Proxy-reported health-related quality of life of patients with juvenile idiopathic arthritis: Pediatric rheumatology international trials organization multinational quality of life cohort study

Objective. To investigate the proxy-reported health-related quality of life (HRQOL) and its determinants in patients with juvenile idiopathic arthritis (JIA).Methods. In this multinational, multicenter, cross-sectional study, HRQOL of patients with JIA was assessed through the Child Health Questionnaire (CHQ) and was compared with that of healthy children of similar age from the same geographic area. of joint inflammation, Childhood Health Assessment Questionnaire (CHAQ), and erythrocyte sedimentation rate.Results. A total of 6,639 participants (3,324 with JIA and 3,315 healthy) were enrolled from 32 countries. The mean SD physical and psychosocial summary scores of the CHQ were significantly lower in patients with JIA than in healthy children (physical: 44.5 +/- 10.6 versus 54.6 +/- 4.0, P < 0.0001; psychosocial: 47.6 +/- 8.7 versus 51.9 +/- 7.59 P < 0.0001), with the physical well-being domain being most impaired. Patients with persistent oligoarthritis had better HRQOL compared with other subtypes, whereas HRQOL was similar across patients with systemic arthritis, polyarthritis, and extended oligoarthritis. A CHAQ score > 1 and a pain intensity rating > 3.4 cm on a 10-cm visual analog scale were the strongest determinants of poorer HRQOL in the physical and psychosocial domains, respectively.Conclusion. We found that patients with JIA have a significant impairment of their HRQOL compared with healthy peers, particularly in the physical domain. Physical well-being was mostly affected by the level of functional impairment, whereas the intensity of pain had the greatest influence on psychosocial health.

Long-Term Outcome and Prognostic Factors of Juvenile Dermatomyositis: A Multinational, Multicenter Study of 490 Patients

Objective. To investigate the long-term outcome and prognostic factors of juvenile dermatomyositis (DM) through a multinational, multicenter study.Methods. Patients consisted of inception cohorts seen between 1980 and 2004 in 27 centers in Europe and Latin America. Predictor variables were sex, continent, ethnicity, onset year, onset age, onset type, onset manifestations, course type, disease duration, and active disease duration. Outcomes were muscle strength/endurance, continued disease activity, cumulative damage, muscle damage, cutaneous damage, calcinosis, lipodystrophy, physical function, and health-related quality of life (HRQOL).Results. A total of 490 patients with a mean disease duration of 7.7 years were included. At the cross-sectional visit, 41.2-52.8% of patients, depending on the instrument used, had reduced muscle strength/endurance, but less than 10% had severe impairment. Persistently active disease was recorded in 41.2-60.5% of the patients, depending on the activity measure used. Sixty-nine percent of the patients had cumulative damage. The frequency of calcinosis and lipodystrophy was 23.6% and 9.7%, respectively. A total of 40.7% of the patients had decreased functional ability, but only 6.5% had major impairment. Only a small fraction had decreased HRQOL. A chronic course, either polycyclic or continuous, consistently predicted a poorer outcome. Mortality rate was 3.1%.Conclusion. This study confirms the marked improvement in functional outcome of juvenile DM when compared with earlier literature. However, many patients had continued disease activity and cumulative damage at followup. A chronic course was the strongest predictor of poor prognosis. These findings highlight the need for treatment strategies that enable a better control of disease activity over time and the reduction of nonreversible damage.

A snapshot of Chile's 20 largest multinational enterprises in 2011: Sustained growth in South America

Includes bibliography

A single-phase single-stage buck-boost inverter intended for low power alternative energy conversion systems: Analysis, design and experimentation

This paper presents the operational analysis of the single-phase integrated buck-boost inverter. This topology is able to convert the DC input voltage into AC voltage with a high static gain, low harmonic content and acceptable efficiency, all in one single-stage. Main functionality aspects are explained, design procedure, system modeling and control, and also component requirements are detailed. Main simulation results are included, and two prototypes were implemented and experimentally tested, where its results are compared with those corresponding to similar topologies available in literature. © 2012 IEEE.

