Variations in the body mass index in Brazilian women undergoing adjuvant chemotherapy for breast cancer

PURPOSE:To evaluate variations in the body mass index in patients undergoing adjuvant chemotherapy for breast cancer, and to associate these changes with patient's age and adjuvant chemotherapy regimen.METHODS:We performed a retrospective cohort study in order to correlate any variation in the body mass index before and after adjuvant chemotherapy with patient's age and adjuvant chemotherapy regimen. Patients who received any form of prior hormone therapy, such as tamoxifen or aromatase inhibitors, were excluded. We selected data for 196 patients with stage I to III breast cancer who were treated by radical or conservative surgery and received adjuvant chemotherapy at the Cancer Institute of the State of São Paulo, Brazil.RESULTS:Before adjuvant chemotherapy, 67.8% of patients were classified as overweight or obese according to their body mass indices. Around 66.3% (95% CI 59.7–73.0) of the patients exhibited an increase in the body mass index after adjuvant chemotherapy. The average age of all patients was 56.3±11.3 years. Participants whose body mass index increased were younger than those with no increase (54.7±11.1 versus 59.3±11.2 years; p=0.007). Patients were treated with the following adjuvant chemotherapy regimens: doxorubicin, cyclophosphamide, and paclitaxel (AC-T, 129 patients, 65.8%); 5-fluoracil, doxorubicin, and cyclophosphamide (36 patients, 18.4%); cyclophosphamide, methotrexate, and 5-fluoracil (16 patients, 8.2%); docetaxel and cyclophosphamide (7 patients, 3.6%); and other regimen (8 patients, 4.1%). The AC-T regimen showed a statistically significant association with increase in the body mass index (p<0.001 by ANOVA).CONCLUSIONS:Most patients with breast cancer showed an increase in the body mass index after adjuvant chemotherapy, especially after the AC-T chemotherapy regimen.

Measuring effects of strategic utilization of social media in business-to-business marketing: Case Greenlux Finland Oy

Utilization of social media is increasingly common in B2B marketing. Social media is an efficient and cheap marketing and communication channel available for everyone, and thus extremely attractive marketing medium. The more companies get involved in social media the more failures are reported. It is not enough for a company to just be present in social media. Succeeding on it requires hard work, investing time and money, and ability to measure and to monitor performance. With an increasing number of companies failing in utilizing social media, together with lack of research on strategic utilization of social media focusing on B2B marketing, measuring, and monitoring create a purpose for this research. The aim of this research is to discover methods for measuring and monitoring effects of strategic utilization of social media in B2B marketing. Most relevant financial and non-financial indicators are discussed, and the methods by which these can be monitored and measured. In addition, effects of strategic utilization of social media on the case company are measured and analyzed. The research methodology used in this research is a participatory action research, which includes elements of both qualitative and quantitative research methods. The case company examined in the research provides a unique opportunity to follow through all phases of strategic utilization of social media for B2B marketing purposes concluding real effects of social media to the case company, and thus gain a deep understanding about this new marketing medium in the perspective of B2B marketing. Duration of the research period is seven months. During this time, information is collected, measured, and analyzed. Case company does not have any other marketing activities simultaneously which makes it possible to examine social media apart from effects of other visible marketing activities. Effects of strategic utilization of social media can be monitored and measured in many ways. Methods that should be used depend on goals set for social media. Fundamental nature of social media requires multidimensional assessment, and thus effects should be measured, and monitored considering both financial and non-financial indicators. The results implicates that effects of strategic utilization of social media are relatively wide ranged. According to the findings, social media affects positively on brand, number of web page visitors, visitor behavior, and on distribution of awareness. According to investment calculations social media is a legitimate investment for case company. Results also implicate that by using social media case company gains conversation, arouses interest, gets attention, and creates interactivity. In addition and as a side note, winter holiday season appears to have a great effect on social media activity of B2B companies’ representatives.

