Process evaluation of a knowledge translation intervention using facilitation of local stakeholder groups to improve neonatal survival in the Quang Ninh province, Vietnam

BACKGROUND: Annually, 2.8 million neonatal deaths occur worldwide, despite the fact that three-quarters of them could be prevented if available evidence-based interventions were used. Facilitation of community groups has been recognized as a promising method to translate knowledge into practice. In northern Vietnam, the Neonatal Health - Knowledge Into Practice trial evaluated facilitation of community groups (2008-2011) and succeeded in reducing the neonatal mortality rate (adjusted odds ratio, 0.51; 95 % confidence interval 0.30-0.89). The aim of this paper is to report on the process (implementation and mechanism of impact) of this intervention. METHODS: Process data were excerpted from diary information from meetings with facilitators and intervention groups, and from supervisor records of monthly meetings with facilitators. Data were analyzed using descriptive statistics. An evaluation including attributes and skills of facilitators (e.g., group management, communication, and commitment) was performed at the end of the intervention using a six-item instrument. Odds ratios were analyzed, adjusted for cluster randomization using general linear mixed models. RESULTS: To ensure eight active facilitators over 3 years, 11 Women's Union representatives were recruited and trained. Of the 44 intervention groups, composed of health staff and commune stakeholders, 43 completed their activities until the end of the study. In total, 95 % (n = 1508) of the intended monthly meetings with an intervention group and a facilitator were conducted. The overall attendance of intervention group members was 86 %. The groups identified 32 unique problems and implemented 39 unique actions. The identified problems targeted health issues concerning both women and neonates. Actions implemented were mainly communication activities. Communes supported by a group with a facilitator who was rated high on attributes and skills (n = 27) had lower odds of neonatal mortality (odds ratio, 0.37; 95 % confidence interval, 0.19-0.73) than control communes (n = 46). CONCLUSIONS: This evaluation identified several factors that might have influenced the outcomes of the trial: continuity of intervention groups' work, adequate attributes and skills of facilitators, and targeting problems along a continuum of care. Such factors are important to consider in scaling-up efforts.

Early initiation of dialysis: mortality and renal function recovery in acute kidney injury patients

INTRODUÇÃO: A decisão de quando iniciar a diálise em pacientes com lesão renal aguda (LRA) que apresentam síndrome urêmica está bem estabelecida, entretanto, com ureia < 200 mg/dl o melhor momento para iniciar a diálise torna-se incerto. OBJETIVO: Este estudo teve como objetivo avaliar a mortalidade e a recuperação da função renal em pacientes com LRA, cujo início da diálise ocorreu em diferentes níveis de ureia. MÉTODOS: Estudo retrospectivo desenvolvido em hospital escola, no estado de São Paulo, Brasil, envolvendo 86 pacientes submetidos à diálise. RESULTADOS: A diálise foi iniciada com uréia > 150 mg/dl em 23 pacientes (grupo I) e uréia > 150 mg/dl em 63 pacientes (grupo II). Hipervolemia e mortalidade foram mais frequentes no grupo I que no grupo II (65,2 x 14,2% - p < 0,05; 39,1 x 68,9% - p < 0,05, respectivamente). Entre os sobreviventes, a recuperação renal foi maior no grupo I (71,4 e 36,8%, respectivamente, p < 0,05). A análise multivariada mostrou risco independente de mortalidade relacionado à sepse, idade > 60 anos, diálise peritoneal e uréia > 150 mg/dl no início da diálise. CONCLUSÃO: Menor mortalidade e maior recuperação renal estão associadas com o diálise iniciada precocemente, conforme baixos níveis de ureia, em pacientes com LRA.

Differential regulation of MMP-13 expression in two models of experimentally induced periodontal disease in rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The Influence of Cutting Speed and Cutting Initiation Location in Specimen Preparation for the Microtensile Bond Strength Test

Purpose: This study evaluated the effect of cutting initiation location and cutting speed on the bond strength between resin cement and feldspathic ceramic.Materials and Methods: Thirty-six blocks (6.4 x 6.4 x 4.8 mm) of ceramic (Vita VM7) were produced. The ceramic surfaces were etched with 10% hydrofluoric acid gel for 60 s and then silanized. Each ceramic block was placed in a silicon mold with the treated surface exposed. A resin cement (Variolink II) was injected into the mold over the treated surface and polymerized. The resin cement-ceramic blocks were divided into two groups according to experimental conditions: a) cutting initiation location - resin cement, ceramic and interface; and b) cutting speed - 10,000, 15,000, and 20,000 rpm. The blocks were sectioned to achieve non-trimmed bar specimens. The microtensile test was performed in a universal testing machine (1 mm/min). The failure modes were examined using an optical light microscope and SEM. Bond strength results were analyzed using one-way ANOVA and Tukey's test (alpha = 0.05).Results: Significant influences of cutting speed and initiation location on bond strength (p < 0.05) were observed. The highest mean was achieved for specimens cut at 15,000 rpm at the interface (15.12 +/- 5.36 MPa). The lowest means were obtained for specimens cut at the highest cutting speed in resin cement (8.50 +/- 3.27 MPa), and cut at the lowest cutting speed in ceramic (8.60 +/- 2.65MPa). All groups showed mainly mixed failure (75% to 100%).Conclusion: The cutting speed and initiation location are important factors that should be considered during specimen preparation for microtensile bond strength testing, as both may influence the bond strength results.

