Cost-effectiveness analysis of universal childhood vaccination against varicella in Brazil

This study conducts a cost-effectiveness analysis of a childhood universal varicella vaccination program in Brazil. An age and time-dependent dynamic model was developed to estimate the incidence of varicella for 30 years. Assuming a single-dose schedule; vaccine efficacy of 85% and coverage of 80%, the program could prevent 74,422,058 cases and 2905 deaths. It would cost R$ 3,178,396,110 and save R$ 660,076,410 to the society and R$ 365,602,305 to the healthcare system. The program is cost-effective (R$ 14,749 and R$ 16,582 per life-year saved under the societal and the healthcare system`s perspective, respectively). The program`s cost-effectiveness is highly sensitive to the vaccine price and number of doses. (C) 2008 Elsevier Ltd. All rights reserved.

Decay chain differential equations: Solution through matrix algebra

A matricial method to solve the decay chain differential equations system is presented. The quantity of each nuclide in the chain at a time t may be evaluated by analytical expressions obtained in a simple way using recurrence relations. This method may be applied to problems of radioactive buildup and decay and can be easily implemented computationally. (C) 2009 Elsevier B.V. All rights reserved.

Analysis of Apical Root Transportation Associated with Protaper Universal F3 and F4 Instruments by Using Digital Subtraction Radiography

Introduction: The aim of this study was to assess the occurrence of apical root transportation after the use of Pro Taper Universal rotary files sizes 3 (F3) and 4 (F4). Methods: Instruments were worked to the apex of the original canal, always by the same operator. Digital subtraction radiography images were produced in buccolingual and mesiodistal projections. A total of 25 radiographs were taken from root canals of human maxillary first molars with curvatures varying from 23-31 degrees. Quantitative data were analyzed by intraclass correlation coefficient and Wilcoxon nonparametric test (P = .05). Results: Buccolingual images revealed a significantly higher degree of apical transportation associated with F4 instruments when compared with F3 instruments in relation to the original canal (Wilcoxon test, P = .007). No significant difference was observed in mesiodistal images (P = .492). Conclusions: F3 instruments should be used with care in curved canals, and F4 instruments should be avoided in apical third preparation of curved canals. (J Endod 2010;36:1052-1055)

A critical view on biaxial and short-beam uniaxial flexural strength tests applied to resin composites using Weibull, fractographic and finite element analyses

Objective. To evaluate the biaxial and short-beam uniaxial strength tests applied to resin composites based upon their Weibull parameters, fractographic features and stress distribution. Methods. Disk- (15 mm x 1 mm) and beam-shaped specimens (10 mm x 2 mm x 1 mm) of three commercial composites (Concept/Vigodent, CA; Heliomolar/Ivoclar-Vivadent, HE; Z250/3M ESPE, FZ) were prepared. After 48h dry storage at 37 degrees C, disks and beams were submitted to piston-on-three-balls (BI) and three-point bending (UNI) tests, respectively. Data were analyzed by Weibull statistics. Fractured surfaces were observed under stereomicroscope and scanning electron microscope. Maximum principal stress (sigma(1)) distribution was determined by finite element analysis (FEA). Maximum sigma(1-BI) and sigma(1-UNI) were compared to FZ strengths calculated by applying the average failure loads to the analytical equations (sigma(a-BI) and sigma(a-UNI)). Results. For BI, characteristic strengths were: 169.9a (FZ), 122.4b (CA) and 104.8c (HE), and for UNI were: 160.3a (FZ), 98.2b (CA) and 91.6b (HE). Weibull moduli ( m) were similar within the same test. CA and HE presented statistically higher m for BI. Surface pores ( BI) and edge flaws ( UNI) were the most frequent fracture origins. sigma(1-BI) was 14% lower than sigma(a-BI.) sigma(1-UNI) was 43% higher than sigma(a-UNI). Significance. Compared to the short-beam uniaxial test, the biaxial test detected more differences among composites and displayed less data scattering for two of the tested materials. Also, biaxial strength was closer to the material`s strength estimated by FEA. (C) 2009 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Heat Release, Time Required, and Cleaning Ability of Mtwo R and ProTaper Universal Retreatment Systems in the Removal of Filling Material

