utilizada foi a revisão crítica de literatura e análise do processo de tombamento do Terreiro Casa Branca.
This study aimed to investigate the influence of water availability and nitrogen fertilization on plant growth, nutrient dynamics, and variables related to soybean crop yield. Trials were performed ...in Teresina, Piauí, Brazil, using randomized blocks in a split-split plot arrangement. The plots corresponded to water regimes (full and deficient), the split plots to N fertilization (0 and 1000 kg ha
N-urea), and the split-split plots to harvest times of soybean plants (16, 23, 30, 37, 44, 58, 65, 79 and 86 days after emergence), with three replicates. In general, the accumulation and partitioning of nitrogen (N), phosphorus (P), potassium (K), calcium (Ca), magnesium (Mg), sulphur (S), copper (Cu), iron (Fe), manganese (Mn), zinc (Zn) and boron (B) were decreased in plants subjected to water deficit and without N fertilization. Although nitrogen fertilization promoted elevated N accumulation in tissues, it did not result in any significant yield gain, and the highest seed yields were found in plants under full irrigation, regardless of N supplementation. However, deficient irrigation decreased the seed oil content of N-fertilized plants. In conclusion, N fertilization is critical for nutrient homeostasis, and water availability impairs biomass and nutrient accumulation, thereby limiting soybean yield performance.
Electroanalysis of Oenological Products for Fingerprinting: a Brief Overview Rodrigues, Pedro Fonseca Soares; Marzocchi Tierno, Paulo Fernando Guimaraes Morando; Couto Carvalho, Gustavo Augusto
Traektorii͡a︡ nauki : mezhdunarodnyĭ ėlektronnyĭ nauchnyĭ zhurnal,
3/2024, Volume:
10, Issue:
3
Journal Article
Peer reviewed
Open access
The oenology industry faces challenges in maintaining wine authenticity amidst diverse environmental factors and production methods. Electroanalytical wine fingerprinting emerges as a promising ...solution to authenticate and validate products. Integrating electrochemical techniques with multivariate analysis enables rapid on-site testing, pattern recognition, and fraud detection. Emerging trends include miniaturisation, nanomaterial utilisation, and machine learning, driving innovation towards sustainable practices. This overview describes current trends and achievements in using electroanalysis to fingerprint oenological products.
Objective
The aim of this study was to evaluate the immunohistochemical expressions of PD1, CD4
+
, and CD8
+
in premalignant lesions (OPML) that were transformed into oral squamous cell carcinoma ...OSCC (OPML-OSCC), in OSCC and also in premalignant lesions that were not transformed into OSCC (OPML-NOSSC).
Materials and methods
Retrospective analyses were performed in order to verify the demographic characteristics of the patients. CD4, CD8, and PD1 IMH studies were carried out on OPML and OSCC samples from 11 patients with OPML-OSCC and OPML, together with samples from 14 patients with OPML-NOSCC. The differences between OPML-OSCC and OPML-NOSCC were analyzed.
Results
Non-homogenous leukoplakia, together with the related oral subsite, and the lack of an exposure to tobacco, were all associated with malignant transformations. There were no statistical differences in the PD1 expression and the CD4
+
cells in OPML-OSCC and OPML-NOSCC. A significant increment in the CD8
+
cells was noted in the OPML that evolved into carcinomas when compared with OPML-NOSCC (
p
= 0.05), whereas there were higher CD8
+
cells levels in the carcinomas when compared with the OPML that evolved into carcinomas (
p
= 0.027).
Conclusions
CD8
+
cells infiltrate more in OPML-NOSCC than in OPML-OSCC. Carcinoma is more infiltrated by CD8
+
cells than its associated OPML.
Clinical relevance
Understanding immunological factors associated with malignant transformation of oral premalignant lesions can open a new way to treat this disease.
The article discusses how "heritage inventions" take place, as possibilities of rights, and, through this, the racialization when making these choices. With the nomination characteristic of the Law ...in mind, we defy its role in cultural systems that interact with patrimonialization, which usually make a distinction of the cultural heritage and practices of the hegemonic groups. In this context, the use of the law, through its nomination power, contained in the legal protection of heritage, has been one of the means used to racialize the issue and, consequently, the nation's identity and representation. In conclusion, we demonstrate that the Federal Constitution of 1988 broke with the hegemonic tradition when it allowed indigenous, Afro-Brazilians and other groups to participate in the national civilization process, by opening cracks in the monolith of the monocultural representation of the Nation in the Luso-Brazilian tradition. The methodology used was a critical review of literature.
The article discusses how "heritage inventions" take place, as possibilities of rights, and, through this, the racialization when making these choices. With the nomination characteristic of the Law ...in mind, we defy its role in cultural systems that interact with patrimonialization, which usually make a distinction of the cultural heritage and practices of the hegemonic groups. In this context, the use of the law, through its nomination power, contained in the legal protection of heritage, has been one of the means used to racialize the issue and, consequently, the nation's identity and representation. In conclusion, we demonstrate that the Federal Constitution of 1988 broke with the hegemonic tradition when it allowed indigenous, Afro-Brazilians and other groups to participate in the national civilization process, by opening cracks in the monolith of the monocultural representation of the Nation in the Luso-Brazilian tradition. The methodology used was a critical review of literature.
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