Analgesic Effects of Sweet-Tasting Solutions for Infants: Current State of Equipoise

OBJECTIVE: The goal was to review published studies of analgesic effects of sweet solutions, to ascertain areas with sufficient evidence of effectiveness and areas of uncertainty. METHODS: Databases searched included Medline, Embase, the Cumulative Index to Nursing and Allied Health Literature database, and PsycINFO, using the terms pain*, infant*, neonat*, newborn*, sucrose, glucose, and alternative sugars. Publications were sorted according to type, year, painful procedure studied, placebo/no-treatment groups, population studied, and country of publication. RESULTS: A total of 298 relevant unique publications involving human infants were identified; 125 (42%) were primary research studies, of which 116 (93%) were randomized controlled trials. Healthy preterm or term newborns were included in 82 studies (65%), and sick or very low birth weight infants were included in 22 (18%). Most studies included single episodes of painful procedures, with only 3 (2%) conducted over long periods. Procedures investigated most frequently were heel lance (49%), venipuncture (14%), and intramuscular injection (14%). Placebo or no-treatment groups were included in 111 studies (89%); in 103 (93%) of those studies, sweet solutions reduced behavioral responses, compared with placebo/no treatment. CONCLUSION: Clinical equipoise relating to analgesic effects of sweet solutions no longer exists for single episodes of procedures for healthy preterm and term newborn infants. Uncertainties include outcomes after prolonged use of sweet solutions, concomitant use of other analgesics, and effectiveness beyond the newborn period. Future research should focus on addressing these knowledge and research gaps. Pediatrics 2010;126:894-902

Methods of quantification of training load in exercise performed at maximal lactate steady state

The aim of the present study was to compare and correlate training impulse (TRIMP) estimates proposed by Banister (TRIMP(Banister)), Stagno (TRIMP(Stagno)) and Manzi (TRIMP(Manzi)). The subjects were submitted to an incremental test on cycle ergometer with heart rate and blood lactate concentration measurements. In the second occasion, they performed 30 min. of exercise at the intensity corresponding to maximal lactate steady state, and TRIMP(Banister), TRIMP(Stagno) and TRIMP(Manzi) were calculated. The mean values of TRIMP(Banister) (56.5 +/- 8.2 u.a.) and TRIMP(Stagno) (51.2 +/- 12.4 u.a.) were not different (P > 0.05) and were highly correlated (r = 0.90). Besides this, they presented a good agreement level, which means low bias and relatively narrow limits of agreement. On the other hand, despite highly correlated (r = 0.93), TRIMP(Stagno) and TRIMP(Manzi) (73.4 +/- 17.6 u.a.) were different (P < 0.05), with low agreement level. The TRIMP(Banister) e TRIMP(Manzi) estimates were not different (P = 0.06) and were highly correlated (r = 0.82), but showed low agreement level. Thus, we concluded that the investigated TRIMP methods are not equivalent. In practical terms, it seems prudent monitor the training process assuming only one of the estimates.

Physiological and perceived exertion responses at intermittent critical power and intermittent maximal lactate steady state

Okuno, NM, Perandini, LAB, Bishop, D, Simoes, HG, Pereira, G, Berthoin, S, Kokubun, E, and Nakamura, FY. Physiological and perceived exertion responses at intermittent critical power and intermittent maximal lactate steady state. J Strength Cond Res 25(7): 2053-2058, 2011-The aim of this study was to compare the power outputs of the intermittent critical power (CPi) with the intermittent maximal lactate steady state (MLSSi) and to compare the physiological and perceptual responses exercising at CPi and MLSSi. Ten subjects performed intermittent trials on a cycle ergometer to determine CPi and MLSSi using 30: 30 seconds of effort and pause. The oxygen uptake ((V) over dotO(2)), heart rate (HR), blood lactate concentration ([Lac]), and rating of perceived exertion (RPE) responses were compared during 30-minute cycling at CPi and MLSSi. The CPi (267 6 45 W) was similar to MLSSi (254 6 39 W), and they were correlated (r = 0.88; p<0.05). The (V) over dotO(2) and HR responses stabilized throughout exercising at CPi (2.52 +/- 0.52 L.min(-1); 156 +/- 8 b.min(-1)) and MLSSi (2.41 +/- 0.32 L.min(-1); 152 +/- 10 b.min(-1)). These physiological variables were similar between conditions. However, the [Lac] and RPE were higher from the middle to the end of exercise duration at CPi ([Lac] = 6.9 +/- 2.6 mM; RPE = 17.1 +/- 2.1 a.u.) compared to MLSSi ([Lac] = 5.1 +/- 0.9 mM; RPE = 15.7 +/- 1.8 a.u.). Therefore, CPi intensity determined from 30: 30 seconds of effort and rest periods on a cycle ergometer is equivalent to the MLSSi, and there is a physiological steady state throughout both exercise intensities, although the [Lac] and RPE responses at CPi are higher than at MLSSi. Thus, the CPi and MLSSi may be used as tools for intermittent training evaluation and prescription.

