Methods of Analysis for Peritubular Capillaritis and Glomerulitis in Acute Renal Rejection: Capillaritis in Management of Routine Diagnosis

Glomerulitis and peritubular capillaritis have been recognized as important lesions in acute renal rejection (AR). We studied glomerulitis and peritubular capillaritis in AR by 2 methods and investigated associations with C4d, type/grade of AR, and allograft survival time. Glomerulitis was measured according to Banff scores (glomerulitis by Banff Method [gBM]) and by counting the number of intraglomerular inflammatory cells (glomerulitis by Quantitative Method [gQM]). Capillaritis was classified by the Banff scoring system (peritubular capillaritis by Banff Method [ptcBM]) and by counting the number of cells in peritubular capillaries in 10 high-power fields (hpf; peritubular capillaritis by Quantitative Method [ptcQM]). These quantitative analyses were performed in an attempt to improve our understanding of the role played by glomerulitis and capillaritis in AR. The g0 + g1 group (gBM) associated with negative C4d (P = .02). In peritubular capillaritis, a larger number of cells per 10 hpf in peritubular capillaries (ptcQM) were observed in positive C4d cases (P = .03). The group g2 + g3 (gBM) correlated with graft loss (P = .01). Peritubular capillaritis was not significantly related to graft survival time. Our study showed that the Banff scoring system is the best method to study glomerulitis and observed that the evaluation of capillaritis in routine biopsies is difficult and additional studies are required for a better understanding of its meaning in AR biopsy specimens of renal allografts.

Informatics competencies in nursing management

This study aimed to identify in scientific literature the informatics competencies required from the nurses to make decision in management process. Through a scoping review, literature databases were searched to find articles published in Portuguese, English, or Spanish, until July 2013. 188 articles were found, and seven were included in this study, published between 1994 and 2011. The studies were written in English (5; 71%), in USA (5; 71%), using experience reports or literature review designs (5; 71%). The informatics competences were categorized according the Technology Informatics Guiding Education Reform (TIGER). The findings highlight gaps in informatics competence to make decisions in the management process--essentially in information management competence.

Relationships between company size, types of production system and supply chain management: evidence from electro-electronics sector in Brazil

Purpose – The purpose of this paper is to investigate how company size and the type of production system affect the adoption of supply chain management (SCM) practices in companies in the electro‐electronics sector in Brazil. Design/methodology/approach – An e‐mail survey of 107 companies associated with the Brazilian Electrical and Electronics Industry Association (ABINEE) was conducted. Statistical techniques were employed to verify the adoption of SCM practices according to the size of the company and its production system. Findings – The major results indicate that the larger the size of the company, the higher the level of adoption of SCM practices, and that the choice of SCM practices depends upon the type of production system implemented. Practical implications – The implications of this study are useful to top management leaders of small and medium‐sized enterprises since the findings enable them to identify the most common practices adopted by either large‐, medium‐ or small‐sized companies in order to benchmark the level of adoption of SCM practices. Production managers can also benefit from this study by identifying the SCM practices that may support certain production systems.

Genetic associations between stayability and reproductive and growth traits in Canchim beef cattle

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Autopsy: quality assurance in the ICU

Objective: To examine the correlation between the clinical diagnosis and autopsy findings in adult patients who died in an intensive care unit (ICU). To determine the rate of agreement of the basic and terminal causes of death and the types of errors in order to improve quality control of future care,Design, Retrospective study.Setting: Adult ICU in a university hospital.Patients: 30 adult patients who died in the ICU. with the exclusion of medicolegal cases.Methods and main results: Anatomo-clinical meetings were held to analyze the pre- and postmortem correlations in 30 consecutive autopsies at the ICU of the University Hospital, School of Medicine of Botucatu/ UNESP, from January 1994 to January 1997. The rate of correct clinical diagnoses of the basic cause was 66.7 %; in 23.3 % of cases, if the correct diagnosis was made, management would have been different, as would have been the evolution of the patient's course (Class I error): in 10 % of the cases the error would not have led to a change in management (Class II error). The rate of correct clinical diagnoses of terminal cause was 80 %.Conclusions: the rate of recognition of the basic cause was 66.7 %, which is consistent with the literature, but the Class I error rate was higher than that reported in the literature.

Management of Orbital Reconstruction

One of the concerns after a major trauma to the orbit is to be rebuilt. This can be achieved with care in management of orbital reconstruction, techniques, types of materials, and osseointegrated implants; it allows satisfactory aesthetic recuperation and well-being, whereas psychological therapy allows for patients' re-insertion in social and family environment to make them feel happier and safer.

