A prospective, randomized, and controlled study of fluid management in children with severe head injury: lactated Ringer's solution versus hypertonic saline.

OBJECTIVES: Resuscitation in severe head injury may be detrimental when given with hypotonic fluids. We evaluated the effects of lactated Ringer's solution (sodium 131 mmol/L, 277 mOsm/L) compared with hypertonic saline (sodium 268 mmol/L, 598 mOsm/L) in severely head-injured children over the first 3 days after injury. DESIGN: An open, randomized, and prospective study. SETTING: A 16-bed pediatric intensive care unit (ICU) (level III) at a university children's hospital. PATIENTS: A total of 35 consecutive children with head injury. INTERVENTIONS: Thirty-two children with Glasgow Coma Scores of <8 were randomly assigned to receive either lactated Ringer's solution (group 1) or hypertonic saline (group 2). Routine care was standardized, and included the following: head positioning at 30 degrees; normothermia (96.8 degrees to 98.6 degrees F [36 degrees to 37 degrees C]); analgesia and sedation with morphine (10 to 30 microg/kg/hr), midazolam (0.2 to 0.3 mg/kg/hr), and phenobarbital; volume-controlled ventilation (PaCO2 of 26.3 to 30 torr [3.5 to 4 kPa]); and optimal oxygenation (PaO2 of 90 to 105 torr [12 to 14 kPa], oxygen saturation of >92%, and hematocrit of >0.30). MEASUREMENTS AND MAIN RESULTS: Mean arterial pressure and intracranial pressure (ICP) were monitored continuously and documented hourly and at every intervention. The means of every 4-hr period were calculated and serum sodium concentrations were measured at the same time. An ICP of 15 mm Hg was treated with a predefined sequence of interventions, and complications were documented. There was no difference with respect to age, male/female ratio, or initial Glasgow Coma Score. In both groups, there was an inverse correlation between serum sodium concentration and ICP (group 1: r = -.13, r2 = .02, p < .03; group 2: r = -.29, r2 = .08, p < .001) that disappeared in group 1 and increased in group 2 (group 1: r = -.08, r2 = .01, NS; group 2: r = -.35, r2 =.12, p < .001). Correlation between serum sodium concentration and cerebral perfusion pressure (CPP) became significant in group 2 after 8 hrs of treatment (r = .2, r2 = .04, p = .002). Over time, ICP and CPP did not significantly differ between the groups. However, to keep ICP at <15 mm Hg, group 2 patients required significantly fewer interventions (p < .02). Group 1 patients received less sodium (8.0 +/- 4.5 vs. 11.5 +/- 5.0 mmol/kg/day, p = .05) and more fluid on day 1 (2850 +/- 1480 vs. 2180 +/- 770 mL/m2, p = .05). They also had a higher frequency of acute respiratory distress syndrome (four vs. 0 patients, p = .1) and more than two complications (six vs. 1 patient, p = .09). Group 2 patients had significantly shorter ICU stay times (11.6 +/- 6.1 vs. 8.0 +/- 2.4 days; p = .04) and shorter mechanical ventilation times (9.5 +/- 6.0 vs. 6.9 +/- 2.2 days; p = .1). The survival rate and duration of hospital stay were similar in both groups. CONCLUSIONS: Treatment of severe head injury with hypertonic saline is superior to that treatment with lactated Ringer's solution. An increase in serum sodium concentrations significantly correlates with lower ICP and higher CPP. Children treated with hypertonic saline require fewer interventions, have fewer complications, and stay a shorter time in the ICU.

