Assessment of Myocardial Ischemia in Obese Individuals Undergoing Physical Stress Echocardiography (PSE)

Background: Physical stress echocardiography is an established methodology for diagnosis and risk stratification of coronary artery disease in patients with physical capacity. In obese (body mass index ≥ 30 kg/m2) the usefulness of pharmacological stress echocardiography has been demonstrated; however, has not been reported the use of physical stress echocardiography in this growing population group. Objective: To assess the frequency of myocardial ischemia in obese and non-obese patients undergoing physical stress echocardiography and compare their clinical and echocardiographic differences. Methods: 4,050 patients who underwent treadmill physical stress echocardiography were studied according to the Bruce protocol, divided into two groups: obese (n = 945; 23.3%) and non-obese (n = 3,105; 76.6%). Results: There was no difference regarding gender. Obese patients were younger (55.4 ± 10.9 vs. 57.56 ± 11.67) and had a higher frequency of hypertension (75.2% vs. 57, 2%; p < 0.0001), diabetis mellitus (15.2% vs. 10.9%; p < 0.0001), dyslipidemia (59.5% vs 51.9%; p < 0.0001), family history of coronary artery disease (59.3% vs. 55.1%; p = 0.023) and physical inactivity (71.4% vs. 52.9%, p < 0.0001). The obese had greater aortic dimensions (3.27 vs. 3.14 cm; p < 0.0001), left atrium (3.97 vs. 3.72 cm; p < 0.0001) and the relative thickness of the ventricule (33.7 vs. 32.8 cm; p < 0.0001). Regarding the presence of myocardial ischemia, there was no difference between groups (19% vs. 17.9%; p = 0.41). In adjusted logistic regression, the presence of myocardial ischemia remained independently associated with age, female gender, diabetes and hypertension. Conclusion: Obesity did not behave as a predictor of the presence of ischemia and the physical stress echocardiography. The application of this assessment tool in large scale sample demonstrates the feasibility of the methodology, also in obese.

Bacillus thuringiensis: fermentation process and risk assessment: a short review

Several factors make the local production of Bacillus thuringiensis (Bt) highly appropriate for pest control in developing nations. Bt can be cheaply produced on a wide variety of low cost, organic substrates. Local production results in considerable savings in hard currency which otherwise would be spent on importation of chemical and biological insecticides. The use of Bt in Brazil has been limited in comparison with chemical insecticides. Although Bt is imported, some Brazilian researchers have been working on its development and production. Fermentation processes (submerged and semi-solid) were applied, using by-products from agro-industries. As the semi-solid fermentation process demonstrated to be interesting for Bt endotoxins production, it could be adopted for small scale local production. Although promising results had been achieved, national products have not been registered due to the absence of a specific legislation for biological products. Effective actions are being developed in order to solve this gap. Regardless of the biocontrol agents being considered atoxic and harmless to the environment, information related to direct and indirect effects of microbials are still insufficient in many cases. The risk analysis of the use of microbial control agents is of upmost importance nowadays, and is also discussed.

Waterborne toxoplasmosis investigated and analysed under hydrogeological assessment: new data and perspectives for further research

We present a set of data on human and chicken Toxoplasma gondiiseroprevalence that was investigated and analysed in light of groundwater vulnerability information in an area endemic for waterborne toxoplasmosis in Brazil. Hydrogeological assessment was undertaken to select sites for water collection from wells for T. gondii oocyst testing and for collecting blood from free-range chickens and humans for anti-T. gondiiserologic testing. Serologic testing of human specimens was done using conventional commercial tests and a sporozoite-specific embryogenesis-related protein (TgERP), which is able to differentiate whether infection resulted from tissue cysts or oocysts. Water specimens were negative for the presence of viable T. gondii oocysts. However, seroprevalence in free-range chickens was significantly associated with vulnerability of groundwater to surface contamination (p < 0.0001; odds ratio: 4.73, 95% confidence interval: 2.18-10.2). Surprisingly, a high prevalence of antibodies against TgERP was detected in human specimens, suggesting the possibility of a continuous contamination of drinking water with T. gondiioocysts in this endemic setting. These findings and the new proposed approach to investigate and analyse endemic toxoplasmosis in light of groundwater vulnerability information associated with prevalence in humans estimated by oocyst antigens recognition have implications for the potential role of hydrogeological assessment in researching waterborne toxoplasmosis at a global scale.