Production of Nile tilapia Oreochromis niloticus and freshwater prawn Macrobrachium rosenbergii stocked at different densities in polyculture systems in Brazil

The effect of stocking prawns Macrobrachium rosenbergii at increasing densities in ponds with Nile tilapia Oreochromis niloticus reared at low density was evaluated. Twelve 0.01-ha earthen ponds were stocked with 1 tilapia/m2 and 0, 2, 4, or 6 post-larvae prawn/m2. Three replicates were randomly assigned to each prawn density. Postlarval prawns were stocked a week prior to tilapia juveniles and both were harvested 175 d after the beginning of the experiment. Tilapia final average weight, survival, production, and food conversion rates did not differ significantly among treatments (P > 0.05); the averages were 531 g. 67%, 3,673 kg/ha, and 1.91, respectively. Prawn survival rates did not differ for the three stocking densities (mean 90%). However, final weight and production were significantly different (P < 0.05) as follows: 34.0, 23.0, and 14.7 g and 639, 909, and 818 kg/ha, respectively for 2, 4, and 6 prawns/m2 densities. Stocking densities up to 6 prawn/m2 did not affect tilapia production and required neither additional feeding nor significant changes in management. The polyculture system allowed an increase in total production with the same amount of supplied feed, thus improving the system sustainability.

Effect of 6-months of physical exercise on the nitrate/nitrite levels in hypertensive postmenopausal women

Background: Evidences have showed that the incidence of arterial hypertension is greater in postmenopausal women as compared to premenopausal. Physical inactivity has been implicated as a major contributor to weight gain and abdominal obesity in postmenopausal women and the incidence of cardiovascular disease increases dramatically after menopause. Additionally, more women than men die each year of coronary heart disease and are twice as likely as men to die within the first year after a heart attack. A healthy lifestyle has been strongly associated with the regular physical activity and evidences have shown that physically active subjects have more longevity with reduction of morbidity and mortality. Nitric oxide (NO) produced by endothelial cells has been implicated in this beneficial effect with improvement of vascular relaxing and reduction in blood pressure in both laboratory animals and human. Although the effect of exercise training in the human cardiovascular system has been largely studied, the majority of these studies were predominantly conducted in men or young volunteers. Therefore, the aim of this work was to investigate the effects of 6 months of dynamic exercise training (ET) on blood pressure and plasma nitrate/nitrite concentration (NOx-) in hypertensive postmenopausal women. Methods: Eleven volunteers were submitted to the ET consisting in 3 days a week, each session of 60 minutes during 6 months at moderate intensity (50% of heart rate reserve). Anthropometric parameters, blood pressure, NOx- concentration were measured at initial time and after ET. Results: A significant reduction in both systolic and diastolic blood pressure values was seen after ET which was accompanied by markedly increase of NOx- levels (basal: 10 ± 0.9; ET: 16 ± 2 μM). Total cholesterol was significantly reduced (basal: 220 ± 38 and ET: 178 ± 22 mg/dl), whereas triglycerides levels were not modified after ET (basal: 141 ± 89 and ET: 147 ± 8 mg/dl). Conclusion: Our study shows that changing in lifestyle promotes reducftion of arterial pressure which was accompanied by increase in nitrite/nitrate concentration. Therefore, 6-months of exercise training are an important approach in management arterial hypertension and play a protective effect in postmenopausal women. © 2009 Zaros et al; licensee BioMed Central Ltd.

Integration in new product development: Case study in a large Brazilian high-technology company

Proficiency in management activities undertaken in product development processes is regarded as a key competitive advantage for companies, particularly for high-tech industrial firms, which benefit from the important competitiveness factor of launching products with a differentiated technological content. This paper's objective was to identify, through case study, practices for integration between the roles of R & D with others involved in product development in a large Brazilian company of industrial automation. The results suggest some management practices to improve the integration in new products development, such as the use of employees from marketing with knowledge and experience previously gained from R & D activities and uses the heavyweight product manager to solve synchronization problems between product and technology development. © Universidad Alberto Hurtado, Facultad de Economía y Negocios.

Ensino de gestão da capacidade e da empresa com o apoio do jogo Mercado Virtual no curso de Mestrado Integrado em Engenharia Industrial e Gestão da UMINHO/Azurém e no Programa de Pós-Graduação em Engenharia de Produção da FEB/Bauru/UNESP

