Predicting adverse events in children with fever and chemotherapy-induced neutropenia: the prospective multicenter SPOG 2003 FN study.

PURPOSE To develop a score predicting the risk of adverse events (AEs) in pediatric patients with cancer who experience fever and neutropenia (FN) and to evaluate its performance. PATIENTS AND METHODS Pediatric patients with cancer presenting with FN induced by nonmyeloablative chemotherapy were observed in a prospective multicenter study. A score predicting the risk of future AEs (ie, serious medical complication, microbiologically defined infection, radiologically confirmed pneumonia) was developed from a multivariate mixed logistic regression model. Its cross-validated predictive performance was compared with that of published risk prediction rules. Results An AE was reported in 122 (29%) of 423 FN episodes. In 57 episodes (13%), the first AE was known only after reassessment after 8 to 24 hours of inpatient management. Predicting AE at reassessment was better than prediction at presentation with FN. A differential leukocyte count did not increase the predictive performance. The score predicting future AE in 358 episodes without known AE at reassessment used the following four variables: preceding chemotherapy more intensive than acute lymphoblastic leukemia maintenance (weight = 4), hemoglobin > or = 90 g/L (weight = 5), leukocyte count less than 0.3 G/L (weight = 3), and platelet count less than 50 G/L (weight = 3). A score (sum of weights) > or = 9 predicted future AEs. The cross-validated performance of this score exceeded the performance of published risk prediction rules. At an overall sensitivity of 92%, 35% of the episodes were classified as low risk, with a specificity of 45% and a negative predictive value of 93%. CONCLUSION This score, based on four routinely accessible characteristics, accurately identifies pediatric patients with cancer with FN at risk for AEs after reassessment.

« Tomorrow Belongs To Me » : représentations de la femme dans une ballade suprémaciste blanche

La version intégrale de ce mémoire est disponible uniquement pour consultation individuelle à la Bibliothèque de musique de l’Université de Montréal (www.bib.umontreal.ca/MU).

Texture Description of low grade and high grade Glioma using Statistical features in Brain MRIs

Low grade and High grade Gliomas are tumors that originate in the glial cells. The main challenge in brain tumor diagnosis is whether a tumor is benign or malignant, primary or metastatic and low or high grade. Based on the patient's MRI, a radiologist could not differentiate whether it is a low grade Glioma or a high grade Glioma. Because both of these are almost visually similar, autopsy confirms the diagnosis of low grade with high-grade and infiltrative features. In this paper, textural description of Grade I and grade III Glioma are extracted using First order statistics and Gray Level Co-occurance Matrix Method (GLCM). Textural features are extracted from 16X16 sub image of the segmented Region of Interest(ROI) .In the proposed method, first order statistical features such as contrast, Intensity , Entropy, Kurtosis and spectral energy and GLCM features extracted were showed promising results. The ranges of these first order statistics and GLCM based features extracted are highly discriminant between grade I and Grade III. In this study which gives statistical textural information of grade I and grade III Glioma which is very useful for further classification and analysis and thus assisting Radiologist in greater extent.

Prevalencia de los trastornos de voz ocupacionales en los docentes de dos instituciones educativas de nivel superior en Colombia en el año 2013-2014

