Systematic review of interventions to improve the provision of information for adults with primary brain tumours and their caregivers

Background: Adults with primary brain tumors and their caregivers have significant information needs. This review assessed the effect of interventions to improve information provision for adult primary brain tumor patients and/or their caregivers. Methods: We included randomized or nonrandomized trials testing educational interventions that had outcomes of information provision, knowledge, understanding, recall, or satisfaction with the intervention, for adults diagnosed with primary brain tumors and/or their family or caregivers. PubMed, MEDLINE, EMBASE and Cochrane Reviews databases were searched for studies published between 1980 and June 2014. Results: Two randomized controlled, one non-randomized controlled, and 10 single group pre-post trials enrolled more than 411 participants. Five group, four practice/process change and four individual interventions assessed satisfaction (12 studies), knowledge (four studies) or information provision (2 studies). Nine studies reported high rates of satisfaction. Three studies showed statistically significant improvements over time in knowledge and two showed greater information was provided to intervention than control group participants, although statistical testing was not performed. Discussion: The trials assessed intermediate outcomes such as satisfaction, and only 4/13 reported on knowledge improvements. Few trials had a randomized controlled design and risk of bias was either evident or could not be assessed in most domains.

Applications of coralline hydroxyapatite with bioabsorbable containment and reinforcement as bone graft substitute : An experimental study

The aim of the present experimental study was to find out if the applications of coralline hydroxyapatite (HA) can be improved by using bioabsorbable containment or binding substance with particulate HA in mandibular contour augmentation and by using bioabsorbable fibre-reinforced HA blocks in filling bone defects and in anterior lumbar interbody fusion. The use of a separate curved polyglycolide (PGA) containment alone or together with a fast resorbing polyglycolide/polylactide (PGA/PLA) binding substance were compared to the conventional non-contained method in ridge augmentation in sheep. The contained methods decreased HA migration, but the augmentations did not differ significantly. The use of the containment caused a risk for wound dehiscence and infection. Histologically there was a rapid connective tissue ingrowth into the HA graft and it was more abundant with the PGA containment compared to the non-contained augmentation and even additionally rich when the HA particles were bound with PGA/PLA copolymer. However, the bone ingrowth was best in the non-contained augmentation exceeding 10-12 % of the total graft area at 24 weeks. Negligible or no bone ingrowth was seen in the cases where the polymer composite was added to the HA particles and, related to that, foreign-body type cells were seen at the interface between the HA and host bone. The PGA and poly-dl/l-lactide (PDLLA) fibre-reinforced coralline HA blocks were studied in the metaphyseal and in the diaphyseal defects in rabbits. A rapid bone ingrowth was seen inside the both types of implants. Both PGA and PDLLA fibres induced an inflammatory fibrous reaction around themselves but it did not hinder the bone ingrowth. The bone ingrowth pattern was directed according to the loading conditions so that the load-carrying cortical ends of the implants as well as the implants sited in the diaphyseal defects were the most ossified. The fibre-reinforced coralline HA implants were further studied as stand-alone grafts in the lumbar anterior interbody implantation in pigs. The strength of the HA implants proved not to be adequate, the implants fractured in six weeks and the disc space was gradually lost similarly to that of the discectomized spaces. Histologically, small quantities of bone ingrowth was seen in some of the PGA and PDLLA reinforced coralline implants while no bone formation was identified in any of the PDLLA reinforced synthetic porous HA implants. While fragmented, the inner structure of the implants was lost, the bone ingrowth was minimal, and the disc was replaced by the fibrous connective tissue. When evaluated radiologically the grade of ossification was assessed as better than histologically, and, when related to the histologic findings, CT was more dependable than the plain films to show ossification of the implanted disc space. Local kyphosis was a frequent finding along with anterior bone bridging and ligament ossification as a consequence of instability of the implanted segment.

Assessment of the residual fatigue strength in RC beams

In conventional analysis and design procedures of reinforced concrete structures, the ability of concrete to resist tension is neglected. Under cyclic loading, the tension-softening behavior of concrete influences its residual strength and subsequent crack propagation. The stability and the residual strength of a cracked reinforced concrete member under fatigue loading, depends on a number of factors such as, reinforcement ratio, specimen size, grade of concrete, and the fracture properties, and also on the tension-softening behavior of concrete. In the present work, a method is proposed to assess the residual strength of a reinforced concrete member subjected to cyclic loading. The crack extension resistance based approach is used for determining the condition for unstable crack propagation. Three different idealization of tension softening models are considered to study the effect of post-peak response of concrete. The effect of reinforcement is modeled as a closing force counteracting the effect of crack opening produced by the external moment. The effect of reinforcement percentage and specimen size on the failure of reinforced beams is studied. Finally, the residual strength of the beams are computed by including the softening behavior of concrete.