Laser therapy in pressure ulcers: evaluation by the Pressure Ulcer Scale for Healing and Nursing Outcomes Classification

AbstractOBJECTIVETo describe the pressure ulcer healing process in critically ill patients treated with conventional dressing therapy plus low-intensity laser therapy evaluated by the Pressure Ulcer Scale for Healing (PUSH) and the result of Wound Healing: Secondary Intention, according to the Nursing Outcomes Classification (NOC).METHODCase report study according to nursing process conducted with an Intensive Care Unit patient. Data were collected with an instrument containing the PUSH and the result of the NOC. In the analysis we used descriptive statistics, considering the scores obtained on the instrument.RESULTSA reduction in the size of lesions of 7cm to 1.5cm of length and 6cm to 1.1cm width, in addition to the increase of epithelial tissue and granulation, decreased secretion and odor.CONCLUSIONThere was improvement in the healing process of the lesion treated with adjuvant therapy and the use of NOC allowed a more detailed and accurate assessment than the PUSH.

Quantitative Assessment of Soil Physical Quality in Northern China Based on S-theory

ABSTRACT Quantitative assessment of soil physical quality is of great importance for eco-environmental pollution and soil quality studies. In this paper, based on the S-theory, data from 16 collection sites in the Haihe River Basin in northern China were used, and the effects of soil particle size distribution and bulk density on three important indices of theS-theory were investigated on a regional scale. The relationships between unsaturated hydraulic conductivityKi at the inflection point and S values (S/hi) were also studied using two different types of fitting equations. The results showed that the polynomial equation was better than the linear equation for describing the relationships between -log Ki and -logS, and -log Kiand -log (S/hi)2; and clay content was the most important factor affecting the soil physical quality index (S). The variation in the S index according to soil clay content was able to be fitted using a double-linear-line approach, with decrease in the S index being much faster for clay content less than 20 %. In contrast, the bulk density index was found to be less important than clay content. The average S index was 0.077, indicating that soil physical quality in the Haihe River Basin was good.

ASSESSMENT OF BIOAVAILABILITY OF HEAVY METALS AFTER VERMICOMPOSTING IN THE PRESENCE OF ELECTRONIC WASTE

ABSTRACT Heavy metals contained in electronic waste, if discarded improperly, can become bioavailable after vermicomposting, posing a risk to the environment. Small-scale vermicomposting experiments were carried out with printed circuit boards (PCBs) to investigate the migration of heavy metals (Cu, Pb, Zn, Ni, and Sn) to the final compost, as well as the mobility and bioavailability of these metals. High total levels of Pb, Sn and Cu in samples of manure with electronic waste (MEW) and vegetables with electronic waste (VEW) were detected. Based on the initial metal levels in the PCBs and their concentration in the resulting compost, the order of migration of these metals to the MEW and VEW samples was Sn (23.1 %)>Pb (18.4 %)>Ni (4.63 %)>Zn (0.46 %)>Cu (0.14 %) and Sn (24.3 %)>Pb (23.6 %)>Ni (11.33 %)>Zn (1.76 %)>Cu (0.60 %), respectively. Mobility and bioavailability of these metals in the compost were evaluated by three-stage sequential extraction, where F1 was the exchangeable fraction, F2 the organic fraction and F3 the residual fraction. The bioavailability factor (BF) was calculated by the ratio of the sum of fractions F1 and F2 divided by the total sum of the fractions (F1 + F2 + F3). The highest bioavailability factor (BF = 0.92) was found for Pb, the heavy metal considered the greatest environmental concern in this study, indicating the high mobility and the possibility of becoming bioavailable of this metal.

