Interests and Values in Obama's foreign Policy: Leading from Behind?

Abstract This study will exam the relative importance of values and interests in Obama's foreign policy, focusing on crucial cases: the military actions related to Afghanistan, Iraq, Libya, Non-Syria, Al-Qaeda and ISIL. We will argue that his "leading from behind" strategy is not very distant from the foreign and defense strategies of his post-Cold War predecessors, by which democracy is seen as an assurance to security. According to Obama's strategy, Americans will only provide support for the building of democracy in the target countries, while this task should be performed by the locals themselves. Americans will provide military training to the new governments as well so they can be responsible for their own security, including preventing regrouping of terrorists in their soil. If Obama opposes the imposing of democracy by the use of force, empirical data shows that his administration is "not prepared to accept" any option that threats US security or American liberal-democratic values, bringing in this way values and interests very close to each other.

Innovation for sustainable urban tourism: some thoughts on best practice

This paper examines a series of strategic initiatives that have been undertaken by Tourism Queensland (TQ), a State Tourism Organization in Australia, to develop tourism and in particular to develop networks in tourism destinations. This paper firstly examines the nature of sustainable urban tourism (SUT) and discusses approaches to defining it. It suggests that developing SUT requires a generic approach to improving sustainable tourism operations amongst all suppliers in an urban area. Further, this approach suggests that best practice in marketing and policy development can be adopted to attract tourists to a SUT destination and examples of this approach are provided.

Chemotherapy versus best supportive care in stage IV non-small cell lung cancer, non metastatic to the brain

Stage IV non-small cell lung cancer is a fatal disease, with a median survival of 14 months. Systemic chemotherapy is the most common approach. However the impact in overall survival and quality of life still a controversy. OBJECTIVES: To determine differences in overall survival and quality of life among patients with stage IV non-small cell lung cancer non-metastatic to the brain treated with best supportive care versus systemic chemotherapy. PATIENTS: From February 1990 through December 1995, 78 eligible patients were admitted with the diagnosis of stage IV non-small cell lung cancer . Patients were divided in 2 groups: Group A (n=31 -- treated with best supportive care ), and Group B (n=47 -- treated with systemic chemotherapy). RESULTS: The median survival time was 23 weeks (range 5 -- 153 weeks) in Group A and 55 weeks (range 7.4 -- 213 weeks) in Group B (p=0.0018). In both groups, the incidence of admission for IV antibiotics and need of blood transfusions were similar. Patients receiving systemic chemotherapy were also stratified into those receiving mytomycin, vinblastin, and cisplatinum, n=25 and those receiving other combination regimens (platinum derivatives associated with other drugs, n=22). Patients receiving mytomycin, vinblastin, and cisplatinum, n=25 had a higher incidence of febrile neutropenia and had their cycles delayed for longer periods of time than the other group. These patients also had a shorter median survival time (51 versus 66 weeks, p=0.005). CONCLUSION: In patients with stage IV non-small cell lung cancer, non-metastatic to the brain, chemotherapy significantly increases survival compared with best supportive care.

The best infertility treatment for vasectomized men: assisted reproduction or vasectomy reversal?

In men with prior vasectomy, microsurgical reconstruction of the reproductive tract is more cost-effective than sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection if the obstructive interval is less than 15 years and no female fertility risk factors are present. If epididymal obstruction is detected or advanced female age is present, the decision to use either microsurgical reconstruction or sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection should be individualized. Sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection is preferred to surgical treatment when female factors requiring in vitro fertilization are present or when the chance for success with sperm retrieval and intracytoplasmic sperm injection exceeds the chance for success with surgical treatment.

When is the Best Time for the Second Antiplatelet Agent in Non-St Elevation Acute Coronary Syndrome?

Abstract Dual antiplatelet therapy is a well-established treatment in patients with non-ST elevation acute coronary syndrome (NSTE-ACS), with class I of recommendation (level of evidence A) in current national and international guidelines. Nonetheless, these guidelines are not precise or consensual regarding the best time to start the second antiplatelet agent. The evidences are conflicting, and after more than a decade using clopidogrel in this scenario, benefits from the routine pretreatment, i.e. without knowing the coronary anatomy, with dual antiplatelet therapy remain uncertain. The recommendation for the upfront treatment with clopidogrel in NSTE-ACS is based on the reduction of non-fatal events in studies that used the conservative strategy with eventual invasive stratification, after many days of the acute event. This approach is different from the current management of these patients, considering the established benefits from the early invasive strategy, especially in moderate to high-risk patients. The only randomized study to date that specifically tested the pretreatment in NSTE-ACS in the context of early invasive strategy, used prasugrel, and it did not show any benefit in reducing ischemic events with pretreatment. On the contrary, its administration increased the risk of bleeding events. This study has brought the pretreatment again into discussion, and led to changes in recent guidelines of the American and European cardiology societies. In this paper, the authors review the main evidence of the pretreatment with dual antiplatelet therapy in NSTE-ACS.

Identification of the best ovitrap installation sites for gravid Aedes (Stegomyia) aegypti in residences in Mirassol, state of São Paulo, Brazil

This study aimed at identifying the best ovitrap installation sites for gravid Aedes aegypti in Mirassol, state of São Paulo, Brazil. Ovitraps were installed in ten houses per block over ten blocks. Four ovitraps were placed per residence, one in the bedroom, one in the living room, and two outdoors with one in a sheltered area and one in an outside site. Each week for eleven weeks, visits were made to examine the ovitraps and to change the paddles used for egg-laying. Eggs were analyzed according to the trap location. The results showed that the outdoor sites received significantly more oviposition than indoor sites. Additionally, in respect to the outdoor sites, the outside site received significantly more oviposition than the sheltered site. A b correlation was observed between positive traps and egg numbers. The results are discussed with respect to the best installation site of the traps and their implications in surveillance and control of dengue vectors.

