Um aplicativo para a aprendizagem do protocolo Advanced Cardiovascular Life Support

Esta pesquisa visa apresentar um aplicativo para apoiar o ensino e a execução do protocolo Advanced Cardiovascular Life Support – ACLS, em ambientes hospitalares, elaborado pela American Heart Association, principal associação de pesquisas cardíacas do mundo. Após seu desenvolvimento, o aplicativo foi testado com um grupo de estudantes voluntários. Por meio da aplicação do modelo Technology Acceptance Model, que utiliza dois critérios de avaliação da aceitação da tecnologia pautados pela utilidade percebida e facilidade de uso percebida, verificou-se que os resultados da simulação utilizando a ferramenta foram positivos, revelando indícios de que o aplicativo proposto foi eficaz em sua função de auxílio à execução do protocolo ACLS

Posterior shoulder tightness and rotator cuff strength assessments in painful shoulders of amateur tennis players

BACKGROUND: Previous studies have shown a relationship between shoulder posterior capsule tightness and shoulder pain in overhead athletes. However, this relationship has not been studied in tennis players. OBJECTIVES: Assessment of the shoulder range of motion (ROM), strength and posterior capsule tightness of skilled amateur tennis players who had complaints of dominant shoulder pain in comparison with tennis players without pain. METHOD: Forty-nine skilled amateur tennis players were distributed in 2 groups: Control Group (n=22) and Painful Group (n=27). The first group was composed of asymptomatic subjects, and the second was composed of subjects with shoulder pain on the dominant side. These groups were evaluated to determine the dominant and non-dominant shoulder ROM (internal and external rotation), isometric shoulder strength (internal and external rotation) and posterior shoulder tightness by blind evaluators. RESULTS: The ANOVA results indicated significant differences between the groups in the dominant shoulder ROM, posterior capsule tightness, external rotation strength and strength ratio (p<0.05). The intragroup analysis (dominant versus non-dominant) in the Painful Group displayed a significant difference for ROM, posterior capsule tightness and external rotation strength (p<0.05). CONCLUSIONS: The tennis players with pain in the dominant shoulder presented greater posterior capsule tightness, internal rotation deficit (ROM), external rotation gain (ROM) and deficits in external rotation strength than the tennis players without pain.Universidade Estadual de Campinas Departamento de Ortopedia e TraumatologiaInstituto Wilson Mello Núcleo de EstudosUniversidade Federal de São Paulo (UNIFESP) Departamento de CiênciasGrupo Especializado em Reabilitação FuncionalIrmandade da Santa Casa de Misericórdia de São Paulo Departamento de FisioterapiaUniversidade de São PauloUNIFESP, Depto. de CiênciasSciEL

Density Variations in the NW Star Stream of M31

The Pan Andromeda Archeological Survey (PAndAS) CFHT Megaprime survey of the M31-M33 system has found a star stream which extends about 120 kpc NW from the center of M31. The great length of the stream, and the likelihood that it does not significantly intersect the disk of M31, means that it is unusually well suited for a measurement of stream gaps and clumps along its length as a test for the predicted thousands of dark matter sub-halos. The main result of this paper is that the density of the stream varies between zero and about three times the mean along its length on scales of 2 to 20 kpc. The probability that the variations are random fluctuations in the star density is less than 10^-5. As a control sample we search for density variations at precisely the same location in stars with metallicity higher than the stream, [Fe/H]=[0, -0.5] and find no variations above the expected shot noise. The lumpiness of the stream is not compatible with a low mass star stream in a smooth galactic potential, nor is it readily compatible with the disturbance caused by the visible M31 satellite galaxies. The stream's density variations appear to be consistent with the effects of a large population of steep mass function dark matter sub-halos, such as found in LCDM simulations, acting on an approximately 10Gyr old star stream. The effects of a single set of halo substructure realizations are shown for illustration, reserving a statistical comparison for another study.Comment: ApJ revised version submitte

Analysis of the Local and Systemic Cytokine Response Profiles in Patients with Community-Acquired Pneumonia. Relationship with Disease Severity and Outcomes.

