Assessment of bioelectrical impedance analysis for the prediction of total body water in cystic fibrosis

The aim of this study was to compare the measurement of total body water (TBW) by deuterium ((H2O)-H-2) dilution and bioelectrical impedance analysis (BIA) in patients with cystic fibrosis (CF) and healthy controls. Thirty-six clinically stable patients with CF (age 25.4 +/- 5.6 yrs) and 42 healthy controls (age 25.4 +/- 4.8) were recruited into this study. TBW was measured by (H2O)-H-2 dilution and predicted by BIA in patients and controls. The TBW predicted from BIA was significantly different from TBW as measured using (H2O)-H-2 in patients (P

Use of an accelerated chest pain assessment protocol in patients at intermediate risk of adverse cardiac events

Objective: To determine the feasibility, safety and effectiveness of a structured clinical pathway for stratification and management of patients presenting with chest pain and classified as having intermediate risk of adverse cardiac outcomes in the subsequent six months. Design: Prospective clinical audit. Participants and setting: 630 consecutive patients who presented to the emergency department of a metropolitan tertiary care hospital between January 2000 and June 2001 with chest pain and intermediate-risk features. Intervention: Use of the Accelerated Chest Pain Assessment Protocol (ACPAP), as advocated by the Management of unstable angina guidelines - 2000 from the National Heart Foundation and the Cardiac Society of Australia and New Zealand. Main outcome measure: Adverse cardiac events during six-month follow-up. Results: 409 patients (65%) were reclassified as low risk and discharged at a mean of 14 hours after assessment in the chest pain unit. None had missed myocardial infarctions, while three (1%) had cardiac events at six months (all elective revascularisation procedures, with no readmissions with acute coronary syndromes). Another 110 patients (17%) were reclassified as high risk, and 21 (19%) of these had cardiac events (mainly revascularisations) by six months. Patients who were unable to exercise or had non-diagnostic exercise stress test results (equivocal risk) had an intermediate cardiac event rate (8%). Conclusions: This study validates use of ACPAP. The protocol eliminated missed myocardial infarction; allowed early, safe discharge of low-risk patients; and led to early identification and management of high-risk patients.

Link invariants associated with gauge equivalent solutions of the Yang-Baxter equation: The one-parameter family of minimal typical representations of Uq[gl(2|1)]

In this paper we investigate the construction of state models for link invariants using representations of the braid group obtained from various gauge choices for a solution of the trigonometric Yang-Baxter equation. Our results show that it is possible to obtain invariants of regular isotopy (as defined by Kauffman) which may not be ambient isotopic. We illustrate our results with explicit computations using solutions of the trigonometric Yang-Baxter equation associated with the one-parameter family of minimal typical representations of the quantum superalgebra U-q,[gl(2/1)]. We have implemented MATHEMATICA code to evaluate the invariants for all prime knots up to 10 crossings.

Matrix metalloproteinase-2 and-9 involvement in canine tumors

Matrix metalloproteinases (MMPs) are a family of enzymes implicated in the degradation and remodeling of extracellular matrix and in vascularization. They are also involved in pathologic processes such as tumor invasion and metastasis in experimental cancer models and in human malignancies. We used gelatin zymography and inummohistochemistry to determine whether MMP-2 and MMP-9 are present in canine tumors and normal tissues and whether MMP production correlates with clinicopathologic parameters of prognostic importance. High levels of pro-MMP-9, pro-MMP-2, and active MMP-2 were detected in most canine tumors. Significantly higher MMP levels were measured in canine tumors than in nontumors, malignancies had higher MMP levels than benign tumors, and sarcomas had higher active MMP-2 than carcinomas. Cartilaginous tumors produced higher MMP levels than did nonsarcomatous malignancies, benign tumors, and normal tissues, and significantly greater MMP-2 than osteosarcomas and fibrosarcomas. Pro-MMP-9 production correlated with the histologic grade of osteosarcomas. The 62-kd form of active MMP-2 was detected only in high-grade, p53-positive, metastatic malignancies. Zymography proved to be a sensitive and quantitative technique for the assessment of MMP presence but has the limitation of requiring fresh tissue; inummohistochemistry is qualitative and comparatively insensitive but could be of value in archival studies. MMP presence was shown in a range of canine tumors, and their link to tumor type and grade was demonstrated for the first time. This study will allow a substantially improved evaluation of veterinary cancer patients and provides baseline information necessary for the design of clinical trials targeting MMPs.

