Measurement of the concentration and size of aerosol particles and identification of the sources in orthopedic surgeries

In this study, the measurement of the concentration and size of particles and the identification of their sources were carried out at five orthopedic surgeries. The aerosol concentration and particle size distribution, ranging from 0.3 mu m 10 mu m, were measured and related to the type of indoor activity. The handling of surgical linen and gowns, handling of the patient, use of electrosurgical apparatus, use of a bone saw, handling of equipment, and cleaning of the room were identified as the most important sources of particles, with each of these activities posing different risks to the health of the patients and workers. The results showed that most of the particles were above 0.5 mu m and that there was a strong correlation among all particles of sizes above 1 mu m. Particles with diameters in the range of 0.3 mu m-0.5 mu m had a good correlation only with particles in the ranges of 0.5 mu m-1.0 mu m and 1.0 mu m-3.0 mu m in three of the surgeries analyzed. Findings led to the conclusion that most of the events responsible for generating aerosol particles in an orthopedic surgery room are brief, intermittent, and highly variable, thus requiring the use of specific instrumentation for their continuous identification and characterization.

Influenza A H1N1/2009 vaccine in juvenile dermatomyositis: reduced immunogenicity in patients under immunosuppressive therapy

Objectives The aim of the present paper is to assess the influence of demographic, muscle enzymes, JDM scores and treatment on non-adjuvanted influenza A H1N1/2009 vaccine immunogenicity in juvenile dermatomyositis (JDM) patients. Methods Thirty JDM patients and 81 healthy age-matched controls were vaccinated. All participants were evaluated pre- and 21 days post-vaccination and serology for anti-HI NI was performed by haemagglutination inhibition assay. Muscle enzymes, JDM scores and treatment were evaluated before and after vaccination. Adverse events were reported. Results After immunisation seroconversion rates were significantly lower in JDM patients compared to age-matched controls (86.7 vs. 97.5%, p=0.044), whereas seropmtection (p=0.121), geometric mean titres (GMT) (p=0.992) and factor increase (FI) in GMT (p=0.827) were similar in both groups. Clinical and labomtorial evaluations revealed that JDM scores and muscle enzymes remained stable throughout the study (p>0.05). A higher frequency of chronic course was observed in non-seroconverted compared to seroconverted (100% vs. 27%, p=0.012). Regarding treatment, a lower rate of seroconversion was observed in patients under prednisone>20mg/day (50% vs. 4%, p=0.039), and in those treated with a combination of prednisone, methotrexate and cyclosporine (50% vs. 4%, p=0.039). Local and systemic vaccine adverse events were mild and similar in patients and controls (p>0.05). Conclusion This study identified that chronic course and immunosuppressive therapy are the major factors hampering seroconversion was JDM, suggesting that a specific protocol may be required for this subgroup of patients. In spite of that, a single dose of non-adjuvanted influenza A/H1N1 2009 vaccine was generally seroprotective in this disease with no evident deleterious effect in disease itself (ClinicalTrials.gov, no. NCT01151644).

Complex, 3D strain patterns in a synkinematic tonalite batholith from the Aracuai Neoproterozoic orogen (Eastern Brazil): Evidence from combined magnetic and isotopic chronology studies

