Effect of facilitation of local maternal-and-newborn stakeholder groups on neonatal mortality : cluster-randomized controlled trial

BACKGROUND: Facilitation of local women's groups may reportedly reduce neonatal mortality. It is not known whether facilitation of groups composed of local health care staff and politicians can improve perinatal outcomes. We hypothesised that facilitation of local stakeholder groups would reduce neonatal mortality (primary outcome) and improve maternal, delivery, and newborn care indicators (secondary outcomes) in Quang Ninh province, Vietnam. METHODS AND FINDINGS: In a cluster-randomized design 44 communes were allocated to intervention and 46 to control. Laywomen facilitated monthly meetings during 3 years in groups composed of health care staff and key persons in the communes. A problem-solving approach was employed. Births and neonatal deaths were monitored, and interviews were performed in households of neonatal deaths and of randomly selected surviving infants. A latent period before effect is expected in this type of intervention, but this timeframe was not pre-specified. Neonatal mortality rate (NMR) from July 2008 to June 2011 was 16.5/1,000 (195 deaths per 11,818 live births) in the intervention communes and 18.4/1,000 (194 per 10,559 live births) in control communes (adjusted odds ratio [OR] 0.96 [95% CI 0.73-1.25]). There was a significant downward time trend of NMR in intervention communes (p = 0.003) but not in control communes (p = 0.184). No significant difference in NMR was observed during the first two years (July 2008 to June 2010) while the third year (July 2010 to June 2011) had significantly lower NMR in intervention arm: adjusted OR 0.51 (95% CI 0.30-0.89). Women in intervention communes more frequently attended antenatal care (adjusted OR 2.27 [95% CI 1.07-4.8]). CONCLUSIONS: A randomized facilitation intervention with local stakeholder groups composed of primary care staff and local politicians working for three years with a perinatal problem-solving approach resulted in increased attendance to antenatal care and reduced neonatal mortality after a latent period. TRIAL REGISTRATION: Current Controlled Trials ISRCTN44599712. Please see later in the article for the Editors' Summary.

Electronic contracting in aircraft aftercare: A case study

Distributed systems comprised of autonomous self-interested entities require some sort of control mechanism to ensure the predictability of the interactions that drive them. This is certainly true in the aerospace domain, where manufacturers, suppliers and operators must coordinate their activities to maximise safety and profit, for example. To address this need, the notion of norms has been proposed which, when incorporated into formal electronic documents, allow for the specification and deployment of contract-driven systems. In this context, we describe the CONTRACT framework and architecture for exactly this purpose, and describe a concrete instantiation of this architecture as a prototype system applied to an aerospace aftercare scenario.

Meteomap: Generation Of Meteorological Variables For Distributed Physically-Based Hydrological Modeling

Distributed energy and water balance models require time-series surfaces of the meteorological variables involved in hydrological processes. Most of the hydrological GIS-based models apply simple interpolation techniques to extrapolate the point scale values registered at weather stations at a watershed scale. In mountainous areas, where the monitoring network ineffectively covers the complex terrain heterogeneity, simple geostatistical methods for spatial interpolation are not always representative enough, and algorithms that explicitly or implicitly account for the features creating strong local gradients in the meteorological variables must be applied. Originally developed as a meteorological pre-processing tool for a complete hydrological model (WiMMed), MeteoMap has become an independent software. The individual interpolation algorithms used to approximate the spatial distribution of each meteorological variable were carefully selected taking into account both, the specific variable being mapped, and the common lack of input data from Mediterranean mountainous areas. They include corrections with height for both rainfall and temperature (Herrero et al., 2007), and topographic corrections for solar radiation (Aguilar et al., 2010). MeteoMap is a GIS-based freeware upon registration. Input data include weather station records and topographic data and the output consists of tables and maps of the meteorological variables at hourly, daily, predefined rainfall event duration or annual scales. It offers its own pre and post-processing tools, including video outlook, map printing and the possibility of exporting the maps to images or ASCII ArcGIS formats. This study presents the friendly user interface of the software and shows some case studies with applications to hydrological modeling.