Hydrodynamics Characteristics and Gas-Liquid Mass Transfer in a Three Phase Fluidized Bed Reactor

This paper presents the experimental characterization of hydrodynamics and gas-liquid mass transfer in a three-phase fluidized bed containing polystyrene and nylon particles. The influence of gas and liquid velocities on phase holdups and volumetric gas-liquid mass transfer coefficient was investigated for flow conditions similar to those applied in biotechnological process. The phase holdups were obtained by the pressure profile technique. The volumetric gas-liquid mass transfer coefficient was obtained adjusting the experimental concentration profiles of dissolved oxygen in the liquid phase with the predictions of the axial dispersion model. According to experimental results the liquid holdup increases with the gas velocity, whereas the solid holdup decreases. The gas holdup increases significantly with the increase in gas velocity, and it shows for the three-phase fluidized bed comparable values or larger than those of bubble column. The volumetric gas-liquid mass transfer coefficient increases significantly with an increase in the air velocity for both bubble column and fluidized beds. In addition, in the operational condition of high liquid velocity, the presence of low-density particles in the bed increased the gas-liquid mass transfer, and thus the volumetric mass transfer coefficient values obtained in the fluidized bed were comparable or larger than those of bubble column.

Chromium mass balance in sodium chlorate process

Kuudenarvoista kromia käytetään natriumkloraatin valmistuksessa prosessin tuotantotehokkuuden ja turvallisuuden parantamiseksi. Kromia kuitenkin poistuu prosessista muutamaa reittiä pitkin. Koska kuuudenarvoisella kromilla on syöpää aiheuttavia, mutageenisiä sekä lisääntymiselle myrkyllisiä ominaisuuksia, olisi tärkeää ymmärtää, miten kromi kulkeutuu prosessin eri osiin, ja kuinka paljon sitä poistuu prosessista. Tämä on tärkeää, jotta osataan hallita kromin käytöstä aiheutuvat riskit, sekä toisaalta myös tehostaa kromin käyttöä prosessissa. Työn tarkoituksena oli tuottaa tietoa kromin käytöstä natriumkloraattiprosessissa. Työssä tutkittiin kromitasetta prosessin keskeisimmissä yksikköoperaatioissa. Myös kromin saostumista katodien pinnalle arvioitiin määrällisesti. Eri prosessinäytteistä tutkittiin lisäksi kromin hapetusasteita. Edellä mainittuja tutkimuskohteita varten määritettiin prosessinäytteiden kromipitoisuus. Eri prosessioperaatioille suoritettiin lisäksi taselaskelmat. Työn tuloksena esitettiin kromitase sekä yksikköoperaatioille että koko prosessille. Erinäisten epätarkkuustekijöiden vuoksi tasetta ei kuitenkaan pystytty määrittämään halutulla tarkkuudella, ja siksi työssä esitettyä tasetta voidaan pitää vain suuntaa antavana laskelmana. Katodien pinnalle saostunutta kromin määrää pidettiin kuitenkin oikean suuruusluokan tuloksena. Prosessinäytteiden hapetusasteita ei voitu arvioida, sillä saadut kokonaiskromitulokset eivät olleet täysin luotettavia. Huolimatta tulosten epätarkkuudesta, työ tuotti tärkeää tietoa prosessin toiminnasta kromin suhteen. Työtä voidaan hyödyntää jatkossa monin tavoin prosessin kromitaseen seurannassa.