The goals of this study were to investigate the relationship of systemic and local cytokine responses with time to clinical stability (TCS) in patients with community-acquired pneumonia (CAP) and to develop a model to integrate multiple cytokine data into “cytokine response profiles” based on local vs. systemic and pro- vs. anti-inflammatory cytokine patterns in order to better understand their relationships with measures of CAP severity and outcomes. Forty hospitalized patients enrolled through the Community Acquired Pneumonia Inflammatory Study Group (CAPISG) were analyzed. Based on the ranked distribution of the levels of eight different pro-inflammatory cytokines and chemokines (IL-1b, IL-6, IL-8, IL-12p40, IL-17A, IFNg, TNFa and CXCL10) in plasma and sputum on hospital admission, a “pro-inflammatory cytokine score (PICS)” was defined. PICS in plasma and sputum were plotted against each other and quadrants used to define profiles based on the four possible high/low combinations. A similar approach was used to contrast sputum PICS vs. anti-inflammatory cytokines (IL-1ra and IL-10). Some of the “profiles” thus defined were found to group patients with common etiologic characteristics and/or associate with similar measures of disease severity and/or clinical outcomes, suggesting the predictive value of the use of cytokine data in CAP patients

Demetallization of Enterococcus faecalis Biofilm: A preliminary study

Objectives: To determine the concentration of calcium, iron, manganese and zinc ions after the application of chelator to Enterococcus faecalis biofilms. Material and Methods: Fifty bovine maxillary central incisors were prepared and inoculated with E. faecalis for 60 days. The following were used as irrigation solutions: 17% EDTA (pH 3, 7 and 10), 2.5% sodium hypochlorite (NaOCl) combined with 17% EDTA (pH 3, 7 and 10), distilled water (pH 3, 7 and 10), and 2.5% NaOCl. Each solution was kept in the root canal for five minutes. Fifteen uncontaminated root canals were irrigated with 17% EDTA (pH 3, 7 and 10). Six teeth were used as bacterial control. The number of calcium, iron, manganese and zinc ions was determined using flame atomic absorption spectrometry. Mean ± standard deviation (SD) values were used for descriptive statistics. Results: Calcium chelation using 17% EDTA at pH 7 was higher than at pH 3 and 10, regardless of whether bacterial biofilm was present. The highest concentration of iron occurred at pH 3 in the presence of bacterial biofilm. The highest concentration of manganese found was 2.5% NaOCl and 17% EDTA at pH 7 in the presence of bacterial biofilm. Zinc levels were not detectable. Conclusions: The pH of chelating agents affected the removal of calcium, iron, and manganese ions. The concentration of iron ions in root canals with bacterial biofilm was higher after the use of 17% EDTA at pH 3 than after the use of the other solutions at all pH levels

Human-Induced Trophic Cascades along the Fecal Detritus Pathway

Human presence and activity in tropical forest is thought to exert top-down regulation over the various ‘green-world’ pathways of plant-based foodwebs. However, these effects have never been explored for the ‘brown-world’ pathways of fecal-detritus webs. The strong effects of humans on tropical game mammals are likely to indirectly influence fecal detritivores (including Scarabaeine dung beetles), with subsequent indirect impacts on detrivore-mediated and plant-facilitating detrital processes. Across a 380-km gradient of human influence in the western Brazilian Amazon, we conducted the first landscape-level assessment of human-induced cascade effects on the fecal detritus pathway, by coupling data on human impact, game mammal and detritivore community structure, and rate measurements of a key detritus process (i.e. dung beetle-mediated secondary seed dispersal). We found evidence that human impact indirectly influences both the diversity and biomass of fecal detritivores, but not detritivore-mediated processes. Cascade strength varied across detritivore groups defined by species' traits. We found smaller-bodied dung beetles were at higher risk of local decline in areas of human presence, and that body size was a better predictor of cascade structure than fecal resource manipulation strategy. Cascade strength was also stronger in upland, unflooded forests, than in seasonally flooded forests. Our results suggest that the impact of human activity in tropical forest on fecal-detritus food web structure is mediated by both species' traits and habitat type. Further research will be required to determine the conditions under which these cascade effects influence fecal-detritus web function