This work combines structural and geochronological data to improve our understanding of the mechanical behaviour of continental crust involving large amount of magma or partially melted material in an abnormally hot collisional belt. We performed a magnetic and geochronological (U/Pb) study on a huge tonalitic batholith from the Neoproterozoic Aracual belt of East Brazil to determine the strain distribution through space and time. Anisotropy of magnetic susceptibility, combined with rock magnetism investigations, supports that the magnetic fabric is a good proxy of the structural fabric. Field measurements together with the magnetic fabrics highlight the presence in the batholith of four domains characterized by contrasted magmatic flow patterns. The western part is characterized by a gently dipping, orogen-parallel (similar to NS) magmatic foliation that bears down-dip lineations, in agreement with westward thrusting onto the Sao Francisco craton. Eastward, the magmatic foliation progressively turns sub-vertical with a lineation that flips from sub-horizontal to sub-vertical over short distances. This latter domain involves an elongated corridor in which the magmatic foliation is sub-horizontal and bears an orogen-parallel lineation. Finally the fourth, narrow domain displays sub-horizontal lineations on a sub-vertical magmatic foliation oblique (similar to N150 degrees E) to the trend of the belt. U/Pb dating of zircons from the various domains revealed homogeneity in age for all samples. This, together with the lack of solid-state deformation suggests that: 1) the whole batholith emplaced during a magmatic event at similar to 580 Ma, 2) the deformation occurred before complete solidification. and 3) the various fabrics are roughly contemporaneous. The complex structural pattern mapped in the studied tonalitic batholith suggests a 3D deformation of a slowly cooling, large magmatic body and its country rock. We suggest that the development of the observed 3D flow field was promoted by the low viscosity of the middle crust that turned gravitational force as an active tectonic force combining with the East-West convergence between the Sao Francisco and Congo cratons. (C) 2012 Elsevier Ltd. All rights reserved.

Penetrance rate estimation in autosomal dominant conditions

Accurate estimates of the penetrance rate of autosomal dominant conditions are important, among other issues, for optimizing recurrence risks in genetic counseling. The present work on penetrance rate estimation from pedigree data considers the following situations: 1) estimation of the penetrance rate K (brief review of the method); 2) construction of exact credible intervals for K estimates; 3) specificity and heterogeneity issues; 4) penetrance rate estimates obtained through molecular testing of families; 5) lack of information about the phenotype of the pedigree generator; 6) genealogies containing grouped parent-offspring information; 7) ascertainment issues responsible for the inflation of K estimates.

Evidence-Based Information on the Clinical Use of Neurofeedback for ADHD

Neurofeedback (NF) is a training to enhance self-regulatory capacity over brain activity patterns and consequently over brain mental states. Recent findings suggest that NF is a promising alternative for the treatment of attention-deficit/hyperactivity disorder (ADHD). We comprehensively reviewed literature searching for studies on the effectiveness and specificity of NF for the treatment of ADHD. In addition, clinically informative evidence-based data are discussed. We found 3 systematic review on the use of NF for ADHD and 6 randomized controlled trials that have not been included in these reviews. Most nonrandomized controlled trials found positive results with medium-to-large effect sizes, but the evidence for effectiveness are less robust when only randomized controlled studies are considered. The direct comparison of NF and sham-NF in 3 published studies have found no group differences, nevertheless methodological caveats, such as the quality of the training protocol used, sample size, and sample selection may have contributed to the negative results. Further data on specificity comes from electrophysiological studies reporting that NF effectively changes brain activity patterns. No safety issues have emerged from clinical trials and NF seems to be well tolerated and accepted. Follow-up studies support long-term effects of NF. Currently there is no available data to guide clinicians on the predictors of response to NF and on optimal treatment protocol. In conclusion, NF is a valid option for the treatment for ADHD, but further evidence is required to guide its use.

The CUPID (Cultural and Psychosocial Influences on Disability) Study: Methods of Data Collection and Characteristics of Study Sample

Background: The CUPID (Cultural and Psychosocial Influences on Disability) study was established to explore the hypothesis that common musculoskeletal disorders (MSDs) and associated disability are importantly influenced by culturally determined health beliefs and expectations. This paper describes the methods of data collection and various characteristics of the study sample. Methods/Principal Findings: A standardised questionnaire covering musculoskeletal symptoms, disability and potential risk factors, was used to collect information from 47 samples of nurses, office workers, and other (mostly manual) workers in 18 countries from six continents. In addition, local investigators provided data on economic aspects of employment for each occupational group. Participation exceeded 80% in 33 of the 47 occupational groups, and after pre-specified exclusions, analysis was based on 12,426 subjects (92 to 1018 per occupational group). As expected, there was high usage of computer keyboards by office workers, while nurses had the highest prevalence of heavy manual lifting in all but one country. There was substantial heterogeneity between occupational groups in economic and psychosocial aspects of work; three-to fivefold variation in awareness of someone outside work with musculoskeletal pain; and more than ten-fold variation in the prevalence of adverse health beliefs about back and arm pain, and in awareness of terms such as "repetitive strain injury" (RSI). Conclusions/Significance: The large differences in psychosocial risk factors (including knowledge and beliefs about MSDs) between occupational groups should allow the study hypothesis to be addressed effectively.