Progression of diffuse gliomas - from the first diagnosis to recurrence

Gliomas are the most frequent primary brain tumours. The cardinal features of gliomas are infiltrative growth pattern and progression from low-grade tumours to a more malignant phenotype. These features of gliomas generally prevent their complete surgical excision and cause their inherent tendency to recur after initial treatment and lead to poor long-term prognosis. Increasing knowledge about the molecular biology of gliomas has produced new markers that supplement histopathological diagnostics. Molecular markers are also used to evaluate the prognosis and predict therapeutic response. The purpose of this thesis is to study molecular events involved in the malignant progression of gliomas. Gliomas are highly vascularised tumours. Contrast enhancement in magnetic resonance imaging (MRI) reflects a disrupted blood-brain barrier and is often seen in malignant gliomas. In this thesis, 62 astrocytomas, oligodendrogliomas and oligoastrocytomas were studied by MRI and immunohistochemistry. Contrast enhancement in preoperative MRI was associated with angiogenesis, tumour cell proliferation and histological grade of gliomas. Activation of oncogenes by gene amplification is a common genetic aberration in gliomas. EGFR amplification on chromosome 7p12 occurs in 30-40% of glioblastomas. PDGFRA, KIT and VEGFR2 are receptor tyrosine kinase genes located on chromosome 4q12. Amplification of these genes was studied using in situ hybridisation in the primary and recurrent astrocytomas, oligodendrogliomas and oligoastrocytomas of 87 patients. PDGFRA, KIT or VEGFR2 amplification was found in 22% of primary tumours and 36% of recurrent tumours including low-grade and malignant gliomas. The most frequent aberration was KIT amplification, which occurred in 10% of primary tumours and in 27% of recurrent tumours. The expression of ezrin, cyclooxygenase 2 (COX-2) and HuR was studied immunohistochemically in a series of primary and recurrent gliomas of 113 patients. Ezrin is a cell membrane-cytoskeleton linking-protein involved in the migration of glioma cells. The COX-2 enzyme is implicated in the carcinogenesis of epithelial neoplasms and is overexpressed in gliomas. HuR is an RNA-stabilising protein, which regulates the expression of several proteins including COX-2. Ezrin, COX-2 and HuR were associated with histological grade and the overall survival of glioma patients. However, in multivariate analysis they were not independent prognostic factors. In conclusion, these results suggest that contrast enhancement in MRI can be used as a surrogate marker for the proliferative and angiogenic potential of gliomas. Aberrations of PDGFRA, KIT and VEGFR2 genes, as well as the dysregulated expression of ezrin, COX-2 and HuR proteins, are linked to the progression of gliomas.

Cox-2, tenascin, CRP, and ingraft chimerism in a model of post-transplant obliterative bronchiolitis

Chronic rejection in the form of obliterative bronchiolitis (OB) is the major cause of death 5 years after lung transplantation. The exact mechanism of OB remains unclear. This study focused on the role of cyclo-oxygenase (COX) -2, tenascin, and C-reactive protein (CRP) expression, and the occurrence of ingraft chimerism (= cells from two genetically distinct individuals in a same individual) in post-transplant OB development. In our porcine model, OB developed invariably in allografts, while autografts stayed patent. The histological changes were similar to those seen in human OB. In order to delay or prevent obliteration, animals were medicated according to certain protocol. In the beginning of the bronchial allograft reaction, COX-2 induction occurred in airway epithelial cells prior to luminal obliteration. COX-2 expression in macrophages and fibroblasts paralleled the onset of inflammation and fibroblast proliferation. This study demonstrated for the first time, that COX-2 expression is associated with the early stage of post- transplant obliterative airway disease. Tenascin expression in the respiratory epithelium appeared to be predictive of histologic features observed in human OB, and influx of immune cells. Expression in the bronchial wall and in the early obliterative lesions coincided with the onset of onset of fibroblast and inflammatory cell proliferation in the early stage of OB and was predictive of further influx of inflammatory and immune cells. CRP expression in the bronchial wall coincided with the remodelling process. High grade of bronchial wall CRP staining intensity predicted inflammation, accelerated fibroproliferation, and luminal obliteration, which are all features of OB. In the early obliterative plaque, majority of cells expressed CRP, but in mature, collagen-rich plaque, expression declined. Local CRP expression might be a response to inflammation and it might promote the development of OB. Early appearance of chimeric (= recipient-derived) cells in the graft airway epithelium predicted epithelial cell injury and obliteration of the bronchial lumen, which both are features of OB. Chimeric cells appeared in the airway epithelium after repair following transplantation-induced ischemic injury. Ingraft chimerism might be a mechanism to repair alloimmune-mediated tissue injury and to protect allografts from rejection after transplantation. The results of this study indicate, that COX-2, tenascin, CRP, and ingraft chimerism have a role in OB development. These findings increase the understanding of the mechanisms of OB, which may be beneficial in further development of diagnostic options.

