Perinatal factors associated with early deaths of preterm infants born in Brazilian Network on Neonatal Research centers

Objective: To evaluate perinatal factors associated with early neonatal death in preterm infants with birth weights (BW) of 400-1,500 g.Methods: A multicenter prospective cohort study of all infants with BW of 400-1,500 g and 23-33 weeks of gestational age (GA), without malformations, who were born alive at eight public university tertiary hospitals in Brazil between June of 2004 and May of 2005. Infants who died within their first 6 days of life were compared with those who did not regarding maternal and neonatal characteristics and morbidity during the first 72 hours of life. Variables associated with the early deaths were identified by stepwise logistic regression.Results: A total of 579 live births met the inclusion criteria. Early deaths occurred in 92 (16%) cases, varying between centers from 5 to 31%, and these differences persisted after controlling for newborn illness severity and mortality risk score (SNAPPE-II). According to the multivariate analysis, the following factors were associated with early intrahospital neonatal deaths: gestational age of 23-27 weeks (odds ratio - OR = 5.0; 95%CI 2.7-9.4), absence of maternal hypertension (OR = 1.9; 95%CI 1.0-3.7), 5th minute Apgar 0-6 (OR = 2.8; 95%CI 1.4-5.4), presence of respiratory distress syndrome (OR = 3.1; 95%CI 1.4-6.6), and network center of birth.Conclusion: Important perinatal factors that are associated with early neonatal deaths in very low birth weight preterm infants can be modified by interventions such as improving fetal vitality at birth and reducing the incidence and severity of respiratory distress syndrome. The heterogeneity of early neonatal rates across the different centers studied indicates that best clinical practices should be identified and disseminated throughout the country.

Cluster analysis and artificial neural network on the superovulatory response prediction in mice

Complex biological systems require sophisticated approach for analysis, once there are variables with distinct measure levels to be analyzed at the same time in them. The mouse assisted reproduction, e.g. superovulation and viable embryos production, demand a multidisciplinary control of the environment, endocrinologic and physiologic status of the animals, of the stressing factors and the conditions which are favorable to their copulation and subsequently oocyte fertilization. In the past, analyses with a simplified approach of these variables were not well succeeded to predict the situations that viable embryos were obtained in mice. Thereby, we suggest a more complex approach with association of the Cluster Analysis and the Artificial Neural Network to predict embryo production in superovulated mice. A robust prediction could avoid the useless death of animals and would allow an ethic management of them in experiments requiring mouse embryo.

Design of a reconfigurable pseudorandom number generator for use in intelligent systems

This paper deals with the design of a network-on-chip reconfigurable pseudorandom number generation unit that can map and execute meta-heuristic algorithms in hardware. The unit can be configured to implement one of the following five linear generator algorithms: a multiplicative congruential, a mixed congruential, a standard multiple recursive, a mixed multiple recursive, and a multiply-with-carry. The generation unit can be used both as a pseudorandom and a message passing-based server, which is able to produce pseudorandom numbers on demand, sending them to the network-on-chip blocks that originate the service request. The generator architecture has been mapped to a field programmable gate array, and showed that millions of numbers in 32-, 64-, 96-, or 128-bit formats can be produced in tens of milliseconds. (C) 2011 Elsevier B.V. All rights reserved.

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.

Influence of the tool edge geometry on specific cutting energy at high-speed cutting

This paper presents specific cutting energy measurements as a function of the cutting speed and tool cutting edge geometry. The experimental work was carried out on a vertical CNC machining center with 7,500 rpm spindle rotation and 7.5 kW power. Hardened steels ASTM H13 (50 HRC) were machined at conventional cutting speed and high-speed cutting (HSC). TiN coated carbides with seven different geometries of chip breaker were applied on dry tests. A special milling tool holder with only one cutting edge was developed and the machining forces needed to calculate the specific cutting energy were recorded using a piezoelectric 4-component dynamometer. Workpiece roughness and chip formation process were also evaluated. The results showed that the specific cutting energy decreased 15.5% when cutting speed was increased up to 700%. An increase of 1 °in tool chip breaker chamfer angle lead to a reduction in the specific cutting energy about 13.7% and 28.6% when machining at HSC and conventional cutting speed respectively. Furthermore the workpiece roughness values evaluated in all test conditions were very low, closer to those of typical grinding operations (∼0.20 μm). Probable adiabatic shear occurred on chip segmentation at HSC Copyright © 2007 by ABCM.

