Knowledge and practices of medical students to prevent tuberculosis transmission in Rio de Janeiro, Brazil

Objectives. To describe knowledge, practices, and associated factors of medical students to prevent transmission of tuberculosis (TB) in five medical schools. Methods. Cross-sectional survey of undergraduate medical students in preclinical and in early and late clinical years. Information was obtained on sociodemographic profile, previous lectures on TB, knowledge about TB transmission, exposure to patients with active pulmonary TB, and use of respiratory protective masks. Results. Among 1 094 respondents, 575 (52.6%) correctly answered that coughing, speaking, and sneezing can transmit TB. Early [adjusted odds ratio = 4.0 (3.0, 5.5)] and late [adjusted odds ratio = 4.2 (3.1, 5.8)] clinical years were associated with correct answers, but having had previous lectures on TB was not. Among those who had previous lectures on TB, the rate of correct answers increased from 42.1% to 61.6%. Among 332 medical students who reported exposure to TB patients, 194 (58.4%) had not used protective masks. More years of clinical experience was associated with the use of masks [adjusted odds ratio = 2.9 (1.4, 6.1)], while knowledge was inversely associated with the use of masks [adjusted odds ratio = 0.4 (0.2, 0.6)]. Conclusions. Many medical students are not aware of the main routes of TB infection, and lectures on TB are not sufficient to change knowledge and practices. Regardless of knowledge about TB transmission, students engage in risky behaviors: more than two-thirds do not use a protective mask when examining an active TB case. We suggest innovative, effective active learning experiences to change this scenario.

Industrial screening

Wills' Mineral Processing Technology provides practising engineers and students of mineral processing, metallurgy and mining with a review of all of the common ore-processing techniques utilized in modern processing installations. Now in its Seventh Edition, this renowned book is a standard reference for the mineral processing industry. Chapters deal with each of the major processing techniques, and coverage includes the latest technical developments in the processing of increasingly complex refractory ores, new equipment and process routes. This new edition has been prepared by the prestigious J K Minerals Research Centre of Australia, which contributes its world-class expertise and ensures that this will continue to be the book of choice for professionals and students in this field. This latest edition highlights the developments and the challenges facing the mineral processor, particularly with regard to the environmental problems posed in improving the efficiency of the existing processes and also in dealing with the waste created. The work is fully indexed and referenced.

Comparison of oral versus sublingual piroxicam during postoperative pain management after lower third molar extraction

In this study, 53 patients received piroxicam, administered orally or sublingually, after undergoing removal of symmetrically positioned lower third molars, during two separate appointments. This study used a randomized, blind, cross-over protocol. Objective and subjective parameters were recorded for comparison of postoperative results for 7 days after surgery. Patients treated with oral or sublingual piroxicam reported low postoperative pain scores. The patients who received piroxicam orally took a similar average amount of analgesic rescue medication compared with patients who received piroxicam sublingually (p > 0.05). Patients exhibited similar values for mouth opening measured just before surgery and immediately following suture removal 7 days later (p > 0.05), and showed no significant differences between routes of piroxicam administration for swelling control during the second or seventh postoperative days (p > 0.05). In summary, pain, trismus and swelling after lower third molar extraction, independent of surgical difficulty, could be controlled by piroxicam 20 mg administered orally or sublingually and no significant differences were observed between the route of delivery used in this study.

The equilibrium penetration of monolayers. Is equilibrium really established?

In studying the penetration of water-soluble surfactants into water-insoluble monolayers the main theoretical problem is to find a relationship that would enable the amount of surfactant that has entered the monolayer to be calculated from a set of equilibrium surface pressure-area isotherms. Despite many attempts, no current theory gives satisfactory results when applied to experimental data (Langmuir 14 (1998) 2148). One possible reason is that equilibrium had not been established when the surface pressure-area curves were measured. The three experiments reported here suggest that equilibrium is extremely difficult to establish in such systems when the area is low or the surface pressure is high. The essence of these experiments is to try to reach the same final condition by two different routes. In the first route, the one nearly always used in equilibrium penetration measurements, the surfactant is injected under the expanded monolayer, which is then slowly compressed in steps, with time allowed at each step for a steady surface pressure to be attained. In the second procedure, the monolayer is first compressed to a high surface pressure and the surfactant then injected. A stepped expansion isotherm may then be observed. Surface pressure-area per monolayer molecule isotherms, reflection spectra, and slow neutron reflectivity data all show the same pattern: if the surfactant was allowed to penetrate while the monolayer was in an expanded state, it was not completely removed when the monolayer was compressed; but if the monolayer was in a highly compressed state when exposed to the surfactant little penetration took place until the film was expanded. There thus appear to be very large energy barriers to the ejection of surfactant from a compressed monolayer and to the penetration of surfactant into a compressed monolayer. Although these experiments have some limitations, it now seems likely that at least some of the penetration data used in evaluating the various thermodynamic treatments of equilibrium penetration were not equilibrium data. (C) 2001 Elsevier Science B.V. All rights reserved.