Assessment of growth and yield performance of rubber tree clones of the IAC 500 series

The objective of this work was to evaluate the performance of 15 clones of the IAC 500 series of Hevea brasiliensis, developed at Instituto Agronômico (IAC), over a 12-year period, in the northwest region of São Paulo State, Brazil. The 15 new clones evaluated are primary clones obtained from selected ortets within half-sib progenies. The clone RRIM 600, of Malaysian origin, was used as the control. Dry rubber yield performance over a four-year period, mean girth at the tenth year, girth increment before and during tapping, thermal properties of the natural rubber produced and other characters of the laticiferous system were evaluated. Forty percent of the clones were superior in comparison to the control for yield. Clone IAC 500 recorded the highest yield (66.81 g per tree per tapping) over four years of tapping, followed by IAC 502 (62.37 g per tree per tapping), whereas the control recorded 48.71 g per tree per tapping. All selected clones were vigorous in growth. The natural rubber from this IAC clones showed thermal stability up to 300ºC. No differences were observed in the thermal behavior of rubber among the IAC series and the RRIM 600 clones. The clones IAC 500, IAC 501, IAC 502, IAC 503 and IAC 506 are the more promising for small-scale plantations, due to growth and yield potential.

Developmental norms for eight instruments used in the neuropsychological assessment of children: studies in Brazil

Norms for a battery of instruments, including Denckla's and Garfield's tests of Motor Persistence, Benton's Right-Left Discrimination, two recall modalities (Immediate and Delayed) of the Bender Test, Wechsler's Digit Span, the Color Span Test and the Human Figure Drawing Test, were developed for the neuropsychological assessment of children in the greater Rio de Janeiro area. Additionally, the behavior of each child was assessed with the Composite Teacher Rating Scale (Brito GNO and Pinto RCA (1991) Journal of Clinical and Experimental Neuropsychology, 13: 417-418). A total of 398 children (199 boys and 199 girls balanced for age) with a mean age of 9.3 years (SD = 2.8), who were attending a public school in Niterói, were the subjects of this study. Gender and age had significant effects on performance which depended on the instrument. Nonachievers performed worse than achievers in most neuropsychological tests. Comparison of our data to the available counterparts in the United States revealed that American children outperformed Brazilian children on the Right-Left Discrimination, Forward Digit Span, Color Span and Human Figure Drawing Tests. Further analysis showed that the neurobehavioral data consist of different factorial dimensions, including Human Body Representation, Motor Persistence of the Legs, Orbito-Orobuccal Motor Persistence, Attention-Memory, Visuospatial Memory, Neuropsychomotor Speed, Hyperactivity-Inattention, and Anxiety-Negative Socialization. We conclude that gender and age should be taken into account when using the normative data for most of the instruments studied in the present report. Furthermore, we stress the need for major changes in the Brazilian public school system in order to foster the development of secondary cognitive abilities in our children

Reliability and validity of the interactive observation scale for psychiatric inpatients applied by nursing aides in daily ward practice

The main characteristic of the nursing Interactive Observation Scale for Psychiatric Inpatients (IOSPI) is the necessity of interaction between raters and patients during assessment. The aim of this study was to evaluate the reliability and validity of the scale in the "real" world of daily ward practice and to determine whether the IOSPI can increase the interaction time between raters and patients and influence the raters' opinion about mental illness. All inpatients of a general university hospital psychiatric ward were assessed daily over a period of two months by 9 nursing aides during the morning and afternoon shifts, with 273 pairs of daily observations. Once a week the patients were interviewed by a psychiatrist who filled in the Brief Psychiatric Rating Scale (BPRS). The IOSPI total score was found to show significant test-retest reliability (interclass correlation coefficient = 0.83) and significant correlation with the BPRS total score (r = 0.69), meeting the criteria of concurrent validity. The instrument can also discriminate between patients in need of further inpatient treatment from those about to be discharged (negative predictive value for discharge = 0.91). Using this scale, the interaction time between nursing aides and patients increased significantly (t = 2.93, P<0.05) and their opinion about the mental illness changed. The "social restrictiveness" factor of the opinion scale about mental illness showed a significant reduction (t = 4.27, P<0.01) and the "interpersonal etiology" factor tended to increase (t = 1.98, P = 0.08). The IOSPI was confirmed as a reliable and valid scale and as an efficient tool to stimulate the therapeutic attitudes of the nursing staff.