Red Blood Cell Transfusions are Independently Associated with Intra-Hospital Mortality in Very Low Birth Weight Preterm Infants

Objective To test the hypothesis that red blood cell (RBC) transfusions in preterm infants are associated with increased intra-hospital mortality.Study design Variables associated with death were studied with Cox regression analysis in a prospective cohort of preterm infants with birth weight <1500 g in the Brazilian Network on Neonatal Research. Intra-hospital death and death after 28 days of life were analyzed as dependent variables. Independent variables were infant demographic and clinical characteristics and RBC transfusions.Results of 1077 infants, 574 (53.3%) received at least one RBC transfusion during the hospital stay. The mean number of transfusions per infant was 3.3 +/- 3.4, with 2.1 +/- 2.1 in the first 28 days of life. Intra-hospital death occurred in 299 neonates (27.8%), and 60 infants (5.6%) died after 28 days of life. After adjusting for confounders, the relative risk of death during hospital stay was 1.49 in infants who received at least one RBC transfusion in the first 28 days of life, compared with infants who did not receive a transfusion. The risk of death after 28 days of life was 1.89 times higher in infants who received more than two RBC transfusions during their hospital stay, compared with infants who received one or two transfusions.Conclusion Transfusion was associated with increased death, and transfusion guidelines should consider risks and benefits of transfusion. (J Pediatr 2011; 159: 371-6).

In situ evaluation of anticancer drug methotrexate-DNA interaction using a DNA-electrochemical biosensor and AFM characterization

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Photosensitivity in antimony based glasses

New glass forming systems based on Sb2O3-SbPO4 has been explored. These glasses present higher thermal stability against devitrification and higher refractive index than chalcogenide glasses. Under irradiation, using Ar-laser 350nm wavelength and 50 mW power density, change on the coloration is observed. Structural and electronic modifications around Sb cations induced by such treatment have been characterized by XANES measurements at the L-Sb edges. on the one hand, XANES spectra, at the LJ edge, show a decrease of the coordination number for Sb atoms induced by exposure to light indicating a breaking of Sb-O bonds in the glassy network. on the other hand, XANES spectra, at the Lt edge, suggest a change in the oxidation state of Sb atoms. These modifications associated to the photodarkening of the glass is reversible either after a couple of days or after heating the glass at the glass transition temperature, T-g.

Sepsis and Neutropenia in Very Low Birth Weight Infants Delivered of Mothers with Preeclampsia

Objective To study the association between maternal preeclampsia and neonatal sepsis in very low birth weight newborns.Study design We studied all infants with birth weights between 500 g and 1500 g who were admitted to 6 neonatal intensive care units of the Brazilian Network on Neonatal Research for 2 years. Exclusion criteria were major malformations, death in the delivery room, and maternal chronic hypertension. Absolute neutrophil count was performed in the first 72 hours of life.Results A total of 911 very low birth weight infants (preeclampsia, 308; non-preeclampsia, 603) were included. The preeclampsia group had significantly higher gestational age, more cesarean deliveries, antenatal steroid, central catheters, total parenteral nutrition, and neutropenia, and less rupture of membranes >18 hours and mechanical ventilation. Both groups had similar incidences of early sepsis (4.6% and 4.2% in preeclampsia and non-preeclampsia groups, respectively) and late sepsis (24% and 22.1% in preeclampsia and non-preeclampsia groups, respectively). Vaginal delivery and neutropenia were associated with multiple logistic regressions with early sepsis, and mechanical ventilation, central catheter, and total parenteral nutrition were associated with late sepsis. Death was associated with neutropenia in very preterm infants.Conclusions Preeclampsia did not increase neonatal sepsis in very low birth weight infants, and death was associated with neutropenia in very preterm infants. (J Pediatr 2010; 157: 434-8).

