Tecnologias para investigação da DAC: relação entre publicações científicas e utilização clínica

FUNDAMENTO: Apesar de algumas evidências sugerirem associação entre a exposição de uma tecnologia na literatura científica e sua difusão na prática clínica, poucos estudos avaliaram essa associação. OBJETIVO: O objetivo deste estudo é analisar se o padrão de publicação científica sobre duas tecnologias competitivas utilizadas na avaliação da doença arterial coronária (DAC) reflete o que ocorre na prática clínica. MÉTODOS: Avaliou-se o número de artigos científicos publicados anualmente na literatura médica (interesse científico global na tecnologia) sobre duas tecnologias utilizadas na avaliação da doença arterial coronária: tomografia computadorizada por feixe de elétrons e tomografia computadorizada com múltiplos detectores. Foi também analisado o número de países que publicam anualmente artigos científicos sobre essas tecnologias (interesse geográfico na tecnologia). RESULTADOS: A tomografia computadorizada por feixe de elétrons (electron beam computed tomography - EBCT) apresentou ápice de "interesse científico global" em 2001, com 127 artigos publicados. Após esse ápice, o "interesse científico global" diminuiu cerca de 50% em 2008. Em oposição, o "interesse científico global" pela tomografia computadorizada com múltiplos detectores (multidetector computed tomography - MDCT) aumentou progressivamente até 2007, com 454 artigos publicados nesse ano. O "interesse científico geográfico" pela EBCT teve ápice em 2002, com 14 países publicando sobre essa tecnologia. Após esse ápice, "o interesse científico geográfico" declinou em quase 25% até 2008, com 11 países publicando artigos sobre essa tecnologia. Em oposição, o "interesse científico geográfico" pela MDCT aumentou progressivamente até 2008, com 37 países publicando artigos sobre ela. CONCLUSÃO: A literatura científica médica é compatível com a substituição da EBCT pela MDCT na avaliação da DAC.

Cooperation, interaction and learning in local production systems: Evidence in Brazilian firms

In a local production system (LPS), besides external economies, the interaction, cooperation, and learning are indicated by the literature as complementary ways of enhancing the LPS's competitiveness and gains. In Brazil, the greater part of LPSs, mostly composed by small enterprises, displays incipient relationships and low levels of interaction and cooperation among their actors. The size of the participating enterprises itself for specificities that engender organizational constraints, which, in turn, can have a considerable impact on their relationships and learning dynamics. For that reason, it is the purpose of this article to present an analysis of interaction, cooperation, and learning relationships among several types of actors pertaining to an LPS in the farming equipment and machinery sector, bearing in mind the specificities of small enterprises. To this end, the fieldwork carried out in this study aimed at: (i) investigating external and internal knowledge sources conducive to learning and (ii) identifying and analyzing motivating and inhibiting factors related to specificities of small enterprises in order to bring the LPS members closer together and increase their cooperation and interaction. Empirical evidence shows that internal aspects of the enterprises, related to management and infrastructure, can have a strong bearing on their joint actions, interaction and learning processes.

Exergy and thermoeconomic analysis of a turbofan engine during a typical commercial flight

In an energy perspective of cost-reduction and configuration-optimization, it becomes necessary to develop and use advanced tools for the analysis, design and improvement of energy conversion systems. In the aeronautical industry, such trend is fundamental since this industry has evolved to design extremely complex aircrafts, with highly integrated systems, requiring more information in order to evaluate the whole system. The aim of this paper is to present an exergy-based analysis as to evaluate the global performance of a typical turbofan engine and its components. The study presents values for exergy efficiency over the whole flight cycle, critical equipment and flight phases considering exergy destruction and estimating internal and exhaust flow costs. (C) 2009 Elsevier Ltd. All rights reserved.

Investigation of the residence time distribution in a plate heat exchanger with series and parallel arrangements using a non-ideal tracer detection technique

The objective was to study the flow pattern in a plate heat exchanger (PHE) through residence time distribution (RTD) experiments. The tested PHE had flat plates and it was part of a laboratory scale pasteurization unit. Series flow and parallel flow configurations were tested with a variable number of passes and channels per pass. Owing to the small scale of the equipment and the short residence times, it was necessary to take into account the influence of the tracer detection unit on the RID data. Four theoretical RID models were adjusted: combined, series combined, generalized convection and axial dispersion. The combined model provided the best fit and it was useful to quantify the active and dead space volumes of the PHE and their dependence on its configuration. Results suggest that the axial dispersion model would present good results for a larger number of passes because of the turbulence associated with the changes of pass. This type of study can be useful to compare the hydraulic performance of different plates or to provide data for the evaluation of heat-induced changes that occur in the processing of heat-sensitive products. (C) 2011 Elsevier Ltd. All rights reserved.