Optimal recovery process conditions for manganese-peroxidase obtained by solid-state fermentation of eucalyptus residue using Lentinula edodes

Enzyme production is a growing field in biotechnology and increasing attention has been devoted to the solid-state fermentation (SSF) of lignocellulosic biomass for production of industrially relevant lignocellulose deconstruction enzymes, especially manganese-peroxidase (MnP), which plays a crucial role in lignin degradation. However, there is a scarcity of studies regarding extraction of the secreted metabolities that are commonly bound to the fermented solids, preventing their accurate detection and limiting recovery efficiency. In the present work, we assessed the effectiveness of extraction process variables (pH, stirring rate, temperature, and extraction time) on recovery efficiency of manganese-peroxidase (MnP) obtained by SSF of eucalyptus residues using Lentinula edodes using statistical design of experiments. The results from this study indicated that of the variables studied, pH was the most significant (p < 0.05%) parameter affecting MnP recovery yield, while temperature, extraction time, and stirring rate presented no statistically significant effects in the studied range. The optimum pH for extraction of MnP was at 4.0-5.0, which yielded 1500-1700 IU kg (1) of enzyme activity at extraction time 4-5 h, under static condition at room temperature. (C) 2011 Elsevier Ltd. All rights reserved.

Assessment of Depressive Symptoms and Cognitive Impairment in Elders From Rural Areas of the Brazilian State of Rio Grande do Sul

The main objective of this study was to examine the relationships among demographic characteristics, depressive symptoms, and cognitive impairment in oldest-old elders from rural areas of the Brazilian State of Rio Grande do Sul. A cross-sectional, descriptive correlational design was used to conduct the study. 137 Brazilian elders age 80 years or over. A target population data form, a county data form, a demographic questionnaire, the Mini-Mental State Examination, and the Depressive Cognition Scale were used to collect the data. A significant difference was found between males and females in regard to cognitive impairment. In addition, educational level and depressive symptoms were correlated with cognitive impairment. Depressive symptoms were a weak but significant predictor of cognitive impairment after controlling for the effect of age, gender, and educational level of the oldest-old elders. The findings need to be interpreted cautiously since the sample scored above the cutoff points for cognitive impairment, and had low scores on depressive symptoms. Despite several limitations, findings from this study can be a foundation for further studies, and well-designed correlational or experimental approaches, are warranted.

City tuberculosis control coordinators` perspectives of patient adherence to DOT in Sao Paulo State, Brazil, 2005

SETTING: Thirty-six priority cities in Sao Paulo State, Brazil, with a high incidence of tuberculosis (TB) cases, deaths and treatment default. OBJECTIVE: To identify the perspectives of city TB control coordinators regarding the most important components of adherence strategies adopted by health care teams to ensure patient adherence in 36 priority cities in the State of Sao Paulo, Brazil. DESIGN: Qualitative research with semi-structured interviews conducted with the coordinators of the National TB Control Programme involved in the management of TB treatment services in the public sector. RESULTS: The main issues thought to influence adherence to directly observed treatment (DOT) by coordinators include incentives and benefits delivered to patients, patient-health care worker bonding and comprehensive care, the encouragement given by others to follow treatment (family, neighbours and health professionals), and help provided by health professionals for patients to recover their self-esteem. CONCLUSION: The main aspects mentioned by city TB control coordinators regarding patient adherence to treatment and to DOT in Sao Paulo are improvements in communications, relationships based on trust, a humane approach and including the patients in the decision-making process concerning their health.