The strategies of multinational companies in 1990s Argentina

Includes bibliography

Green supply chain management in local and multinational high-tech companies located in Brazil

The objective of this article is to analyse how green supply chain management (GSCM) practices are being adopted by some high-tech companies located in Brazil. The research was conducted using the case study approach, focusing on eight companies that are representative of this sector. The main results are: (a) the most adopted GSCM practices in the studied high-tech companies located in Brazil are internal environmental management, investment recovery and reverse logistics and (b) Brazilian environmental legislation and international policies are very important in driving the adoption of GSCM practices. The internationalisation of companies was also found to be a variable that interferes with the adoption of GSCM practices. This is one of the first studies that examine the relationship between GSCM and the internationalisation of companies located in Brazil. © 2013 Springer-Verlag London.

Profile and possibility of a multinational ore marketing enterprise: the case of Latin America

Includes bibliography

Corrositex®, BCOP and HET-CAM as alternative methods to animal experimentation

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

Infrastructure Support for Controlled Experimentation with Software Testing and Regression Testing Techniques

Where the creation, understanding, and assessment of software testing and regression testing techniques are concerned, controlled experimentation is an indispensable research methodology. Obtaining the infrastructure necessary to support such experimentation, however, is difficult and expensive. As a result, progress in experimentation with testing techniques has been slow, and empirical data on the costs and effectiveness of techniques remains relatively scarce. To help address this problem, we have been designing and constructing infrastructure to support controlled experimentation with testing and regression testing techniques. This paper reports on the challenges faced by researchers experimenting with testing techniques, including those that inform the design of our infrastructure. The paper then describes the infrastructure that we are creating in response to these challenges, and that we are now making available to other researchers, and discusses the impact that this infrastructure has and can be expected to have.

Progress in animal experimentation ethics. A case study from a brazilian medical school and from the international medical literature

PURPOSE: This study describes in Brazil and in the global biomedical community the time course of the development of animal research welfare guidelines. METHODS: The database of the Ethics Committee of the Faculty of Medicine of Ribeirao Preto (EC/FMRP-USP), Brazil, was surveyed since its inception in 2002 as the regulations became more stringent to provide better protection of animal research welfare at this institution. Medline database was evaluated to identify the number of publications in the period between 1968 and 2008 that used research animals and were in compliance with established ethics guidelines. RESULTS: The EC/FMRP-USP evaluated 979 projects up until 2009. Most of the applications came from Department of Physiology and the most frequently requested species was the rat. In 2004, national research funding agencies started to request prior approval from institutional review ethics committees prior to application review and this requirement became federal law in Brazil in 2008. The analysis of international publications revealed a relative reduction in studies involving research animals (18% in 1968 to 7.5% in 2008). CONCLUSIONS: The present work showed that in the last four decades major changes occurred in the guidelines dictating use of research animals occurred and they are being adopted by developing countries. Moreover, animal welfare concern in the scientific community preceded the introduction of journal guidelines for this purpose. Furthermore, in Brazil it was anticipated that laws were needed to protect animal research welfare from being not upheld.

Metacontingencies, Experimentation and Nonhumans: Searching for Conceptual and Methodological Advances

Metacontingency has been described as the functional relation between interlocking behavioral contingencies, plus their direct and immediate effect, called aggregated product, and a selecting event dependent of such effect, called cultural consequence. The metacontingencies analysis enables the discussion of human behavior complexity in social systems. In the present study, we aimed to review and discuss: (a) the importance of basic behavioral processes analysis for the comprehension of social human phenomena; (b) the necessity of constructing and improving metacontingencies experimental models; (c) the current state of metacontingencies experimental investigations in humans; (d) the use of animal models as a way to control the effects of verbal behavior, among other variables, over cultural selection; (e) a concrete and illustrative proposal of an animal model of metacontingencies.