Resumen: En la población docente, el uso de la voz como principal herramienta del trabajo por su esfuerzo constante y prolongado constituye el principal factor de riesgo para padecer trastornos de la voz, concomitante con otros factores que inciden en la presentación de estas patologías. Objetivo: Determinar la prevalencia de los trastornos en la voz y sus factores asociados de la población docente de dos instituciones de educación superior (IES) en Colombia y los factores de riesgo asociados. Materiales y métodos: Se realizó un estudio descriptivo de tipo transversal, en el que participaron 149 docentes de dos IES (instituciones de educación superior) de dos ciudades de Colombia. Se aplicó un cuestionario sustentado en el Modelo de Técnicas Foniátricas para Prevenir la Disfonía en Profesores de Secundaria en Portugal y validado por la escuela de Medicina y Ciencias de la Salud, programa de fonoaudiología de la Universidad del Rosario con el trabajo denominado “La Voz como herramienta de trabajo” para Colombia; el cual indagaba los factores riesgo asociados al uso de la voz en el quehacer docente. Se realizó un análisis descriptivo de las variables cualitativas con frecuencias absolutas y porcentajes, medidas de tendencia central, promedio y mediana, de dispersión y desviación estándar. La información recolectada fue analizada con el software SPSS.PASW 18. La correlación entre las variables dependientes y las independientes, se realizaron con el coeficiente no-paramétrico de Spearman y la asociación con la prueba Ji-cuadrado de Pearson o el test exacto de Fisher (valores esperados < 5). Se evaluaron las distribuciones de las variables ordinales de las variables de problemas de la voz con el género, con la prueba no-paramétrica exacta de Mann Whitney. Las pruebas estadísticas se evaluaron a un nivel de significancia del 5% (p<0.05). Resultados: El promedio de edad fue de 36±11.7 años, con un rango que varió entre 25 y 68 años. El género más frecuente fue el masculino con 57,0% de participación. Los datos presentados se dan como resultado de las respuestas a tres preguntas indicativas de los trastornos de voz, las cuales no fueron respondidas por la totalidad de los docentes, por esta razón los datos se presentan así t= número total de personas que respondieron la pregunta y n= número de personas que respondieron afirmativamente. La prevalencia de alteración de voz fue del 63,4% (t=82; n=52), de disminución en el volumen de su voz de 57,3% (t=122; n=70) y cansancio laríngeo en el 76,8% (t=121; n=93). El cansancio laríngeo fue significativamente mayor en los hombres que en las mujeres (p=0.026, Test Mann Whitney exacto a una cola), con algunos hábitos de voz como el realizar esfuerzos en el cuello al hablar (rs = 0,461; p< 0,001) y con la dificultad para inhalar o exhalar aire al hablar (rs = 0,368; p<0.001), con el ruido de fondo (rs =0,361, p<0,001), al permanecer en ambientes contaminados con polvo y humedad (rs=0,311; p=0.001), con sufrir de estrés representado por dolor cervical en espalda y hombros (rs=0,349, p<0.001), y con los problemas familiares (rs= 0,397; p<0.001). Al analizar con la disminución del volumen de voz durante la práctica docente, las correlaciones más significativas mostradas fue estadísticamente mayor entre los hombres que en las mujeres (p=0.006, Test Mann Whitney exacto a una cola), con el esfuerzo cervical para hablar (rs =:0,596, p=<,001), y con el presentar dificultad para inhalar/exhalar aire al usar la voz (rs =0,508, p<,001), con la exposición a ruido de fondo (rs=0,204, p=0,030), ambientes contaminados con polvo y humedad (rs:=305, p<,001), con el estrés (rs =0,316, p=0,001), con los problemas familiares (rs =0,560, p<,001) y en las mujeres con la alteración de la voz en presencia de la menstruación (rs =0,751, p=0,000). Por último, se correlacionó con las alteraciones de voz durante la exposición laboral en la que se mostró mayor correlación en las mujeres que en los hombres (p=0.001, Test Mann Whitney exacto a una cola). Se mostró correlación directa con el no realizar pausas al hablar (rs=0,337, p<0,001), con toser para aclarar la voz (rs =0,349, p=0,001), y con el uso de la voz grave (rs =0,975; p=,004) ,con la presencia de ruido de fondo mientras se dicta clase (rs =0,370, p=0,001) con el permanecer en ambientes contaminados con polvo y humedad (rs =0,253,p=,023), con los síntomas cervicales asociados al estrés (rs=0,323, p=0,003), e inversa con los cambios en tono y volumen de la voz en presencia de menstruación en las mujeres (rs=-0,414,p=,017). Conclusiones: Con los hallazgos encontrados en este estudio es importante reconocer que en las características demográficas, se encontró que el género masculino refirió mayor cantidad de problemas de voz. Para las características laborales la antigüedad ocupacional es factor principal que incide en los problemas de voz; en el análisis de las características demográfico– laborales en las variables analizadas, el grupo etario que reporto cansancio laríngeo se encontraba entre los 36 a 45 años de edad, y los que referían un tiempo de exposición ocupacional mayor a 6 y menor a 15 años. En cuanto a los factores ambientales se identificó que la asociación más significativa está relacionada con estar sometido a cambios bruscos de temperatura, estar expuesto a ruido de fondo durante su labor y finalmente a permanecer en ambientes contaminados. Por ultimo al analizar las alteraciones de la voz con las características personales de los docentes, se observó que el estrés y los problemas familiares inciden de forma significativa en estas patologías. Con estos resultados se recomienda establecer un sistema de vigilancia epidemiológica en las IES, donde se capacite integralmente a los docentes en cuanto a los factores de riesgo personales y de hábitos de voz, además de supervisar y adecuar los factores ambientales que inciden en la presentación de trastornos de voz para evitar la presentación de estas patologías.