Introduction: This ex vivo study evaluated the heat release, time required, and cleaning efficacy of MTwo (VDW, Munich, Germany) and ProTaper Universal Retreatment systems (Dentsply/Maillefer, Ballaigues, Switzerland) and hand instrumentation in the removal of filling material. Methods: Sixty single-rooted human teeth with a single straight canal were obturated with gutta-percha and zinc oxide and eugenol-based cement and randomly allocated to 3 groups (n = 20). After 30-day storage at 37 degrees C and 100% humidity, the root fillings were removed using ProTaper UR, MTwo R, or hand files. Heat release, time required, and cleaning efficacy data were analyzed statistically (analysis of variance and the Tukey test, alpha = 0.05). Results: None of the techniques removed the root fillings completely. Filling material removal with ProTaper UR was faster but caused more heat release. Mtwo R produced less heat release than the other techniques but was the least efficient in removing gutta-percha/sealer. Conclusions: ProTaper UR and MTwo R caused the greatest and lowest temperature increase on root surface, respectively; regardless of the type of instrument, more heat was released in the cervical third. Pro Taper UR needed less time to remove fillings than MTwo R. All techniques left filling debris in the root canals. (I Endod 2010;36:1870-1873)

The universal newborn hearing screening in Brazil: From identification to intervention

Objective: The objective of the study is to investigate the results of the newborn hearing screening program carried out in a Public Hospital in Brazil, in the first 3 years regarding: (1) the prevalence of hearing impairment; (2) the influence of the universal hearing screening program on the age at which the diagnosis of hearing loss is defined; (3) the cost effectiveness of the program; (4) the outcomes, in terms of the age in which the hearing rehabilitation started. Methods: A descriptive study of the first 3 years after starting the universal newborn hearing screening in a Public Hospital of Bauru, Sao Paulo state, Brazil. The screening method consists of a two-stage screening approach with transient otoacoustic emissions (TOAE), conducted by an audiologist. If the outcome in the second-stage screening is REFER, the infant is submitted to diagnostic follow-up testing and intervention at the Audiology and Speech Pathology Clinic at the University of Sao Paulo, campus of Bauru. The evaluation of the costs of the universal newborn hearing screening program per each screened newborn (around 4000/year) was done based on a proposal by the National Center for Hearing Assessment and Management, of the Utah State University, United States of America. Results: 11,466 newborns were submitted to hearing screening, corresponding to 90.52% of the living newborns. The prevalence of sensorineural hearing loss was 0.96:1000. Of the 11 children with sensorineural hearing loss, eight children received hearing aids and five started the therapeutic process before the age of 1. Currently, four children between the ages of 11 months and 2 years old were submitted to cochlear implant surgery. The cost of hearing screening was US$7.00 and the annual cost of the universal newborn hearing screening program was US$26,940.47. Conclusion: The hospital-based universal newborn hearing screening carried out through the Brazilian National Health System is viable, with promising results. However, in a country such as Brazil, which presents large socio-economic differences, the same type of analyses should be performed in several regions, so as to take into account specific aspects, to implement the newborn hearing screening along with the Public System. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

INDEFINITE QUASILINEAR ELLIPTIC EQUATIONS IN EXTERIOR DOMAINS WITH EXPONENTIAL CRITICAL GROWTH

This paper is concerned with the existence of solutions for the quasilinear problem {-div(vertical bar del u vertical bar(N-2) del u) + vertical bar u vertical bar(N-2) u = a(x)g(u) in Omega u = 0 on partial derivative Omega, where Omega subset of R(N) (N >= 2) is an exterior domain; that is, Omega = R(N)\omega, where omega subset of R(N) is a bounded domain, the nonlinearity g(u) has an exponential critical growth at infinity and a(x) is a continuous function and changes sign in Omega. A variational method is applied to establish the existence of a nontrivial solution for the above problem.

MULTIPLICITY OF POSITIVE SOLUTIONS FOR A CLASS OF NONLINEAR SCHRODINGER EQUATIONS

This paper proves the multiplicity of positive solutions for the following class of quasilinear problems: {-epsilon(p)Delta(p)u+(lambda A(x) + 1)vertical bar u vertical bar(p-2)u = f(u), R(N) u(x)>0 in R(N), where Delta(p) is the p-Laplacian operator, N > p >= 2, lambda and epsilon are positive parameters, A is a nonnegative continuous function and f is a continuous function with subcritical growth. Here, we use variational methods to get multiplicity of positive solutions involving the Lusternick-Schnirelman category of intA(-1)(0) for all sufficiently large lambda and small epsilon.

