Variability on red blood cell transfusion practices among Brazilian neonatal intensive care units

BACKGROUND:Guidelines for red blood cell (RBC) transfusions exist; however, transfusion practices vary among centers. This study aimed to analyze transfusion practices and the impact of patients and institutional characteristics on the indications of RBC transfusions in preterm infants.STUDY DESIGN and METHODS:RBC transfusion practices were investigated in a multicenter prospective cohort of preterm infants with a birth weight of less than 1500 g born at eight public university neonatal intensive care units of the Brazilian Network on Neonatal Research. Variables associated with any RBC transfusions were analyzed by logistic regression analysis.RESULTS:Of 952 very-low-birth-weight infants, 532 (55.9%) received at least one RBC transfusion. The percentages of transfused neonates were 48.9, 54.5, 56.0, 61.2, 56.3, 47.8, 75.4, and 44.7%, respectively, for Centers 1 through 8. The number of transfusions during the first 28 days of life was higher in Center 4 and 7 than in other centers. After 28 days, the number of transfusions decreased, except for Center 7. Multivariate logistic regression analysis showed higher likelihood of transfusion in infants with late onset sepsis (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.8-4.4), intraventricular hemorrhage (OR, 9.4; 95% CI, 3.3-26.8), intubation at birth (OR, 1.7; 95% CI, 1.0-2.8), need for umbilical catheter (OR, 2.4; 95% CI, 1.3-4.4), days on mechanical ventilation (OR, 1.1; 95% CI, 1.0-1.2), oxygen therapy (OR, 1.1; 95% CI, 1.0-1.1), parenteral nutrition (OR, 1.1; 95% CI, 1.0-1.1), and birth center (p < 0.001).CONCLUSIONS:The need of RBC transfusions in very-low-birth-weight preterm infants was associated with clinical conditions and birth center. The distribution of the number of transfusions during hospital stay may be used as a measure of neonatal care quality.

Cytogenetic and random amplified polymorphic DNA analysis of Leptodactylus species from rural and urban environments (Anura, Amphibia)

Cytogenetic and random amplified polymorphic DNA analyses carried out in the species Leptodactylus podicipinus, L. ocellatus, L. labyrinthicus, and L. fuscus from rural and urban habitats of the northwest region of São Paulo State, Brazil, showed that the karyotypes (2n = 22), constitutive heterochromatin distribution and nucleolus organizer region (NOR) location did not differ between the populations from the two environments. The in situ hybridization with an rDNA probe confirmed the location of the NORs on chromosome 8 revealing an in tandem duplication of that region in one of the chromosomes of L. fuscus. DAPI showed that part of the C-band-positive heterochromatin is rich in AT, including that in the proximity the NORs in L. podicipinus and L. ocellatus. The molecular analyses showed that the two populations (urban and rural) of L. podicipinus and L. fuscus are similar from a genetic point of view. The urban and rural populations of species L. ocellatus and L. labyrinthicus showed differences in genetic structures, probably due to urbanization which interferes with the dispersion of those frogs. The marked differences observed between the two populations of L. ocellatus can be representing the cryptic condition of the species. Unweighted pair-group method of analysis and genetic distance analysis detected the genetic proximity between L. ocellatus and L. fuscus. The results indicate that there was no reduction in the genetic diversity in the populations from the urban environment; however, the survival of these frogs would not be guaranteed in the case of an increase in human impact especially for populations of L. labyrinthicus and L. ocellatus. ©FUNPEC-RP.

Cone-beam computed tomography analysis of the apical third of curved roots after mechanical preparation with different automated systems

The present study evaluated by cone-beam computed tomography (CBCT) the apical canal transportation and centralizing ability of different automated systems after root canal preparation. The mesiobuccal canals of maxillary first molars (n=10 per group) were prepared with: GI - reciprocating system with K-Flexofile; GII - reciprocating system with NiTiFlex files; GIII - rotary system with K3 instruments; GIV - rotary system with RaCe instruments. CBCT scans were taken before and after biomechanical preparation up to a #40.02 diameter. Canal transportation was determined by measuring the smallest distance between the inner canal walls and the mesial and distal sides of the root. The centralization ability corresponded to the difference between the measurements from transportation evaluation, using the linear voxel to voxel method of analysis. The mean transportation was 0.06 ± 0.14 mm, with a tendency to deviate to the mesial side of the root (n=22), with no statistically significant difference among the groups (p=0.4153). The mean centralization index was 0.15 ± 0.65 also without statistically significant difference among the groups (p=0.0881). It may be concluded that apical canal transportation and centralization ability were not influenced by the type of mechanical movement and instruments used.

