Block oriented model order reduction of interconnected systems

Unintended and parasitic coupling effects are becoming more relevant in currently designed, small-scale/highfrequency RFICs. Electromagnetic (EM) based procedures must be used to generate accurate models for proper verification of system behaviour. But these EM methodologies may take advantage of structural sub-system organization as well as information inherent to the IC physical layout, to improve their efficiency. Model order reduction techniques, required for fast and accurate evaluation and simulation of such models, must address and may benefit from the provided hierarchical information. System-based interconnection techniques can handle some of these situations, but suffer from some drawbacks when applied to complete EM models. We will present an alternative methodology, based on similar principles, that overcomes the limitations of such approaches. The procedure, based on structure-preserving model order reduction techniques, is proved to be a generalization of the interconnected system based framework. Further improvements that allow a trade off between global error and block size, and thus allow a better control on the reduction, will be also presented

Perception of sleep duration in adult patients with suspected obstructive sleep apnea

PURPOSE: Discrepancies between subjective and objective measures of total sleep time (TST) are frequent among insomnia patients, but this issue remains scarcely investigated in obstructive sleep apnea (OSA). We aimed to evaluate if sleep perception is affected by the severity of OSA. METHODS: We performed a 3-month cross-sectional study of Brazilian adults undergoing overnight polysomnography (PSG). TST was objectively assessed from PSG and by a self-reported questionnaire (subjective measurement). Sleep perception index (SPI) was defined by the ratio of subjective and objective values. Diagnosis of OSA was based on an apnea/hypopnea index (AHI) ≥ 5.0/h, being its severity classified according to AHI thresholds: 5.0-14.9/h (mild OSA), 15.0-29.9/h (moderate OSA), and ≥ 30.0/h (severe OSA). RESULTS: Overall, 727 patients were included (58.0% males). A significant difference was found in SPI between non-OSA and OSA groups (p = 0.014). Mean SPI values significantly decreased as the OSA severity increased: without OSA (100.1 ± 40.9%), mild OSA (95.1 ± 24.6%), moderate OSA (93.5 ± 25.2%), and severe OSA (90.6 ± 28.2%), p = 0.036. Using logistic regression, increasing SPI was associated with a reduction in the likelihood of presenting any OSA (p = 0.018), moderate/severe OSA (p = 0.019), and severe OSA (p = 0.028). However, insomnia was not considered as an independent variable for the presence of any OSA, moderate/severe OSA, and severe OSA (all p-values > 0.05). CONCLUSION: In a clinical referral cohort, SPI significantly decreases with increasing OSA severity, but is not modified by the presence of insomnia symptoms.publishersversionpublishe

A Bovine Pericardium Rigid Prosthesis For Left Ventricle Restoration: 12 Years Of Follow-up [prótese Rígida De Pericárdio Bovino Para Remodelamento Ventricular Esquerdo: 12 Anos De Seguimento]