A petri net based timing model for hardware/software co-design of digital systems

We have recently proposed an extension to Petri nets in order to be able to directly deal with all aspects of embedded digital systems. This extension is meant to be used as an internal model of our co-design environment. After analyzing relevant related work, and presenting a short introduction to our extension as a background material, we describe the details of the timing model we use in our approach, which is mainly based in Merlin's time model. We conclude the paper by discussing an example of its usage. © 2004 IEEE.

Paleocanais no megaleque do rio Taquari: mapeamento e signifcado geomorfológico

This paper presents the results of the frst systematic mapping of the paleochannel network on the Taquari megafan (Pantanal, Brazil). We used remote sensing data collected by the ASTER sensor, which captures images with 15 m square pixels. A total of 34 scenes, acquired from 2001-2006, were used in the analysis. These data were processed using a decorrelation stretch technique in order to obtain a better visual identifcation of the paleochannels. The mapping procedure began with the overlay of a 1:50.000 IBGE articulation, in order to systematize the extraction of features and to reduce the subjectivity inherent to visual analysis methods. We mapped a total of 33,205 km of paleochannels. The density of these features is related to the relative ages of distinct geomorphological compartments, known as depositional lobes. The mapped features preserve avulsion events that occurred on the megafan. The results suggest that low-magnitude avulsions occur more frequently than larger events.

Fluoride concentration in public water supply: 72 months of analysis

Known as one of the ten most important advances on Public Health in the 20th century, fluoridation of public water supply is a measure of wide population coverage, which is effective on caries control. The city of Araçatuba, in the Northwest region of the São Paulo state, Brazil, started public water supply fluoridation in 1972 and, based on the average annual highest temperature, has kept the fluoride concentration between 0.6 to 0.8 mgF/L. The purpose of this study was to analyze monthly the fluoride concentration in public water supply in the city of Araçatuba during 72 months. Water samples were collected monthly on weekdays, directly from the water distribution network, on pre-established locations and analyzed in duplicate between November 2004 and October 2010 at the Research Laboratory of the Nucleus for Public Health (NEPESCO) of the Public Health Graduate Program from Araçatuba Dental School/UNESP, Brazil, using an fluoride-specific electrode connected to an ion analyzer. From the total of samples (n=591), 67.2% (n=397) presented fluoride concentration between 0.6 and 0.8 mgF/L; 20.6% (n=122) below 0.6 mgF/L; 11.5% (n=68) between 0.8 and 1.2 mgF/L and 0.7% (n=4) above 1.2 mgF/L. Most samples showed fluoride levels within the recommended parameters. Minimal variation was observed among the analyzed collection locations, showing that the city has been able to control the fluoride levels in the public water supply and reinforcing the importance of surveillance and constant monitoring to assure the quality of the water delivered to the population.

Approximation of hyperbolic tangent activation function using hybrid methods

Artificial Neural Networks are widely used in various applications in engineering, as such solutions of nonlinear problems. The implementation of this technique in reconfigurable devices is a great challenge to researchers by several factors, such as floating point precision, nonlinear activation function, performance and area used in FPGA. The contribution of this work is the approximation of a nonlinear function used in ANN, the popular hyperbolic tangent activation function. The system architecture is composed of several scenarios that provide a tradeoff of performance, precision and area used in FPGA. The results are compared in different scenarios and with current literature on error analysis, area and system performance. © 2013 IEEE.

Identificação de perfis diferenciais de metilação do DNA na endometriose

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeito do fresamento com alta velocidade de corte na usinabilidade de aços ferríticos com grãos ultrafinos

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