Analysis of polymerization time on abrasive wear of dental resins

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Influence of high insertion torque on implant placement - an anisotropic bone stress analysis

The aim of this study was to evaluate the influence of the high values of insertion torques on the stress and strain distribution in cortical and cancellous bones. Based on tomography imaging, a representative mathematical model of a partial maxilla was built using Mimics 11.11 and Solid Works 2010 softwares. Six models were built and each of them received an implant with one of the following insertion torques: 30, 40, 50, 60, 70 or 80 Ncm on the external hexagon. The cortical and cancellous bones were considered anisotropic. The bone/implant interface was considered perfectly bonded. The numerical analysis was carried out using Ansys Workbench 10.0. The convergence of analysis (6%) drove the mesh refinement. Maximum principal stress (σ max) and maximum principal strain (ε max) were obtained for cortical and cancellous bones around to implant. Pearson's correlation test was used to determine the correlation between insertion torque and stress concentration in the periimplant bone tissue, considering the significance level at 5%. The increase in the insertion torque generated an increase in the σ max and ε max values for cortical and cancellous bone. The σmax was smaller for the cancellous bone, with greater stress variation among the insertion torques. The ε max was higher in the cancellous bone in comparison to the cortical bone. According to the methodology used and the limits of this study, it can be concluded that higher insertion torques increased tensile and compressive stress concentrations in the periimplant bone tissue.

The CND-Goiaba 1.0 software for nutritional diagnosis of guava (Psidium guajava L.) 'Paluma', in Brazil

Computer programs enable the transformation of raw data into useful information for decision making in many fields, including agriculture. Various programs have been developed to assist farmers to make better decisions about crop management practices and plant nutrition parameters. This article introduces the CND-Goiaba 1.0 software (C Sharp) and its use as a tool to perform the mathematical calculations involved in determining the compositional nutrient diagnosis (CND) indexes for the guava tree. This program was developed in Brazil, the world's leading producer of red guavas. A database was created based on 205 leaf samples collected in commercial plots (sampling units) of cultivated 'Paluma' guava trees (Psidium guajava L.) with ages between 5 and 20 years, during the 2009-2010 and 2010-2011 growing seasons. The production data were normally distributed according to the Shapiro-Wilk test (W=0.988; p=0.11). The software made it possible to diagnose that 63% of the orchards evaluated needed to improve the nutritional status of their trees. The CND method showed severe nutritional imbalances in Mg and Zn in these orchards. © ISHS.

Evaluation of mature cow weight: Genetic correlations with traits used in selection indices, correlated responses, and genetic trends in Nelore cattle

Genetic correlations of selection indices and the traits considered in these indices with mature weight (MW) of Nelore females and correlated responses were estimated to determine whether current selection practices will result in an undesired correlated response in MW. Genetic trends for weaning and yearling indices and MW were also estimated. Data from 612,244 Nelore animals born between 1984 and 2010, belonging to different beef cattle evaluation programs from Brazil and Paraguay, were used. The following traits were studied: weaning conformation (WC), weaning precocity (WP), weaning muscling (WM), yearling conformation (YC), yearling precocity (YP), yearling muscling (YM), weaning and yearling indices, BW gain from birth to weaning (BWG), postweaning BW gain (PWG), scrotal circumference (SC), and MW. The variance and covariance components were estimated by Bayesian inference in a multitrait analysis, including all traits in the same analysis, using a nonlinear (threshold) animal model for visual scores and a linear animal model for the other traits. The mean direct heritabilities were 0.21 ± 0.007 (WC), 0.22 ± 0.007 (WP), 0.20 ± 0.007 (WM), 0.43 ± 0.005 (YC), 0.40 ± 0.005 (YP), 0.40 ± 0.005 (YM), 0.17 ± 0.003 (BWG), 0.21 ± 0.004 (PWG), 0.32 ± 0.001 (SC), and 0.44 ± 0.018 (MW). The genetic correlations between MW and weaning and yearling indices were positive and of medium magnitude (0.30 ± 0.01 and 0.31 ± 0.01, respectively). The genetic changes in weaning index, yearling index, and MW, expressed as units of genetic SD per year, were 0.26, 0.27, and 0.01, respectively. The genetic trend for MW was nonsignificant, suggesting no negative correlated response. The selection practice based on the use of sires with high final index giving preference for those better ranked for yearling precocity and muscling than for conformation generates only a minimal correlated response in MW. © 2013 American Society of Animal Science. All rights reserved.