Phraseological translation

Almost all texts contain some complex lexical units, belonging to the phraseology of the language of a specialized field or of the general language. The translator must first identify this phraseologism, and then understand its meaning. However, it is not enough to propose an explanation in the target language: the translator has to establish its phraseologically equivalent lexical unit in meaning and in phraseological formulations.

GNN is a self-glucosylating protein involved in the initiation step of glycogen biosynthesis in Neurospora crassa

The initiation of glycogen synthesis requires the protein glycogenin, which incorporates glucose residues through a self-glucosylation reaction, and then acts as substrate for chain elongation by glycogen synthase and branching enzyme. Numerous sequences of glycogenin-like proteins are available in the databases but the enzymes from mammalian skeletal muscle and from Saccharomyces cerevisiae are the best characterized. We report the isolation of a cDNA from the fungus Neurospora crassa, which encodes a protein, GNN, which has properties characteristic of glycogenin. The protein is one of the largest glycogenins but shares several conserved domains common to other family members. Recombinant GNN produced in Escherichia coli was able to incorporate glucose in a self-glucosylation reaction, to trans-glucosylate exogenous substrates, and to act as substrate for chain elongation by glycogen synthase. Recombinant protein was sensitive to C-terminal proteolysis, leading to stable species of around 31 kDa, which maintained all functional properties. The role of GNN as an initiator of glycogen metabolism was confirmed by its ability to complement the glycogen deficiency of a S. cerevisiae strain (glg1 glg2) lacking glycogenin and unable to accumulate glycogen. Disruption of the gnn gene of N. crassa by repeat induced point mutation (RIP) resulted in a strain that was unable to synthesize glycogen, even though the glycogen synthase activity was unchanged. Northern blot analysis showed that the gnn gene was induced during vegetative growth and was repressed upon carbon starvation. (C) 2004 Elsevier B.V. All rights reserved.

Annexin-A1 gene expression during liver development and post-translation modification after experimental endotoxemia

Objective and design: We have previously reported a role for annexin-A1 in liver proliferation and tumorogenicity as well as its action as an acute phase protein in a model of endotoxemia in interleukin-6 null mice.Material and methods: In this study, we have investigated the analysis of the gene and protein expression in annexin-A1 null mice and the wild type livers during foetal and adult life, and in the presence of a proinflammatory stimulus.Results: The data indicate a link between the expression of the annexin-A1 as serine-phosphorylated-protein during early events of the inflammatory response and as tyrosine-phosphorylated-form at later time-points, during the resolution of inflammation.Conclusions: The study of annexin-A1 post-translation modification may promote a new annexin-A1 peptide discovery programme to treat specific pathologies.

Convective storm initiation in a moist tropical environment

Radar and satellite data from the Tropical Rainfall Measuring Mission-Large-Scale Biosphere-Atmosphere (TRMM-LBA) project have been examined to determine causes for convective storm initiation in the southwest Amazon region. The locations and times of storm initiation were based on the National Center for Atmospheric Research (NCAR) S-band dual-polarization Doppler radar (S-Pol). Both the radar and the Geostationary Operational Environmental Satellite-8 (GOES-8) visible data were used to identify cold pools produced by convective precipitation. These data along with high-resolution topographic data were used to determine possible convective storm triggering mechanisms. The terrain elevation varied from 100 to 600 m. Tropical forests cover the area with numerous clear-cut areas used for cattle grazing and farming. This paper presents the results from 5 February 1999. A total of 315 storms were initiated within 130 km of the S-Pol radar. This day was classified as a weak monsoon regime where convection developed in response to the diurnal cycle of solar heating. Scattered shallow cumulus during the morning developed into deep convection by early afternoon. Storm initiation began about 1100 LST and peaked around 1500-1600 LST. The causes of storm initiation were classified into four categories. The most common initiation mechanism was caused by forced lifting by a gust front (GF; 36%). Forcing by terrain (>300 m) without any other triggering mechanism accounted for 21% of the initiations and colliding GFs accounted for 16%. For the remaining 27% a triggering mechanism was not identified. Examination of all days during TRMM-LBA showed that this one detailed study day was representative of many days. A conceptual model of storm initiation and evolution is presented. The results of this study should have implications for other locations when synoptic-scale forcing mechanisms are at a minimum. These results should also have implications for very short-period forecasting techniques in any location where terrain, GFs, and colliding boundaries influence storm evolution.