Summary:We examined the incidence, risk factors and associated mortality of acute renal failure requiring dialysis (Renal Bearman Grade [BG] 3) in a 3-year cohort of 97 consecutive allogeneic blood and marrow transplantation (alloBMT) patients. In all, 20 (21%) developed Renal BG3 (all died by day +132) and 77 (79%) developed renal insufficiency (Renal BG1-2). Renal BG3 was a contributing or primary cause of death in 18 (90%) patients who continued to require dialysis at time of death. The two Renal BG3 patients whose deaths were not related to renal failure died on day +103 of hemorrhage and day +132 of underlying disease. By univariate analysis, age, unrelated donor, veno-occlusive disease (VOD) and grade III-IV acute graft-versus-host disease with hepatic involvement were significantly associated with Renal BG3. The multivariate model of time to Renal BG3 determined only a prior diagnosis of severe acute GVHD (RR ¼ 4.1, 95% CI 1.6-10.3, P ¼ 0.003) and VOD (RR ¼ 9.1, 95% CI 3.5-23.7, Po0.001) as significant independent predictors. Renal BG3 is generally considered a conditioning regimen-related toxicity. This study demonstrates that Renal BG3 is most commonly a complication of hepatic co-morbidities after allogeneic blood and marrow transplantation and identifies patients with a very poor prognosis.
DISTANCE EDUCATION TEACHER TRAINING FOR THE USE OF TIC's IN THE AMAZON REGION: PRESENT TUTOR ABSTRACTThis article presents an analysis of the legal history of DLE Education and presents the results of a study carried out in the Porto Velho North Campus of the Federal Institute of Education, Science and Technology of Rondônia (IFRO). The subject of School Evasion in the Technical courses in Finance in the modality of distance education -DLE. The general objective was to present a proposal of political-pedagogical intervention with the IFRO in the Technical Course in Finance, DLE modality with the objective of reintegrating the students evaded to the course, giving them a new opportunity to finish their studies. Regarding the methodological procedures, the descriptive qualitative approach was adopted, so that a semi-structured questionnaire and documentary analysis were the instruments used to collect data. The research collaborators were students who had been evaded from the DLE Subsequent Finance Technical course, polo coordinators and DLE tutors. The results show that the main reasons why students drop out of the course are economic difficulties (65% -Class 2014/1) and to reconcile study and profession (35% -Class 2015/2). Another important result is that of the 481 student enrollments that had escaped from the DLE Finance course, 272 students returned and completed the course.
DISTANCE EDUCATION TEACHER TRAINING FOR THE USE OF TIC's IN THE AMAZON REGION: PRESENT TUTOR ABSTRACTThis research had as general objective to verify the formation of the Presence Tutors that work in Distance Education in the Amazon region. The research collaborators are teachers of the DLE courses of the IFRO campus in Porto Velho Zona Norte, with a total sample of 29 individuals. The data collection was done from the application of a questionnaire with closed and open questions. This instrument was submitted and later approved by the research ethics committee, in compliance with the ethical precepts of Resolution 466/12 of the National Health Council, under the number of opinions: 1.566.512. After verifying the data, it was noticed that the analyzed profiles indicate a formation of specialists, which suggests a moderate knowledge since they are not always specialists in the area in which they work.
This work seeks to discuss the conception of affected and the reconfiguration of the territory and social lives with the observation and analysis of two communities not considered affected by the Jirau HPP: that of the small Village Jirau and Village of the Penha. The research is characterized as theoretical-descriptive, based on the issues related to the territory of occurrence of impacts of the construction and operation of hydroelectric plants, and fieldwork was performed with non-participant observation, the data were compiled from the perception of the researchers and allow us to conclude that the damage of the construction of the HPP, in these communities, put them in a condition of being affected , the impact happens in the territory as a result of the influence and confluence of the networks of life lived, comprising the river and what relates it, the connecting roads, the networks of housing.
BackgroundThere are five different anti-TNF biologics: three are bivalent full length (FL) antibodies (adalimumab, golimumab, and infliximab), one a bivalent fusion protein (etanercept), and one a univalent PEGylated Fab' (PF) (certolizumab pegol [CZP]). Administration of such protein biologics can induce anti-drug antibodies (ADAbs), of which the majority are anti-idiotypic antibodies (anti-ID).1 The potential cross-linking of bivalent anti-IDs with bivalent biologics can result in the formation of large immune complexes (ICs), which are subsequently cleared by mechanisms using the multiple Fc domains, thereby resulting in a decrease in the efficacy of the biologic. Since univalent biologics, such as CZP, only have one binding Fab' arm, such large cross-linked anti-ID-mediated ICs are unlikely to form. Therefore, anti-IDs may have a different effect on the elimination and bioavailability of univalent and bivalent biologics in vivo.ObjectivesTo determine if the valency of a biologic will affect the in vitro size and in vivo elimination from the plasma of ICs formed with an anti-ID following intravenous (IV) administration to BALB/c mice.MethodsAn anti-ID antibody to CZP was generated and used for subsequent studies to mimic an ADAb response. Univalent PF CZP was reengineered as a bivalent FL humanized IgG1 antibody (similar to adalimumab) to directly compare the effect of valency on IC-mediated clearance. This FL antibody showed very similar TNF neutralization compared to the conventional PF molecule in a bioassay. To generate ICs, the anti-ID was incubated overnight with either PF or FL CZP, and the size of the resultant ICs determined by analytical ultracentrifugation (AU). The anti-ID complexes and PF and FL CZP alone were then administered IV to the mice, and the elimination of the anti-TNFs from the circulation was monitored by quantitative liquid chromatography-mass spectrometry (LC-MS) in serial plasma samples.ResultsAU analysis of the immune complexes formed between PF CZP and the anti-ID showed the presence of one peak corresponding in size to one anti-ID molecule bound to two PF molecules (∼3.5x105 Da). In contrast, the FL CZP/anti-ID mixture showed ICs of various sizes up to very large molecular weights (>1x106 Da), with the predominant species corresponding to a complex of two anti-IDs bound to two FL CZP molecules (∼6x105 Da). The in vivo studies showed that the FL CZP/anti-ID ICs were eliminated much faster (t1/2=0.3 hours) than the FL CZP alone (t1/2=44.5 hours), whereas the PF CZP/anti-ID ICs were eliminated more slowly (t1/2=60.5 hours) than the PF CZP alone (t1/2=19.7 hours).ConclusionsThe FL CZP molecule formed large ICs with the anti-ID, which led to much faster elimination than the FL molecule alone. This result suggests that an ADAb response to a FL antibody could lead to rapid elimination and loss of efficacy of the drug in patients. In contrast, the PF CZP/anti-ID complex had a longer half-life than the PF CZP alone, presumably because this molecule was not seen as an IC due to the presence...
<p class="ResumoeAbstract">O papel da educação escolar para as comunidades atingidas por barragens tem sido pouco debatido no meio científico. A ausência de políticas públicas voltadas para atender a demanda deste estrato populacional tem causado diversos problemas de ordem econômica, social e ambiental. Desta forma, esta pesquisa teve como objetivo geral retratar a importância dada a educação escolar sob o olhar das populações atingidas pela barragem da Usina Hidrelétrica (UHE) Santo Antônio. Para tanto, foi realizado uma pesquisa de campo nos 7 assentamentos da referida UHE. A ferramenta utilizada foi o questionário, 93 indivíduos participaram da amostra. Os resultados evidenciam que as recordações dos entrevistados acerca da escola remetem a um ambiente importante e significativo para a comunidade. </p>
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