Comprehensive Study of Crystal Growth from Solution

Crystal growth is an essential phase in crystallization kinetics. The rate of crystal growth provides significant information for the design and control of crystallization processes; nevertheless, obtaining accurate growth rate data is still challenging due to a number of factors that prevail in crystal growth. In industrial crystallization, crystals are generally grown from multi-componentand multi-particle solutions under complicated hydrodynamic conditions; thus, it is crucial to increase the general understanding of the growth kinetics in these systems. The aim of this work is to develop a model of the crystal growth rate from solution. An extensive literature review of crystal growth focuses on themodelling of growth kinetics and thermodynamics, and new measuring techniques that have been introduced in the field of crystallization. The growth of a singlecrystal is investigated in binary and ternary systems. The binary system consists of potassium dihydrogen phosphate (KDP, crystallizing solute) and water (solvent), and the ternary system includes KDP, water and an organic admixture. The studied admixtures, urea, ethanol and 1-propanol, are employed at relatively highconcentrations (of up to 5.0 molal). The influence of the admixtures on the solution thermodynamics is studied using the Pitzer activity coefficient model. Theprediction method of the ternary solubility in the studied systems is introduced and verified. The growth rate of the KDP (101) face in the studied systems aremeasured in the growth cell as a function of supersaturation, the admixture concentration, the solution velocity over a crystal and temperature. In addition, the surface morphology of the KDP (101) face is studied using ex situ atomic force microscopy (AFM). The crystal growth rate in the ternary systems is modelled on the basis of the two-step growth model that contains the Maxwell-Stefan (MS) equations and a surface-reaction model. This model is used together with measuredcrystal growth rate data to develop a new method for the evaluation of the model parameters. The validation of the model is justified with experiments. The crystal growth rate in an imperfectly mixed suspension crystallizer is investigatedusing computational fluid dynamics (CFD). A solid-liquid suspension flow that includes multi-sized particles is described by the multi-fluid model as well as by a standard k-epsilon turbulence model and an interface momentum transfer model. The local crystal growth rate is determined from calculated flow information in a diffusion-controlled crystal growth regime. The calculated results are evaluated experimentally.

On reduced games and the lexmax solution

For a family of reduced games satisfying a monotonicity property, we introduced the reduced equal split-off set, an extension of the equal split-off set (Branzei et. al, 2006), and study its relation with the core. Regardless of the reduction operation we consider, the intersection between both sets is either empty or a singleton containing the lexmax solution (Arin et al., 2008). We also provide a procedure for computing the lexmax solution for a class of games that includes games with large core (Sharkey, 1982). [JEL Classification: C71]

Stratification of the severity of critically ill patients with classification trees

Background: Development of three classification trees (CT) based on the CART (Classification and Regression Trees), CHAID (Chi-Square Automatic Interaction Detection) and C4.5 methodologies for the calculation of probability of hospital mortality; the comparison of the results with the APACHE II, SAPS II and MPM II-24 scores, and with a model based on multiple logistic regression (LR). Methods: Retrospective study of 2864 patients. Random partition (70:30) into a Development Set (DS) n = 1808 and Validation Set (VS) n = 808. Their properties of discrimination are compared with the ROC curve (AUC CI 95%), Percent of correct classification (PCC CI 95%); and the calibration with the Calibration Curve and the Standardized Mortality Ratio (SMR CI 95%). Results: CTs are produced with a different selection of variables and decision rules: CART (5 variables and 8 decision rules), CHAID (7 variables and 15 rules) and C4.5 (6 variables and 10 rules). The common variables were: inotropic therapy, Glasgow, age, (A-a)O2 gradient and antecedent of chronic illness. In VS: all the models achieved acceptable discrimination with AUC above 0.7. CT: CART (0.75(0.71-0.81)), CHAID (0.76(0.72-0.79)) and C4.5 (0.76(0.73-0.80)). PCC: CART (72(69- 75)), CHAID (72(69-75)) and C4.5 (76(73-79)). Calibration (SMR) better in the CT: CART (1.04(0.95-1.31)), CHAID (1.06(0.97-1.15) and C4.5 (1.08(0.98-1.16)). Conclusion: With different methodologies of CTs, trees are generated with different selection of variables and decision rules. The CTs are easy to interpret, and they stratify the risk of hospital mortality. The CTs should be taken into account for the classification of the prognosis of critically ill patients.

