The Behavior of Demineralized Bone Matrix (DBM) in Post-Extraction Sockets

Autogenous bone grafts are considered to be the gold standard in bone regeneration because of their osteogenic activity; however, due to limited availability of intraoral donor sites and the need to resolve the demands of patients requires an alternative to these. Two male patients were submitted to implant surgery in two stages with 6 months intervals between each of them: the first was exodontia and placement of DBM graft into the socket; the second stage was the drill with a 2 mm internal diameter trephine in center of the alveolar ridge previously grafted with DBM and subsequent implant placement. The samples were analyzed under histological techniques. A very mature bone was observed at 6 months after DBM graft placement in the sockets, showing it to be a good alternative as bone graft.

Use of pulse pressure variation to estimate changes in preload during experimental acute normovolemic hemodilution

Background. Acute normovolemic hemodilution (ANH) is an alternative to blood transfusion in surgeries involving blood loss. This experimental study was designed to evaluate whether pulse pressure variation (PPV) would be an adequate tool for monitoring changes in preload during ANH, as assessed by transesophageal echocardiography. Methods. Twenty-one anesthetized and mechanically ventilated pigs were randomized into three groups: CTL (control), HES (hemodilution with 6% hydroxyethyl starch at a 1:1 ratio) or NS (hemodilution with saline 0.9% at a 3:1 ratio). Hemodilution was performed in animals of groups NS and HES in two stages, with target hematocrits 22% and 15%, achieved at 30-minute intervals. After two hours, 50% of the blood volume withdrawn was transfused and animals were monitored for another hour. Statistical analysis was based on ANOVA for repeated measures followed by multiple comparison test (P<0.05). Pearson's correlations were performed between changes in left ventricular end-diastolic volume (LVEDV) and PPV, central venous pressure (CVP) and pulmonary artery occlusion pressure (PAOP). Results. Group NS received a significantly greater amount of fluids during ANH (NS, 900 +/- 168 mL vs. HES, 200 +/- 50 mL, P<0.05) and presented greater urine output (NS, 2643 +/- 1097mL vs. HES, 641 +/- 338mL, P<0.001). Significant decreases in LVEDV were observed in group NS from completion of ANH until transfusion. In group HES, only increases in LVEDV were observed, at the end of ANH and at transfusion. Such changes in LVEDV (Delta LVEDV) were better reflected by changes in PPV (Delta PPV, R=-0.62) than changes in CVP (Delta CVP R=0.32) or in PAOP (Delta PAOP, R=0.42, respectively). Conclusion. Changes in preload during ANH were detected by changes in PPV. Delta PPV was superior to Delta PAOP and Delta CVP to this end. (Minerva Anestesiol 2012;78:426-33)

Metropolitan and regional health planning: dilemmas of the Pact for Health in the Baixada Santista Metropolitan Area, Sao Paulo State, Brazil

This paper focuses on the relationship between metropolitan and regional health planning based on the processes of regionalization and the Pact for Health in the Baixada Santista Metropolitan Area, Sao Paulo State, Brazil. The method used was a case study in two stages, namely during initial implementation of the Pact for Health (2007) and the Regional Administration Committees (CGR) and in 2010. Municipal and regional health systems managers and the director of the Metropolitan Agency were interviewed, and records were analyzed from ten years of meetings of the Regional Inter-Administration Committee and the Regional Development Council. Four issues emerged: financing and infrastructure; health services utilization; inefficiency of the Regional Health Administration's instruments and decision-making levels; and the relationship between different levels in the Administration. Metropolitan health management remained as an underlying issue, appearing only incidentally or tangentially to regional management. Despite some limitations, the CGR has been legitimized as a space for regional health management.

Self-reported hearing loss among elderly individuals in the city of Sao Paulo, Brazil: prevalence and associated factors (SABE Study, 2006)

This article describes the prevalence of self-reported hearing loss in an elderly population in the city of Sao Paulo, Brazil, and associated factors, based on a cross-sectional descriptive and quantitative study. The sample consisted of individuals over 65 years of age selected from census tracts in two stages, with replacement and probability proportional to the population 75 years of age or older. Statistical analysis used Stata 10 with weighted data, Rao-Scott test, and backward stepwise Poisson regression. 1,115 elders were interviewed. Prevalence of self-reported hearing loss was 30.4%, and higher levels were associated with age over 75 years, male gender, self-reported musculoskeletal conditions, dizziness, visual impairment, and difficulty using the telephone. Increased knowledge of factors associated with hearing loss would support public policies on hearing. The high prevalence found in this study underlines the importance of addressing this issue among the elderly.