Power imbalance application region method for distributed synchronous generator anti-islanding protection design and evaluation

This paper presents a novel graphical approach to adjust and evaluate frequency-based relays employed in anti-islanding protection schemes of distributed synchronous generators, in order to meet the anti-islanding and abnormal frequency variation requirements, simultaneously. The proposed method defines a region in the power mismatch space, inside which the relay non-detection zone should be located, if the above-mentioned requirements must be met. Such region is called power imbalance application region. Results show that this method can help protection engineers to adjust frequency-based relays to improve the anti-islanding capability and to minimize false operation occurrences, keeping the abnormal frequency variation utility requirements satisfied. Moreover, the proposed method can be employed to coordinate different types of frequency-based relays, aiming at improving overall performance of the distributed generator frequency protection scheme. (C) 2011 Elsevier B.V. All rights reserved.

Innovation concept for measurement gross error detection and identification in power system state estimation

In this study, the innovation approach is used to estimate the measurement total error associated with power system state estimation. This is required because the power system equations are very much correlated with each other and as a consequence part of the measurements errors is masked. For that purpose an index, innovation index (II), which provides the quantity of new information a measurement contains is proposed. A critical measurement is the limit case of a measurement with low II, it has a zero II index and its error is totally masked. In other words, that measurement does not bring any innovation for the gross error test. Using the II of a measurement, the masked gross error by the state estimation is recovered; then the total gross error of that measurement is composed. Instead of the classical normalised measurement residual amplitude, the corresponding normalised composed measurement residual amplitude is used in the gross error detection and identification test, but with m degrees of freedom. The gross error processing turns out to be very simple to implement, requiring only few adaptations to the existing state estimation software. The IEEE-14 bus system is used to validate the proposed gross error detection and identification test.

Experimental investigation on adaptive robust controller designs applied to a free-floating space manipulator

This paper aims to formulate and investigate the application of various nonlinear H(infinity) control methods to a fiee-floating space manipulator subject to parametric uncertainties and external disturbances. From a tutorial perspective, a model-based approach and adaptive procedures based on linear parametrization, neural networks and fuzzy systems are covered by this work. A comparative study is conducted based on experimental implementations performed with an actual underactuated fixed-base planar manipulator which is, following the DEM concept, dynamically equivalent to a free-floating space manipulator. (C) 2011 Elsevier Ltd. All rights reserved.

Bending of stochastic Kirchhoff plates on Winkler foundations via the Galerkin method and the Askey-Wiener scheme

In this paper, the method of Galerkin and the Askey-Wiener scheme are used to obtain approximate solutions to the stochastic displacement response of Kirchhoff plates with uncertain parameters. Theoretical and numerical results are presented. The Lax-Milgram lemma is used to express the conditions for existence and uniqueness of the solution. Uncertainties in plate and foundation stiffness are modeled by respecting these conditions, hence using Legendre polynomials indexed in uniform random variables. The space of approximate solutions is built using results of density between the space of continuous functions and Sobolev spaces. Approximate Galerkin solutions are compared with results of Monte Carlo simulation, in terms of first and second order moments and in terms of histograms of the displacement response. Numerical results for two example problems show very fast convergence to the exact solution, at excellent accuracies. The Askey-Wiener Galerkin scheme developed herein is able to reproduce the histogram of the displacement response. The scheme is shown to be a theoretically sound and efficient method for the solution of stochastic problems in engineering. (C) 2009 Elsevier Ltd. All rights reserved.

INFLUENCE OF ROOF MATERIAL ON THERMAL COMFORT IN BROILER HOUSINGS IN THE STATE OF SAO PAULO

This paper presents a different roof tiles influence study on the thermal comfort for broiler housings. The research was conducted at UNESP`s Experimental Campus at Dracena, state of Sao Paulo, Brazil. Four prototypes in real scale were built, each with an area of 28 m(2). The prototype was covered with roof tiles made of recycled long-life packing material, ceramic tiles, ceramic tiles painted with white coating, and fiber/cement tiles. Temperatures inside the structures were recorded in the winter 2007 over a 90-day period. The results obtained indicated that recycled tile thermal behavior was similar to ceramic tiles. However for the winter period all the prototypes had presented comfort thermal index not in the broilers thermo neutral zone.