The igapó of the Negro River in central Amazonia: Linking late-successional inundation forest with fluvial geomorphology

Despite important progress on Amazonian floodplain research, the flooded forest of the Negro River igapó has been little investigated. In particular, no study has previously focused the linkage between fluvial geomorphology and the floristic variation across the course of the river. In this paper we describe and interpret relations between igapó forest, fluvial geomorphology and the spatial evolution of the igapó forest through the Holocene. Therefore, we investigate the effect of geomorphological units of the floodplain and channel patterns on tree diversity, composition and structural parameters of the late-successional igapó forest. Our results show that sites sharing almost identical flooding regime, exhibit variable tree assemblages, species richness and structural parameters such as basal area, tree density and tree heights, indicating a trend in which the geomorphologic styles seem to partially control the organization of igapó's tree communities. This can be also explained by the high variability of well-developed geomorphologic units in short distances and concentrated in small areas. In this dynamic the inputs from the species pool of tributary rivers play a crucial role, but also the depositional and erosional processes associated with the evolution of the floodplain during the Holocene may control floristic and structural components of the igapó forests. These results suggest that a comprehensive approach integrating floristic and geomorphologic methods is needed to understand the distribution of the complex vegetation patterns in complex floodplains such as the igapó of the Negro River. This combination of approaches may introduce a better comprehension of the temporal and spatial evolutionary analysis and a logic rationale to understand the vegetation distribution and variability in function of major landforms, soil distributions and hydrology. Thus, by integrating the past into macroecological analyses will sharpen our understanding of the underlying forces for contemporary floristic patterns along the inundation forests of the Negro River. © 2013 Elsevier Ltd.

Towards criterion validity in classroom language analysis: methodological constraints of metadiscourse and inter-rater agreement

This paper reports on a process to validate a revised version of a system for coding classroom discourse in foreign language lessons, a context in which the dual role of language (as content and means of communication) and the speakers' specific pedagogical aims lead to a certain degree of ambiguity in language analysis. The language used by teachers and students has been extensively studied, and a framework of concepts concerning classroom discourse well-established. Models for coding classroom language need, however, to be revised when they are applied to specific research contexts. The application and revision of an initial framework can lead to the development of earlier models, and to the re-definition of previously established categories of analysis that have to be validated. The procedures followed to validate a coding system are related here as guidelines for conducting research under similar circumstances. The advantages of using instruments that incorporate two types of data, that is, quantitative measures and qualitative information from raters' metadiscourse, are discussed, and it is suggested that such procedure can contribute to the process of validation itself, towards attaining reliability of research results, as well as indicate some constraints of the adopted research methodology.

Prevalence of health promotion programs in primary health care units in Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Axial loads on implant-supported partial fixed prostheses for external and internal hex connections and machined and plastic copings: strain gauge analysis

The aim of this in vitro study was to use strain gauge (SG) analysis to compare the effects of the implant-abutment joint, the coping, and the location of load on strain distribution in the bone around implants supporting 3-unit fixed partial prostheses. Three external hexagon (EH) implants and 3 internal hexagon (IH) implants were inserted into 2 polyurethane blocks. Microunit abutments were screwed onto their respective implant groups. Machined cobalt-chromium copings and plastic copings were screwed onto the abutments, which received standard wax patterns. The wax patterns were cast in a cobalt-chromium alloy (n = 5): group 1 = EH/machined. group 2 = EH/plastic, group 3 = IH/machined, and group 4 = IH/plastic. Four SGs were bonded onto the surface of the block tangentially to the implants. Each metallic structure was screwed onto the abutments and an axial load of 30 kg was applied at 5 predetermined points. The magnitude of microstrain on each SG was recorded in units of microstrain (mu epsilon). The data were analyzed using 3-factor repeated measures analysis of variance and a Tukey test (alpha = 0.05). The results showed statistically significant differences for the type of implant-abutment joint, loading point, and interaction at the implant-abutment joint/loading point. The IH connection showed higher microstrain values than the EH connection. It was concluded that the type of coping did not interfere in the magnitude of microstrain, but the implant/abutment joint and axial loading location influenced this magnitude.

Human development and data envelopment analysis: a structured literature review

Given the importance the concept of productive efficiency has on analyzing the human development process, which is complex and multidimensional, this study conducts a literature review on the research works that have used the data envelopment analysis (DEA) to measure and analyze the development process. Therefore, we researched the databases of Scopus and Web of Science, and considered the following analysis dimensions: bibliometrics, scope, DEA models and extensions used, interfaces with other techniques, units analyzed and depth of analysis. In addition to a brief summary, the main gaps in each analysis dimension were assessed, which may serve to guide future researches. (C) 2015 Elsevier Ltd. All rights reserved.

A first-derivative spectrophotometric method for the determination of ciprofloxacin hydrochloride in ophthalmic solution

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)