Open circuit interaction of borohydride with oxidized platinum surfaces

An interesting method to investigate the effect of fuel crossover in low temperature fuel cells consists of studying the open circuit interaction between the reducing fuel and an oxide-covered catalyst. Herein we report the experimental study of the open circuit interaction between borohydride and oxidized platinum surfaces in alkaline media. When compared to the case of hydrogen and other small organic molecules, two remarkable new features were observed. Firstly, the interaction with borohydride resulted in a very-fast reduction process with transient times about two to three orders of magnitude smaller. The second peculiarity was that the decrease of the open circuit potential was found to occur in two-stages and this, previously unseen, feature was correlated with the two-hump profile found in the backward sweep in the cyclic voltammogram The consequences of our findings are discussed in connection with fundamental and applied aspects. (C) 2011 Elsevier B.V All rights reserved.

Demographic characterization of supervised dog and cat populations in Sao Paulo city, Brazil

This study aimed to estimate the owned dog and cat populations of Sao Paulo city using a complex sample with random selection in two stages. In each administrative district, six census sectors and 20 households in each sampled sector were visited from September 2006 to September 2009, totalizing 11,272 interviews. The human: dog ratio was 4.34 and the human: cat ratio was 19.33. The dog population was 2,507,401 and the cat population, 562,965. The dog population was composted of 52.7% males, while among the cat population it was 45.1%. The proportion of sterilized females (23.4% among dogs and 46.1% among cats) was higher than males (11.4% among dogs and 31.5% among cats). The mean age of dogs was 4.99 years, and for cats, 3.53 years. The proportion of restricted (without access to the street) dogs, 64.4%, was higher than restricted cats, 42.5%. The average number of animals/household was 1.60 for dogs and 1.69 for cats. The animal ownership is associated with cultural factors, therefore the characterization of canine and feline population is essential to implement an adequate animal population management program and zoonosis control.

Development of Novel Guava Puree Films Containing Chitosan Nanoparticles

One of the overall goals of industries is to use packages that do not cause environmental problems at disposal time, but that have the same properties as the conventional ones. The goal of this study is to synthesize edible films based on hydroxypropyl methylcellulose (HPMC) with guava puree and chitosan (CS) nanoparticles. This was divided into two stages, the first is the synthesis of chitosan nanoparticles and the second is the production of the films. For the nanoparticles, average size and zeta potential measurements were performed. The characterizations of mechanical and thermal properties, solubility and water vapor permeability tests were conducted in the films. It was observed that when the nanoparticles were added to HPMC and guava puree films, they improved their mechanical and thermal properties, as well as decreased the films solubility and permeability. The potential application of the films prepared would be in edible films with flavor and odor to extend the shelf life of products.

An investigation about Brazilian mango and grape exports

Purpose - The objective of this paper is to characterise the transactions between European buyers and Brazilian mango and grape producers. Design/methodology/approach - The method selected for this paper was multiple case studies. The Brazilian mango and grape supply chains' export activities to Europe were investigated. The field research was undertaken in Brazil, Germany, The Netherlands and the UK. In total, 41 face-to-face interviews were carried out. Findings - The supermarkets' literature tends to generalise the strategies of retailers focusing on differentiation and preferred suppliers. However, in empirical research conducted in the UK, Germany and The Netherlands it is possible to conclude that the procurement strategies of supermarkets can vary sharply. The results reveal the presence of different agents who demand different quality standards. The level of intensity depends on consumer behaviour, the features of product commercialised and the characteristics of the production segment in each country. Research limitations/implications - First, in relation to the empirical method there is a limitation because the case study does not allow statistical generalisation. Consequently, it will be interesting to undertake quantitative research in order to quantify the variables presented and their impact on the structure of value chains. Second, the research focuses only on two stages of the supply chain, producers and buyers. Practical implications - The differences between UK and German supermarkets challenge the supermarket literature, which tends to generalise the strategies of retailers focusing on differentiation and preferred suppliers. Originality/value - The study shows that the issue of influence and activities of retail agents along the value chain can be analysed taking several variables into consideration: the products commercialised; the distribution segment; and the consumer market. This result opens the way for analysing different structures of the value chain and the impact of these differences on the entry of producers for developing countries into the global market.