Use of web-based formative assessment to support student learning in metabolism/nutrition unit

In 2002, an integrated basic science course was introduced into the Bachelor of Dental Sciences programme at the University of Queensland, Australia. Learning activities for the Metabolism and Nutrition unit within this integrated course included lectures, problem-based learning tutorials, computer-based self-directed learning exercises and practicals. To support student learning and assist students to develop the skills necessary to become lifelong learners, an extensive bank of formative assessment questions was set up using the commercially available package, WebCT®. Questions included short-answer, multiple-choice and extended matching questions. As significant staff time was involved in setting up the question database, the extent to which students used the formative assessment and their perceptions of its usefulness to their learning were evaluated to determine whether formative assessment should be extended to other units within the course. More than 90% of the class completed formative assessment tasks associated with learning activities scheduled in the first two weeks of the block, but this declined to less than 50% by the fourth and final week of the block. Patterns of usage of the formative assessment were also compared in students who scored in the top 10% for all assessment for the semester with those who scored in the lowest 10%. High-performing students accessed the Web-based formative assessment about twice as often as those who scored in the lowest band. However, marks for the formative assessment tests did not differ significantly between the two groups. In a questionnaire that was administered at the completion of the block, students rated the formative assessment highly, with 80% regarding it as being helpful for their learning. In conclusion, although substantial staff time was required to set up the question database, this appeared to be justified by the positive responses of the students.

Electropalatographic assessment of tongue-to-palate contacts exhibited in dysarthria following traumatic brain injury: Spatial characteristics

Consonant imprecision has been reported to be a common feature of the dysarthric speech disturbances exhibited by individuals who have sustained a traumatic brain injury (TBI). Inaccurate tongue placements against the hard palate during consonant articulation may be one factor underlying the imprecision. To investigate this hypothesis, electropalatography (EPG) was used to assess the spatial characteristics of the tongue-to-palate contacts exhibited by three males (aged 23-29 years) with dysarthria following severe TBI. Five nonneurologically impaired adults served as control subjects. Twelve single-syllable words of CV or CVC construction (where initial C = /t, d, S, z, k, g/, V=/i, a/) were read aloud three times by each subject while wearing an EPG palate. Spatial characteristics were analyzed in terms of the location, pattern, and amount of tongue-to-palate contact at the frame of maximum contact during production of each consonant. The results revealed that for the majority of consonants, the patterns and locations of contacts exhibited by the TBI subjects were consistent with the contacts generated by the group of control subjects. One notable exception was one subject's production of the alveolar fricatives in which complete closure across the palate was demonstrated, rather than the characteristic groove configuration. Major discrepancies were also noted in relation to the amount of tongue-to-palate contact exhibited, with two TBI subjects consistently demonstrating increased contacts compared to the control subjects. The implications of these findings for the development of treatment programs for dysarthric speech disorders subsequent to TBI are highlighted.

Quality of life assessment in the community-dwelling elderly: Validation of the Assessment of Quality of Life (AQoL) Instrument and comparison with the SF-36

Measurement of Health-Related Quality of Life (HRQoL) of the elderly requires instruments with demonstrated sensitivity, reliability, and validity, particularly with the increasing proportion of older people entering the health care system. This article reports the psychometric properties of the 12-item Assessment of Quality of Life (AQoL) instrument in chronically ill community-dwelling elderly people with an 18-month follow-up. Comparator instruments included the SF-36 and the OARS. Construct validity of the AQoL was strong when examined via factor analysis and convergent and divergent validity against other scales. Receiver Operator Characteristic (ROC) curve analyses and relative efficiency estimates indicated the AQoL is sensitive, responsive, and had the strongest predicative validity for nursing home entry. It was also sensitive to economic prediction over the follow-up. Given these robust psychometric properties and the brevity of the scale, AQoL appears to be a suitable instrument for epidemiologic studies where HRQoL and utility data are required from elderly populations. (C) 2003 Elsevier Science Inc. All rights reserved.