O jogo de empresas Mercado Virtual foi desenvolvido para mediar o processo ensino-aprendizagem na área de tomada decisão e gestão de empresas e tem um banco de dados que armazena as decisões dos alunos. Os dados nele armazenados foram analisados em relação ao balanceamento de capacidade, objetivo de lucro e uso de recursos financeiros da empresa e foram encontradas incoerências entre os conteúdos pertinentes ao modelo e as decisões dos alunos. Elas foram classificadas como lacunas de aprendizado. Com o objetivo de analisar se as mesmas se repetem entre alunos do Programa de Mestrado Engenharia de Produção da UNESP de Bauru e Mestrado Integrado em Engenharia Industrial e Gestão da Uminho de Guimarães, Portugal, foram realizados dois experimentos, um em cada grupo. Para realizá-los utilizou-se o jogo Mercado Virtual e uma planilha de dimensionamento da empresa nos dois locais. A Sala de Estudos, os indicadores e o questionário de pesquisa da opinião foram utilizados somente em Portugal. Os resultados mostraram que o jogo é capaz de evidenciar as diferenças de domínio de conteúdo nos dois grupos e, também, que estas diferenças estão associadas aos projetos dos cursos. Sendo uma pesquisa exploratória, os experimentos foram realizados considerando-se somente os controles do jogo. Por isso, propõe-se a realização de pesquisas adicionais combinando controle sobre algumas das variáveis relacionadas do uso do jogo e atuação sobre aprendizagem dos alunos na forma de entrevistas e pesquisas não estruturadas. Conforme previsto, a pesquisa mostrou que os jogos podem ser utilizados com objetivos de aprendizagem mais amplos, considerando-se a avaliação indireta e cruzada sobre as decisões tomadas pelos alunos, como é o caso dos indicadores. Outra contribuição importante da pesquisa refere-se ao uso de jogos de empresas sob condições pouco controladas, ou seja, não houve...

Genomic analysis for managing small and endangered populations: a case study in Tyrol Grey cattle

Analysis of genomic data is increasingly becoming part of the livestock industry. Therefore, the routine collection of genomic information would be an invaluable resource for effective management of breeding programs in small, endangered populations. The objective of the paper was to demonstrate how genomic data could be used to analyse (1) linkage disequlibrium (LD), LD decay and the effective population size (NeLD); (2) Inbreeding level and effective population size (NeROH) based on runs of homozygosity (ROH); (3) Prediction of genomic breeding values (GEBV) using small within-breed and genomic information from other breeds. The Tyrol Grey population was used as an example, with the goal to highlight the potential of genomic analyses for small breeds. In addition to our own results we discuss additional use of genomics to assess relatedness, admixture proportions, and inheritance of harmful variants. The example data set consisted of 218 Tyrol Grey bull genotypes, which were all available AI bulls in the population. After standard quality control restrictions 34,581 SNPs remained for the analysis. A separate quality control was applied to determine ROH levels based on Illumina GenCall and Illumina GenTrain scores, resulting into 211 bulls and 33,604 SNPs. LD was computed as the squared correlation coefficient between SNPs within a 10 mega base pair (Mb) region. ROHs were derived based on regions covering at least 4, 8, and 16 Mb, suggesting that animals had common ancestors approximately 12, 6, and 3 generations ago, respectively. The corresponding mean inbreeding coefficients (F ROH) were 4.0% for 4 Mb, 2.9% for 8 Mb and 1.6% for 16 Mb runs. With an average generation interval of 5.66 years, estimated NeROH was 125 (NeROH>16 Mb), 186 (NeROH>8 Mb) and 370 (NeROH>4 Mb) indicating strict avoidance of close inbreeding in the population. The LD was used as an alternative method to infer the population history and the Ne. The results show a continuous decrease in NeLD, to 780, 120, and 80 for 100, 10, and 5 generations ago, respectively. Genomic selection was developed for and is working well in large breeds. The same methodology was applied in Tyrol Grey cattle, using different reference populations. Contrary to the expectations, the accuracy of GEBVs with very small within breed reference populations were very high, between 0.13-0.91 and 0.12-0.63, when estimated breeding values and deregressed breeding values were used as pseudo-phenotypes, respectively. Subsequent analyses confirmed the high accuracies being a consequence of low reliabilities of pseudo-phenotypes in the validation set, thus being heavily influenced by parent averages. Multi-breed and across breed reference sets gave inconsistent and lower accuracies. Genomic information may have a crucial role in management of small breeds, even if its primary usage differs from that of large breeds. It allows to assess relatedness between individuals, trends in inbreeding and to take decisions accordingly. These decisions would be based on the real genome architecture, rather than conventional pedigree information, which can be missing or incomplete. We strongly suggest the routine genotyping of all individuals that belong to a small breed in order to facilitate the effective management of endangered livestock populations.

How to progress from discourse to practice? a new agenda for change in medical schools into the next decade

In the context of medical school instruction, the segmented approach of a focus on specialties and excessive use of technology seem to hamper the development of the professional-patient relationship and an understanding of the ethics of this relationship. The real world presents complexities that require multiple approaches. Engagement in the community where health competence is developed allows extending the usefulness of what is learned. Health services are spaces where the relationship between theory and practice in health care are real and where the social role of the university can be revealed. Yet some competencies are still lacking and may require an explicit agenda to enact. Ten topics are presented for focus here: environmental awareness, involvement of students in medical school, social networks, interprofessional learning, new technologies for the management of care, virtual reality, working with errors, training in management for results, concept of leadership, and internationalization of schools. Potential barriers to this agenda are an underinvestment in ambulatory care infrastructure and community-based health care facilities, as well as in information technology offered at these facilities; an inflexible departmental culture; and an environment centered on a discipline-based medical curriculum.