Functional outcome and health-related quality of life after traumatic brain injury in the framework of the International Classification of Functioning, Disability and Health (ICF)

Traumatic brain injury (TBI) affects people of all ages and is a cause of long-term disability. In recent years, the epidemiological patterns of TBI have been changing. TBI is a heterogeneous disorder with different forms of presentation and highly individual outcome regarding functioning and health-related quality of life (HRQoL). The meaning of disability differs from person to person based on the individual s personality, value system, past experience, and the purpose he or she sees in life. Understanding of all these viewpoints is needed in comprehensive rehabilitation. This study examines the epidemiology of TBI in Finland as well as functioning and HRQoL after TBI, and compares the subjective and objective assessments of outcome. The frame of reference is the International Classification of Functioning, Disability and Health (ICF). The subjects of Study I represent the population of Finnish TBI patients who experienced their first TBI between 1991 and 2005. The 55 Finnish subjects of Studies II and IV participated in the first wave of the international Quality of life after brain injury (QOLIBRI) validation study. The 795 subjects from six language areas of Study III formed the second wave of the QOLIBRI validation study. The average annual incidence of Finnish hospitalised TBI patients during the years 1991-2005 was 101:100 000 in patients who had TBI as the primary diagnosis and did not have a previous TBI in their medical history. Males (59.2%) were at considerably higher risk of getting a TBI than females. The most common external cause of the injury was falls in all age groups. The number of TBI patients ≥ 70 years of age increased by 59.4% while the number of inhabitants older than 70 years increased by 30.3% in the population of Finland during the same time period. The functioning of a sample of 55 persons with TBI was assessed by extracting information from the patients medical documents using the ICF checklist. The most common problems were found in the ICF components of Body Functions (b) and Activities and Participation (d). HRQoL was assessed with the QOLIBRI which showed the highest level of satisfaction on the Emotions, Physical Problems and Daily Life and Autonomy scales. The highest scores were obtained by the youngest participants and participants living independently without the help of other people, and by people who were working. The relationship between the functional outcome and HRQoL was not straightforward. The procedure of linking the QOLIBRI and the GOSE to the ICF showed that these two outcome measures cover the relevant domains of TBI patients functioning. The QOLIBRI provides the patients subjective view, while the GOSE summarises the objective elements of functioning. Our study indicates that there are certain domains of functioning that are not traditionally sufficiently documented but are important for the HRQoL of persons with TBI. This was the finding especially in the domains of interpersonal relationships, social and leisure activities, self, and the environment. Rehabilitation aims to optimize functioning and to minimize the experience of disability among people with health conditions, and it needs to be based on a comprehensive understanding of human functioning. As an integrative model, the ICF may serve as a frame of reference in achieving such an understanding.

Reverse flotation of silica from Kudremukh iron ore .2. Optimization of flotation process

An experimental programme based on statistical analysis was used for optimizing the reverse Rotation of silica from non-magnetic spiral preconcentrate of Kudremukh iron ore. Flotation of silica with amine and starch as the Rotation reagents was studied to estimate the optimum reagent levels at various mesh of grind. The experiments were first carried out using a two level three factor design. Analysis of the results showed that two parameters namely, the concentration level of the amine collector and the mesh of grind, were significant. Experiments based on an orthogonal design of the hexagonal type were then carried out to determine the effects of these two variables, on recovery and grade of the concentrate. Regression equations have been developed as models. Response contours have been plotted using the 'path of steepest ascent', maximum response has been optimized at 0.27 kg/ton of amine collector, 0.5 kg/ton of starch and mesh of grind of 48.7% passing 300 mesh to give a recovery of 83.43% of Fe in the concentrate containing 66.6% Fe and 2.17% SiO2.