Time constraints on magmatism along the Major Gercino Shear Zone, southern Brazil: Implications for West Gondwana reconstruction

The Dom Feliciano Belt, situated in southernmost Brazil and Uruguay, contains a large mass of granite-gneissic rocks (also known as Florianopolis/Pelotas Batholith) formed during the pre-, syn- and post-orogenic phases of the Brasiliano/Pan-African cycle. In the NE extreme of this granitic mass, pre-, syn- and post-tectonic granites associated with the Major Gercino Shear Zone (MGSZ) are exposed. The granitic manifestation along the MGSZ can be divided into pre-kinematic tonalitic gneisses, peraluminous high-K calcalkaline early kinematic shoshonitic, and metaluminous post-kinematic granites. U-Pb zircon data suggest an age of 649 +/- 10 Ma for the pre-tectonic gneisses, and a time span from 623 +/- 6 Ma to 588 +/- 3 Ma for the early to post-tectonic magmatism. Negative epsilon Hf (t) values ranging from -4.6 to -14.6 and Hf model ages ranging from 1.64 to 2.39 Ga for magmatic zircons coupled with whole rock Nd model ages ranging from 1.24 to 2.05 Ga and epsilon Nd (t) values ranging from -3.84 to -7.50, point to a crustal derivation for the granitic magmatism. The geochemical and isotope data support a continental magmatic arc generated from melting of dominant Paleoproterozoic crust, and a similar evolution for the granitic batholiths of the eastern Dom Feliciano Belt and western Kaoko Belt. (C) 2011 International Association for Gondwana Research. Published by Elsevier B.V. All rights reserved.

Craniometric diversity of the common vampire bat (Desmodus rotundus) in Central and South America

The common vampire bat, Desmodus rotundus Geoffroy, 1810, is a species with an extensive geographical distribution, occurring in a wide variety of habitats. A recent phylogeographical study using molecular markers described a scenario in which this species is formed by 5 distinct geographically circumscribed mitochondrial clacks. Here we studied the craniometric variation of the common vampire bat to assess the amount of subdivision within this species and to test for the possibility of distinct morphological patterns associated with geographical lineages. We used 16 measurements from 1,581 complete skulls of adult D. rotundus representing 226 localities in South America and Mesoamerica. The assessment of morphological diversity between groups was done by the estimation of minimum F-ST values. Overall, the results show that most of the within-species variation is a result of the size component. Both shape data and size data are correlated with geographic distances. Our results favor the origin of biological diversity as the outcome of genetic drift and stepping-stone pattern of gene flow instead of local adaptations to local environmental conditions. The F-ST analyses also support male-biased dispersal. The results give little evidence to support previous suggestions that the common vampire bat may be composed of 2 or more species.

Impact of diabetes mellitus on arterial stiffness in a representative sample of an urban Brazilian population