Background: Myocardial infarction might result in dilated left ventricle and numerous techniques have been described to restore the original left ventricle shape and identify tools for late survival assessment. The aim of this study is to compare our experience with a modified Dor procedure using a rigid prosthesis to the septal anterior ventricular exclusion procedure (SAVE) for left ventricle restoration. The EuroScore index for prediction of late follow up survival was evaluated. Methods: We evaluated 80 patients who underwent left ventricle restoration between 1999 to 2007 and eight patients were excluded with incomplete data. A modified Dor procedure with rigid prosthesis (MD group) was performed on 53 patients and 19 underwent the septal anterior ventricular exclusion procedure (SAVE group). The patients were classified according their left ventricle shape as type I, II or III. Kaplan-Meier and Cox proportional hazard ratio regressions analysis were performed to assess survival after both techniques and expected surgical mortality using EuroScore index ranking after 12 years of follow up. Results: The operative mortality was comparable in both groups ranked by EuroScore index. The groups were comparable for all clinical data, except the MD group had more patients using intra-aortic balloon pumps before surgery, (5.7% vs. 0; P<0.01). Kaplan Meier analysis by left ventricle shape showed comparable survival for all patients, with slightly higher survival for type I. Kaplan Meier analysis of all death showed equivalent survival curves for both techniques after 12 years of follow up (71.5 ± 12.3 vs. 46.6 ±20.5 years; P=0.08). Kaplan Meier analysis of EuroScore index for all patients showed a difference between the three ranked categories, i.e., 0 to 10%, 11 to 49% and higher than 50% expected surgical mortality after 12 years of follow up (70.9 ± 16.2 vs. 67.5 ± 12.7 vs. 53.0 ± 15.5; P=0.003). Conclusion: The MD procedure showed consistent ejection fraction improvements after long term follow up. Survival was comparable for all ventricular types and for the MD and SAVE procedures. The EuroScore index is a useful index for late survival assessment of ventricular restoration techniques.262164172Cooley, D.A., Hallman, G.L., Henly, W.S., Left ventricular aneurysm due to myocardial infarctionexperience with 37 patients undergoing aneurysmectomy (1964) Arch Surg, 88, pp. 114-121Jatene, A.D., Left ventricular aneurysmectomy. Resection or reconstruction (1985) J Thorac Cardiovasc Surg, 89 (3), pp. 321-331Dor, V., Saab, M., Coste, P., Kornaszewska, M., Montiglio, F., Left ventricular aneurysm: A new surgical approach (1989) Thorac Cardiovasc Surg, 37 (1), pp. 11-19Dor, V., Sabatier, M., di Donato, M., Montiglio, F., Toso, A., Maioli, M., Efficacy of endoventricular patch plasty in large postinfarction akinetic scar and severe left ventricular dysfunction: Comparison with a series of large dyskinetic scars (1998) J Thorac Cardiovasc Surg, 116 (1), pp. 50-59Braile, D.M., Mustafa, R.M., Ardito, R.V., Zaiantchick, M., Coelho, W.M., (1991) Correction of the Left Ventricle Geometry with Semi Rigid Bovine Pericardial Prosthesis Rev Bras Cir Cardiovasc, 6 (2), pp. 109-115Isomura, T., Horii, T., Suma, H., Buckberg, G.D., Septal anterior ventricular exclusion operation (Pacopexy) for ischemic dilated cardiomyopathy: Treat form not disease (2006) Eur J Cardiothorac Surg, 29 (SUPPL. 1), pp. S245-S250. , RESTORE GroupJones, R.H., Velazquez, E.J., Michler, R.E., Sopko, G., Oh, J.K., O'Connor, C.M., Coronary bypass surgery with or without surgical ventricular reconstruction (2009) N Engl J Med, 360 (17), pp. 1705-1717di Donato, M., Castelvecchio, S., Kukulski, T., Bussadori, C., Giacomazzi, F., Frigiola, A., Surgical ventricular restoration: Left ventricular shape influence on cardiac function, clinical status, and survival (2009) Ann Thorac Surg, 87 (2), pp. 455-461Najafi, M., Sheikhvatan, M., Montazeri, A., Sheikhfathollahi, M., Predictors of quality of life among patients undergoing coronary artery bypass surgery (2008) Acta Cardiol, 63 (6), pp. 713-721Messaoudi, N., de Cocker, J., Stockman, B.A., Bossaert, L.L., Rodrigus, I.E., Is EuroSCORE useful in the prediction of