Transdermal penetration of vasoconstrictors - Present understanding and assessment of the human epidermal flux and retention of free bases and ion-pairs

Purpose. As reductions in dermal clearance increase the residence time of solutes in the skin and underlying tissues we compared the topical penetration of potentially useful vasoconstrictors (VCs) through human epidermis as both free bases and ion-pairs with salicylic acid (SA). Methods. We determined the in vitro epidermal flux of ephedrine, naphazoline, oxymetazoline, phenylephrine, and xylometazoline applied as saturated solutions in propylene glycol: water (1: 1) and of ephedrine, naphazoline and tetrahydrozoline as 10% solutions of 1: 1 molar ratio ion-pairs with SA in liquid paraffin. Results. As free bases, ephedrine had the highest maximal flux, Jmax = 77.4 +/- 11.7 mug/cm(2)/h, being 4-fold higher than tetrahydrozoline and xylometazoline, 6-fold higher than phenylephrine, 10-fold higher than naphazoline and 100-fold higher than oxymetazoline. Stepwise regression of solute physicochemical properties identified melting point as the most significant predictor of flux. As ion-pairs with SA, ephedrine and naphazoline had similar fluxes (11.5 +/- 2.3 and 12.0 +/- 1.6 mug/cm(2)/h respectively), whereas tetrahydrozoline was approximately 3-fold slower. Corresponding fluxes of SA from the ion-pairs were 18.6 +/- 0.6, 7.8 +/- 0.8 and 1.1 +/- 0.1 respectively. Transdermal transport of VC's is discussed. Conclusions. Epidermal retention of VCs and SA did not correspond to their molar ratio on application and confirmed that following partitioning into the stratum corneum, ion-pairs separate and further penetration is governed by individual solute characteristics.

Qualidade fisiológica de sementes e diversidade genética de maracujazeiros cultivados em diferentes altitudes no Espírito Santo

O maracujazeiro pertence à família Passifloraceae e ao gênero Passiflora que é o mais importante economicamente. Altitudes entre 100 a 900 m são indicadas para o plantio do maracujazeiro e estudos sobre localizações geográficas distintas possibilitam expressões do genótipo, influenciadas pelas condições ambientais. O gradiente altitudinal influencia a distribuição da variação genética dentro e entre populações de plantas e a diversidade genética muda com a altitude. O presente trabalho teve como objetivo avaliar a qualidade fisiológica de sementes e a diversidade genética de maracujazeiros cultivados em diferentes altitudes do Espírito Santo. Para avaliação da qualidade fisiológica das sementes, os frutos de Passiflora spp. maduros foram colhidos em pomares localizados em altitudes baixa (0-100 m), média (>100 até 600 m) e alta (>600 m) de diferentes municípios do Espírito Santo. Os tratamentos pré-germinativos nas sementes foram: T1- escarificação física, feita manualmente com lixa d´água nº 120; T2- tratamento com ácido giberélico (GA3) na concentração de 500 mg L-1 com embebição por 24 horas e T3- sementes sem escarificação realizados nas sementes em laboratório e em casa de vegetação. Foi avaliado o envelhecimento acelerado tradicional, envelhecimento acelerado com saturação salina e deterioração controlada em sementes de maracujá amarelo sem escarificação localizado em alta altitude e as condições que apresentaram menor deterioração das sementes para aplicação às demais espécies e altitudes com os respectivos tratamentos pré-germinativos que apresentaram maiores valores de germinação e vigor em laboratório e em casa de vegetação. Assim, para as sementes do maracujá amarelo utilizou-se o tratamento sem escarificação, para sementes de maracujá roxo, a escarificação física e para as sementes de maracujá doce, o tratamento com ácido giberélico. O teste de envelhecimento acelerado com saturação salina a 43 ºC por 72 horas e deterioração controlada a 25% de umidade expostas por 24 horas diferencia as espécies nas diferentes altitudes. Sementes de maracujá amarelo e sementes localizadas em alta altitude apresentam qualidade fisiológica superior. Para a avaliação da diversidade genética foram utilizadas folhas jovens de cinco plantas matrizes de Passiflora edulis Sims f. flavicarpa Degener, P. edulis Sims e P. alata Curtis cultivadas em três altitudes (baixa, média e alta) do Espírito Santo. Para SSR foi encontrado baixo número de alelos, alta heterozigosidade esperada e altos valores de PIC e para a análise ISSR detectou um elevado número de bandas por primer e alto polimorfismo. Há maior similaridade genética entre P. edulis f. flavicarpa Deg. e P. edulis. Passiflora alata apresenta maior distância genética em relação às espécies. As populações de baixa altitude se diferenciam das demais independente da espécie e do marcador utilizado.