Background Independent of other cardiovascular (CV) risk factors, increased arterial stiffness has been established as a predictor of morbidity and mortality. The main aim of this study was to investigate the impact of diabetes on arterial stiffness in a representative sample of an urban Brazilian population plus Amerindians. Methods A total of 1,415 individuals from the general population were randomly selected plus 588 Amerindians from a native community in Brazil. In addition, a sub-sample of 380 individuals from the general population had 5-year follow-up data. Pulse wave velocity (PWV) was measured with a non-invasive automatic device (Complior, Colson; Garges les Gonesses, France) and increased arterial stiffness was defined as PWV ≥ 12 m/s. Results In the overall group, diabetic individuals had higher frequencies of increased arterial stiffness and hypertension. They also had higher values of PWV, body mass index, total cholesterol, triglycerides, systolic and diastolic blood pressures compared to non-diabetic individuals (p < 0.01). In an analysis stratified by hypertension, PWV values and increased arterial stiffness frequency were higher in diabetic individuals in both groups (hypertensive and non-hypertensive) (p < 0.05). Furthermore, higher risk for increased arterial stiffness was observed in the diabetic individuals from the overall group (OR = 2.27; CI = 1.47-3.52, p < 0.001) and from the hypertensive group (OR = 2.70; CI = 1.58-4.75, p < 0.001), adjusted for covariates. Regarding the ethnic stratification, diabetic individuals from Amerindian, White, and Mulatto (mixed-race) groups had higher PWV values and a greater frequency of increased arterial stiffness compared to non-diabetic individuals. Both diabetic and non-diabetic individuals had higher PWV values after 5 years. There was no significant difference in the 5-year PWV progression in diabetic compared to non-diabetic individuals. Conclusions These results confirm, in a sample of Brazilian population, that the presence of diabetes is associated with increased arterial stiffness and it may contribute in part to increased cardiovascular risk in diabetic patients.

Cirurgias plásticas para readequação de contorno corporal de pacientes submetidos a cirurgia bariátrica durante a adolescência

INTRODUÇÃO: A partir da década de 1990 foram iniciados os primeiros tratamentos cirúrgicos da obesidade em adolescentes, seguindo a sequência cirurgia bariátrica, perda ponderal e dismorfismo corporal, criando demanda por cirurgias plásticas para readequação do contorno corporal. O objetivo deste estudo foi identificar fatores associados a cirurgias plásticas de readequação de contorno corporal (morbidade e mortalidade), realizadas em pacientes submetidos a cirurgia bariátrica durante a adolescência. MÉTODO: Entre janeiro de 2008 e janeiro de 2011, 5 pacientes submetidos a gastroplastia redutora durante a adolescência, com consequente perda e estabilização de peso, foram submetidos a cirurgias plásticas do contorno corporal. A média de idade no início das cirurgias plásticas foi de 19,7 anos, sendo 3 (60%) pacientes do sexo feminino. Foram realizadas dermolipectomias abdominais em todos (100%) os pacientes, dermolipectomias crurais em 4 (80%), dermolipectomias braquiais em 2 (40%), mamoplastia com inclusão de implantes de silicone em 2 (40%) pacientes do sexo feminino, mastopexia na terceira paciente do sexo feminino (20%) e correção de ginecomastia em 1 (20%), toracoplastia em 2 (40%), torsoplastia em 2 (40%) e torsoplastia reversa em 1 (20%). Foram realizadas, em média, 3 intervenções cirúrgicas por paciente, sendo operados 20 sítios cirúrgicos. RESULTADOS: Ocorreram deiscências em 3 (15% dos sítios cirúrgicos) casos e foi necessário revisar a ressecção dermogordurosa por flacidez residual em 3 (15% dos sítios cirúrgicos) casos. CONCLUSÕES: Foram identificados alguns fatores associados às cirurgias plásticas de readequação de contorno corporal na amostra de 5 pacientes submetidos a cirurgia bariátrica durante a adolescência, comparáveis aos da literatura específica.

On the morphological differentiation between Libinia spinosa and L. ferreirae (Crustacea: Brachyura: Majoidea: Epialtidae)

Libinia spinosa H. Milne Edwards in Guérin, 1832 and L. ferreirae Brito Capello, 1871, inhabit very similar environments, and their geographic and bathymetric distributions overlap for about 3000 km along the southwestern Atlantic. Both species are commonly caught in the same haul and differentiating between them can often be difficult. Traditionally, morphological differentiation between L. spinosa and L. ferreirae has been based exclusively on the number of spines along the median, longitudinal line of the carapace and the development of a process at the anterolateral angle of the basal segment of the antenna. Because Libinia spinosa and L. ferreirae share similar numbers of median spines (7 and 6, respectively), and the number of median spines of the carapace and the process at the anterolateral angle of the basal antennal segment are variable, they are of little value in separating these species. It is shown herein that unequivocal identification can be easily achieved based on features of the male and female thoracic sternum, pereiopod dactyli, and infraorbital notch. A lectotype is designated for L. spinosa and its authorship and date are corrected. Libinia gibbosa A. Milne-Edwards, 1878, is demonstrated to be a junior synonym of L. ferreirae. The holotype of L. gibbosa is figured for the first time.