extended intensive care unit stay after cardiac surgery? (2009) Eur J Cardiothorac Surg, 36 (1), pp. 35-39Santarpino, G., Onorati, F., Rubino, A.S., Abdalla, K., Caroleo, S., Santangelo, E., Preoperative intraaortic balloon pumping improves outcomes for high-risk patients in routine coronary artery bypass graft surgery (2009) Ann Thorac Surg, 87 (2), pp. 481-488Nashef, S.A., Roques, F., Michel, P., Gauducheau, E., Lemeshow, S., Salamon, R., European system for cardiac operative risk evaluation (EuroSCORE) (1999) Eur J Cardiothorac Surg, 16 (1), pp. 9-13Dor, V., Sabatier, M., di Donato, M., Maioli, M., Toso, A., Montiglio, F., Late hemodynamic results after left ventricular patch repair associated with coronary grafting in patients with postinfarction akinetic or dyskinetic aneurysm of the left ventricle (1995) J Thorac Cardiovasc Surg, 110 (5), pp. 1291-1299Athanasuleas, C.L., Buckberg, G.D., Stanley, A.W., Siler, W., Dor, V., Didonato, M., RESTORE Group. Surgical ventricular restoration: The RESTORE Group experience (2004) Heart Fail Rev, 9 (4), pp. 287-297Salati, M., di Biasi, P., Paje, A., Santoli, C., Left ventricular geometry after endoventriculoplasty (1993) Eur J Cardiothorac Surg, 7 (11), pp. 574-578Buckberg, G.D., Coghlan, H.C., Torrent-Guasp, F., The structure and function of the helical heart and its buttress wrapping. VI. Geometric Concepts of Heart Failure and Use For Structural Correction (2001) Semin Thorac Cardiovasc Surg, 13 (4), pp. 386-401di Donato, M., Sabatier, M., Dor, V., Gensini, G.F., Toso, A., Maioli, M., Effects of the Dor procedure on left ventricular dimension and shape and geometric correlates of mitral regurgitation one year after surgery (2001) J Thorac Cardiovasc Surg, 121 (1), pp. 91-96Suma, H., Horii, T., Isomura, T., Buckberg, G., A new concept of ventricular restoration for nonischemic dilated cardiomyopathy (2006) Eur J Cardiothorac Surg, 29 (SUPPL. 1), pp. S207-S212. , RESTORE GroupForm versus disease: Optimizing geometry during ventricular restoration (2006) Eur J Cardiothorac Surg, 29 (SUPPL. 1), pp. S238-S244. , RESTORE GroupKieser, T.M., The left ventricle: To reconstruct or not: Lessons from the STICH trial (2009) J Thorac Cardiovasc Surg, 138 (3), p. 784Suma, H., Isomura, T., Horii, T., Buckberg, G., Role of site selection for left ventriculoplasty to treat idiopathic dilated cardiomyopathy (2004) Heart Fail Rev, 9 (4), pp. 329-336. , RESTORE GroupDancini, J.L., Rodrigues, J.J., Santos, J.S., Pinto, R.F.A., Burgos, F.J.C., Conforti, C.A., Left ventricular aneurysmectomy: Late followup (1996) Rev Bras Cir Cardiovasc, 1 (11), pp. 23-29Almeida, R.M.S., Lima, J.D., Bastos, L.C., Carvalho, C.T., Loures, D.R., Endoventricular circular patch plasty with septal exclusion: Initial experience (2000) Rev Bras Cir Cardiovasc, 4 (15), pp. 302-307Campagnucci, V.P., Rivetti, L.A., Pinto e Silva, A.M.R., Gandra, S.M.A., Pereira, W.L., Aneurismectomia de ventrículo esquerdo com o coração batendo ininterruptamente: Resultados imediatos (2006) Rev Bras Cir Cardiovasc, 21 (1), pp. 55-61Herrera, C.B., Insalralde, A., Brandi, A.C., Santos, C.A., Herrera, D.D., Soares, M.J.F., Correção de aneurisma de ventrículo esquerdo em paciente chagásico empregando prótese de pericárdio bovino (2000) Rev Bras Cir Cardiovasc, 15 (1), pp. 72-74Sgarbi, C.J., Ardito, R.V., Santos, R.C., Bogdan, R.A.B., Arruda Jr., F.V., Silva, E.M., Correção cirúrgica do aneurisma de ventrículo esquerdo: Comparação entre as técnicas de sutura linear e reconstrução geométrica (2000) Rev Bras Cir Cardiovasc, 15 (4), pp. 293-301Versteegh, M.I., Lamb, H.J., Bax, J.J., Curiel, F.B., van der Wall, E.E., de Roos, A., MRI evaluation of left ventricular function in anterior LV aneurysms before and after surgical resection (2003) Eur J Cardiothorac Surg, 23 (4), pp. 609-613Use of cardiac magnetic resonance imaging in surgical ventricular restoration (2006) Eur J Cardiothorac Surg, 29 (SUPPL. 1), pp. S216-S224. , Buckberg GD;RESTORE GroupWalker, J.C., Guccione, J.M., Jiang, Y., Zhang, P., Wallace, A.W., Hsu, E.W., Helical myofiber orientation after myocardial infarction and left ventricular surgical restoration in sheep (2005) J Thorac Cardiovasc Surg, 129 (2), pp. 382-39