Heterogeneous mass transfer in fluidized beds by computational fluid dynamics

The main objective of this research is to estimate and characterize heterogeneous mass transfer coefficients in bench- and pilot-scale fluidized bed processes by the means of computational fluid dynamics (CFD). A further objective is to benchmark the heterogeneous mass transfer coefficients predicted by fine-grid Eulerian CFD simulations against empirical data presented in the scientific literature. First, a fine-grid two-dimensional Eulerian CFD model with a solid and gas phase has been designed. The model is applied for transient two-dimensional simulations of char combustion in small-scale bubbling and turbulent fluidized beds. The same approach is used to simulate a novel fluidized bed energy conversion process developed for the carbon capture, chemical looping combustion operated with a gaseous fuel. In order to analyze the results of the CFD simulations, two one-dimensional fluidized bed models have been formulated. The single-phase and bubble-emulsion models were applied to derive the average gas-bed and interphase mass transfer coefficients, respectively. In the analysis, the effects of various fluidized bed operation parameters, such as fluidization, velocity, particle and bubble diameter, reactor size, and chemical kinetics, on the heterogeneous mass transfer coefficients in the lower fluidized bed are evaluated extensively. The analysis shows that the fine-grid Eulerian CFD model can predict the heterogeneous mass transfer coefficients quantitatively with acceptable accuracy. Qualitatively, the CFD-based research of fluidized bed process revealed several new scientific results, such as parametrical relationships. The huge variance of seven orders of magnitude within the bed Sherwood numbers presented in the literature could be explained by the change of controlling mechanisms in the overall heterogeneous mass transfer process with the varied process conditions. The research opens new process-specific insights into the reactive fluidized bed processes, such as a strong mass transfer control over heterogeneous reaction rate, a dominance of interphase mass transfer in the fine-particle fluidized beds and a strong chemical kinetic dependence of the average gas-bed mass transfer. The obtained mass transfer coefficients can be applied in fluidized bed models used for various engineering design, reactor scale-up and process research tasks, and they consequently provide an enhanced prediction accuracy of the performance of fluidized bed processes.

Do early life factors influence body mass index in adolescents?

The association between early life factors and body mass index (BMI) in adulthood has been demonstrated in developed countries. The aim of the present study was to assess the influence of early life factors (birth weight, gestational age, maternal smoking, and social class) on BMI in young adulthood with adjustment for adult socioeconomic position. A cohort study was carried out in 1978/79 with 6827 mother-child pairs from Ribeirão Preto city, located in the most developed economic area of the country. Biological, economic and social variables and newborn anthropometric measurements were obtained shortly after delivery. In 1996, 1189 males from this cohort, 34.3% of the original male population, were submitted to anthropometric measurements and were asked about their current schooling on the occasion of army recruitment. A multiple linear regression model was applied to determine variables associated with BMI. Mean BMI was 22.7 (95%CI = 22.5-23.0). After adjustment, BMI was 1.22 kg/m² higher among infants born with high birth weight (³4000 g), 1.21 kg/m² higher among individuals of low social class at birth and 0.69 kg/m² higher among individuals whose mothers smoked during pregnancy (P < 0.05). The association between social class at birth and BMI remained statistically significant (P < 0.05) even after adjustment for adult schooling. These findings suggest that early life social influences on BMI were more important and were not reversed by late socioeconomic position. Therefore, prevention of overweight and obesity should focus not only on changes in adult life styles but also on factors such as high birth weight.

Do intrauterine growth restriction and overweight at primary school age increase the risk of elevated body mass index in young adults?

Obesity is one of the rising public health problems characterized as a risk factor for many chronic diseases in adulthood. Early life events such as intrauterine growth restriction, as well as life style, are associated with an increased prevalence of this disease. The present study was performed to determine if intrauterine growth restriction interacts with overweight at primary school age to affect body mass index (BMI) in young adults. From June 1, 1978 to May 31, 1979, 6827 singleton liveborns from Ribeirão Preto, São Paulo State, Brazil, corresponding to 98% of all births at the 8 maternity hospitals, were examined and their mothers were interviewed. Samples from the initial cohort were examined again at primary school age (8 to 11 years of age) and at the time of military service (18 years of age). There were 519 male individuals with complete measurements taken in the three surveys. Intrauterine growth-restricted individuals had a BMI 0.68 kg/m² lower than that of individuals who were not restricted (95%CI = -1.34 to -0.03) and overweight at primary school age showed a positive and strong effect on BMI at 18 years of age (coefficient 5.03, 95%CI = 4.27 to 5.79). However, the increase in BMI was much higher - 6.90 kg/m² - when the conscript had been born with intrauterine growth restriction and presented overweight at primary school age (95%CI = 4.55 to 9.26). These findings indicate that the effect of intrauterine growth restrictionon BMI at 18 years of age is modified by later weight gain during school age.