Avaliação do risco cardiovascular e fatores associados na população de Anchieta-ES

As doenças cardiovasculares são as principais causas de morte no mundo e muitos constituem os fatores de risco para essas doenças. Objetiva-se investigar o risco cardiovascular para evento coronariano agudo de acordo com o escore de Framingham em população adulta do município de Anchieta-ES. Estudo transversal com dados da linha de base do estudo Carmen Anchieta, iniciado em 2010. A amostra foi sistemática e estratificada por micro área de abrangência das Unidades de Saúde da Família, sexo e idade e 539 pessoas foram selecionadas para este estudo por terem os dados completos. Os dados foram coletados mediante entrevista no domicílio, exames laboratoriais de sangue, verificação da pressão arterial e antropometria nas Unidades de Saúde. As variáveis de exposição constituem escolaridade, raça-cor, renda familiar, residência em espaço urbano ou rural, estado civil, consumo de álcool, atividade física, índice de massa corpórea e autoavaliação de saúde. Para a classificação do risco cardiovascular utilizou-se o escore de Framingham. Foi realizada análise bivariada e regressão logística multinomial para testar a hipótese de associação entre as variáveis e o risco cardiovascular mediante o cálculo da razão de chances (RC) e intervalo de confiança de 95%. O nível de significância foi p < 0,05. Os resultados mostraram predominância de pessoas nas faixas etárias entre 25 a 54 anos, casadas, pardas, ensino fundamental incompleto, baixa renda, insuficientemente ativas, com sobrepeso e obesidade em mais da metade da amostra, 38,6% ingeriam bebida alcoólica e 55,7% relaram saúde muito boa ou boa. O risco cardiovascular foi baixo em 74%, intermediário em 11,3% e elevado em 14,7%. Estiveram associados ao risco cardiovascular intermediário ser analfabeto 8,89 (3,193-24,756), ter ensino fundamental incompleto 3,17 (1,450-6,964) e ser viúvo/ separado 2,55 (1,165-5,583) e associados ao risco cardiovascular elevado ser analfabeto 11,34 (4,281-30,049), ensino fundamental incompleto 2,95 (1,362-6,407) e autoavaliação da saúde muito ruim/ruim 2,98 (1,072-8,307) e regular 2,25 (1,294-3,925). Ser solteiro constituiu fator de proteção 0,40 (0,183-0,902).

Brazil's strategic partnerships: an assessment of the Lula era (2003-2010)

This article examines the priority bilateral relations of Brazil, named "strategic partnerships", both because of their tradition and historical relevance and due to the existence of political and economic cooperation projects. An assessment of these relationships, especially under Lula's administration, is made in this work, bearing in mind the concept of "strategic partnerships" and its development in Brazilian foreign policy. There will be considered partnerships with the US; Argentina; Japan; China; India; South Africa and the European Union. In the article, the meaning of the increase in these relationships is interpreted on the grounds of its significance to the international insertion strategy of Brazil

Multi-level governance and social cohesion in the European Union: the assessment of local agents, a study case inside Galicia

Implementing multi-level governance has been a key priority in EU cohesion policy. This study assesses the perceived achievements and shortcomings in implementing European Social Fund by analyzing the deficits and weaknesses as well as the poor participation of local agents who are in direct contact with the beneficiaries in order to design and implement this fund, which is the main financial instrument of EU social policy.