Epidemiological characterization of resistance and PCR typing of Shigella flexneri and Shigella sonnei strains isolated from bacillary dysentery cases in Southeast Brazil

Shigella spp are Gram-negative, anaerobic facultative, non-motile, and non-sporulated bacilli of the Enterobacteriaceae family responsible for "Shigellosis" or bacillary dysentery, an important cause of worldwide morbidity and mortality. However, despite this, there are very few epidemiological studies about this bacterium in Brazil. We studied the antibiotic resistance profiles and the clonal structure of 60 Shigella strains (30 S. flexneri and 30 S. sonnei) isolated from shigellosis cases in different cities within the metropolitan area of Campinas, State of São Paulo, Brazil. We used the following well-characterized molecular techniques: enterobacterial repetitive intergenic consensus, repetitive extragenic palindromic, and double-repetitive element-polymerase chain reaction to characterize the bacteria. Also, the antibiotic resistance of the strains was determined by the diffusion disk method. Many strains of S. flexneri and S. sonnei were found to be multi-resistant. S. flexneri strains were resistant to ampicillin in 83.3% of cases, chloramphenicol in 70.0%, streptomycin in 86.7%, sulfamethoxazole in 80.0%, and tetracycline in 80.0%, while a smaller number of strains were resistant to cephalothin (3.3%) and sulfazotrim (10.0%). S. sonnei strains were mainly resistant to sulfamethoxazole (100.0%) and tetracycline (96.7%) and, to a lesser extent, to ampicillin (6.7%) and streptomycin (26.7%). Polymerase chain reaction-based typing supported the existence of specific clones responsible for the shigellosis cases in the different cities and there was evidence of transmission between cities. This clonal structure would probably be the result of selection for virulence and resistance phenotypes. These data indicate that the human sanitary conditions of the cities investigated should be improved

Development, validation and comparative study with no-apnea, STOP-bang, and NoSAS

Background: Obstructive sleep apnea (OSA) is a very prevalent disorder. Here, we aimed to develop and validate a practical questionnaire with yes-or-no answers, and to compare its performance with other well-validated instruments: No-Apnea, STOP-Bang, and NoSAS. Methods: A cross-sectional study containing consecutively selected sleep-lab subjects underwent full polysomnography. A 4-item model, named GOAL questionnaire (gender, obesity, age, and loud snoring), was developed and subsequently validated, with item-scoring of 0–4 points (≥2 points indicating high risk for OSA). Discrimination was assessed by area under the curve (AUC), while predictive parameters were calculated using contingency tables. OSA severity was classified based on conventionally accepted apnea/hypopnea index thresholds: ≥5.0/h (OSA≥5), ≥15.0/h (OSA≥15), and ≥30.0/h (OSA≥30). Results: Overall, 7377 adults were grouped into two large and independent cohorts: derivation (n = 3771) and validation (n = 3606). In the derivation cohort, screening of OSA≥5, OSA≥15, and OSA≥30 revealed that GOAL questionnaire achieved sensitivity ranging from 83.3% to 94.0% and specificity ranging from 62.4% to 38.5%. In the validation cohort, screening of OSA≥5, OSA≥15, and OSA≥30, corroborated validation steps with sensitivity ranging from 83.7% to 94.2% and specificity from 63.4% to 37.7%. In both cohorts, discriminatory ability of GOAL questionnaire for screening of OSA≥5, OSA≥15, and OSA≥30 was similar to No-Apnea, STOP-Bang or NoSAS. Conclusion: All four instruments had similar performance, leading to a possible greater practical implementation of the GOAL questionnaire, a simple instrument with only four parameters easily obtained during clinical evaluation.publishersversionpublishe

Sulfonation and anticoagulant activity of fungal exocellular β-(1→6)-d-glucan (lasiodiplodan)