Infecção hospitalar em pacientes cirúrgicos de hospital universitário

Analisar fatores intercorrentes e a incidência da infecção em pacientes operados no Hospital Universitário da UFRN. Métodos: Foram estudados, através de protocolo previamente estabelecido, 3.120 pacientes internados que se submeteram a procedimentos cirúrgicos no período de janeiro de 1999 a outubro de 2002. Resultados: O índice de infecção hospitalar foi de 5,9%, e a topografia de maior incidência foi a ferida operatória (3,7%). Infecção respiratória ocorreu em 1,2%, urinária em 0,6% e bacteremia em 0,1%. O índice de infecção comunitária foi de 9,2%, predominando infecção urinária (5%) e respiratória (2,1%). Quanto ao grau de contaminação das feridas operatórias, as feridas limpas (1479) apresentaram infecção em 2,9%, as feridas limpascontaminadas (1277) em 6,0% dos casos, as feridas contaminadas (270) em 15,1%, e as ferida infectadas (94) resultaram em infecção em 30,75% dos casos. Conclusão: Concluiu-se que a incidência de infecção cirúrgica foi compatível com os índices na literatura mundial. A partir desses dados, ratifica-se a importância de medidas de controle de infecção hospitalar de forma sistemática, como vem sendo realizado no hospital onde o estudo foi realizado

Infecção hospitalar em pacientes cirúrgicos de hospital universitário

Objetivo: Analisar fatores intercorrentes e a incidência da infecção em pacientes operados no Hospital Universitário da UFRN. Métodos: Foram estudados, através de protocolo previamente estabelecido, 3.120 pacientes internados que se submeteram a procedimentos cirúrgicos no período de janeiro de 1999 a outubro de 2002. Resultados: O índice de infecção hospitalar foi de 5,9%, e a topografia de maior incidência foi a ferida operatória (3,7%). Infecção respiratória ocorreu em 1,2%, urinária em 0,6% e bacteremia em 0,1%. O índice de infecção comunitária foi de 9,2%, predominando infecção urinária (5%) e respiratória (2,1%). Quanto ao grau de contaminação das feridas operatórias, as feridas limpas (1479) apresentaram infecção em 2,9%, as feridas limpascontaminadas (1277) em 6,0% dos casos, as feridas contaminadas (270) em 15,1%, e as ferida infectadas (94) resultaram em infecção em 30,75% dos casos. Conclusão: Concluiu-se que a incidência de infecção cirúrgica foi compatível com os índices na literatura mundial. A partir desses dados, ratifica-se a importância de medidas de controle de infecção hospitalar de forma sistemática, como vem sendo realizado no hospital onde o estudo foi realizado

Isolation and characterization of ten novel microsatellite loci in the red-winged tinamou (Rhynchotus rufescens, Tinamiformes, Aves) and cross-amplification in other tinamous

We describe the isolation and characterization of ten microsatellite loci from the red-winged tinamou (Rhynchotus rufescens) and also evaluated the cross-amplification of these loci and other ten loci previously developed for the great tinamou (Tinamus major) in other tinamous. Genetic variability was assessed using 24 individuals. Six loci were polymorphic with moderate to high number of alleles per locus (2-12 alleles) and showed expected heterozygosity (HE) ranging from 0.267 to 0.860. All loci conformed to the Hardy-Weinberg expectation and linkage disequilibrium was not significant for any pair of loci. This battery of polymorphic loci showed high paternity exclusion probability (0.986) and low genetic identity probability (4.95 x 10(-5)), proving to be helpful for parentage tests and population analyses in the red-winged tinamou. The cross-amplification was moderate where of the 160 locus/taxon combinations, 46 (28.75%) successfully amplified.