Nitrogen and carbon flows through Belandur lake - Role of Bellandur lake as a natural wetland treating Bangalore wastewater

Much of the Bangalore sewage is treated in three streams namely Bellandur (K&C Valley),Vrishabhavati and Hebbal-Nagavara stream systems. Among these it is estimated that out of a total of about 500MLD of partially treated sewage is let into the Bellandur tank. We estimate that a total of about 77t N non-industrial anthropogenic nitrogen efflux (mainly urine and excreta) in Bangalore city. This is distributed between that handled by the three sewage streams, soak-pits and land deposition. About 17-24.5t N enters the Bellandur tank daily. This has been happening over few decades and our observations suggest that this approximately 380ha tank is functioning as a C and N removal system with reasonable efficiency. The ammoniacal and nitrate nitrogen content of the water at the discharge points were estimated and found that over 80% of the nitrogen influx and over 75% of the C influx is removed by this tank system. We observed that there are three nitrogen sinks namely bacterial, micro-algal and macrophytes. The micro-algal fraction is dominated by Microcystis and Euglenophyceae members and they appear to constitute a significant fraction. Water hyacinth represents the single largest representative of the macrophytes. This tank has been functioning in this manner for over three decades. We attempt to study this phenomenon from a material balance approach and show that it is functioning with a reasonable degree of satisfaction as a natural wetland. As the population served and concomitant influx into this wetland increases, there is a potential for the system to be overloaded and to collapse. Therefore a better understanding of its function and the need for maintenance is discussed in the paper.

Fracture analysis of concrete using singular fractal functions with lattice beam network and confirmation with acoustic emission study

In the present study singular fractal functions (SFF) were used to generate stress-strain plots for quasibrittle material like concrete and cement mortar and subsequently stress-strain plot of cement mortar obtained using SFF was used for modeling fracture process in concrete. The fracture surface of concrete is rough and irregular. The fracture surface of concrete is affected by the concrete's microstructure that is influenced by water cement ratio, grade of cement and type of aggregate 11-41. Also the macrostructural properties such as the size and shape of the specimen, the initial notch length and the rate of loading contribute to the shape of the fracture surface of concrete. It is known that concrete is a heterogeneous and quasi-brittle material containing micro-defects and its mechanical properties strongly relate to the presence of micro-pores and micro-cracks in concrete 11-41. The damage in concrete is believed to be mainly due to initiation and development of micro-defects with irregularity and fractal characteristics. However, repeated observations at various magnifications also reveal a variety of additional structures that fall between the `micro' and the `macro' and have not yet been described satisfactorily in a systematic manner [1-11,15-17]. The concept of singular fractal functions by Mosolov was used to generate stress-strain plot of cement concrete, cement mortar and subsequently the stress-strain plot of cement mortar was used in two-dimensional lattice model [28]. A two-dimensional lattice model was used to study concrete fracture by considering softening of matrix (cement mortar). The results obtained from simulations with lattice model show softening behavior of concrete and fairly agrees with the experimental results. The number of fractured elements are compared with the acoustic emission (AE) hits. The trend in the cumulative fractured beam elements in the lattice fracture simulation reasonably reflected the trend in the recorded AE measurements. In other words, the pattern in which AE hits were distributed around the notch has the same trend as that of the fractured elements around the notch which is in support of lattice model. (C) 2011 Elsevier Ltd. All rights reserved.

ABOUT FORMS OF ELECTRONIC AND IONIC DEVICES WITH THERMIONIC CATHODES.

The miniaturization of electronic and ionic devices with thermionic cathodes and thc improvement of their vacuum properties are questions of very great interest to the electronic engineer. However there have bcen no proposals so far to analyse the problem of miniaturization of such devices In a fundamental way. The present work suggests a choice of the geometrical shape of the cathode, the anode and the envelope of the device, that may help towards such a fundamcnlal approach.It is shown that a design, in which the cathode and the envelope of the tube are made of thm prismatic shape and the anode coincides with the cnvclope, offers a slriknrg advantage over the conventional cylindrical design, in respect of over-all size. The use of the prismatic shape will lead to considerable economy in msterials and may facilitate simpler prodoct~ont echn~ques. I n respect of the miin criteria of vacuum, namely the grade of vacuum, the internal volume occupied by residual gases, the evolution of gases in the internal space and the diffusion of gases from outside into the devicc, it is shown that the prismatic form is at least as good as, if not somewhat superior lo, the cylindrical form.In the actual construction of thin prismatic tubes, manv practical problems will arise, the most important being the mechanical strength and stablity of the structure. But the changeover from the conventional cylindrical to the new prirmaiic form, with its basic advantages, is a development that merits close attention.