AbstractAn exocellular β-(1→6)-d-glucan (lasiodiplodan) produced by a strain of Lasiodiplodia theobromae (MMLR) grown on sucrose was derivatized by sulfonation to promote anticoagulant activity. The structural features of the sulfonated β-(1→6)-d-glucan were investigated by UV–vis, FT-IR and 13C NMR spectroscopy, and the anticoagulant activity was investigated by the classical coagulation assays APTT, PT and TT using heparin as standard. The content of sulfur and degree of substitution of the sulfonated glucan was 11.73% and 0.95, respectively. UV spectroscopy showed a band at 261nm due to the unsaturated bond formed in the sulfonation reaction. Results of FT-IR and 13C NMR indicated that sulfonyl groups were inserted on the polysaccharide. The sulfonated β-(1→6)-d-glucan presented anticoagulant activity as demonstrated by the increase in dose dependence of APTT and TT, and these actions most likely occurred because of the inserted sulfonate groups on the polysaccharide. The lasiodiplodan did not inhibit the coagulation tests

Epidemiological Characterization Of Resistance And Pcr Typing Of Shigella Flexneri And Shigella Sonnei Strains Isolated From Bacillary Dysentery Cases In Southeast Brazil

Shigella spp are Gram-negative, anaerobic facultative, non-montile, and non-sporulated bacilli of the Enterobacteriaceae family responsible or "Shigellosis" or bacillary dysentery, an important cause of worldwide morbidity and mortality. However, despite this, there are very few epidemiological studies about this bacterium in Brazil. We studied the antibiotic resistance profiles and the clonal structure of 60 Shigella strains (30 S.flexneri and 30 S. sonnei) isolated from shigellosis cases in different cities within the metropolitan area of Campinas, State of São Paulo, Brazil. We used the following well-characterized molecular techniques: enterobacterial repetitive intergenic consensus, repetitive extragenic palindromic, and double-repetitive element-polymerase chain reaction to characterize the bacteria. Also, the antibiotic resistance of the strains was determined by the diffusion disk method. Many strains of S. flexneri and S. sonnei were found to be multi-resistant. S. flexneri strains were resistant to ampicillin in 83.3% of cases, chloramphenicol in 70.0%, streptomycin in 86.7%, sulfamethoxazole in 80.0%, and tetracycline in 80.0%, while a smaller number of strains were resistant to cephalothin (3.3%) and sulfazotrim (10.0%). S. sonnei strains were mainly resistant to sulfamethoxazole (100.0%) and tetracycline (96.7%) and, to a lesser extent, to ampicillin (6.7%) and streptomycin (26.7%). Polymerase chain reaction-based typing supported the existence of specific clones responsible for the shigellosis cases in the different cities and there was evidence of transmission between cities. This clonal structure would probably be the result of selection for virulence and resistance phenotypes. These data indicate that the human sanitary conditions of the cities investigated should be improved.402249258Murray, P.R., Rosenthal, K.S., Kobayashi, G.S., Pfaller, M.A., (1998) Medical Microbiology, , 3rd edn. St. Louis: Mosby-Year BookJawetz, E., Melnick, J.L., Adelber, E.A., (2000) Microbiologia Médica, , Rio de Janeiro: Guanabara KooganSansonetti, P.J., Rupture, invasion and inflammatory destruction of the intestinal barrier by Shigella, making sense of prokaryote-eukaryote cross-talks (2001) FEMS Microbiol Rev, 25, pp. 3-14Thong, K.L., Hoe, S.L., Puthucheary, S.D., Yasin, R.M., Detection of virulence genes in Malaysian Shigella species by multiplex PCR assay (2005) BMC Infect Dis, 5, p. 8Parsot, C., Shigella spp. and enteroinvasive Escherichia coli pathogenicity factors (2005) FEMS Microbiol Lett, 252, pp. 11-18Kopecko, D.J., Holcombe, J., Formal, S.B., Molecular characterization of plasmids from virulent and spontaneously occurring avirulent colonial variants of Shigella flexneri (1979) Infect Immun, 24, pp. 580-582Hale, T.L., Genetic basis of