Impact Of Pharmacist Interventions On Drug-related Problems And Laboratory Markers In Outpatients With Human Immunodeficiency Virus Infection.

Substantial complexity has been introduced into treatment regimens for patients with human immunodeficiency virus (HIV) infection. Many drug-related problems (DRPs) are detected in these patients, such as low adherence, therapeutic inefficacy, and safety issues. We evaluated the impact of pharmacist interventions on CD4+ T-lymphocyte count, HIV viral load, and DRPs in patients with HIV infection. In this 18-month prospective controlled study, 90 outpatients were selected by convenience sampling from the Hospital Dia-University of Campinas Teaching Hospital (Brazil). Forty-five patients comprised the pharmacist intervention group and 45 the control group; all patients had HIV infection with or without acquired immunodeficiency syndrome. Pharmaceutical appointments were conducted based on the Pharmacotherapy Workup method, although DRPs and pharmacist intervention classifications were modified for applicability to institutional service limitations and research requirements. Pharmacist interventions were performed immediately after detection of DRPs. The main outcome measures were DRPs, CD4+ T-lymphocyte count, and HIV viral load. After pharmacist intervention, DRPs decreased from 5.2 (95% confidence interval [CI] =4.1-6.2) to 4.2 (95% CI =3.3-5.1) per patient (P=0.043). A total of 122 pharmacist interventions were proposed, with an average of 2.7 interventions per patient. All the pharmacist interventions were accepted by physicians, and among patients, the interventions were well accepted during the appointments, but compliance with the interventions was not measured. A statistically significant increase in CD4+ T-lymphocyte count in the intervention group was found (260.7 cells/mm(3) [95% CI =175.8-345.6] to 312.0 cells/mm(3) [95% CI =23.5-40.6], P=0.015), which was not observed in the control group. There was no statistical difference between the groups regarding HIV viral load. This study suggests that pharmacist interventions in patients with HIV infection can cause an increase in CD4+ T-lymphocyte counts and a decrease in DRPs, demonstrating the importance of an optimal pharmaceutical care plan.

Graded Meshes In Bio-thermal Problems With Transmission-line Modeling Method.

In this study, the transmission-line modeling (TLM) applied to bio-thermal problems was improved by incorporating several novel computational techniques, which include application of graded meshes which resulted in 9 times faster in computational time and uses only a fraction (16%) of the computational resources used by regular meshes in analyzing heat flow through heterogeneous media. Graded meshes, unlike regular meshes, allow heat sources to be modeled in all segments of the mesh. A new boundary condition that considers thermal properties and thus resulting in a more realistic modeling of complex problems is introduced. Also, a new way of calculating an error parameter is introduced. The calculated temperatures between nodes were compared against the results obtained from the literature and agreed within less than 1% difference. It is reasonable, therefore, to conclude that the improved TLM model described herein has great potential in heat transfer of biological systems.

[access To Information About How To Prevent Oral Problems Among School Children In The Public School Network].

The scope of this study is to identify the prevalence of access to information about how to prevent oral problems among schoolchildren in the public school network, as well as the factors associated with such access. This is a cross-sectional and analytical study conducted among 12-year-old schoolchildren in a Brazilian municipality with a large population. The examinations were performed by 24 trained dentists and calibrated with the aid of 24 recorders. Data collection occurred in 36 public schools selected from the 89 public schools of the city. Descriptive, univariate and multiple analyses were conducted. Of the 2510 schoolchildren included in the study, 2211 reported having received information about how to prevent oral problems. Access to such information was greater among those who used private dental services; and lower among those who used the service for treatment, who evaluated the service as regular or bad/awful. The latter use toothbrush only or toothbrush and tongue scrubbing as a means of oral hygiene and who reported not being satisfied with the appearance of their teeth. The conclusion drawn is that the majority of schoolchildren had access to information about how to prevent oral problems, though access was associated with the characteristics of health services, health behavior and outcomes.

