Collection of tracheal aspirate: safety and microbiological concordance between two techniques

Objective: To evaluate the safety of the performance of the traditional and protected collection techniques of tracheal aspirate and to identify qualitative and quantitative agreement of the results of microbiological cultures between the techniques. Method: Clinical, prospective, comparative, single-blind research. The sample was composed of 54 patients of >18 years of age, undergoing invasive mechanical ventilation for a period of ≥48 hours and with suspected Ventilator Associated Pneumonia. The two techniques were implemented in the same patient, one immediately after the other, with an order of random execution, according to randomization by specialized software. Results: No significant events occurred oxygen desaturation, hemodynamic instability or tracheobronchial hemorrhage (p<0.05) and, although there were differences in some strains, there was qualitative and quantitative agreement between the techniques (p<0.001). Conclusion: Utilization of the protected technique provided no advantage over the traditional and execution of both techniques was safe for the patient.


Um Laboratório Expedito para uma Sociedade Crioula

A descoberta de Cabo Verde não foi resultado de planos de pesquisa, como o caminho marítimo para a Índia, nem de missões exploratórias, como as que reconheceram e levantaram os litorais do continente africano. Foi um achado (1460)1 não previsto nas viagens marítimas portuguesas que rapidamente se utilizou em função dos objectivos principais da navegação atlântica vertical: o comércio com a Costa de África e o avanço para o Atlântico Sul. Seguir-se-ia, um pouco mais tarde, c. 1520, o fornecimento de escravos às Índias de Castela navegando o Atlântico na horizontal. A posição relativa de Cabo Verde, suficientemente afastado da costa para ficar fora do alcance de ataques das populações africanas e convenientemente próximo para facultar uma fácil e cómoda comunicação, viria a conferir ao arquipélago o carácter de área estratégica, consignado juridicamente, com variantes, ao longo dos tempos.

The Brazilian policy for reduction of accidents and violence aligns with international perspectives?

The study analyzed The Brazilian Policy for Reduction of Morbidity and Mortality from Accidents and Violence, in the socio-political perspective. We used as a base the chapter “Violence: a global public health problem” from the World Report on Violence and Health. The analysis revealed convergent and divergent elements of the Brazilian Policy in comparison with the international perspectives. We verified that the Brazilian Policy tried to converge to the international policies, however: it emphasizes the health promotion actions, but are limited to the context and behavior of individuals and individual communities; the performance of health professionals is expected without providing more structural investments, as the improvement in work conditions, the increase of financial and material resources; there are few clear definitions of the government and economical sector responsibilities.

Hybridization and speciation.

Hybridization has many and varied impacts on the process of speciation. Hybridization may slow or reverse differentiation by allowing gene flow and recombination. It may accelerate speciation via adaptive introgression or cause near-instantaneous speciation by allopolyploidization. It may have multiple effects at different stages and in different spatial contexts within a single speciation event. We offer a perspective on the context and evolutionary significance of hybridization during speciation, highlighting issues of current interest and debate. In secondary contact zones, it is uncertain if barriers to gene flow will be strengthened or broken down due to recombination and gene flow. Theory and empirical evidence suggest the latter is more likely, except within and around strongly selected genomic regions. Hybridization may contribute to speciation through the formation of new hybrid taxa, whereas introgression of a few loci may promote adaptive divergence and so facilitate speciation. Gene regulatory networks, epigenetic effects and the evolution of selfish genetic material in the genome suggest that the Dobzhansky-Muller model of hybrid incompatibilities requires a broader interpretation. Finally, although the incidence of reinforcement remains uncertain, this and other interactions in areas of sympatry may have knock-on effects on speciation both within and outside regions of hybridization.

Stepwise multiple testing as formalized data snooping

It is common in econometric applications that several hypothesis tests arecarried out at the same time. The problem then becomes how to decide whichhypotheses to reject, accounting for the multitude of tests. In this paper,we suggest a stepwise multiple testing procedure which asymptoticallycontrols the familywise error rate at a desired level. Compared to relatedsingle-step methods, our procedure is more powerful in the sense that itoften will reject more false hypotheses. In addition, we advocate the useof studentization when it is feasible. Unlike some stepwise methods, ourmethod implicitly captures the joint dependence structure of the teststatistics, which results in increased ability to detect alternativehypotheses. We prove our method asymptotically controls the familywise errorrate under minimal assumptions. We present our methodology in the context ofcomparing several strategies to a common benchmark and deciding whichstrategies actually beat the benchmark. However, our ideas can easily beextended and/or modied to other contexts, such as making inference for theindividual regression coecients in a multiple regression framework. Somesimulation studies show the improvements of our methods over previous proposals. We also provide an application to a set of real data.