Tympanometry and Spectral Gradient Acoustic Reflectometry in the Diagnosis of Otitis Media in Young Children

Acute otitis media (AOM) is the most prevalent bacterial infection among children. Tympanometry and spectral gradient acoustic reflectometry (SG-AR) are adjunctive diagnostic tools to pneumatic otoscopy. The aim was to investigate the diagnostic accuracy and success rates of tympanometry and SG-AR performed by physicians and nurses. The study populations comprised 515 (I-II), 281 (III), and 156 (IV) outpatients (6-35 months). Physicians performed 4246 tympanometric (I) and SG-AR (II) examinations. Nurses performed 1782 (III) and 753 (IV) examinations at symptomatic and asymptomatic visits, respectively. Pneumatic otoscopy by the physician was the diagnostic standard. The accuracy of test results by physicians or nurses (I-IV) and the proportion of visits with accurate exclusive test results from both ears (III-IV) were analyzed. Type B tympanogram and SG-AR level 5 (<49˚) predicted middle ear effusion (MEE). At asymptomatic visits, type A and C1 tympanograms (peak pressure > -200 daPa) and SG-AR level 1 (>95˚) indicated healthy middle ear. Negative predictive values of type A and C1 tympanograms by nurses in excluding AOM at symptomatic and MEE at asymptomatic visits were 94% and 95%, respectively. Nurses obtained type A or C1 tympanogram from both ears at 94/459 (20%) and 81/196 (41%) of symptomatic and asymptomatic visits, respectively. SG-AR level 1 was rarely obtained from both ears. Type A and C1 tympanograms were accurate in excluding AOM at symptomatic and MEE at asymptomatic visits. However, nurses obtained these tympanograms from both ears only at one fifth of symptomatic visits and less than half of asymptomatic visits.

Association of polymorphisms at the ADIPOR1 regulatory region with type 2 diabetes and body mass index in a Brazilian population with European or African ancestry

Association studies between ADIPOR1 genetic variants and predisposition to type 2 diabetes (DM2) have provided contradictory results. We determined if two single nucleotide polymorphisms (SNP c.-8503G>A and SNP c.10225C>G) in regulatory regions of ADIPOR1 in 567 Brazilian individuals of European (EA; N = 443) or African (AfA; N = 124) ancestry from rural (quilombo remnants; N = 439) and urban (N = 567) areas. We detected a significant effect of ethnicity on the distribution of the allelic frequencies of both SNPs in these populations (EA: -8503A = 0.27; AfA: -8503A = 0.16; P = 0.001 and EA: 10225G = 0.35; AfA: 10225G = 0.51; P < 0.001). Neither of the polymorphisms were associated with DM2 in the case-control study in EA (SNP c.-8503G>A: DM2 group -8503A = 0.26; control group -8503A = 0.30; P = 0.14/SNP 10225C>G: DM2 group 10225G = 0.37; control group 10225G = 0.32; P = 0.40) and AfA populations (SNP c.-8503G>A: DM2 group -8503A = 0.16; control group -8503A = 0.15; P = 0.34/SNP 10225C>G: DM2 group 10225G = 0.51; control group 10225G = 0.52; P = 0.50). Similarly, none of the polymorphisms were associated with metabolic/anthropometric risk factors for DM2 in any of the three populations, except for HDL cholesterol, which was significantly higher in AfA heterozygotes (GC = 53.75 ± 17.26 mg/dL) than in homozygotes. We conclude that ADIPOR1 polymorphisms are unlikely to be major risk factors for DM2 or for metabolic/anthropometric measurements that represent risk factors for DM2 in populations of European and African ancestries.