Effect of grain boundary engineering on the microstructure and mechanical properties of copper containing austenitic stainless steel

The present investigation deals with grain boundary engineering of a modified austenitic stainless steel to obtain a material with enhanced properties. Three types of processing that are generally in agreement with the principles of grain boundary engineering were carried out. The parameters for each of the processing routes were fine-tuned and optimized. The as-processed samples were characterized for microstructure and texture. The influence of processing on properties was estimated by evaluating the room temperature mechanical properties through micro-tensile tests. It was possible to obtain remarkably high fractions of CSL boundaries in certain samples. The results of the micro-tensile tests indicate that the grain boundary engineered samples exhibited higher ductility than the conventionally processed samples. The investigation provides a detailed account of the approach to be adopted for GBE processing of this grade of steel. (C) 2014 Elsevier B.V. All rights reserved.

Investigation of orographic features influencing spatial distribution of rainfall over the Western Ghats of India using satellite data

Using remotely sensed Tropical Rainfall Measuring Mission (TRMM) 3B42 rainfall and topographic data from the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) Digital Elevation Model (DEM), the impact of oroghraphical aspects such as topography, spatial variability of elevation and altitude of apexes are examined to investigate capacious summer monsoon rainfall over the Western Ghats (WG) of India. TRMM 3B42 v7 rainfall data is validated with Indian Meteorological Department (IMD) gridded rainfall data at 0.5 degrees resolution over the WG. The analysis of spatial pattern of monsoon rainfall with orography of the WG ascertains that the grade of orographic precipitation depends mainly on topography of the mountain barrier followed by steepness of windward side slope and altitude of the mountain. Longer and broader, i.e. cascaded topography, elevated summits and gradually increasing slopes impel the enhancement in precipitation. Comparing topography of various states of the WG, it has been observed that windward side of Karnataka receives intense rainfall in the WG during summer monsoon. It has been observed that the rainfall is enhanced before the peak of the mountain and confined up to the height about 800m over the WG. In addition to this, the spatial distribution of heavy and very heavy rainfall events in the last 14 years has also been explored. Heavy and very heavy rain events on this hilly terrain are categorized with a threshold of precipitation (R) in the range 150>R>120mmday(-1) and exceeding 150mmday(-1) using probability distribution of TRMM 3B42 v7 rainfall. The areas which are prone to heavy precipitation are identified. The study would help policy makers to manage the hazard scenario and, to improve weather predictions on mountainous terrain of the WG.

Optimal design of building structures using genetic algorithms

A general framework for multi-criteria optimal design is presented which is well-suited for automated design of structural systems. A systematic computer-aided optimal design decision process is developed which allows the designer to rapidly evaluate and improve a proposed design by taking into account the major factors of interest related to different aspects such as design, construction, and operation.

The proposed optimal design process requires the selection of the most promising choice of design parameters taken from a large design space, based on an evaluation using specified criteria. The design parameters specify a particular design, and so they relate to member sizes, structural configuration, etc. The evaluation of the design uses performance parameters which may include structural response parameters, risks due to uncertain loads and modeling errors, construction and operating costs, etc. Preference functions are used to implement the design criteria in a "soft" form. These preference functions give a measure of the degree of satisfaction of each design criterion. The overall evaluation measure for a design is built up from the individual measures for each criterion through a preference combination rule. The goal of the optimal design process is to obtain a design that has the highest overall evaluation measure - an optimization problem.

Genetic algorithms are stochastic optimization methods that are based on evolutionary theory. They provide the exploration power necessary to explore high-dimensional search spaces to seek these optimal solutions. Two special genetic algorithms, hGA and vGA, are presented here for continuous and discrete optimization problems, respectively.

The methodology is demonstrated with several examples involving the design of truss and frame systems. These examples are solved by using the proposed hGA and vGA.