Improved nonparametric confidence intervals in time series regressions

Condence intervals in econometric time series regressions suffer fromnotorious coverage problems. This is especially true when the dependencein the data is noticeable and sample sizes are small to moderate, as isoften the case in empirical studies. This paper suggests using thestudentized block bootstrap and discusses practical issues, such as thechoice of the block size. A particular data-dependent method is proposedto automate the method. As a side note, it is pointed out that symmetricconfidence intervals are preferred over equal-tailed ones, since theyexhibit improved coverage accuracy. The improvements in small sampleperformance are supported by a simulation study.

Subsampling the mean of heavy-tailed dependent observations

We establish the validity of subsampling confidence intervals for themean of a dependent series with heavy-tailed marginal distributions.Using point process theory, we study both linear and nonlinear GARCH-liketime series models. We propose a data-dependent method for the optimalblock size selection and investigate its performance by means of asimulation study.

L'ulcère de Savary: une nouvelle complication du reflux gastro-oesophagien?A propos de 32 observations endoscopiques [Savary's ulcer: a new complication of gastroesophageal reflux? Apropos of 32 endoscopically observed cases].

Savary's ulcer is a rare and little known peptic ulcer situated just above Barrett's esophagus. It is predominant in elderly women, bleeds less than Barrett's ulcer and is almost always associated with peptic stenosis. It is, like Barrett's and Wolf's ulcers, a complication of gastroesophageal reflux and not of Barrett's esophagus.

Ciclo biológico e predação de três espécies de coccinelídeos (Coleoptera, Coccinellidae) sobre o pulgão-gigante-do-pinus Cinara atlantica (Wilson) (Hemiptera, Aphididae)

Afídeos do gênero Cinara Curtis são importantes pragas de coníferas em vários países. No Brasil Cinara atlantica (Wilson, 1919) tem causado danos em plantações comerciais de Pinus spp. e o controle biológico com predadores pode ser uma opção melhor que o controle químico. Este trabalho teve por objetivo estudar a biologia e a capacidade de predação dos coccinelídeos Hippodamia convergens Guérin-Méneville, 1842, Cycloneda sanguinea (Linnaeus, 1763) e Eriopis connexa (German, 1824) (Coleoptera, Coccinellidae) sobre ninfas de C. atlantica. O estudo foi conduzido sob condições controladas (temperatura: 23 ± 1ºC, UR: 70 ± 10% e fotofase: 14 h.). Foi verificado que ninfas de C. atlantica são adequadas como alimento para as três espécies de coccinelídeos, assegurando seu desenvolvimento e reprodução. H. convergens e C. sanguinea apresentaram maior longevidade e capacidade de reprodução e também maior capacidade de predação (3832 e 3633 ninfas de C. atlantica em comparação a 2735 ninfas consumidas por E. connexa durante o ciclo completo, respectivamente para as espécies). Estas espécies de predadores podem contribuir para a redução da população de Cinara no campo.

A Importância do Marketing no Sector Bancário - Caso Caixa Económica de Cabo Verde

Actualmente as empresas precisam adoptar as melhores praticas de gestão para se sobreviverem neste mercado competitivo e com tendencias em aumentar a competitividade cada vez mais, uma vez que estamos num mercado globalizado. Devido a esses acontecimentos é que o presente trabalho teve como objectivo maior conhecer a importância do marketing no sector bancário. A metodologia utilizada para a concretização desta pesquisa, no que se refere aos objectivos traçados foi a metodologia exploratóoria, onde consegui–se retratar os aspectos teóricos sobre o marketing, o marketing bancário, fazer um breve apanhado do sector e também realizou – se um estudo de caso na Caixa Económica de Cabo Verde - CECV. A fim de responder o problema da pesquisa optou – se pela utilização de duas técnicas de recolha de dados, nomeadamente, realização de uma entrevista com o coordenador de marketing da empresa em estudo e análise documental da mesma e conseguentemente foram analisados e interpretados as informações obtidas. Ficou provado que a empresa utiliza uma filosofia de marketing interno, assim como também se provou que realmente investir em marketing reflete de uma forma positiva evolução da quota do mercado da empresa. De uma forma geral o resultado obtido foi favorável (o que se esperava), constatando que na verdade o marketing é de grande importância na gestão da empresa estudada, pois contribui para o alcance dos seus objectivos.

