Validity and reliability of the Portuguese version of the Epilepsy Medication Treatment Complexity Index for Brazil

We evaluated the reliability and validity of a Brazilian-Portuguese version of the Epilepsy Medication Treatment Complexity Index (EMTCI). Interrater reliability was evaluated with the intraclass correlation coefficient (ICC), and validity was evaluated by correlation of mean EMTCI scores with the following variables: number of antiepileptic drugs (AEDs), seizure control, patients` perception of seizure control, and adherence to the therapeutic regimen as measured with the Morisky scale. We studied patients with epilepsy followed in a tertiary university-based hospital outpatient clinic setting, aged 18 years or older, independent in daily living activities, and without cognitive impairment or active psychiatric disease. ICCs ranged from 0.721 to 0.999. Mean EMTCI scores were significantly correlated with the variables assessed. Higher EMTCI scores were associated with an increasing number of AEDs, uncontrolled seizures, patients` perception of lack of seizure control, and poorer adherence to the therapeutic regimen. The results indicate that the Brazilian-Portuguese EMTCI is reliable and valid to be applied clinically in the country. The Brazilian-Portuguese EMTCI version may be a useful tool in developing strategies to minimize treatment complexity, possibly improving seizure control and quality of life in people with epilepsy in our milieu. (C) 2011 Elsevier Inc. All rights reserved.

Performance of body fat and body mass index cutoffs in elevated blood pressure screening among male children and adolescents

For percentage of body fat (%BF), there are no internationally accepted cutoffs. The primary function of body fat cutoffs should be to identify not only excessive body fatness, but also the increased risk of unhealthy outcomes, such as hypertension. The purpose of this study was to analyze the accuracy of different %BF and body mass index (BMI) cutoffs as screening measures for EBP in pediatric populations. It was a cross-sectional study with a sample of 358 male subjects from 8 to 18 years old. BP was measured by the oscilometric method, and body composition was measured by dual-energy X-ray absorptiometry (DXA). The accuracy of three reference tables used for body fat cutoffs was assessed. The three body fat reference tables were highly specific, but insensitive, for elevated BP screening. For elevated BP screening, all body fat cutoffs presented similar sensitivity (range=48.3-53.7%) and specificity (range=79.2-84.1%). The body fat cutoffs performed no better than BMI in screening of children and adolescents at risk of elevated BP (EBP). BMI seems a more attractive tool for this function, as it performed similarly and can be applied in large surveys and with lower costs. Hypertension Research (2011) 34, 963-967; doi:10.1038/hr.2011.61; published online 26 May 2011

Technological advances and mechanistic basis for fungal biopulping

Biopulping fundamentals, technology and mechanisms are reviewed in this article. Mill evaluation of Eucalyptus grandis wood chips biotreated by Ceriporiopsis subvermispora on a 50-tonne pilot-plant demonstrated that equivalent energy savings can be obtained in lab- and mill-scale biopulping. Some drawbacks concerning limited improvements in pulp strength and contamination of the chip pile with opportunist fungi have been observed. The use of pre-cultured wood chips as inoculum seed for the biotreatment process minimized contamination problems related to the use of blended mycelium and corn-steep liquor in the inoculation step. Alkaline wash restored part of the brightness in biopulps and marketable brightness values were obtained by one-stage bleaching with 5% H2O2 when bio-TMP pulps were under evaluation. Considering the current scenario, the understanding of biopulping mechanisms has gained renewed attention because more resistant and competitive fungal species could be selected with basis on a function-directed screening project. A series of studies aimed to elucidate structural changes in lignin during wood biodegradation by C. subvermispora had indicated that lignin depolymerization occurs during initial stages of wood biotreatment. Aromatic hydroxyls did not increase with the split of aryl-ether linkages, suggesting that the ether-cleavage-products remain as quitione-type structures. On the other hand, cellulose is more resistant to the attack by C subvermispora. MnP-initiated lipid peroxidation reactions have been proposed to explain degradation of non-phenolic lignin substructures by C subvermispora, while the lack of cellobiohydrolases and the occurrence of systems able to suppress Fenton`s reaction in the cultures have explained non-efficient cellulose degradation by this biopulping fungus. (C) 2007 Elsevier Inc. All rights reserved.