Brazilian version of the Berg balance scale

The purpose of the present study was to translate and adapt the Berg balance scale, an instrument for functional balance assessment, to Brazilian-Portuguese and to determine the reliability of scores obtained with the Brazilian adaptation. Two persons proficient in English independently translated the original scale into Brazilian-Portuguese and a consensus version was generated. Two translators performed a back translation. Discrepancies were discussed and solved by a panel. Forty patients older than 65 years and 40 therapists were included in the cultural adaptation phase. If more than 15% of therapists or patients reported difficulty in understanding an item, that item was reformulated and reapplied. The final Brazilian version was then tested on 36 elderly patients (over age 65). The average age was 72 years. Reliability of the measure was assessed twice by one physical therapist (1-week interval between assessments) and once by one independent physical therapist. Descriptive analysis was used to characterize the patients. The intraclass correlation coefficient (ICC) and Pearson's correlation coefficient were computed to assess intra- and interobserver reliability. Six questions were modified during the translation stage and cultural adaptation phase. The ICC for intra- and interobserver reliability was 0.99 (P < 0.001) and 0.98 (P < 0.001), respectively. The Pearson correlation coefficient for intra- and interobserver reliability was 0.98 (P < 0.001) and 0.97 (P < 0.001), respectively. We conclude that the Brazilian version of the Berg balance scale is a reliable instrument to be used in balance assessment of elderly Brazilian patients.

Reliability and validity of a Portuguese version of the Young Mania Rating Scale

The reliability and validity of a Portuguese version of the Young Mania Rating Scale were evaluated. The original scale was translated into and adapted to Portuguese by the authors. Definitions of clinical manifestations, a semi-structured anchored interview and more explicit rating criteria were added to the scale. Fifty-five adult subjects, aged 18 to 60 years, with a diagnosis of Current Manic Episode according to DSM-III-R criteria were assessed using the Young Mania Rating Scale as well as the Brief Psychiatric Rating Scale in two sessions held at intervals from 7 to 10 days. Good reliability ratings were obtained, with intra-class correlation coefficient of 0.97 for total scores, and levels of agreement above 0.80 (P < 0.001) for all individual items. Internal consistency analysis resulted in an alpha = 0.67 for the scale as a whole, and an alpha = 0.72 for each standardized item (P < 0.001). For the concurrent validity, a correlation of 0.78 was obtained by the Pearson coefficient between the total scores of the Young Mania Rating Scale and Brief Psychiatric Rating Scale. The results are similar to those reported for the English version, indicating that the Portuguese version of the scale constitutes a reliable and valid instrument for the assessment of manic patients.

Behavioral and physiological methods for early quantitative assessment of spinal cord injury and prognosis in rats