Trends and strategies of ozone application in environmental problems

Efforts presented by the scientific community in recent years towards the development of numerous green chemical processes and wastewater treatment technologies are presented and discussed. In the light of these approaches, environmentally friendly technologies, as well as the key role played by the well-known advanced oxidation processes, are discussed, giving special attention to the ones comprising ozone applications. Fundamentals and applied aspects dealing with ozone technology and its application are also presented.

Changes in parents' and self-reports of behavioral problems in Brazilian adolescents after behavioral treatment with urine alarm for nocturnal enuresis

PURPOSE: Compare parents' reports of youth problems (PRYP) with adolescent problems self-reports (APSR) pre/post behavioral treatment of nocturnal enuresis (NE) based on the use of a urine alarm. MATERIALS AND METHODS: Adolescents (N = 19) with mono-symptomatic (primary or secondary) nocturnal enuresis group treatment for 40 weeks. Discharge criterion was established as 8 weeks with consecutive dry nights. PRYP and APSR were scored by the Child Behavior Checklist (CBCL) and Youth Self-Report (YSR). RESULTS: Pre-treatment data: 1) Higher number of clinical cases based on parent report than on self-report for Internalizing Problems (IP) (13/19 vs. 4/19), Externalizing Problems (EP) (7/19 vs. 5/19) and Total Problem (TP) (11/19 vs. 5/19); 2) Mean PRYP scores for IP (60.8) and TP (61) were within the deviant range (T score ≥ 60); while mean PRYP scores for EP (57.4) and mean APSR scores (IP = 52.4, EP = 49.5, TP = 52.4) were within the normal range. Difference between PRYP' and APSR' scores was significant. Post treatment data: 1) Discharge for majority of the participants (16/19); 2) Reduction in the number of clinical cases on parental evaluation: 9/19 adolescents remained within clinical range for IP, 2/19 for EP, and 7/19 for TP. 3) All post-treatment mean scores were within the normal range; the difference between pre and post evaluation scores was significant for PRYP. CONCLUSIONS: The behavioral treatment based on the use of urine alarm is effective for adolescents with mono-symptomatic (primary and secondary) nocturnal enuresis. The study favors the hypothesis that enuresis is a cause, not a consequence, of other behavioral problems.

UNIQUENESS AND NONUNIQUENESS RESULTS FOR A CERTAIN CLASS OF ALMOST PERIODIC DISTRIBUTIONS

We consider distributions u is an element of S'(R) of the form u(t) = Sigma(n is an element of N) a(n)e(i lambda nt), where (a(n))(n is an element of N) subset of C and Lambda = (lambda n)(n is an element of N) subset of R have the following properties: (a(n))(n is an element of N) is an element of s', that is, there is a q is an element of N such that (n(-q) a(n))(n is an element of N) is an element of l(1); for the real sequence., there are n(0) is an element of N, C > 0, and alpha > 0 such that n >= n(0) double right arrow vertical bar lambda(n)vertical bar >= Cn(alpha). Let I(epsilon) subset of R be an interval of length epsilon. We prove that for given Lambda, (1) if Lambda = O(n(alpha)) with alpha < 1, then there exists epsilon > 0 such that u vertical bar I(epsilon) = 0 double right arrow u 0; (2) if Lambda = O(n) is uniformly discrete, then there exists epsilon > 0 such that u vertical bar I(epsilon) = 0 double right arrow u 0; (3) if alpha > 1 and. is uniformly discrete, then for all epsilon > 0, u vertical bar I(epsilon) = 0 double right arrow u = 0. Since distributions of the above mentioned form are very common in engineering, as in the case of the modeling of ocean waves, signal processing, and vibrations of beams, plates, and shells, those uniqueness and nonuniqueness results have important consequences for identification problems in the applied sciences. We show an identification method and close this article with a simple example to show that the recovery of geometrical imperfections in a cylindrical shell is possible from a measurement of its dynamics.