Impact of Childhood Cancer on Parents` Relationships: An Integrative Review

Purpose: The diagnosis of cancer and the treatment decisions associated with it may cause uncertainty, stress, and anxiety among parents. Emotional tensions can affect parents` relationships during the trajectory of the child`s cancer illness. We conducted an integrative review to examine the evidence related to the effects of childhood cancer on parents` relationships. Methods: An integrative literature search of studies published between 1997 and 2009 was conducted in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychology Information (PsycINFO), PubMed, Scopus, CUIDEN, and Latin American and Caribbean Health Science Literature (LILACS). The key words used were neoplasms, child, marriage, spouses, family relations, and nursing. Articles were reviewed if the (a) topic addressed parents` relationships during childhood cancer; (b) participants were mothers, fathers, or both; (c) design was either qualitative or quantitative; (d) language was English, Portuguese, or Spanish; (e) date of publication was between January 1997 and October 2009; and (f) abstract was available. Results: Fourteen articles met the search criteria and were reviewed using Cooper`s framework for integrative reviews. Four themes emerged: (a) changes in the parents` relationship during the trajectory of the child`s illness; (b) difficulty in communication between couples; (c) gender differences in parental stress and coping; and (d) role changes. Conclusions and Implications: Findings revealed positive and negative changes in parents` relationships, communication, stress, and roles. Nurses need to assess the impact of cancer diagnosis and treatments on parent relationships, offer support and encouragement, and allow expression of feelings. Future research is needed to develop and test interventions that increase parents` potentials and strengthen relationships during the challenging trajectory of their children`s cancer and treatment. Clinical Relevance: The multiple sources of stress and uncertainty associated with a child`s cancer diagnosis and treatment affect parents` relationships. Difficulties in communication appear frequently in parents` relationship. Our findings may guide healthcare professionals in identifying parents at risk for developing conflicts, communication problems, and lack of alignment between parents that could interfere with providing optimal care for their child with cancer. Healthcare professionals may promote dialogue and encourage parents to express their feelings, seek mutual support, and establish a partnership in dealing with the child`s illness.

A Study on Unconditionally Stable FDTD Methods for the Modeling of Metamaterials

We assess the performance of three unconditionally stable finite-difference time-domain (FDTD) methods for the modeling of doubly dispersive metamaterials: 1) locally one-dimensional FDTD; 2) locally one-dimensional FDTD with Strang splitting; and (3) alternating direction implicit FDTD. We use both double-negative media and zero-index media as benchmarks.

Relationship between technological properties and slab surface roughness of siliceous dimension stones

Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)[06/52521-0]

A flexible consensus scheme for multicriteria group decision making under linguistic assessments

The present paper proposes a flexible consensus scheme for group decision making, which allows one to obtain a consistent collective opinion, from information provided by each expert in terms of multigranular fuzzy estimates. It is based on a linguistic hierarchical model with multigranular sets of linguistic terms, and the choice of the most suitable set is a prerogative of each expert. From the human viewpoint, using such model is advantageous, since it permits each expert to utilize linguistic terms that reflect more adequately the level of uncertainty intrinsic to his evaluation. From the operational viewpoint, the advantage of using such model lies in the fact that it allows one to express the linguistic information in a unique domain, without losses of information, during the discussion process. The proposed consensus scheme supposes that the moderator can interfere in the discussion process in different ways. The intervention can be a request to any expert to update his opinion or can be the adjustment of the weight of each expert`s opinion. An optimal adjustment can be achieved through the execution of an optimization procedure that searches for the weights that maximize a corresponding soft consensus index. In order to demonstrate the usefulness of the presented consensus scheme, a technique for multicriteria analysis, based on fuzzy preference relation modeling, is utilized for solving a hypothetical enterprise strategy planning problem, generated with the use of the Balanced Scorecard methodology. (C) 2009 Elsevier Inc. All rights reserved.

A Power-Quality Index to Assess the Impact of Voltage Harmonic Distortions and Unbalance to Three-Phase Induction Motors

This paper discusses the need to simultaneously monitor voltage unbalance and harmonic distortions in addition to root-mean-square voltage values. An alternative way to obtain the parameters related to voltage unbalance at fundamental frequency as well as voltage harmonic distortions is here proposed, which is based on the representation of instantaneous values at the axes and at the instantaneous Euclidean norm. A new power-quality (PQ) index is then proposed to combine the effects of voltage unbalance and harmonic distortions. This new index is easily implemented into existing electronic power meters. This PQ index is determined from the analysis of temperature rise in induction motor windings, which were tested for long periods of time. This paper also shows that these voltage disturbances, which are harmful to the lifetime expectancy of motors, can be measured by alternative ways in relation to conventional methods. Although this paper deals with induction motors only, the results show the relevance for further studies on other pieces of equipment.

Fuzzy risk index for power transformer failures due to external short-circuits

A novel methodology to assess the risk of power transformer failures caused by external faults, such as short-circuit, taking the paper insulation condition into account, is presented. The risk index is obtained by contrasting the insulation paper condition with the probability that the transformer withstands the short-circuit current flowing along the winding during an external fault. In order to assess the risk, this probability and the value of the degree of polymerization of the insulating paper are regarded as inputs of a type-2 fuzzy logic system (T2-FLS), which computes the fuzzy risk level. A Monte Carlo simulation has been used to find the survival function of the currents flowing through the transformer winding during a single-phase or a three-phase short-circuit. The Roy Billinton Test System and a real power system have been used to test the results. (C) 2008 Elsevier B.V. All rights reserved.