Adherence to best care practices in normal birth: construction and validation of an instrument

Abstract OBJECTIVE To describe the stages of construction and validation of an instrument in order to analyze the adherence to best care practices during labour and birth. METHOD Methodological research, carried out in three steps: construction of dimensions and items, face and content validity and semantic analysis of the items. RESULTS The face and content validity was carried out by 10 judges working in healthcare, teaching and research. Items with Content Validity Index (CVI) ≥ 0.9 were kept in full or undergone revisions as suggested by the judges. Semantic analysis, performed twice, indicated that there was no difficulty in understanding the items. CONCLUSION The instrument with three dimensions (organization of healthcare network to pregnancy and childbirth, evidence-based practices and work processes) followed the steps recommended in the literature, concluded with 50 items and total CVI of 0.98.

Produção, propriedades e aplicação de celulases na hidrólise de resíduos agroindustriais

Cellulases have been intensively studied in the past few years, due to the interests in biofuels production from lignocellulosic materials, since they permit maintaining mild conditions during the conversion process. These enzymes can be produced by a broad variety of naturally occurring microorganisms, such as from genera Aspergillus, Trichoderma, Penicillium and Humicola. Targeting the increasing of expression levels, molecular biology tools have been used for heterologous genes insertion in host cells, e. g., Pichia pastoris and Escherichia coli. Enzymes from fungal cellulolytic complex usually act best at pH between 4 and 5 under temperatures from 40 to 60 °C and can be used for either sequential (SHF) or simultaneous (SSF) hydrolysis together alcoholic fermentation. In this review, the main raw materials for production of cellulases are identified, as well as the state of art of enzymes' properties, production and main applications.

Pulmonar recruitment in acute respiratory distress syndrome. What is the best strategy?

Supporting patients with acute respiratory distress syndrome (ARDS), using a protective mechanical ventilation strategy characterized by low tidal volume and limitation of positive end-expiratory pressure (PEEP) is a standard practice in the intensive care unit. However, these strategies can promote lung de-recruitment, leading to the cyclic closing and reopening of collapsed alveoli and small airways. Recruitment maneuvers (RM) can be used to augment other methods, like positive end-expiratory pressure and positioning, to improve aerated lung volume. Clinical practice varies widely, and the optimal method and patient selection for recruitment maneuvers have not been determined, considerable uncertainty remaining regarding the appropriateness of RM. This review aims to discuss recent findings about the available types of RM, and compare the effectiveness, indications and adverse effects among them, as well as their impact on morbidity and mortality in ARDS patients. Recent developments include experimental and clinical evidence that a stepwise extended recruitment maneuver may cause an improvement in aerated lung volume and decrease the biological impact seen with the traditionally used sustained inflation, with less adverse effects. Prone positioning can reduce mortality in severe ARDS patients and may be an useful adjunct to recruitment maneuvers and advanced ventilatory strategies, such noisy ventilation and BIVENT, which have been useful in providing lung recruitment.

Weed control via intercropping with gliricidia: II. corn crop

A reduction in herbicide use is one of modern agriculture's main interests and several alternatives are being investigated with this objective, including intercropping. Gliricídia (Gliricidia sepium) mulch has no allelopathic effect on corn or beans but significantly decreased the population of some weed species. The objective of this study was to evaluate green ear and grain yield in corn cultivars as a response to weed control achieved via intercropping with gliricidia. A completely randomized block design with five replicates and split-plots was used. Cultivars AG 1051, AG 2060, BRS 2020, and PL 6880 (assigned to plots) were submitted to the following treatments: no hoeing, hoeing (performed at 20 and 40 days after sowing the corn), and corn intercropped with gliricidia. Gliricidia was grown in a transplanting system to ensure uniform germination and fast establishment in the field. Seeding was made in 200-cell trays with one seed per cell (35 mL volume). The plants emerged two to three days after sowing and were transplanted to a permanent site two to three days after emergence. Corn was sown on the same day gliricidia was transplanted. Sixteen weed species occurred at different frequencies, with uneven distribution in the experimental area. Cultivars AG 1051 and AG 2060 were the best with reference to most characteristics employed to evaluate green corn yield. Cultivar AG 1051 provided the highest grain yield. The highest green ear yield and grain yield values were obtained with hoeing. However, the fact that intercropped plots showed intermediate yield between the values obtained for hoed and non-hoed plots indicates that gliricidia was beneficial to corn, and exerted a certain level of weed control.

Using the best linear predictor (BLP) in the selection between and among half-sib progenies of the CMS-39 maize population

Data of corn ear production (kg/ha) of 196 half-sib progenies (HSP) of the maize population CMS-39 obtained from experiments carried out in four environments were used to adapt and assess the BLP method (best linear predictor) in comparison with to the selection among and within half-sib progenies (SAWHSP). The 196 HSP of the CMS-39 population developed by the National Center for Maize and Sorghum Research (CNPMS-EMBRAPA) were related through their pedigree with the recombined progenies of the previous selection cycle. The two methodologies used for the selection of the twenty best half-sib progenies, BLP and SAWHSP, led to similar expected genetic gains. There was a tendency in the BLP methodology to select a greater number of related progenies because of the previous generation (pedigree) than the other method. This implies that greater care with the effective size of the population must be taken with this method. The SAWHSP methodology was efficient in isolating the additive genetic variance component from the phenotypic component. The pedigree system, although unnecessary for the routine use of the SAWHSP methodology, allowed the prediction of an increase in the inbreeding of the population in the long term SAWHSP selection when recombination is simultaneous to creation of new progenies.