Production and carbon allocation in a clonal Eucalyptus plantation with water and nutrient manipulations

We examined resource limitations on growth and carbon allocation in a fast-growing, clonal plantation of Eucalyptus grandis x urophylla in Brazil by characterizing responses to annual rainfall, and response to irrigation and fertililization for 2 years. Productivity measures included gross primary production (GPP), total belowground carbon allocation (TBCA), bole growth, and net ecosystem production (NEP). Replicate plots within a single plantation were established at the midpoint of the rotation (end of year 3), with treatments of no additional fertilization or irrigation, heavy fertilization (to remove any nutrient limitation), irrigation (to remove any water limitation), and irrigation plus fertilization. Rainfall was unusually high in the first year (1769mm) of the experiment, and control plots had high rates of GPP (6.64 kg C m(-2) year(-1)), TBCA (2.14 kg C m(-2) year(-1)), and bole growth (1.81 kg C m(-2) year). Irrigation increased each of these rates by 15-17%. The second year of the experiment had average rainfall (1210 mm), and lower rainfall decreased production in control plots by 46% (GPP), 52% (TBCA), and 40% (bole growth). Fertilization treatments had neglible effects. The response to irrigation was much greater in the drier year, with irrigated plots exceeding the production in control plots by 83% (GPP), 239% (TBCA), and 24% (bole growth). Even though the rate of irrigation ensured no water limitation to tree growth, the high rainfall year showed higher production in irrigated plots for both GPP (38% greater than in drier year) and bole growth (23% greater). Varying humidity and supplies of water led to a range in NEP of 0.8-2.7 kg C m(-2) year. This difference between control and irrigated treatments, combined with differences between drier and wetter years, indicated a strong response of these Eucalyptus trees to both water supply and atmospheric humidity during the dry season. The efficiency of converting light energy into fixed carbon ranged from a low of 0.027 mol C to a high of 0.060 mol C per mol of absorbed photosynthetically active radiation (APAR), and the efficiency of bolewood production ranged from 0.78 to 1.98 g wood per MJ of APAR. Irrigation increased the efficiency of wood production per unit of water used from 2.55 kg wood m(-3) in the rainfed plot to 3.51 kg m(-3) in irrigated plots. Detailed information on the response of C budgets to environmental conditions and resource supplies will be necessary for accurate predictions of plantation yields across years and landscapes. (V) 2007 Elsevier B.V. All rights reserved.

The ""single-section"" Golgi method adapted for formalin-fixed human brain and light microscopy

The Golgi method has been used for over a century to describe the general morphology of neurons in the nervous system of different species. The ""single-section"" Golgi method of Gabbott and Somogyi (1984) and the modifications made by Izzo et al. (1987) are able to produce consistent results. Here, we describe procedures to show cortical and subcortical neurons of human brains immersed in formalin for months or even years. The tissue was sliced with a vibratome, post-fixed in a combination of paraformaldehyde and picric acid in phosphate buffer, followed by osmium tetroxide and potassium dicromate, ""sandwiched"" between cover slips, and immersed in silver nitrate. The whole procedure takes between 5 and 11 days to achieve good results. The Golgi method has its characteristic pitfalls but, with this procedure, neurons and glia appear well-impregnated, allowing qualitative and quantitative studies under light microscopy. This contribution adds to the basic techniques for the study of human nervous tissue with the same advantages described for the ""single-section"" Golgi method in other species; it is easy and fast, requires minimal equipment, and provides consistent results. (C) 2010 Elsevier B.V. All rights reserved.

Satisfação no trabalho e rotatividade dos médicos do Programa de Saúde da Família

Um dos problemas mais graves identificados na implantação do Programa de Saúde da Família no Brasil é a rotatividade do médico generalista. Já que o modelo se fundamenta no vínculo entre profissionais da equipe e população, a alta rotatividade dos médicos pode comprometer a efetividade do modelo. Pesquisa realizada no município de São Paulo para verificar a existência de correlação entre satisfação no trabalho dos médicos do programa e a rotatividade desses profissionais confirmou a hipótese da existência de correlação negativa. O prestígio da instituição parceira do município na implantação do programa foi o fator mais importante na determinação da rotatividade dos médicos. Outros fatores de satisfação no trabalho que apresentaram correlação com a rotatividade foram: capacitação, distância das unidades de saúde e disponibilidade de materiais e equipamentos para realização das atividades profissionais.