Gender differences in serum CK-MB mass levels in healthy Braziliansubjects

The creatine kinase-isoenzyme MB (CK-MB) mass assay is one of the laboratory tests used for the diagnosis of myocardial infarction. It is recommended, however, that reference limits should take gender and race into account. In the present study, we analyzed the plasma CK-MB mass and troponin levels of 244 healthy volunteers without a personal history of coronary artery disease and with no chronic diseases, muscular trauma or hypothyroidism, and not taking statins. The tests were performed with commercial kits, CK-MB mass turbo kit and Troponin I turbo kit, using the Immulite 1000 analyzer from Siemens Healthcare Diagnostic. The values were separated according to gender and showed significant differences by the Mann-Whitney test. Mean (± SD) CK-MB mass values were 2.55 ± 1.09 for women (N = 121; age = 41.20 ± 10.13 years) and 3.49 ± 1.41 ng/mL for men (N = 123; age = 38.16 ± 11.12 years). Gender-specific reference values at the 99th percentile level, according to the Medicalc statistical software, were 5.40 ng/mL for women and 7.13 ng/mL for men. The influence of race was not considered because of the high miscegenation of the Brazilian population. The CK-MB values obtained were higher than the 5.10 mg/mL proposed by the manufacturer of the laboratory kit. Therefore, decision limits should be related to population and gender in order to improve the specificity of this diagnostic tool, avoiding misclassification of patients

Anthropometric midarm measurements can detect systemic fat-free mass depletion in patients with chronic obstructive pulmonary disease

Our objective was to determine whether anthropometric measurements of the midarm (MA) could identify subjects with whole body fat-free mass (FFM) depletion. Fifty-five patients (31% females; age: 64.6 ± 9.3 years) with mild/very severe chronic obstructive pulmonary disease (COPD), 18 smokers without COPD (39% females; age: 49.0 ± 7.3 years) and 23 never smoked controls (57% females; age: 48.2 ± 9.6 years) were evaluated. Spirometry, muscle strength and MA circumference were measured. MA muscle area was estimated by anthropometry and MA cross-sectional area by computerized tomography (CT) scan. Bioelectrical impedance was used as the reference method for FFM. MA circumference and MA muscle area correlated with FFM and biceps and triceps strength. Receiver operating characteristic curve analysis showed that MA circumference and MA muscle area cut-off points presented sensitivity and specificity >82% to discriminate FFM-depleted subjects. CT scan measurements did not provide improved sensitivity or specificity. For all groups, there was no significant statistical difference between MA muscle area [35.2 (29.3-45.0) cm²] and MA cross-sectional area values [36.4 (28.5-43.3) cm²] and the linear correlation coefficient between tests was r = 0.77 (P < 0.001). However, Bland-Altman plots revealed wide 95% limits of agreement (-14.7 to 15.0 cm²) between anthropometric and CT scan measurements. Anthropometric MA measurements may provide useful information for identifying subjects with whole body FFM depletion. This is a low-cost technique and can be used in a wider patient population to identify those likely to benefit from a complete body composition evaluation.

The Utilization of Chinese Social Media in Internationalization into China: Perspective of a Western Company

The purpose of this qualitative research is to analyze western-based companies’ social media usage in internationalization into China and to identify social media presence’ impact on the internationalization process. Additionally, the benefits and challenges a western company may face while using social media in China will be illustrated. Competitive advantages, knowledge, networks and relations, and costs and risks could be identified as the key antecedents for successful internationalization. A great social media presence could create a competitive advantage for a western company while competitive advantages may be communicated in social media marketing, knowledge and networks can be enhanced and utilized in internationalization via social media two-way communication. The biggest benefit for internationalization resulted from decreased marketing costs due to cost-effectiveness of social media. The results revealed that cost effective brand awareness was the main benefit from the social media usage in internationalization into China. However, companies struggled with the limited resources and despite of understanding the importance of Chinese social media, lacked sufficient resources for the social media operations. Companies should determine clear strategy and goals that they are willing to achieve via social media in internationalization process, and allocate required resources according to the social media strategy. Localization of the social media operations is important in China, and business-to-consumer companies tend to benefit more from the social media presence. Business-to-business companies may increase the brand’s credibility by successful Chinese social media operations.