Enhancing consumer liking of low salt tomato soup over repeated exposure by herb and spice seasonings

There is strong evidence for the link between high dietary sodium and increased risk of cardiovascular disease which drives the need to reduce salt content in foods. In this study, herb and spice blends were used to enhance consumer acceptability of a low salt tomato soup (0.26% w/w). Subjects (n=148) scored their liking of tomato soup samples over five consecutive days. The first and last days were pre-and post-exposure visits where all participants rated three tomato soup samples; standard, low salt and low salt with added herbs and spices. The middle 3 days were the repeated exposure phase where participants were divided into three balanced groups; consuming the standard soup, the low salt soup, or the low salt soup with added herbs and spices. Reducing salt in the tomato soup led to a significant decline in consumer acceptability, and incorporating herbs and spices did not lead to an immediate enhancement in liking. However, inclusion of herbs and spices enhanced the perception of the salty taste of the low salt soup to the same level as the standard. Repeated exposure to the herbs and spice-modified soup led to a significant increase in the overall liking and liking of flavour, texture and aftertaste of the soup, whereas no changes in liking were observed for the standard and low salt tomato soups over repeated exposure. Moreover, a positive trend in increasing the post-exposure liking of the herbs and spices soup was observed. The findings suggest that the use of herbs and spices is a useful approach to reduce salt content in foods; however, herbs and spices should be chosen carefully to complement the food as large contrasts in flavour can polarise consumer liking.

Atypical processing of voice sounds in infants at risk for Autism Spectrum Disorder

Adults diagnosed with autism spectrum disorder (ASD) show a reduced sensitivity (degree of selective response) to social stimuli such as human voices. In order to determine whether this reduced sensitivity is a consequence of years of poor social interaction and communication or is present prior to significant experience, we used functional MRI to examine cortical sensitivity to auditory stimuli in infants at high familial risk for later emerging ASD (HR group, N = 15), and compared this to infants with no family history of ASD (LR group, N = 18). The infants (aged between 4 and 7 months) were presented with voice and environmental sounds while asleep in the scanner and their behaviour was also examined in the context of observed parent-infant interaction. Whereas LR infants showed early specialisation for human voice processing in right temporal and medial frontal regions, the HR infants did not. Similarly, LR infants showed stronger sensitivity than HR infants to sad vocalisations in the right fusiform gyrus and left hippocampus. Also, in the HR group only, there was an association between each infant's degree of engagement during social interaction and the degree of voice sensitivity in key cortical regions. These results suggest that at least some infants at high-risk for ASD have atypical neural responses to human voice with and without emotional valence. Further exploration of the relationship between behaviour during social interaction and voice processing may help better understand the mechanisms that lead to different outcomes in at risk populations.

Lymphocyte transformation assay for C neoformans antigen is not reliable for detecting cellular impairment in patients with Neurocryptococcosis