Combining Legendre's Polynomials and Genetic Algorithm in the Solution of Nonlinear Initial-Value Problems

This work develops a method for solving ordinary differential equations, that is, initial-value problems, with solutions approximated by using Legendre's polynomials. An iterative procedure for the adjustment of the polynomial coefficients is developed, based on the genetic algorithm. This procedure is applied to several examples providing comparisons between its results and the best polynomial fitting when numerical solutions by the traditional Runge-Kutta or Adams methods are available. The resulting algorithm provides reliable solutions even if the numerical solutions are not available, that is, when the mass matrix is singular or the equation produces unstable running processes.

Methodology to forecast the harvest date of banana bunches

Introduction. This method is used to forecast the harvest date of banana bunches from as early as the plant shooting stage. It facilitates the harvest of bunches with the same physiological age. The principle, key advantages, time required and expected results are presented. Materials and methods. Details of the four steps of the method ( installation of the temperature sensor, tagging bunches at the flowering stage, temperature sum calculation and estimation of bunch harvest date) are described. Possible problems are discussed. Results. The application of the method allows drawing a curve of the temperature sum accumulated by the bunches which have to be harvested at exactly 900 degree-days physiological age.

Radiative decay of the X(3872) as a mixed molecule-charmonium state in QCD sum rules

We use QCD sum rules (QCDSR) to calculate the width of the radiative decay of the meson X(3872), assumed to be a mixture between charmonium and exotic molecular [c (q) over bar][q (c) over bar] states with J(PC) = 1(++). We find that in a small range for the values of the mixing angle, 5 degrees <= theta <= 13 degrees, we get the branching ratio Gamma(X -> J/psi gamma)/Gamma(X -> J/psi pi(+)pi(-)) = 0.19 +/- 0.13, which is in agreement, with the experimental value. This result is compatible with the analysis of the mass and decay width of the mode J/psi(n pi) performed in the same approach.

Bs0 meson and the Bs0BK coupling from QCD sum rules

We evaluate the mass of the B(s0) scalar meson and the coupling constant in the B(s0)BK vertex in the framework of QCD sum rules. We consider the B(s0) as a tetraquark state to evaluate its mass. We get m(Bs0) = (5.85 +/- 0.13) GeV, which is in agreement, considering the uncertainties, with predictions supposing it as a b (s) over bar state or a B (K) over bar bound state with J(P) = 0(+). To evaluate the g(Bs0BK) coupling, we use the three-point correlation functions of the vertex, considering B(s0) as a normal b (s) over bar state. The obtained coupling constant is: g(Bs0BK) = (16.3 +/- 3.2) GeV. This number is in agreement with light-cone QCD sum rules calculation. We have also compared the decay width of the B(s0) -> BK process considering the B(s0) to be a b (s) over bar state and a BK molecular state. The width obtained for the BK molecular state is twice as big as the width obtained for the b (s) over bar state. Therefore, we conclude that with the knowledge of the mass and the decay width of the B(s0) meson, one can discriminate between the different theoretical proposals for its structure.

QCD sum rules for the X(3872) as a mixed molecule-charmonium state

We use QCD sum rules to test the nature of the meson X(3872), assumed to be a mixture between charmonium and exotic molecular [c (q) over bar][q (c) over bar] states with J(PC) = 1(++). We find that there is only a small range for the values of the mixing angle theta that can provide simultaneously good agreement with the experimental value of the mass and the decay width, and this range is 5(0) <= theta <= 3(0). In this range we get m(X) = (3.77 +/- 0.18) GeV and Gamma(X -> J/psi pi(+)pi(-)) = (9.3 +/- 6.9) MeV, which are compatible, within the errors, with the experimental values. We, therefore, conclude that the X(3872) is approximately 97% a charmonium state with 3% admixture of similar to 88% D(0)D*(0) molecule and similar to 12% D(+)D*(-) molecule.