Soliton solutions for quasilinear Schrodinger equations with critical growth

In this paper we establish the existence of standing wave solutions for quasilinear Schrodinger equations involving critical growth. By using a change of variables, the quasilinear equations are reduced to semilinear one. whose associated functionals are well defined in the usual Sobolev space and satisfy the geometric conditions of the mountain pass theorem. Using this fact, we obtain a Cerami sequence converging weakly to a solution v. In the proof that v is nontrivial, the main tool is the concentration-compactness principle due to P.L. Lions together with some classical arguments used by H. Brezis and L. Nirenberg (1983) in [9]. (C) 2009 Elsevier Inc. All rights reserved.

SINGULARITY THEORY AND FORCED SYMMETRY BREAKING IN EQUATIONS

A theory of bifurcation equivalence for forced symmetry breaking bifurcation problems is developed. We classify (O(2), 1) problems of corank 2 of low codimension and discuss examples of bifurcation problems leading to such symmetry breaking.

DAMPED WAVE EQUATIONS WITH FAST GROWING DISSIPATIVE NONLINEARITIES

Let a > 0, Omega subset of R(N) be a bounded smooth domain and - A denotes the Laplace operator with Dirichlet boundary condition in L(2)(Omega). We study the damped wave problem {u(tt) + au(t) + Au - f(u), t > 0, u(0) = u(0) is an element of H(0)(1)(Omega), u(t)(0) = v(0) is an element of L(2)(Omega), where f : R -> R is a continuously differentiable function satisfying the growth condition vertical bar f(s) - f (t)vertical bar <= C vertical bar s - t vertical bar(1 + vertical bar s vertical bar(rho-1) + vertical bar t vertical bar(rho-1)), 1 < rho < (N - 2)/(N + 2), (N >= 3), and the dissipativeness condition limsup(vertical bar s vertical bar ->infinity) s/f(s) < lambda(1) with lambda(1) being the first eigenvalue of A. We construct the global weak solutions of this problem as the limits as eta -> 0(+) of the solutions of wave equations involving the strong damping term 2 eta A(1/2)u with eta > 0. We define a subclass LS subset of C ([0, infinity), L(2)(Omega) x H(-1)(Omega)) boolean AND L(infinity)([0, infinity), H(0)(1)(Omega) x L(2)(Omega)) of the `limit` solutions such that through each initial condition from H(0)(1)(Omega) x L(2)(Omega) passes at least one solution of the class LS. We show that the class LS has bounded dissipativeness property in H(0)(1)(Omega) x L(2)(Omega) and we construct a closed bounded invariant subset A of H(0)(1)(Omega) x L(2)(Omega), which is weakly compact in H(0)(1)(Omega) x L(2)(Omega) and compact in H({I})(s)(Omega) x H(s-1)(Omega), s is an element of [0, 1). Furthermore A attracts bounded subsets of H(0)(1)(Omega) x L(2)(Omega) in H({I})(s)(Omega) x H(s-1)(Omega), for each s is an element of [0, 1). For N = 3, 4, 5 we also prove a local uniqueness result for the case of smooth initial data.

Averaging for retarded functional differential equations

We consider retarded functional differential equations in the setting of Kurzweil-Henstock integrable functions and we state an averaging result for these equations. Our result generalizes previous ones. (C) 2011 Elsevier Inc. All rights reserved.

Permanence of stability for a class of system of differential equations with two delays

The paper studies a class of a system of linear retarded differential difference equations with several parameters. It presents some sufficient conditions under which no stability changes for an equilibrium point occurs. Application of these results is given. (c) 2007 Elsevier Ltd. All rights reserved.

UNIVERSAL COVERING OF DRIFTLESS CONTROL SYSTEMS

Let M be a finite-dimensional manifold and Sigma be a driftless control system on M of full rank. We prove that for a given initial state x epsilon M, the covering space Gamma(Sigma, x) for a monotonic homotopy of trajectories of Sigma which is recently constructed in [1] coincides with the simply connected universal covering manifold of M and that the terminal projection epsilon(x) : Gamma(Sigma, x) -> M given by epsilon(x) ([alpha]) = alpha(1) is a covering mapping.

Global solutions for impulsive abstract partial differential equations

In this paper, we study the existence of global solutions for a class of impulsive abstract functional differential equation. An application involving a parabolic system With impulses is considered. (c) 2008 Elsevier Ltd. All rights reserved.