WATER HOMEOSTASIS, FRAILTY AND COGNITIVE FUNCTION IN THE NURSING HOME

Objective: - To develop and test a practical clinical method to assess frailty in nursing homes; - To investigate the relationship between cognitive status of the elderly and the balance between water compartments of their body composition. Design and subjects: Cross-sectional study, conducted at two nursing homes in Boston-MA. Methods: Body mass and height (Ht) were evaluated to calculate BMI (body mass index, in Kg/m(2)). The cognitive decline was evaluated based on the scores obtained from the Mini-Mental State Examination (MMSE); The extracellular to total body water ratio (ECW/TBW) was calculated after the analysis of TBW from deuterium and tritium dilution and ECW from bromide dilution. Single-frequency BIA analysis data were investigated for resistance (R) and reactance (Xc), plotted in an R/Ht Xc/Ht graph (vectorial analysis-BIVA). The BIVA results of nursing home residents were compared against the data obtained from the NHANES Ill study. TBW and ECW values were compared with a group of free-living elderly volunteers. Results: The ECW/TBW was significantly higher in nursing home residents than in the free-living individuals. BIVA analysis showed significantly higher Xc/Ht values in the reference subjects. The MMSE did not present a significant correlation with ECW/TBW for either gender. Conclusion: We proposed the ECW/TBW ratio and BIVA as surrogate methods for the clinical assessment of frailty. We tested successfully both approaches with nursing home patients and free-living volunteers and compared them to a national data base. The advent of new, portable instruments will enable field tests to further validate our proposed "Frailty Factor" in future studies. We found no correlation between frailty and cognitive decline in the nursing home.

Obstructive sleep apnea is common among patients referred for coronary artery bypass grafting and can be diagnosed by portable monitoring

Background Obstructive sleep apnea (OSA) is common among patients with coronary artery disease. However, OSA remains largely under recognized. The lack of clinical suspicion and difficulties to access full polysomnography (PSG) are limiting factors. The aim of this study was to evaluate, among patients referred to coronary artery bypass grafting (CABG): (i) the prevalence of OSA, (ii) the association of OSA with clinical symptoms, (iii) the performance of overnight unattended portable monitoring (PM) as an alternative method for the diagnosis of OSA. Methods Consecutive patients referred for CABG were evaluated by standard physical evaluation and validated questionnaires (Berlin questionnaire and Epworth Sleepiness Scale) and underwent full PSG and PM (Stardust II). Results We studied 70 consecutive patients (76% men), age 58 +/- 7 years (mean +/- SD), BMI [median (interquartile range)] 27.6 kg/m(2) (25.8-31.1). The prevalence of OSA (full PSG) using an apnea-hypopnea index of at least 5 events/h was 87%. Commonly used clinical traits for the screening of OSA such as the Epworth Sleepiness Scale and neck circumference had low sensitivities to detect OSA. In contrast, the Berlin questionnaire showed a good sensitivity (72%) to detect OSA. PM showed good sensitivity (92%) and specificity (67%) for the diagnosis of OSA. Conclusion OSA is strikingly common among patients referred for CABG. The Berlin questionnaire, but not symptom of excessive daytime sleepiness is a useful tool to screen OSA. PM is useful for the diagnosis of OSA and therefore is an attractive tool for widespread use among patients with coronary artery disease. Coron Artery Dis 23:31-38 (C) 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Homogeneity assessment of a station climate series (1933-2005) in the Metropolitan Area of Sao Paulo: instruments change and urbanization effects

This work assessed homogeneity of the Institute of Astronomy, Geophysics and Atmospheric Sciences (IAG) weather station climate series, using various statistical techniques. The record from this target station is one of the longest in Brazil, having commenced in 1933 with observations of precipitation, and temperatures and other variables later in 1936. Thus, it is one of the few stations in Brazil with enough data for long-term climate variability and climate change studies. There is, however, a possibility that its data may have been contaminated by some artifacts over time. Admittedly, there was an intervention on the observations in 1958, with the replacement of instruments, for which the size of impact has not been yet evaluated. The station transformed in the course of time from rural to urban, and this may also have influenced homogeneity of the observations and makes the station less representative for climate studies over larger spatial scales. Homogeneity of the target station was assessed applying both absolute, or single station tests, and tests relatively to regional climate, in annual scale, regarding daily precipitation, relative humidity, maximum (TMax), minimum (TMin), and wet bulb temperatures. Among these quantities, only precipitation does not exhibit any inhomogeneity. A clear signal of change of instruments in 1958 was detected in the TMax and relative humidity data, the latter certainly because of its strong dependence on temperature. This signal is not very clear in TMin, but it presents non-climatic discontinuities around 1953 and around 1970. A significant homogeneity break is found around 1990 for TMax and wet bulb temperature. The discontinuities detected after 1958 may have been caused by urbanization, as the observed warming trend in the station is considerably greater than that corresponding to regional climate.