80 anos do Manifesto dos Pioneiros da Educação Nova: questões para debate

O artigo, produzido no âmbito das comemorações dos 80 anos de publicação do Manifesto dos Pioneiros da Educação Nova, interroga-se sobre a atualidade dessa carta. Para tanto, explora as condições históricas de emergência do documento, os significados atribuídos à Escola Nova no Brasil na década de 1930 e as contendas ocorridas na arena educacional no período. Além disso, discorre sobre as especificidades do movimento escolanovista brasileiro, procurando demonstrar que a Escola Nova constituiu-se no país como uma fórmula, com significados múltiplos e distintas apropriações produzidas no entrelaçamento de três vertentes: a pedagógica, a ideológica e a política. No que tange ao primeiro aspecto, a indefinição das fronteiras conceituais permitiu que a expressão Escola Nova aglutinasse diferentes educadores, católicos e liberais, em torno de princípios pedagógicos do ensino ativo. No segundo caso, a fórmula ofereceu-se como meio para a transformação da sociedade, servindo às finalidades divergentes dos grupos em litígio. Já na terceira acepção, tornou-se bandeira política, sendo capturada como signo de renovação do sistema educacional pelo Manifesto e por seus signatários. Assim, o documento emergiu como parte do jogo político pela disputa do controle do Estado e de suas dinâmicas, e, portanto, como elemento de coesão de uma frente de educadores que, a despeito de suas diferenças, articulava-se em torno de alguns objetivos comuns, como laicidade, gratuidade e obrigatoriedade da educação. Ademais, ele também foi representante de um grupo de intelectuais que abraçava um mesmo projeto de nação, ainda que com divergências internas.

The performance of four molecular methods for the laboratory diagnosis of congenital toxoplasmosis in amniotic fluid samples

Introduction Toxoplasmosis may be life-threatening in fetuses and in immune-deficient patients. Conventional laboratory diagnosis of toxoplasmosis is based on the presence of IgM and IgG anti-Toxoplasma gondii antibodies; however, molecular techniques have emerged as alternative tools due to their increased sensitivity. The aim of this study was to compare the performance of 4 PCR-based methods for the laboratory diagnosis of toxoplasmosis. One hundred pregnant women who seroconverted during pregnancy were included in the study. The definition of cases was based on a 12-month follow-up of the infants. Methods Amniotic fluid samples were submitted to DNA extraction and amplification by the following 4 Toxoplasma techniques performed with parasite B1 gene primers: conventional PCR, nested-PCR, multiplex-nested-PCR, and real-time PCR. Seven parameters were analyzed, sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and efficiency (Ef). Results Fifty-nine of the 100 infants had toxoplasmosis; 42 (71.2%) had IgM antibodies at birth but were asymptomatic, and the remaining 17 cases had non-detectable IgM antibodies but high IgG antibody titers that were associated with retinochoroiditis in 8 (13.5%) cases, abnormal cranial ultrasound in 5 (8.5%) cases, and signs/symptoms suggestive of infection in 4 (6.8%) cases. The conventional PCR assay detected 50 cases (9 false-negatives), nested-PCR detected 58 cases (1 false-negative and 4 false-positives), multiplex-nested-PCR detected 57 cases (2 false-negatives), and real-time-PCR detected 58 cases (1 false-negative). Conclusions The real-time PCR assay was the best-performing technique based on the parameters of Se (98.3%), Sp (100%), PPV (100%), NPV (97.6%), PLR (â^ž), NLR (0.017), and Ef (99%).