Defining Nutrient and Biochemical Oxygen Demand Baselines for Tropical Rivers and Streams in So Paulo State (Brazil): A Comparison Between Reference and Impacted Sites

Determining reference concentrations in rivers and streams is an important tool for environmental management. Reference conditions for eutrophication-related water variables are unavailable for Brazilian freshwaters. We aimed to establish reference baselines for So Paulo State tropical rivers and streams for total phosphorus (TP) and nitrogen (TN), nitrogen-ammonia (NH(4) (+)) and Biochemical Oxygen Demand (BOD) through the best professional judgment and the trisection methods. Data from 319 sites monitored by the So Paulo State Environmental Company (2005 to 2009) and from the 22 Water Resources Management Units in So Paulo State were assessed (N = 27,131). We verified that data from different management units dominated by similar land cover could be analyzed together (Analysis of Variance, P = 0.504). Cumulative frequency diagrams showed that industrialized management units were characterized by the worst water quality (e.g. average TP of 0.51 mg/L), followed by agricultural watersheds. TN and NH(4) (+) were associated with urban percentages and population density (Spearman Rank Correlation Test, P < 0.05). Best professional judgment and trisection (median of lower third of all sites) methods for determining reference concentrations showed agreement: 0.03 & 0.04 mg/L (TP), 0.31 & 0.34 mg/L (TN), 0.06 & 0.10 mg-N/L (NH(4) (+)) and 2 & 2 mg/L (BOD), respectively. Our reference concentrations were similar to TP and TN reference values proposed for temperate water bodies. These baselines can help with water management in So Paulo State, as well as providing some of the first such information for tropical ecosystems.

Dendritic Arm Spacing Affecting Mechanical Properties and Wear Behavior of Al-Sn and Al-Si Alloys Directionally Solidified under Unsteady-State Conditions

Alloys of Al-Sn and Al-Si are widely used in tribological applications such as cylinder liners and journal bearings. Studies of the influence of the as-cast microstructures of these alloys on the final mechanical properties and wear resistance can be very useful for planning solidification conditions in order to permit a desired level of final properties to be achieved. The aim of the present study was to contribute to a better understanding about the relationship between the scale of the dendritic network and the corresponding mechanical properties and wear behavior. The Al-Sn (15 and 20 wt pct Sn) and Al-Si (3 and 5 wt pct Si) alloys were directionally solidified under unsteady-state heat flow conditions in water-cooled molds in order to permit samples with a wide range of dendritic spacings to be obtained. These samples were subjected to tensile and wear tests, and experimental quantitative expressions correlating the ultimate tensile strength (UTS), yield tensile strength, elongation, and wear volume to the primary dendritic arm spacing (DAS) have been determined. The wear resistance was shown to be significantly affected by the scale of primary dendrite arm spacing. For Al-Si alloys, the refinement of the dendritic array improved the wear resistance, while for the Al-Sn alloys, an opposite effect was observed, i.e., the increase in primary dendrite arm spacing improved the wear resistance. The effect of inverse segregation, which is observed for Al-Sn alloys, on the wear resistance is also discussed.

Chemical composition of mixed construction and demolition recycled aggregates from the State of Sao Paulo

Construction and Demolition Waste (CDW) represents. about 50% of the total Brazilian municipal solid waste: thus, recycling represents huge benefits both in environmental and economic perspectives. Herein, the chemical characterization results of three samples from two different recycling plants from the State of Sao Paulo is prevented. The results demonstrated that the visual classification into grey and red is not related to the chemical composition but mostly to the grain size fraction. The chemical composition of the CDW varies according to the content of cement paste, natural aggregates (quartz sand or granite), red ceramic and clay. Furthermore, the production of recycled concrete aggregates requires two crushing stages to meet the technical standards. The sand fraction (below 4.8 mm) presents high grades of SiO(2), which indicates the liberation of cement paste to fines (< 0.15 mm). The fines have a great potential to be used in the cement industry.

Three-phase harmonic distortion state estimation algorithm based on evolutionary strategies

This paper presents a new methodology to estimate unbalanced harmonic distortions in a power system, based on measurements of a limited number of given sites. The algorithm utilizes evolutionary strategies (ES), a development branch of evolutionary algorithms. The problem solving algorithm herein proposed makes use of data from various power quality meters, which can either be synchronized by high technology GPS devices or by using information from a fundamental frequency load flow, what makes the overall power quality monitoring system much less costly. The ES based harmonic estimation model is applied to a 14 bus network to compare its performance to a conventional Monte Carlo approach. It is also applied to a 50 bus subtransmission network in order to compare the three-phase and single-phase approaches as well as the robustness of the proposed method. (C) 2010 Elsevier B.V. All rights reserved.