Investigation of a Pt3Sn/C Electro-Catalyst in a Direct Ethanol Fuel Cell Operating at Low Temperatures for Portable Applications

A 20% Pt3Sn/C catalyst was prepared by reduction with formic acid and used in a direct ethanol fuel cell at low temperatures. The electro-catalytic activity of this bimetallic catalyst was compared to that of a commercial 20% Pt/C catalyst. The PtSn catalyst showed better results in the investigated temperature range (30 degrees-70 degrees C). Generally, Sn promotes ethanol oxidation by adsorption of OH species at considerably lower potentials compared to Pt, allowing the occurrence of a bifunctional mechanism. The bimetallic catalyst was physico-chemically characterized by X-ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS) analyses. The presence of SnO2 in the bulk and surface of the catalyst was observed. It appears that SnO2 can enhance the ethanol electro-oxidation activity at low potentials due to the supply of oxygen-containing species for the oxidative removal of CO and CH3CO species adsorbed on adjacent Pt active sites.

The Influence of Environmental Temperature and Air Humidity on the Maintenance of Sterility of Surgical Instruments Sterilized in Different Wraps

State of Sao Paulo Research Foundation (FAPESP), Brazil

RELATIONSHIP AMONG EXTRACTIVES, LIGNIN AND HOLOCELLULOSE CONTENTS WITH PERFORMANCE INDEX OF SEVEN WOOD SPECIES USED FOR BOWS OF STRING INSTRUMENTS

In this paper we investigate the influence of extractives, lignin and holocellulose contents on performance index (PI) of seven woods used or tested for violin bows. Woods with higher values of this index (PI = root MOE/rho, where MOE is modulus of elasticity and rho is density) have a higher bending stiffness at a given mass, which can be related to bow wood quality. Extractive content was negatively correlated with PI in Caesalpinia echinata, Hanclroanthus sp. and Astronium lecointei. In C. echinata holocellulose was positively correlated with PI. These results need to be further explored with more samples and by testing additional wood properties. Although the chemical constituents could provide an indication of quality, it is not possible to establish appropriate woods for bows solely by examining their chemical constituents.

Efficacy of NiTi rotary instruments in removing calcium hydroxide dressing residues from root canal walls

The aim of this study was to evaluate the efficacy of three rotary instrument systems (K3, Pro Taper and Twisted File) in removing calcium hydroxide residues from root canal walls. Thirty-four human mandibular incisors were instrumented with the Pro Taper System up to the F2 instrument, irrigated with 2.5% NaOCl followed by 17% EDTA, and filled with a calcium hydroxide intracanal dressing. After 7 days, the calcium hydroxide dressing was removed using the following rotary instruments: G1. - NiTi size 25, 0.06 taper, of the K3 System; G2 - NiTi F2, of the Pro Taper System; or G3 - NiTi size 25, 0.06 taper, of the Twisted File System. The teeth were longitudinally grooved on the buccal and lingual root surfaces, split along their long axis, and their apical and cervical canal thirds were evaluated by SEM (x1000). The images were scored and the data were statistically analyzed using the Kruskall Wallis test. None of the instruments removed the calcium hydroxide dressing completely, either in the apical or cervical thirds, and no significant differences were observed among the rotary instruments tested (p > 0.05).

Analysis of kinematic, kinetic and electromyographic patterns during root canal preparation with rotary and manual instruments

Objective: This study assessed the muscular activity during root canal preparation through kinematics, kinetics, and electromyography (EMG). Material and Methods: The operators prepared one canal with RaCe rotary instruments and another with Flexofiles. The kinematics of the major joints was reconstructed using an optoelectronic system and electromyographic responses of the flexor carpi radial's, extensor carpi radialis, brachioradialis, biceps brachii, triceps brachii, middle deltoid, and upper trapezius were recorded. The joint torques of the shoulder, elbow and wrist were calculated using inverse dynamics. In the kinematic analysis, angular movements of the wrist and elbow were classified as low risk factors for work-related musculoskeletal disorders. With respect to the shoulder, the classification was medium-risk. Results: There was no significant difference revealed by the kinetic reports. The EMG results showed that for the middle deltoid and upper trapezius the rotary instrumentation elicited higher values. The flexor carpi radialis and extensor carpi radialis, as well as the brachioradialis showed a higher value with the manual method. Conclusion: The muscular recruitment for accomplishment of articular movements for root canal preparation with either the rotary or manual techniques is distinct. Nevertheless, the rotary instrument presented less difficulty in the generation of the joint torque in each articulation, thus, presenting a greater uniformity of joint torques.