Resummation of infrared divergences in the free energy of spin-two fields

We derive a closed form expression for the sum of all the infrared divergent contributions to the free energy of a gas of gravitons. An important ingredient of our calculation is the use of a gauge fixing procedure such that the graviton propagator becomes both traceless and transverse. This has been shown to be possible, in a previous work, using a general gauge fixing procedure, in the context of the lowest order expansion of the Einstein-Hilbert action, describing noninteracting spin-two fields. In order to encompass the problems involving thermal loops, such as the resummation of the free energy, in the present work, we have extended this procedure to the situations when the interactions are taken into account.

Width of exotics from QCD sum rules : Tetraquarks or molecules?

We investigate the widths of the recently observed charmonium like resonances X(3872), Z(4430), and Z(2)(4250) using QCD sum rules. Extending previous analyses regarding these states as diquark-antiquark states or molecules of D mesons, we introduce the Breit-Wigner function in the pole term. We find that introducing the width increases the mass at the small Borel window region. Using the operator-product expansion up to dimension 8, we find that the sum rules based on interpolating current with molecular components give a stable Borel curve from which both the masses and widths of these resonances can be well obtained. Thus the QCD sum rule approach strongly favors the molecular description of these states.

Kinetic energy sum spectra in nonmesonic weak decay of hypernuclei

We evaluate the coincidence spectra in the nonmesonic weak decay (NMWD) Lambda N -> nN of Lambda hypernuclei (4)(Lambda)He, (5)(Lambda)He, (12)(Lambda)C, (16)(Lambda)O, and (28)(Lambda)Si, as a function of the sum of kinetic energies E(nN)=E(n)+E(N) for N=n,p. The strangeness-changing transition potential is described by the one-meson-exchange model, with commonly used parametrization. Two versions of the independent-particle shell model (IPSM) are employed to account for the nuclear structure of the final residual nuclei. They are as follows: (a) IPSM-a, where no correlation, except for the Pauli principle, is taken into account and (b) IPSM-b, where the highly excited hole states are considered to be quasistationary and are described by Breit-Wigner distributions, whose widths are estimated from the experimental data. All np and nn spectra exhibit a series of peaks in the energy interval 110 MeV < E(nN)< 170 MeV, one for each occupied shell-model state. Within the IPSM-a, and because of the recoil effect, each peak covers an energy interval proportional to A(-1) , going from congruent to 4 MeV for (28)(Lambda)Si to congruent to 40 MeV for (4)(Lambda)He. Such a description could be pretty fair for the light (4)(Lambda)He and (5)(Lambda)He hypernuclei. For the remaining, heavier, hypernuclei it is very important, however, to consider as well the spreading in strength of the deep-hole states and bring into play the IPSM-b approach. Notwithstanding the nuclear model that is employed the results depend only very weakly on the details of the dynamics involved in the decay process proper. We propose that the IPSM is the appropriate lowest-order approximation for the theoretical calculations of the of kinetic energy sum spectra in the NMWD. It is in comparison to this picture that one should appraise the effects of the final-state interactions and of the two-nucleon-induced decay mode.

Social interaction as a heuristic for combinatorial optimization problems

We investigate the performance of a variant of Axelrod's model for dissemination of culture-the Adaptive Culture Heuristic (ACH)-on solving an NP-Complete optimization problem, namely, the classification of binary input patterns of size F by a Boolean Binary Perceptron. In this heuristic, N agents, characterized by binary strings of length F which represent possible solutions to the optimization problem, are fixed at the sites of a square lattice and interact with their nearest neighbors only. The interactions are such that the agents' strings (or cultures) become more similar to the low-cost strings of their neighbors resulting in the dissemination of these strings across the lattice. Eventually the dynamics freezes into a homogeneous absorbing configuration in which all agents exhibit identical solutions to the optimization problem. We find through extensive simulations that the probability of finding the optimal solution is a function of the reduced variable F/N(1/4) so that the number of agents must increase with the fourth power of the problem size, N proportional to F(4), to guarantee a fixed probability of success. In this case, we find that the relaxation time to reach an absorbing configuration scales with F(6) which can be interpreted as the overall computational cost of the ACH to find an optimal set of weights for a Boolean binary perceptron, given a fixed probability of success.