Solution scanning as a key policy tool: identifying management interventions to help maintain and enhance regulating ecosystem services

The major task of policy makers and practitioners when confronted with a resource management problem is to decide on the potential solution(s) to adopt from a range of available options. However, this process is unlikely to be successful and cost effective without access to an independently verified and comprehensive available list of options. There is currently burgeoning interest in ecosystem services and quantitative assessments of their importance and value. Recognition of the value of ecosystem services to human well-being represents an increasingly important argument for protecting and restoring the natural environment, alongside the moral and ethical justifications for conservation. As well as understanding the benefits of ecosystem services, it is also important to synthesize the practical interventions that are capable of maintaining and/or enhancing these services. Apart from pest regulation, pollination, and global climate regulation, this type of exercise has attracted relatively little attention. Through a systematic consultation exercise, we identify a candidate list of 296 possible interventions across the main regulating services of air quality regulation, climate regulation, water flow regulation, erosion regulation, water purification and waste treatment, disease regulation, pest regulation, pollination and natural hazard regulation. The range of interventions differs greatly between habitats and services depending upon the ease of manipulation and the level of research intensity. Some interventions have the potential to deliver benefits across a range of regulating services, especially those that reduce soil loss and maintain forest cover. Synthesis and applications: Solution scanning is important for questioning existing knowledge and identifying the range of options available to researchers and practitioners, as well as serving as the necessary basis for assessing cost effectiveness and guiding implementation strategies. We recommend that it become a routine part of decision making in all environmental policy areas.

Metabolic responses of guava trees irrigated withdifferent N and K levels in São Francisco Valley

The guava (Psidium guajava L.) cv. Paluma has been cultivated in São Francisco Valley, Northeastern of Brazil, for in natura consumption and processing purposes. In spite of its importance, there are few scientific knowledge regarding guava physiology, nutrition, irrigation and fertigation. The objective of this work was to evaluate the effect of weather conditions and different concentrations of N and K applied by fertigation in foliar contents of reducing sugars, total soluble sugars, starch, sucrose, amino acids, and proteins. The field experiment was carried out at Bebedouro Experimental Field and the biochemical evaluations at the Laboratory of Seed and Plant Physiology, both located at Embrapa Semi-Árido, Petrolina-PE. The doses of 200 g N and 100 g K2O; 400 g N and 200 g K2O; 600 g N and 300 g K2O; and 800 g N and 400 g K2O per plant were applied in an experiment field. The experimental design was totally randomized blocks, with four treatments and five blocks. The weather conditions influenced the plant photosynthesis, which affects the plants metabolism. Guava presented specific responses to N and K fertigation for each parameter evaluated. The weather conditions during the evaluation period influenced guava responses to N and K fertigation.

Effects of levels of nitrogen and potassium on yield and fruit maturation of irrigated guava trees in the São Francisco Valley

Yield and physical and chemical characteristics of 'Paluma' guava fruit were evaluated as a function of the harvest at different maturity stages, under influence of nitrogen and potassium fertilization, in Petrolina, State of Pernambuco, Brazil. Fertilizer rates were 67 kg N + 33 kg K2O, 133 kg N + 67 kg K2O, 200 kg N + 100 kg K2O and 267 kg N + 133 kg K2O per hectare. Fruits were evaluated at maturity stages 2, 3, 4 and 5, established according to peel color. Higher doses of N and K induced higher yields. Nevertheless, fertilization with 200 kg of N + 100 kg of K per hectare improved fruit quality, delaying ascorbic acid breakdown and conserving pulp firmness. Main changes took place at maturity stages 4 and 5, when the fruit should present ideal conditions for consumption, namely the increase on soluble solids and soluble sugars content.