Invasive candidiasis and oral manifestations in premature newborns

Objective: To investigate prevalence of invasive candidiasis in a Neonatal Intensive Care Unit and to evaluate oral diseases and Candida spp. colonization in low birth weight preterm newborns. Methods: A descriptive epidemiological study performed in two stages. First, prevalence of candidiasis was analyzed in a database of 295 preterm patients admitted to hospital for over 10 days and birth weight less than 2,000g. In the second stage, oral changes and Candida spp. colonization were assessed in 65 patients weighing less than 2,000g, up to 4 week-old, hospitalized for over 10 days and presenting oral abnormalities compatible with fungal lesions. Swab samples were collected in the mouth to identify fungi. Results: Prevalence of candidiasis was 5.4% in the database analyzed. It correlated with prolonged hospital length of stay (p<0.001), in average, 31 days, and 85% risk of developing infection in the first 25 days. It correlated with low birth weight (p<0.001), with mean of 1,140g. The most frequent alterations were white soft plaques, detachable, in oral mucosa and tongue. Intense oral colonization by Candida spp was observed (80%). Conclusions: The frequency of invasive candidiasis was low and correlated with low birth weight and prolonged hospital stay. The most common oral changes were white plaques compatible with pseudomembranous candidiasis and colonization by Candida spp. was above average.

A elaboração de um ambiente virtual de aprendizagem em síndromes genéticas

Objetivo: desenvolver um ambiente virtual de aprendizagem (AVA) para alunos do ensino fundamental sobre síndromes genéticas. Método: o AVA, conhecido como Cybertutor, possibilita o aprendizado do aluno pela internet de forma interativa. A metodologia deste estudo foi composta de duas etapas, a de desenvolvimento e a de disponibilização do AVA. O desenvolvimento do conteúdo educacional, gráfico e audiovisual do Cybertutor contou com o auxílio de um geneticista do HRAC/ USP e de informações científicas disponibilizadas em livros, artigos, teses e dissertações nacionais e internacionais. O Cybertutor foi disponibilizado na plataforma do Projeto Jovem Doutor (http://www. jovemdoutor.org.br/jdr/) pela equipe técnica da DTM/FMUSP. Resultados: o Cybertutor elaborado possibilitou estruturar o conteúdo educacional, gráfico e audiovisual em tópicos, inserir questões de reforço, lista de discussão e verificar o desempenho dos alunos. Conclusão: o AVA desenvolvido pode ser uma importante ferramenta de educação em saúde em Síndromes Genéticas, abrangendo as mais diversas regiões do país.

The succession process at social enterprises in Brazil

This research was based on a study of social enterprises in Brazil, to find out if and how these organizations plan and manage the succession process for their senior positions. The study investigated the subset of the associations dedicated to collectively producing goods and services, because they are formally set up and aimed at speeding up the dynamism of local development. The empirical research consisted of two stages. The first was a survey covering a sample of 378 organizations, to find out which of those had already undergone or were undergoing a succession process. The second interviewed the main manager of 32 organizations, to obtain a description of their succession experience. In this stage, the research aimed to analyze how the Individual, Organization and Environment dimensions interact to configure the succession process, identifying which factors of each of these dimensions can facilitate or limit this process. The following guiding elements were taken as the analytical basis: Individual dimension - leadership roles, skill and styles; Organization dimension - structure, planning, advisory boards, communication (transparency), control and evaluation; and Environment dimension - influence of the stakeholders (community, suppliers, clients, and business partners) on the succession process. The results indicated that succession in the researched associations is in the construction stage: it adapts to the requirements of current circumstances but is evidently in need of improvement in order for more effective planning and shared management of the process to be achieved.