IκB-ζ controls the constitutive NF-κB target gene network and survival of ABC DLBCL.

Constitutive activation of the nuclear factor-κ B (NF-κB) pathway is a hallmark of the activated B-cell-like (ABC) subtype of diffuse large B-cell lymphoma (DLBCL). Recurrent mutations of NF-κB regulators that cause constitutive activity of this oncogenic pathway have been identified. However, it remains unclear how specific target genes are regulated. We identified the atypical nuclear IκB protein IκB-ζ to be upregulated in ABC compared with germinal center B-cell-like (GCB) DLBCL primary patient samples. Knockdown of IκB-ζ by RNA interference was toxic to ABC but not to GCB DLBCL cell lines. Gene expression profiling after IκB-ζ knockdown demonstrated a significant downregulation of a large number of known NF-κB target genes, indicating an essential role of IκB-ζ in regulating a specific set of NF-κB target genes. To further investigate how IκB-ζ mediates NF-κB activity, we performed immunoprecipitations and detected a physical interaction of IκB-ζ with both p50 and p52 NF-κB subunits, indicating that IκB-ζ interacts with components of both the canonical and the noncanonical NF-κB pathway in ABC DLBCL. Collectively, our data demonstrate that IκB-ζ is essential for nuclear NF-κB activity in ABC DLBCL, and thus might represent a promising molecular target for future therapies.

Some hypothesis tests for the covariance matrix when the dimension is large compared to the sample size

This paper analyzes whether standard covariance matrix tests work whendimensionality is large, and in particular larger than sample size. Inthe latter case, the singularity of the sample covariance matrix makeslikelihood ratio tests degenerate, but other tests based on quadraticforms of sample covariance matrix eigenvalues remain well-defined. Westudy the consistency property and limiting distribution of these testsas dimensionality and sample size go to infinity together, with theirratio converging to a finite non-zero limit. We find that the existingtest for sphericity is robust against high dimensionality, but not thetest for equality of the covariance matrix to a given matrix. For thelatter test, we develop a new correction to the existing test statisticthat makes it robust against high dimensionality.

Honey, I shrunk the sample covariance matrix

The central message of this paper is that nobody should be using the samplecovariance matrix for the purpose of portfolio optimization. It containsestimation error of the kind most likely to perturb a mean-varianceoptimizer. In its place, we suggest using the matrix obtained from thesample covariance matrix through a transformation called shrinkage. Thistends to pull the most extreme coefficients towards more central values,thereby systematically reducing estimation error where it matters most.Statistically, the challenge is to know the optimal shrinkage intensity,and we give the formula for that. Without changing any other step in theportfolio optimization process, we show on actual stock market data thatshrinkage reduces tracking error relative to a benchmark index, andsubstantially increases the realized information ratio of the activeportfolio manager.

Exact and approximate stepdown methods for multiple hypothesis testing

Consider the problem of testing k hypotheses simultaneously. In this paper,we discuss finite and large sample theory of stepdown methods that providecontrol of the familywise error rate (FWE). In order to improve upon theBonferroni method or Holm's (1979) stepdown method, Westfall and Young(1993) make eective use of resampling to construct stepdown methods thatimplicitly estimate the dependence structure of the test statistics. However,their methods depend on an assumption called subset pivotality. The goalof this paper is to construct general stepdown methods that do not requiresuch an assumption. In order to accomplish this, we take a close look atwhat makes stepdown procedures work, and a key component is a monotonicityrequirement of critical values. By imposing such monotonicity on estimatedcritical values (which is not an assumption on the model but an assumptionon the method), it is demonstrated that the problem of constructing a validmultiple test procedure which controls the FWE can be reduced to the problemof contructing a single test which controls the usual probability of a Type 1error. This reduction allows us to draw upon an enormous resamplingliterature as a general means of test contruction.