Production costs and fruit yield profitability in the initial harvest of custard apple trees

The aim of this study was to estimate the production cost and economic indicators associated with the production and sales of fruits from 20 custard apple progenies during the initial five harvests, in order to identify the harvest season from which custard apple exploitation becomes profitable, as well as the most promising progenies from an economic point of view. The fruit yield data upon which the present work was based were obtained during the period from 2001 to 2005, in an experiment that evaluated 20 custard apple half-sibling progenies, under sprinkler irrigation. The progenies were evaluated in a random block design with five replicates and plots consisting of four plants each. The exploitation of custard apple progenies only showed to be a profitable agribusiness after the fourth year. Before that, only A3 and A4 progenies in the second year, and P3 and P11 in the third year provided profitable incomes. Considering the methodological assumptions imposed concerning the time period analysis and the prices as of July 2007, the most important profitability indicators (operating profit, return index and equilibrium price) evidenced that the A4 progeny is the most recommended, although other progenies are also highlighted, such as FJ1 and FJ2. As already discussed, the progenies showing the highest average yields of five harvests are not always the most economically recommendable ones.

Preferential reproduction mode of hermaphrodite papaya plant (Carica papaya L; Caricaceae)

This research was done to study the reproductive system of papaya hermaphrodite plant based on the histochemical nature of pollen grain, stigma receptivity, in vivo pollen grain germination and pollen:ovule ratio. In the histochemical analysis, pollen grains were stained by using Sudan IV and I2KI solution ; the stigma receptivity was assessed by alpha-naphthtyl acetate solution in closed and opened flowers. Pollen germination and pollen tube growing were examined in flower buds near anthesis with 0.1% aniline blue. To estimate the pollen:ovule ratio , anthers from each flower bud were dissected and all pollen grains were counted; ovules were dissected from ovaries and were counted under stereomicroscope. The results indicated that papaya pollen grains are of lipidic nature; the stigmas were receptive before the opening and until 48 hours after opening; the pollen grains germinated and emitted polinic tube before flower opening and the pollen:ovule ratio indicated the predominance of autogamous reproductive system. These results indicate that hermaphrodite papaya trees is preferentially of optional autogamous with cleistogamy.

Genetic dissimilarity among jabuticaba trees native to southwestern Paraná, Brazil

Knowledge on the genetic diversity within and between genotype groups is of great importance for breeding programs. The purpose of this study was to estimate the genetic dissimilarity among 36 native jabuticaba trees (Plinia cauliflora) from five sites in the southwestern region of Paraná, Brazil. Sixteen fruit traits were analyzed, based on multivariate techniques (canonical variables, Tocher and UPGMA), using Mahalanobis' distance as dissimilarity measure. By the techniques of clustering and graphic dispersion, together with the comparison of means, the genetic diversity among native jabuticaba trees was efficiently identified, indicating a high potential of these genotypes for breeding programs. The traits of greatest importance for dissimilarity were percentage of pulp and of skin, which are easily measured. The clustering structure is related to the collection sites and for breeding programs, genotypes from different sites should be crossed to generate progenies to be tested. Genotypes 'CV5' and 'VT3' should be conserved in genebanks, due to its important agronomic traits.

Soil carbon and nitrogen mineralization under different tillage systems and Permanent Groundcover cultivation between Orange trees

The objective of this work was to evaluate the alterations in carbon and nitrogen mineralization due to different soil tillage systems and groundcover species for intercropped orange trees. The experiment was established in an Ultisol soil (Typic Paleudults) originated from Caiuá sandstone in northwestern of the state of Paraná, Brazil, in an area previously cultivated with pasture (Brachiaria humidicola). Two soil tillage systems were evaluated: conventional tillage (CT) in the entire area and strip tillage (ST) with a 2-m width, each with different groundcover vegetation management systems. The citrus cultivar utilized was the 'Pera' orange (Citrus sinensis) grafted onto a 'Rangpur' lime rootstock. The soil samples were collected at a 0-15-cm depth after five years of experiment development. Samples were collected from under the tree canopy and from the inter-row space after the following treatments: (1) CT and annual cover crop with the leguminous Calopogonium mucunoides; (2) CT and perennial cover crop with the leguminous peanut Arachis pintoi; (3) CT and evergreen cover crop with Bahiagrass Paspalum notatum; (4) CT and cover crop with spontaneous B. humidicola grass vegetation; and (5) ST and maintenance of the remaining grass (pasture) of B. humidicola. The soil tillage systems and different groundcover vegetation influenced the C and N mineralization, both under the tree canopy and in the inter-row space. The cultivation of B. humidicola under strip tillage provided higher potential mineralization than the other treatments in the inter-row space. Strip tillage increased the C and N mineralization compared to conventional tillage. The grass cultivation increased the C and N mineralization when compared to the others treatments cultivated in the inter-row space.