Background: Cryptococcus neoformans causes meningitis and disseminated infection in healthy individuals, but more commonly in hosts with defective immune responses. Cell-mediated immunity is an important component of the immune response to a great variety of infections, including yeast infections. We aimed to evaluate a specific lymphocyte transformation assay to Cryptococcus neoformans in order to identify immunodeficiency associated to neurocryptococcosis (NCC) as primary cause of the mycosis.Methods: Healthy volunteers, poultry growers, and HIV-seronegative patients with neurocryptococcosis were tested for cellular immune response. Cryptococcal meningitis was diagnosed by India ink staining of cerebrospinal fluid and cryptococcal antigen test (Immunomycol-Inc, SP, Brazil). Isolated peripheral blood mononuclear cells were stimulated with C. neoformans antigen, C. albicans antigen, and pokeweed mitogen. The amount of H-3-thymidine incorporated was assessed, and the results were expressed as stimulation index (SI) and log SI, sensitivity, specificity, and cut-off value (receiver operating characteristics curve). We applied unpaired Student t tests to compare data and considered significant differences for p<0.05.Results: The lymphotoxin alpha showed a low capacity with all the stimuli for classifying patients as responders and non-responders. Lymphotoxin alpha stimulated by heated-killed antigen from patients with neurocryptococcosis was not affected by TCD4+ cell count, and the intensity of response did not correlate with the clinical evolution of neurocryptococcosis.Conclusion: Response to lymphocyte transformation assay should be analyzed based on a normal range and using more than one stimulator. The use of a cut-off value to classify patients with neurocryptococcosis is inadequate. Statistical analysis should be based on the log transformation of SI. A more purified antigen for evaluating specific response to C. neoformans is needed.

Mechanical removal of necrotic periodontal ligament by either Robinson bristle brush with pumice or scalpel blade. Histomorphometric analysis and scanning electron microscopy

One of the important factors accounting for successful delayed replantation of avulsed teeth is seemingly the type of root surface treatment. Removal of necrotic cemental periodontal ligament remnants may prevent the occurrence of external root resorption, which is the major cause of loss of teeth replanted in such conditions. The purpose of this study was to compare the efficacy of two mechanical techniques for removal of root-adhered periodontal ligament. Preservation or removal of the cementum layer concomitantly with these procedures was also assessed. Forty-five roots of healthy premolars extracted for orthodontic purposes were selected. After extraction, the teeth were kept dry at room temperature for 1 h and then immersed in saline for rehydration for an additional 10 min. Thereafter, the roots were assigned to three groups, as follows: group 1 (control) - the cemental periodontal ligament was preserved; group 2 - removal of the periodontal ligament by scraping root surface with a scalpel blade (SBS); group 3 - periodontal ligament remnants were removed using a Robinson bristle brush at low-speed with pumice/water slurry (RBP). The specimens were analysed histomorphometrically and examined by scanning electron microscopy. The quantitative and qualitative analyses of the results showed that the RBP technique was significantly more effective than the SBS technique for removal of the periodontal ligament remnants adhered to root surface. Both techniques preserved the cementum layer.

Collision of positronium with atoms, molecules and ions using a modified coupled-channel framework

Scattering of positronium (Ps) from atoms (H, He, Ne, Ar), molecule (H(2)) and ion (He(+)) have been investigated using a coupled-channel (CC) formalism with a regularised non-local exchange potential. The advantage of using such a regularized exchange potential in the close-coupling formalism and the normalizability aspect of the solution at low energies with a minimum effective coupling are discussed. Results for the elastic and total scattering cross-sections, resonance and binding energies in Ps-H, and pick-off annihilation results in Ps-He are found to be in excellent agreement with measurements and variational predictions. (C) 2000 Elsevier B.V. B.V. All rights reserved.

High sensitivity low cost capacitive strain gage

This paper describes a high senstivity low cost capacitive strain gage sensor. The theory, design, and sensor construction details are presented. It consists of eight capacitive sensors connected in two full bridges. The capacitive strain gage sensor structure was designed in order to produce high sensitivity and low dependence with temperature. By using a simple signal conditioning circuit constituted by a differential amplifier, a band-pass filter, and a precision rectifier the device can measure forces with resolution of 0.009 N and precision of 98.7%. It is rugged, presents linear response, and good repeatability. It presents sensitivity of 8.7 V/N and fall time of 12 ms.