Methods for reliable evaluation of spinal cord (SC) injury in rats at short periods (2 and 24 h) after lesion were tested to characterize the mechanisms implicated in primary SC damage. We measured the physiological changes occurring after several procedures for producing SC injury, with particular emphasis on sensorimotor functions. Segmental and suprasegmental reflexes were tested in 39 male Wistar rats weighing 250-300 g divided into three control groups that were subjected to a) anesthesia, b) dissection of soft prevertebral tissue, and c) laminectomy of the vertebral segments between T10 and L1. In the lesion group the SC was completely transected, hemisected or subjected to vertebral compression. All animals were evaluated 2 and 24 h after the experimental procedure by the hind limb motility index, Bohlman motor score, open-field, hot-plate, tail flick, and paw compression tests. The locomotion scale proved to be less sensitive than the sensorimotor tests. A reduction in exploratory movements was detected in the animals 24 h after the procedures. The hot-plate was the most sensitive test for detecting sensorimotor deficiencies following light, moderate or severe SC injury. The most sensitive and simplest test of reflex function was the hot-plate. The hemisection model promoted reproducible moderate SC injury which allowed us to quantify the resulting behavior and analyze the evolution of the lesion and its consequences during the first 24 h after injury. We conclude that hemisection permitted the quantitation of behavioral responses for evaluation of the development of deficits after lesions. Hind limb evaluation scores and spontaneous exploration events provided a sensitive index of immediate injury effects after SC lesion at 2 and 24 h. Taken together, locomotion scales, open-field, and hot-plate tests represent reproducible, quantitatively sensitive methods for detecting functional deficiencies within short periods of time, indicating their potential for the study of cellular mechanisms of primary injury and repair after traumatic SC injury.

Development and assessment of acceptability and nutritional properties of a light snack

A light snack was developed using a fat replacer as a flavor fixative agent. The product presented a calorie reduction of up to 47.5% in comparison with products available on the market. The impact of this fat replacer on the sensory properties was determined by comparing this light snack to the traditional ones. No significant difference in texture was observed; however, there was a difference in color (deltaE = 8.67), due mainly to luminosity (deltaL = 7.79). The light snack presented high sensory acceptability (7.27 ± 1.3; 82.5% of grades were > 7 on 9-point hedonic scale); no significant difference in snack acceptability was observed. However, the traditional snack was significantly preferred in sensory terms (p < 0.05). In an opinion survey when the consumers were informed about snack composition, 75% of them said that they would buy the light snack instead of the traditional one. The caloric and fat reductions allow the use of the claims "light snack" and "fat free", in accordance with the legislation of various countries. We conclude that it is technologically possible to use a fat replacer in snack production, resulting in a sensory acceptable light snack with great potential to replace traditional ones.

Evaluation of process parameters in the industrial scale production of fish nuggets

This work reports the use of experimental design for the assessment of the effects of process parameters on the production of fish nuggets in an industrial scale environment. The effect of independent factors on the physicochemical and microbiological parameters was investigated through a full 24 experimental design. The studied factors included the temperature of fish fillet and pulp in the mixer, the temperature of the added fat, the temperature of water and the ratio of protein extraction time to emulsion time. The physicochemical analyses showed that the higher temperature of the pulp and fillet of fish, the lower the protein in the final product. Microbiological analyses revealed that the counting of Staphylococcus coagulase positive, total and thermo-tolerant coliforms were in accordance with the current legislation.

Designing and validating the methodology for the Internet assessment of fish consumption at a university setting

Assessing fish consumption is complex and involves several factors; however, the use of questionnaires in surveys and the use of the Internet as tool to collect data have been considered promising approaches. Therefore, the objective of this research was to design a data collection technique using a questionnaire to assess fish consumption by making it available on a specific home page on the Internet. A bibliographical survey or review was carried out to identify the features of the instrument, and therefore pre-tests were conducted with previous instruments, followed by the Focus Group technique. Specialists then performed an analysis and conducted an online pre-test. Multivariate data analysis was applied using the SmartPLS software. The results indicate that 1.966 participants belonging to the University of São Paulo (USP) community participated in the test, and after the exclusion of some variables, a statistically significant results were obtained. The final constructs comprised consumption, quality, and general characteristics. The instrument consisted of behavioral statements in a 5-point Likert scale and multiple-choice questions. The Cronbach's alpha reliability coefficient was 0.66 for general characteristics, 0.98 for quality, and 0.91 for consumption, which indicate good reliability of the instrument. In conclusion, the results proved that the Internet assessment is efficient. The instrument of analysis allowed us to better understand the process of buying and consuming fish in the country, and it can be used as base for further research.