Improvement of radiology services based on the process management approach

The health sector requires continuous investments to ensure the improvement of products and services from a technological standpoint, the use of new materials, equipment and tools, and the application of process management methods. Methods associated with the process management approach, such as the development of reference models of business processes, can provide significant innovations in the health sector and respond to the current market trend for modern management in this sector (Gunderman et al. (2008) [4]). This article proposes a process model for diagnostic medical X-ray imaging, from which it derives a primary reference model and describes how this information leads to gains in quality and improvements. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

Volumetric reconstruction of the mean flow around circular cylinders fitted with strakes

The volumetric reconstruction technique presented in this paper employs a two-camera stereoscopic particle image velocimetry (SPIV) system in order to reconstruct the mean flow behind a fixed cylinder fitted with helical strakes, which are commonly used to suppress vortex-induced vibrations (VIV). The technique is based on the measurement of velocity fields at equivalent adjacent planes that results in pseudo volumetric fields. The main advantage over proper volumetric techniques is the avoidance of additional equipment and complexity. The averaged velocity fields behind the straked cylinders and the geometrical periodicity of the three-start configuration are used to further simplify the reconstruction process. Two straked cylindrical models with the same pitch (p = 10d) and two different heights (h = 0.1 and 0.2d) are tested. The reconstructed flow shows that the strakes introduce in the wake flow a well-defined wavelength of one-third of the pitch. Measurements of hydrodynamic forces, fluctuating velocity, vortex formation length, and vortex shedding frequency show the interdependence of the wake parameters. The vortex formation length is increased by the strakes, which is an important effect for the suppression of vortex-induced vibrations. The results presented complement previous investigations concerning the effectiveness of strakes as VIV suppressors and provide a basis of comparison to numerical simulations.

Evaluation of Automotive Varnish as a Coating for Density Measurements of Soil Clods

Saran F-310 resin (Dow Chemical Co, Midland, MI) has been widely used to coat soil clods for density and size measurements; however, the manufacturer has recently stopped producing this resin and supplies are difficult to obtain. Hence, we evaluated the feasibility of using Lazzudur 7502 (Sherwin-Williams, Cleveland, OH) automotive varnish to coat soil clods for density measurement. Preliminary evaluations showed that immersion of clods in the varnish did nor affect clod cohesion and that a single immersion in Lazzudur with 30 min of post-immersion drying produced density results nor significantly (P < 0.05) different to those obtained using saran. This technique was tested across seven soils and no significant (P < 0.05) difference was found in the density of the clods measured using the two coating methods. This work suggests that automotive varnish can he used as an alternative to saran resin for clod density measurements.

Prevalence of work-related musculoskeletal disorders in Brazilian hairdressers

Background There are occupational risks inherent to the activities of professional hairdressers, which are not frequently studied, and therefore not considered in the formulation of health policies for this group. Aims To verify the prevalence of work-related musculoskeletal disorders (WRMDs) in hairdressers through symptom reports, to characterize the most frequently affected anatomical parts and to identify and analyse risk factors of WRMDs in hairdressing. Methods A cross-sectional epidemiological study of 220 hairdressers from beauty parlours in Sao Paulo (Brazil) was carried out. Each hairdresser completed a self-administered questionnaire which included information on socio-demographic characteristics, working conditions and health-related musculoskeletal system complaints. Ergonomic analyses were also performed in six parlours. Results The prevalence of WRMDs was 71%. Risk factors were associated with psychosocial factors and factors related to discomfort and work fatigue such as lack of acknowledgement of work and uncomfortable posture at work [odds ratio (OR) = 3.54; 95% confidence interval (CI) 1.51-8.30], not feeling comfortable with body/neck/shoulders while working (OR = 2.78; 95% CI 1.40-5.54) and having > 15 years of professional activity (OR = 3.04; 95% CI 1.17-7.91). Conclusion Occupational risk factors associated with the development of WRMDs in hairdressers are related to biomechanical, organizational and psychosocial work factors. The high prevalence of WRMDs found highlights the importance of disseminating recommendations for prevention of symptoms with regards to the provision of suitable furniture, equipment and work tools, environmental conditions, size of workplace, work organization and psychosocial work factors.

Diagnostic reference levels for the most frequent radiological examinations carried out in Brazil

Objectives. A large-scale survey of doses to patients undergoing the most frequent radiological examinations was carried out in health services in Sao Paulo (347 radiological examinations per 1 000 inhabitants), the most populous Brazilian state. Methods. A postal dosimetric kit with thermoluminescence dosimeters was used to evaluate the entrance surface dose (ESD) to patients. A stratified sampling technique applied to the national health database furnished important data on the distribution of equipment and the annual number of examinations. Chest, head (skull and sinus), and spine (cervical, thoracic, and lumbar) examinations were included in the trial. A total of 83 rooms and 868 patients were included, and 1 415 values of ESD were measured. Results. The data show large coefficients of variation in tube charge, giving rise to large variations in ESD values. Also, a series of high ESD values associated with unnecessary localizing fluoroscopy were detected. Diagnostic reference levels were determined, based on the 75th percentile (third quartile) of the ESD distributions. For adult patients, the diagnostic reference levels achieved are very similar to those obtained in international surveys. However, the situation is different for pediatric patients: the ESD values found in this survey are twice as large as the international recommendations for chest radiographs of children. Conclusions. Despite the reduced number of ESD values and rooms for the pediatric patient group, it is recommended that practices in chest examinations be revised and that specific national reference doses and image quality be established after a broader survey is carried out.