Effect of Nitrogen Ion Implantation on the Flexibility of Rotary Nickel-Titanium Instruments

Introduction: The aim of this study was to assess the effect of nitrogen ion implantation on the flexibility of rotary nickel-titanium (NiTi) instruments as measured by the load required to bend implanted and nonimplanted instruments at a 30 degrees angle. Methods: Thirty K3 files, size #40, 0.02 taper and 25-mm length, were allocated into 2 groups as follows: group A, 15 files exposed to nitrogen ion implantation at a dose of 2.5 x 10(17) ions/cm(2), voltage 200 KeV, current density 1 mu A/cm(2), temperature 130 degrees C, and vacuum conditions of 10 x 10(-6) mm Hg for 6 hours; and group B, 15 nonimplanted files. One extra file was used for process control. All instruments were subjected to bend testing on a modified troptometer, with measurement of the load required for flexure to an angle of 30 degrees. The Mann-Whitney U test was used for statistical analysis. Findings with P <.05 were considered significant. Results: The mean load required to bend instruments at a 30 degrees angle was 376.26 g for implanted instruments and 383.78 g for nonimplanted instruments. The difference was not statistically significant. Conclusions: Our findings show that nitrogen ion implantation has no appreciable effect on the flexibility of NiTi instruments. (J Endod 2012;38:673-675)

Portable light transmission measuring system for preserved corneas

Abstract Background The authors have developed a small portable device for the objective measurement of the transparency of corneas stored in preservative medium, for use by eye banks in evaluation prior to transplantation. Methods The optical system consists of a white light, lenses, and pinholes that collimate the white light beams and illuminate the cornea in its preservative medium, and an optical filter (400–700 nm) that selects the range of the wavelength of interest. A sensor detects the light that passes through the cornea, and the average corneal transparency is displayed. In order to obtain only the tissue transparency, an electronic circuit was built to detect a baseline input of the preservative medium prior to the measurement of corneal transparency. The operation of the system involves three steps: adjusting the "0 %" transmittance of the instrument, determining the "100 %" transmittance of the system, and finally measuring the transparency of the preserved cornea inside the storage medium. Results Fifty selected corneas were evaluated. Each cornea was submitted to three evaluation methods: subjective classification of transparency through a slit lamp, quantification of the transmittance of light using a corneal spectrophotometer previously developed, and measurement of transparency with the portable device. Conclusion By comparing the three methods and using the expertise of eye bank trained personnel, a table for quantifying corneal transparency with the new device has been developed. The correlation factor between the corneal spectrophotometer and the new device is 0,99813, leading to a system that is able to standardize transparency measurements of preserved corneas, which is currently done subjectively.

Microbial load in instruments used in surgeries classified as clean

Introduction / objectives The number of orthopedic surgery, especially surgery of total hip and knee, have been more frequent due to technological advances. This study aims to determine the microbial load in the instruments used in clean surgeries, quantifying and identifying the genus and species of microbial growth.Methods Orthopedic surgical instruments were immersed, after use, in sterile water, sonicated in ultrasonic washer and consecutively shaken. Then, the lavage was filtered through a 0.45micron membrane, the result was incubated in aerobic medium, anaerobic medium and medium for fungi and yeasts. Results In clean surgeries, results showed that 47% of used instruments had microbiological growth in the range of 1 to 100 CFU/instrument. The most prevalent organism was Staphylococcus coagulase negative (28%), followed by Bacillus subtilis (11%).This study refuted the hypothesis that clean surgeries happen in micro-organismsfree surgery field. Conclusion The microbiological findings reinforce the importance of antibiotic prophylaxis, practice already well established for this category of surgical procedure.

Prospect on intergalactic magnetic field measurements with gamma-ray instruments

Observing high-energy gamma-rays from Active Galactic Nuclei (AGN) offers a unique potential to probe extremely tiny values of the intergalactic magnetic field (IGMF), a long standing question of astrophysics, astropa rticle physics and cosmology. Very high energy (VHE) photons from blazars propagating along the line of sight interact with the extragalactic background light (EBL) and produce e + e − pairs. Through inverse-Compton interaction, mainly on the cosmic microwave background (CMB), these pairs generate secondary GeV-TeV compo- nents accompanying the primary VHE signal. Such secondary components would be detected in the gamma-ray range as delayed “pair echos” for very weak IGMF ( B< 10 − 16 G ), while they should result in a spatially extended ga mma-ray emission around the source for higher IGMF values ( B> 10 − 16 G ). Coordinated observations with space (i.e. Fermi) and ground- based gamma-ray instruments, such as the pre sent Cherenkov experiments H.E.S.S., MAGIC and VERITAS, the future Cherenkov Telescope Array (CTA) Observatory, and the wide-field detectors such as HAWC and LHAASO, should allow to analyze and finally detect such echos, extended emission or pair halos, and to further characterize the IGMF.