Biology of Thaumastocoris peregrinus in different eucalyptus species and hybrids

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Chemical Composition and Antioxidant and Antimycobacterial Activities of Bromelia balansae (Bromeliaceae)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

A Novel Diagnostic Target in the Hepatitis C Virus Genome

BackgroundDetection and quantification of hepatitis C virus (HCV) RNA is integral to diagnostic and therapeutic regimens. All molecular assays target the viral 5'-noncoding region (59-NCR), and all show genotype-dependent variation of sensitivities and viral load results. Non-western HCV genotypes have been under-represented in evaluation studies. An alternative diagnostic target region within the HCV genome could facilitate a new generation of assays.Methods and FindingsIn this study we determined by de novo sequencing that the 3'-X-tail element, characterized significantly later than the rest of the genome, is highly conserved across genotypes. To prove its clinical utility as a molecular diagnostic target, a prototype qualitative and quantitative test was developed and evaluated multicentrically on a large and complete panel of 725 clinical plasma samples, covering HCV genotypes 1-6, from four continents (Germany, UK, Brazil, South Africa, Singapore). To our knowledge, this is the most diversified and comprehensive panel of clinical and genotype specimens used in HCV nucleic acid testing (NAT) validation to date. The lower limit of detection (LOD) was 18.4 IU/ml (95% confidence interval, 15.3-24.1 IU/ml), suggesting applicability in donor blood screening. The upper LOD exceeded 10(-9) IU/ml, facilitating viral load monitoring within a wide dynamic range. In 598 genotyped samples, quantified by Bayer VERSANT 3.0 branched DNA (bDNA), X-tail-based viral loads were highly concordant with bDNA for all genotypes. Correlation coefficients between bDNA and X-tail NAT, for genotypes 1-6, were: 0.92, 0.85, 0.95, 0.91, 0.95, and 0.96, respectively; X-tail-based viral loads deviated by more than 0.5 log10 from 5'-NCR-based viral loads in only 12% of samples (maximum deviation, 0.85 log10). The successful introduction of X-tail NAT in a Brazilian laboratory confirmed the practical stability and robustness of the X-tail-based protocol. The assay was implemented at low reaction costs (US$8.70 per sample), short turnover times (2.5 h for up to 96 samples), and without technical difficulties.ConclusionThis study indicates a way to fundamentally improve HCV viral load monitoring and infection screening. Our prototype assay can serve as a template for a new generation of viral load assays. Additionally, to our knowledge this study provides the first open protocol to permit industry-grade HCV detection and quantification in resource-limited settings.

Prevalence and risk factors for urinary incontinence in healthy pregnant Brazilian women

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Evaluation of pH and Calcium Ion Release of Calcium Hydroxide Pastes Containing Different Substances

Introduction: The objective of this study was to evaluate the pH and calcium ion release of calcium hydroxide pastes associated with different substances. Methods: Forty acrylic teeth with simulated root canals were divided into 4 groups according to the substance associated to the calcium hydroxide paste: chlorhexidine (CHX) in 2 formulations (1% solution and 2% gel), Casearia sylvestris Sw extract, and propylene glycol (control). The teeth with pastes and sealed coronal accesses were immersed in 10 mL deionized water. After 10 minutes, 24 hours, 48 hours, and 7, 15, and 30 days, the teeth were removed to another container, and the liquid was analyzed. Calcium ion release was measured by atomic absorption spectrophotometry, and pH readings were made with a pH meter. Data were analyzed statistically by analysis of variance and Tukey test (alpha = 0.05). Results: Calcium analysis revealed significant differences (P < .05) for 1% CHX solution and 2% CHX gel at 10 minutes. After 24 hours, 2% CHX gel x Control and 2% CHX gel x 1% CHX solution differed significantly (P < .05). After 48 hours, there were significant differences (P < .05) for 2% CHX gel x Control and Extract x Control. No differences (P > .05) were observed among groups in the other periods. Regarding the pH, there were significant differences (P < .05) for 2% CHX gel x Control and 2% CHX gel x 1% CHX solution after 48 hours and for 2% CHX gel x Control after 15 days. In the other periods, no differences (P > .05) were observed among groups. Conclusions: All pastes behaved similarly in terms of pH and calcium ion release in the studied periods. (J Endod 2009;35:1274-1277)

Central nervous system of Rhipicephalus sanguineus ticks (Acari: Ixodidae): an ultrastructural study

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

Peptídeos cíclicos de biomassa vegetal: características, diversidade, biossíntese e atividades biológicas

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

GC Fingerprints Coupled to Pattern-Recognition Multivariate SIMCA Chemometric Analysis for Brazilian Gasoline Quality Studies

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)