Wolbachia-mediated sperm modification is dependent on the host genotype in Drosophila

Estimates of Wolbachia density in the eggs, testes and whole flies of drosophilid hosts have been unable to predict the lack of cytoplasmic incompatibility (CI) expression in so-called mod(-) variants. Consequently, the working hypothesis has been that CI expression, although related to Wolbachia density, is also governed by unknown factors that are influenced by both host and bacterial genomes. Here, we compare the behaviour of the mod(-) over-replicating Wolbachia popcorn strain in its native Drosophila melanogaster host to the same strain transinfected into a novel host, namely Drosophila simulans. We report that (i) the popcorn strain is a close relative of other D. melanogaster infections, (ii) the mod(-) status of popcorn in D. melanogaster appears to result from its inability to colonize sperm bundles, (iii) popcorn is present in the bundles in D. simulans and induces strong CI expression, which demonstrates that the bacterial strain does not lack the genetic machinery for inducing CI and that there is host-species-specific control over Wolbachia tissue tropism, and (iv) infection of sperm bundles by the mod(-) D. simulans wCof strain indicates that there are several independent routes by which a strain can be a CI non-expressor.

Sub-structure syntheses and relative stereochemistry in the bistramide (bistratene) series of marine metabolites

The (6R*,9S*,11S*) and (22S*,23R*,27R*,31R*) stereochemistry, respectively, of the tetrahydropyranyl and spiroacetal moieties in bistramide A (1) have been established by stereoselective syntheses and high field NMR comparisons. Routes to the gamma-amino acid moiety are outlined. (C) 2002 Elsevier Science Ltd. All rights reserved.

Differential sorting and fate of endocytosed GPI-anchored proteins

In this paper, we studied the fate of endocytosed glycosylphosphatidyl inositol anchored proteins (GPI-APs) in mammalian cells, using aerolysin, a bacterial toxin that binds to the GPI anchor, as a probe. We find that GPI-APs are transported down the endocytic pathway to reducing late endosomes in BHK cells, using biochemical, morphological and functional approaches. We also find that this transport correlates with the association to raft-like membranes and thus that lipid rafts are present in late endosomes (in addition to the Golgi and the plasma membrane). In marked contrast, endocytosed GPI-APs reach the recycling endosome in CHO cells and this transport correlates with a decreased raft association. GPI-APs are, however, diverted from the recycling endosome and routed to late endosomes in CHO cells, when their raft association is increased by clustering seven or less GPI-APs with an aerolysin mutant. We conclude that the different endocytic routes followed by GPI-APs in different cell types depend on the residence time of GPI-APs in lipid rafts, and hence that raft partitioning regulates GPI-APs sorting in the endocytic pathway.

Parenteral and mucosal delivery of a novel multi-epitope M protein-based group A streptococcal vaccine construct: investigation of immunogenicity in mice

Primary vaccine strategies against group A streptococci (GAS) have focused on the M protein-the target of opsonic antibodies important for protective immunity. We have previously reported protection of mice against GAS infection following parenteral delivery of a multi-epitope vaccine construct, referred to as a heteropolymer. This current report has assessed mucosal (intranasal (i.n.) and oral) delivery of the heteropolymer in mice with regard to the induction and specificity of mucosal and systemic antibody responses, and compared this to parenteral delivery. GAS-specific IgA responses were detected in saliva and gut upon i.n. and oral delivery of the heteropolymer co-administered with cholera toxin B subunit, respectively. High titre serum IgG responses were elicited to the heteropolymer following all routes of delivery when administered with adjuvant. Moreover, as with parenteral delivery, serum IgG antibodies were detected to the individual heteropolymer peptides following i.n. but not oral delivery. These data support the potential of the i.n. route in the mucosal delivery of a GAS vaccine. (C) 2002 Elsevier Science Ltd. All rights reserved.

Experimental human infection with the dog hookworm, Ancylostoma caninum

Objective: To investigate possible routes for human infection by the dog hookworm (Ancylostoma caninum). Design, setting and participant. Relatively small numbers of infective larvae were administered orally and percutaneously to an informed healthy volunteer (J K L) under medical supervision, at intervals between May 1998 and May 1999. Main outcome measures: Symptoms; weekly blood eosinophil counts; faecal microscopy. Results: A marked blood eosinophilia followed a single oral exposure to 100 infective larvae, while faecal examination remained negative. Eosinophil counts then declined gradually, although a rapid, spontaneous rise several months later, at the beginning of spring, possibly indicated reactivation of dormant larvae. Blood eosinophil numbers did not rise significantly after percutaneous infection with 200 larvae. A subsequent, smaller, oral inoculum of 20 larvae provoked an eosinophil response similar to that of the first experiment. Conclusions: Our findings suggest that, following ingestion, some infective larvae of A. caninum develop directly into adult worms in the human gut (as they do in dogs). While the percutaneous route might be the most common means of human exposure to canine hookworm larvae, leading generally to subclinical infection, oral infection may be more likely to provoke symptomatic eosinophilic enteritis.