Ontogenetic Variation in Ammonia Excretion during the Early Life Stages of the Amazon River Prawn, Macrobrachium amazonicum

Dry mass (DM) and total ammonia-N (TAN) excretion were determined in embryos, larvae (ZI-ZIX, Z = zoea ), and postlarvae (PL) at 1, 7, and 14 d after metamorphosis (PL1, PL7, and PL14) of Macrobrachium amazonicum. Animals in postmolt-intermolt (A-C) stages were sorted according to their developmental stages, and placed into incubation chambers (similar to 30 mL) for 2 h to quantify TAN excretion. After this period, analyses were carried out using Koroleff`s method for TAN determination. Individual TAN excretion generally increased throughout ontogenetic development and varied from 0.0090 +/- 0.0039 mu g TAN/individual/h in embryo to 1.041 +/- 0.249 mu g TAN/individual/h in PL14. There was no significant difference between embryo-ZIV and ZV-ZIX (P > 0.05), whereas PL1, PL7, and PL14 differed (P < 0.05) from each other. Higher increments in individual ammonia-N excretion were observed between ZIV-ZV, PL1-PL7, and PL7-PL14. Mass-specific excretion rates presented two groups, embryo-ZII (P > 0.05) and ZIII-PL14 (P > 0.05). The lowest value was found in embryo (0.17 +/- 0.07 mu g TAN/mg DM/h) and the maximum values in ZV and PL1 (0.65 +/- 0.25 and 0.64 +/- 0.27 mu g TAN/mg DM/h, respectively). Results indicate that metabolic rate is proportional to the body mass in M. amazonicum, during early life stages. Variations in ammonia excretion during this phase may be associated mainly with body size. Data obtained in the present study may be useful in developing and optimizing rearing techniques of M. amazonicum, such as the proportions between biofilter and rearing tank size, and stocking density in culture tanks or in transport bags.

On estimating the basic reproduction number in distinct stages of a contagious disease spreading

In epidemiology, the basic reproduction number R-0 is usually defined as the average number of new infections caused by a single infective individual introduced into a completely susceptible population. According to this definition. R-0 is related to the initial stage of the spreading of a contagious disease. However, from epidemiological models based on ordinary differential equations (ODE), R-0 is commonly derived from a linear stability analysis and interpreted as a bifurcation parameter: typically, when R-0 >1, the contagious disease tends to persist in the population because the endemic stationary solution is asymptotically stable: when R-0 <1, the corresponding pathogen tends to naturally disappear because the disease-free stationary solution is asymptotically stable. Here we intend to answer the following question: Do these two different approaches for calculating R-0 give the same numerical values? In other words, is the number of secondary infections caused by a unique sick individual equal to the threshold obtained from stability analysis of steady states of ODE? For finding the answer, we use a susceptibleinfective-recovered (SIR) model described in terms of ODE and also in terms of a probabilistic cellular automaton (PCA), where each individual (corresponding to a cell of the PCA lattice) is connected to others by a random network favoring local contacts. The values of R-0 obtained from both approaches are compared, showing good agreement. (C) 2012 Elsevier B.V. All rights reserved.

Two new species of Hudsonimyia Roback, 1979 (Diptera: Chironomidae: Tanypodinae) from Neotropical Region unveiled by morphology and DNA barcoding

Two new species of Hudsonimyia Roback, 1979 (Diptera: Chironomidae: Tanypodinae) are described and illustrated as male, pupa and larva. The generic diagnosis of pupa is emended and keys to males, pupae and larvae of known species are provided. The different life stages for one of the described species were associated by DNA barcodes.

The preimaginal stages of the ensign wasp Evania appendigaster (Hymenoptera, Evaniidae), a cockroach egg predator

Evania appendigaster is a cosmopolitan wasp that deposits eggs in the oothecae of some species of cockroaches; its larvae then consume the cockroach eggs and embryos. It is a candidate for the biological control of cockroaches, but little is known about its basic biology. Here we describe the external morphology of all immature stages of E. appendigaster and compare them with the larvae of related species. The life cycle of E. appendigaster includes three larval instars, each with 13 body segments. Their mouthparts were generally reduced, except for the mandibles, which were always sclerotized and toothed, and were especially robust in second-instar larvae. Antennal and mouthpart sensilla were basiconic and difficult to observe. Larvae of E. appendigaster are similar in form to other described evaniid larvae, but quite different from the two available descriptions of larvae of gasteruptiid and aulacid wasps. Further descriptions of evaniid larvae will be useful in determining how widespread this morphology is within the family, and in understanding phylogenetic relationships within Hymenoptera.