Novel equation to determine the hepatic triglyceride concentration in humans by MRI: diagnosis and monitoring of NAFLD in obese patients before and after bariatric surgery

Background: Non-alcoholic fatty liver disease (NAFLD) is caused by abnormal accumulation of lipids within liver cells. Its prevalence is increasing in developed countries in association with obesity, and it represents a risk factor for non-alcoholic steatohepatitis (NASH), cirrhosis and hepatocellular carcinoma. Since NAFLD is usually asymptomatic at diagnosis, new non-invasive approaches are needed to determine the hepatic lipid content in terms of diagnosis, treatment and control of disease progression. Here, we investigated the potential of magnetic resonance imaging (MRI) to quantitate and monitor the hepatic triglyceride concentration in humans. Methods: A prospective study of diagnostic accuracy was conducted among 129 consecutive adult patients (97 obesity and 32 non-obese) to compare multi-echo MRI fat fraction, grade of steatosis estimated by histopathology, and biochemical measurement of hepatic triglyceride concentration (that is, Folch value). Results: MRI fat fraction positively correlates with the grade of steatosis estimated on a 0 to 3 scale by histopathology. However, this correlation value was stronger when MRI fat fraction was linked to the Folch value, resulting in a novel equation to predict the hepatic triglyceride concentration (mg of triglycerides/g of liver tissue = 5.082 + (432.104 * multi-echo MRI fat fraction)). Validation of this formula in 31 additional patients (24 obese and 7 controls) resulted in robust correlation between the measured and estimated Folch values. Multivariate analysis showed that none of the variables investigated improves the Folch prediction capacity of the equation. Obese patients show increased steatosis compared to controls using MRI fat fraction and Folch value. Bariatric surgery improved MRI fat fraction values and the Folch value estimated in obese patients one year after surgery. Conclusions: Multi-echo MRI is an accurate approach to determine the hepatic lipid concentration by using our novel equation, representing an economic non-invasive method to diagnose and monitor steatosis in humans.

Análise associativa: identificação de padrões de associação entre o perfil socioeconômico dos alunos do ensino básico e os resultados nas provas de matemática

Nos dias atuais, a maioria das operações feitas por empresas e organizações é armazenada em bancos de dados que podem ser explorados por pesquisadores com o objetivo de se obter informações úteis para auxílio da tomada de decisão. Devido ao grande volume envolvido, a extração e análise dos dados não é uma tarefa simples. O processo geral de conversão de dados brutos em informações úteis chama-se Descoberta de Conhecimento em Bancos de Dados (KDD - Knowledge Discovery in Databases). Uma das etapas deste processo é a Mineração de Dados (Data Mining), que consiste na aplicação de algoritmos e técnicas estatísticas para explorar informações contidas implicitamente em grandes bancos de dados. Muitas áreas utilizam o processo KDD para facilitar o reconhecimento de padrões ou modelos em suas bases de informações. Este trabalho apresenta uma aplicação prática do processo KDD utilizando a base de dados de alunos do 9 ano do ensino básico do Estado do Rio de Janeiro, disponibilizada no site do INEP, com o objetivo de descobrir padrões interessantes entre o perfil socioeconômico do aluno e seu desempenho obtido em Matemática na Prova Brasil 2011. Neste trabalho, utilizando-se da ferramenta chamada Weka (Waikato Environment for Knowledge Analysis), foi aplicada a tarefa de mineração de dados conhecida como associação, onde se extraiu regras por intermédio do algoritmo Apriori. Neste estudo foi possível descobrir, por exemplo, que alunos que já foram reprovados uma vez tendem a tirar uma nota inferior na prova de matemática, assim como alunos que nunca foram reprovados tiveram um melhor desempenho. Outros fatores, como a sua pretensão futura, a escolaridade dos pais, a preferência de matemática, o grupo étnico o qual o aluno pertence, se o aluno lê sites frequentemente, também influenciam positivamente ou negativamente no aprendizado do discente. Também foi feita uma análise de acordo com a infraestrutura da escola onde o aluno estuda e com isso, pôde-se afirmar que os padrões descobertos ocorrem independentemente se estes alunos estudam em escolas que possuem infraestrutura boa ou ruim. Os resultados obtidos podem ser utilizados para traçar perfis de estudantes que tem um melhor ou um pior desempenho em matemática e para a elaboração de políticas públicas na área de educação, voltadas ao ensino fundamental.