Heroin overdose: Research and evidence-based intervention

Drug overdose is a major cause of Premature death and morbidity among heroin users. This article examines recent research into heroin overdose to inform interventions that will reduce the rate of overdose death. The demographic characteristics of overdose cases are discussed, including factors associated with overdose: polydrug use, drug purity, drug tolerance, routes of administration, and suicide. Responses by heroin users at overdoses are also examined. Potential interventions to reduce the rate of overdose and overdose-related morbidity are examined in light of the emerging data in this field.

Effect of solute lipophilicity on penetration through canine skin

Objective To investigate the effect of lipophilicity on the percutaneous penetration of a homologous series of alcohols through canine skin Design Skin harvested from Greyhound thorax was placed in Franz-type diffusion cells and the in vitro passage of radio-labelled (C-14) alcohols (ethanol, butanol, hexanol and octanol (Log P 0.19 - 3.0)) through separate skin sections was measured in replicates of five. Permeability coefficient (k(P), cm/h), maximum flux (J(max), mol/cm(2)/h) and residue remaining within the skin were determined. Results The k(P) increased with increasing lipophilicity (6.2 x 10(-4) +/- 1.6 x 10(-4) cm/h for ethanol to 1.8 x 10(-2) 3.6 x 10(-3) cm/h for octanol). Alcohol residues remaining within each skin sample followed a similar pattern. An exponential decrease in Jmax with increasing lipophilicity was observed. Conclusion Changes in canine skin permeability occur with increasing alcohol lipophilicity. This finding has practical consequences for the design of topical formulations and optimisation of drug delivery through animal skin.

Modelagem e simulação de sistema logístico de distribuição de carne de frango

O sistema logístico para distribuição de produtos acabados caracteriza-se pela integração dos serviços de comunicação, transporte e financeiros com a finalidade de atender às demandas do consumidor final. Estima-se que no estado do Espírito Santo, o consumo de carne de frango seja de 44,4 quilos per capita por ano. Para atender a esta demanda, o estado conta com matadouros-frigoríficos distribuídos pelo seu território, bem como, com a participação de outras empresas localizadas no país. Em sistemas de transportes, são característicos Problemas de Roteamento de Veículos (VRP), que precisam ser estudados, caracterizados e otimizados, normalmente, através de rotinas computacionais, que permitem avaliar maior quantidade de variáveis. O presente trabalho teve por objetivo caracterizar um VRP de um matadouro-frigorífico da região do Sul do Espírito Santo e desenvolver um aplicativo computacional que seja suporte para os gestores de logística, servindo para avaliar e propor rotas, e analisar parâmetros logísticos do processo de distribuição de produtos. No desenvolvimento do aplicativo computacional foi necessário caracterizar o sistema logístico da empresa, coletar e analisar os dados das operações logísticas, desenvolver as rotinas computacionais que representassem o sistema em estudo, verificar a confiabilidade dos resultados fornecidos pelo aplicativo, validá-lo e então, poder realizar as experimentações. O aplicativo desenvolvido permitiu reproduzir dados do sistema estudado e avaliar rotas segundo parâmetros logísticos. Pode-se concluir que o aplicativo computacional desenvolvido é útil aos gestores de logística, permitindo a avaliação das rotas praticadas e de novas configurações de rotas.

Automated traffic route identification through the shared nearest neighbour algorithm

Many organisations need to extract useful information from huge amounts of movement data. One example is found in maritime transportation, where the automated identification of a diverse range of traffic routes is a key management issue for improving the maintenance of ports and ocean routes, and accelerating ship traffic. This paper addresses, in a first stage, the research challenge of developing an approach for the automated identification of traffic routes based on clustering motion vectors rather than reconstructed trajectories. The immediate benefit of the proposed approach is to avoid the reconstruction of trajectories in terms of their geometric shape of the path, their position in space, their life span, and changes of speed, direction and other attributes over time. For clustering the moving objects, an adapted version of the Shared Nearest Neighbour algorithm is used. The motion vectors, with a position and a direction, are analysed in order to identify clusters of vectors that are moving towards the same direction. These clusters represent traffic routes and the preliminary results have shown to be promising for the automated identification of traffic routes with different shapes and densities, as well as for handling noise data.

Success factors of regional airports: the case of Oporto airport

Oporto Airport (OPO) is a success story among European regional airports. This success is expressed, among other ways, in the rapid expansion of routes and the strong growth in demand, as well as in the recognition of the airport’s quality by its users. Over the past decade, the volume of traffic increased by almost 3.4 million passengers, from the 2.6 million recorded in 2002 to over 6 million in 2012. In this paper, we analyse some of the factors that influenced the success of Oporto Airport, namely the expansion of capacity and improvements to infrastructure, the increase in the number of routes and the increased demand in response to the new capacities of this airport-airlines set. Particular emphasis is given to the role of low cost carriers (LCC) in the growth of Oporto Airport and to strategies of attracting more traffic. Some of the main opportunities and challenges that this airport will face in the coming years are also discussed.