First report of Pestalotiopsis diospyri causing canker on persimmon trees

During 2006 to 2009 season symptoms of a canker disease were observed on twigs and branches of young and mature persimmon trees (Diospyros kaki L.) cv. Fuyu in the States of Santa Catarina and Paraná in the Southern Brazil. The cankers result in severe damage and reduced production. Isolations from the margins of these cankers revealed a genus of Pestalotiopsis. Koch's postulates were confirmed using two isolates of the pathogen which was identified as Pestalotiopsis diospyri.

Quince 'CPP': new dwarf rootstock for pear trees on organic and high density planting

In Brazil, pear production presents the same incipient situation over the last 15 years, due mostly to low production technology. In this context, this study aimed to evaluate the development, growth and production of the pear tree cultivars Cascatense, Tenra and Hosui grafted on 'CPP' quince rootstock, using 'FT' pear as interstem. This trial was carried out in Guarapuava, State of Paraná, Southern region of Brazil, by five productive cycles. The pear trees were planted in September of 2004, spaced at 1.0 x 4.0 m (2,500 trees ha-1), trained to the modified central leader, on a Four-wire trellis, with drip irrigation and cultivated under organic production system. The following variables were evaluated: sprouting, anthesis, yield, fruit weight, soluble solids content, titratable acidity, pulp firmness, canopy area per plant and per hectare and trunk diameter. The pear tree cv. Tenra was outstanding most of the years for fruit yield, and, consequently, showed the highest accumulated yield over the period (51.6 t ha-1), followed by the cultivars Cascatense (39.7 t ha-1) and Hosui (18.7 t ha-1). All pear cultivars presented suitable physical-chemical characteristics for commercial purposes, with minimal average soluble solids content of 11% at harvest. The maximum canopy area per hectare was attained for cv. Cascatense (3063.2 m²), that was considered insufficient for a high yield. These results suggest the needs for studies with higher density planting and other training systems, searching optimize canopy volume. One of the most limiting factors in the organic pear orchard was the incidence of pear dieback caused by Botriosphaeria dothidea, severe more often in pear trees cv. Hosui.

Spatiotemporal variability in radial growth of trees in the Central Pyrenees: climatic and site influences.

To understand how tree growth has responded to recent climate warming, an understanding of the tree-climate-site complex is necessary. To achieve this, radial growth variability among 204 trees established before 1850 was studied in relation to both climatic and site factors. Seventeen forest stands were sampled in the Spanish Central Pyrenees. Three species were studied: Pinus uncinata, Abies alba, and Pinus sylvestris. For each tree, a ring-width residual chronology was built. All trees cross-dated well, indicating a common influence of the regional climate. For the 1952-1993 period, the radial growth of all species, especially P. uncinata, was positively correlated with warm Novembers during the year before ring formation and warm Mays of the year the annual ring formed. Differences in species-stand elevation modulated the growth-climate associations. Radial growth in P. uncinata at high elevation sites was reduced when May temperatures were colder and May precipitation more abundant. In the 20th century, two contrasting periods in radial growth were observed: one (1900-1949) with low frequency of narrow and wide rings, low mean annual sensitivity, and low common growth variation; and another (1950-1994) with the reverse characteristics. The increased variability in radial growth since the 1950s was observed for all species and sites, which suggests a climatic cause. The low shared variance among tree chronologies during the first half of the 20th century may result from a"relaxation" of the elevation gradient, allowing local site conditions to dominate macroclimatic influence. These temporal trends may be related to the recently reported increase of climatic variability and warmer conditions. This study emphasizes the need to carefully assess the relationships between radial growth and site conditions along ecological gradients to improve dendroclimatic reconstructions.