Shedding light on technological development in Brazil

We try to shed some light oil the question of wily technology-intensive businesses often fail in less-developed countries and under what circumstances they are likely to be a Success from the perspective of both domestic and export markets. The answers were drawn from a set of empirical evidences from Brazilian firms applying photonics technologies. Sonic of the issues faced by them are related to the question of state versus private initiative, entering traditional versus niche market, and technology transfer versus product development management. In overall, we concluded that weakness of the institutions and inadequacy of social and organizational demography play a key role in explaining to a large extent wily countries differ in technological development and diffusion. In this context, we point out obstacles, which must be removed in order to make public policies and firm`s achievements more efficient. (C) 2008 Elsevier Ltd. All rights reserved.

Technological characterization of phosphate ore types from the Salitre Alkaline Complex, MG - Fosfertil Area

The present study was carried out on six different ore types from the Salitre Alkaline Complex aiming to determine their mineralogical composition and the major features that are relevant in the mineral processing. The P(2)O(5) grades vary from 9 to 25%. The slime content (-0, 020 mm) varies between 20 and 34% (w/w) and carries 17-22% of the P(2)O(5) content. The samples essentially consist of apatite, iron oxi-hydroxides, ilmenite, clay minerals, carbonate, quartz, pyroxene, perovskite, secondary phosphates and other minor accessory minerals. Below 0.21 mm, apatite essentially occurs in free particles showing a clean surface or a weak coating of it-on oxi-hydroxides; the highly covered apatite (not recoverable by flotation) varies from 6 to 9%. In the deslimed fraction (above 0.020 mm) more than 97% of the total phosphor content occurs as apatite; the estimated P 2 0 5 potential recovery in flotation concentration is over 90% (71-76% overall recovery).

PCJ River Basins` Water Availability Caused by Water Diversion Scenarios to Supply Metropolitan Areas of So Paulo

A dynamic systems simulation model of water resources was developed as a tool to help analyze alternatives to water resources management for the Piracicaba, Capivari and Jundiai River Water Basins (RB-PCJ), and used to run six 50-year simulations from 2004 to 2054. The model estimates water supply and demand, as well as contamination load by several consumers. Six runs were performed using a constant mean precipitation value, changing water supply and demand and different volumes diverted from RB-PCJ to RB-Alto Tiet. For the Business as Usual scenario, the Sustainability Index went from 0.44 in 2004 to 0.20 by 2054. The Water Sustainability Index changed from 74% in 2004 to 131% by 2054. The Falkenmark Index changed from 1,403 m(3) person (-aEuro parts per thousand 1) year (-aEuro parts per thousand 1) in 2004 to 734 m(3) person (-aEuro parts per thousand 1) year (-aEuro parts per thousand 1) by 2054. We concluded that sanitation is one of the major problems for the PCJ River Basins.

Water Resources Assessment at Piracicaba, Capivari and Jundiai River Basins: A Dynamic Systems Approach

The Piracicaba, Capivari, and Jundiai River Basins (RB-PCJ) are mainly located in the State of So Paulo, Brazil. Using a dynamics systems simulation model (WRM-PCJ) to assess water resources sustainability, five 50-year simulations were run. WRM-PCJ was developed as a tool to aid decision and policy makers on the RB-PCJ Watershed Committee. The model has 254 variables. The model was calibrated and validated using available information from the 80s. Falkenmark Water Stress Index went from 1,403 m(3) person (-aEuro parts per thousand 1) year (-aEuro parts per thousand 1) in 2004 to 734 m(3) P (-aEuro parts per thousand 1) year (-aEuro parts per thousand 1) in 2054, and Xu Sustainability Index from 0.44 to 0.20. In 2004, the Keller River Basin Development Phase was Conservation, and by 2054 was Augmentation. The three criteria used to evaluate water resources showed that the watershed is at crucial water resources management turning point. The WRM-PCJ performed well, and it proved to be an excellent tool for decision and policy makers at RB-PCJ.

The potential for increasing rubber production by matching tapping intensity to leaf area index

Understanding resource capture can help design appropriate species combinations, planting designs and management. Leaf area index (LAI) and its longevity are the most important factors defining dry matter production and thus growth and productivity. The ecophysiological modifications and yield of rubber (Hevea spp.) in an agroforestry system (AFS) with beans (Phaseolus vulgaris L.) were studied. The experiment was established in Southeast-Brazil, with three rubber cultivars: IAN 3087, RRIM 600 and RRIM 527. The AFS comprised double rows of rubber trees along with beans sown in autumn and winter seasons in 1999. There was about 50% higher rubber yield per tree in the AFS than the rubber monoculture. Trees within the AFS responded to higher solar radiation availability with higher LAI and total foliage area, allowing its greater interception. All three cultivars had higher LAI in the AFS than monoculture, reaching maximum values in the AFS between April and May of 3.17 for RRIM 527; 2.83 for RRIM 600 and 2.28 for IAN 3087. The maximum LAI values for monocrop rubber trees were: 2.65, 2.62 and 1.99, respectively, for each cultivar. Rubber production and LAI were positively correlated in both the AFS and monoculture but leaf fall of rubber trees in the AFS was delayed and total phytomass was larger. It is suggested that trees in the AFS were under exploited and could yield more without compromising their life cycle if the tapping system was intensified. This shows how knowledge of LAI can be used to manage tapping intensity in the field, leading to higher rubber yield.