Social media in the purchasing of knowledge-intensive business services

The purpose of this thesis was to understand how industrial buyers utilize social media in the purchasing of knowledge-intensive business services. By combining theories from past research a theoretical framework was formed to visualize the role of the social media at the different stages of the purchasing process. The subject was approached from the industrial buyers’ perspective instead of the knowledge-intensive business firm. The research was conducted using two qualitative research methods: interviews and netnography. The selected interviewees have been involved in the decision-making unit for purchasing knowledge-intensive business services. Additionally all of them are using various social media. Based on the interviews social media is used merely to support decision-making. Some of the interviewees had also shared their own experiences about the service and collaboration with the service provider with other social media users. Based on the interviews two social media were chosen for closer examination. The findings from netnography support the results from the interviews. The outcome of knowledgeintensive business services is dependable of the professionals. Therefore the information is used during decision-making process to confirm the formed image of the service, and the professionals of the service provider. Information obtained from social media complements information provided by the supplier. Even though the interviewees had not themselves used social media to find information about the service during search process, finding from netnography suggest it to exist. Industrial buyers ask other users’ opinions and experience about the services, and receive recommendations to them. Some recommendations are given publicly, but more discreet information is shared in private conversations. Observations in social media show that industrial buyers might be exposed to triggers to promote problem recognition as well. Companies share news and successful customer cases through their social media profiles, which might affect the industrial buyers, but to confirm this requires further research. The industrial buyers’ use of social media during different purchasing processes of knowledgeintensive business services can be conceptualize based on the findings. This helps companies to create right content to their social media pages, and encourage professionals to develop their networks in social media.

Marketing Brock University in the 1980's: assessing freshman student feedback in strategic planning approach

Universities have entered a period of rapid change and upheaval due to an external environment beyond their control which includes shifting demographic patterns, accelerating technology, funding shortages, and keener competition for students. Strategic planning, a comprehensive vision which challenges universities to take bold and creative measures to meet the threats and opportunities of the future, is an institutional imperative in the 1980's. This paper examines freshman student feedback in an effort to incorporate this important element into a strategic plan for Brock University, a small, predominantly liberal arts university in St. Catharines, Ontario. The study was designed to provide information on the characteristics of the 1985-86 pool of freshman registrants: their attitudes towards Brock's recruitment measures, their general university priorities, and their influences in regard to university selection (along with other demographical and attitudinal data). A survey involving fixed-alternative questions of a subjective and objective nature was administered in two large freshman classes at Brock in which a broad cross-section of academic programs was anticipated. Computer analysis of the data for the 357 respondents included total raw frequencies and rounded percentages, as well as subgroup cross-tabulation by geographic home area of respondent, academic major, and high school graduating average. The four directional hypotheses put forward were all substantiatied by the survey data, indicating that 1) the university's current recruitment program had been a positive influence during their university search 2) parents were the most influential group in the students' decisions related to university 3) respondents viewed institutional reputation as less of a priority than an enjoyable university lifestyle in a personal learning atmosphere 4) students had a decided preference for co-operative study and internship programs. Strategic planning recommendations included a reduction in the faculty/student ratio through faculty hirings to restore the close rapport between professors and students, increased recruitment presentations in Ontario high schools to enlarge the applicant pool, creation of an Office of Co-operative Study and Internship Programs, institutional emphasis on a "customer orientation", and an extension of research into student demographics and attitudinal data.