Análise comparativa do uso da tabela fonética do português brasileiro cantado por cantores argentinos com e sem o uso de um recurso áudio visual

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Treatment of Atrophic Mandibular Fractures with the Pencilboneplate: Report of 2 Cases

The incidence of fractures of the atrophic edentulous mandible is still low, even with the increasing life expectancy. The reduced blood supply of the sclerotic bone, the diminished contact area between bone fragments and the patient’s systemic condition makes the treatment of those fractures a challenge for any professional. Treatment of atrophic mandibular fractures by means of miniplate osteosynthesis has not been the preferred method of fixa- tion by many authors. Yet, many surgeons have applied this type of fixation for the atrophied jaw sections. This paper reports 2 cases of fractured atrophic mandibles treated with the pencilboneplate, a monocortical 2.0 mm titanium, 8 or 10-hole hardware with reinforcement on its middle portion, highlighting important considerations of its use. The pencilboneplate appears to be a valuable option for the treatment of atrophic mandibular fractures, espe- cially by an intra-oral approach, and warrants further bio- mechanical and clinical studies.

Short-term low-intensity blood flow restricted interval training improves both aerobic fitness and muscle strength

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Lymphocyte transformation assay for C neoformans antigen is not reliable for detecting cellular impairment in patients with Neurocryptococcosis

Background: Cryptococcus neoformans causes meningitis and disseminated infection in healthy individuals, but more commonly in hosts with defective immune responses. Cell-mediated immunity is an important component of the immune response to a great variety of infections, including yeast infections. We aimed to evaluate a specific lymphocyte transformation assay to Cryptococcus neoformans in order to identify immunodeficiency associated to neurocryptococcosis (NCC) as primary cause of the mycosis. Methods: Healthy volunteers, poultry growers, and HIV-seronegative patients with neurocryptococcosis were tested for cellular immune response. Cryptococcal meningitis was diagnosed by India ink staining of cerebrospinal fluid and cryptococcal antigen test (Immunomycol-Inc, SP, Brazil). Isolated peripheral blood mononuclear cells were stimulated with C. neoformans antigen, C. albicans antigen, and pokeweed mitogen. The amount of H-3-thymidine incorporated was assessed, and the results were expressed as stimulation index (SI) and log SI, sensitivity, specificity, and cut-off value (receiver operating characteristics curve). We applied unpaired Student t tests to compare data and considered significant differences for p<0.05. Results: The lymphotoxin alpha showed a low capacity with all the stimuli for classifying patients as responders and non-responders. Lymphotoxin alpha stimulated by heated-killed antigen from patients with neurocryptococcosis was not affected by TCD4+ cell count, and the intensity of response did not correlate with the clinical evolution of neurocryptococcosis. Conclusion: Response to lymphocyte transformation assay should be analyzed based on a normal range and using more than one stimulator. The use of a cut-off value to classify patients with neurocryptococcosis is inadequate. Statistical analysis should be based on the log transformation of SI. A more purified antigen for evaluating specific response to C. neoformans is needed.

SAG2A protein from Toxoplasma gondii interacts with both innate and adaptive immune compartments of infected hosts

Abstract Background Toxoplasma gondii is an intracellular parasite that causes relevant clinical disease in humans and animals. Several studies have been performed in order to understand the interactions between proteins of the parasite and host cells. SAG2A is a 22 kDa protein that is mainly found in the surface of tachyzoites. In the present work, our aim was to correlate the predicted three-dimensional structure of this protein with the immune system of infected hosts. Methods To accomplish our goals, we performed in silico analysis of the amino acid sequence of SAG2A, correlating the predictions with in vitro stimulation of antigen presenting cells and serological assays. Results Structure modeling predicts that SAG2A protein possesses an unfolded C-terminal end, which varies its conformation within distinct strain types of T. gondii. This structure within the protein shelters a known B-cell immunodominant epitope, which presents low identity with its closest phyllogenetically related protein, an orthologue predicted in Neospora caninum. In agreement with the in silico observations, sera of known T. gondii infected mice and goats recognized recombinant SAG2A, whereas no serological cross-reactivity was observed with samples from N. caninum animals. Additionally, the C-terminal end of the protein was able to down-modulate pro-inflammatory responses of activated macrophages and dendritic cells. Conclusions Altogether, we demonstrate herein that recombinant SAG2A protein from T. gondii is immunologically relevant in the host-parasite interface and may be targeted in therapeutic and diagnostic procedures designed against the infection.