virulence in Shigella species (1991) Microbiol Rev, 55, pp. 206-224Rolland, K., Lambert-Zechovsky, N., Picard, B., Denamur, E., Shigella and enteroinvasive Escherichia coli strains are derived from distinct ancestral strains of E. coli (1998) Microbiology, 144 (PART 9), pp. 2667-2672Coimbra, R.S., Grimont, F., Grimont, P.A., Identification of Shigella serotypes by restriction of amplified O-antigen gene cluster (1999) Res Microbiol, 150, pp. 543-553Joklik, W.K., Willet, H.P., Amos, D.B., Wilfert, C.M., (1994) Microbiblogía, , Zinsser (Editor), Buenos Aires: Editora Médica PanamericanaShears, P., Shigelle infections (1996) Ann Trop Med Parasitol, 90, pp. 105-114Ochman, H., Whittam, T.S., Caugant, D.A., Selander, R.K., Enzyme polymorphism and genetic population structure in Escherichia Coli and Shigella (1983) J Gen Microbiol, 129, pp. 2715-2726Navia, M.M., Capitano, L., Ruiz, J., Vargas, M., Urassa, H., Schellemberg, D., Typing and characterization of mechanisms of resistance of Shigella spp. isolated from feces of children under 5 years of age from Ifakara, Tanzania (1999) J Clin Microbiol, 37, pp. 3113-3117Surdeanu, M., Ciudin, L., Pencu, E., Straut, M., Comparative study of three different DNA fingerprint techniques for molecular typing of Shigella flexneri strains isolated in Romania (2003) Eur J Epidemiol, 18, pp. 703-710Brenner, D.J., Fanning, G.R., Miklos, G.V., Steigerwalt, A.G., Polynucleotide sequence relatedness among Shigella species (1973) Int J Syst Bacteriol, 23, pp. 1-7Brenner, D.J., Fanning, G.R., Skerman, F.J., Falkow, S., Polynucleotide sequence divergence among strains of Escherichia coli and closely related organisms (1972) J Bacteriol, 109, pp. 953-965Brenner, D.J., Steigerwalt, A.G., Wathen, H.G., Gross, R.J., Rowe, B., Confirmation of aerogenic strains of Shigella boydii 13 and further study of Shigella serotypes by DNA relatedness (1982) J Clin Microbiol, 16, pp. 432-436Pupo, G.M., Karaolis, D.K., Lan, R., Reeves, P.R., Evolutionary relationships among pathogenic and nonpathogenic Escherichia coli strains inferred from multilocus enzyme electrophoresis and mdh sequence studies (1997) Infect Immun, 65, pp. 2685-2692Pupo, G.M., Lan, R., Reeves, P.R., Multiple independent origins of Shigella clones of Escherichia coli and convergent evolution of many of their characteristics (2000) Proc Natl Acad Sci U S A, 97, pp. 10567-10572Lee, T.M., Chang, C.Y., Chang, L.L., Chen, W.M., Wang, T.K., Chang, S.F., One predominant type of genetically closely related Shigelia sonnei prevalent in four sequential outbreaks in school children (2003) Diagn Microbiol Infect Dis, 45, pp. 173-181Liu, P.Y., Lau, Y.J., Hu, B.S., Shyr, J.M., Shi, Z.Y., Tsai, W.S., Analysis of clonal relationships among isolates of Shigella sonnei by different molecular typing methods (1995) J Clin Microbiol, 33, pp. 1779-1783Lima, A.A., Lima, N.L., Pinho, M.C., Barros Jr., E.A., Teixeira, M.J., Martins, M.C., High frequency of strains multiply resistant to ampicillin, trimethoprim-sulfamethoxazole, streptomycin, chloramphenicol, and tetracycline isolated from patients with shigellosis in northeastern Brazil during the period 1988 to 1993 (1995) Antimicrob Agents Chemother, 39, pp. 256-259Lima, A.A., Sidrim, J.J., Lima, N.L., Titlow, W., Evans, M.E., Greenberg, R.N., Molecular epidemiology of multiply antibiotic-resistant Shigella flexneri in Fortaleza, Brazil (1997) J Clin Microbiol, 35, pp. 1061-1065Lan, R., Alles, M.C., Donohoe, K., Martinez, M.B., Reeves, P.R., Molecular evolutionary relationships of enteroinvasive Escherichia coli and Shigella spp (2004) Infect Immun, 72, pp. 5080-5088Versalovic, J., Koeuth, T., Lupski, J.R., Distribution of repetitive DNA sequences in eubacteria and application to fingerprinting of bacterial genomes (1991) Nucleic Acids Res, 19, pp. 6823-6831Friedman, C.R., Stoeckle, M.Y., Johnson Jr., W.D., Riley, L.W., Double-repetitive-element PCR method for subtyping Mycobacterium tuberculosis clinical isolates (1995) J Clin Microbiol, 33, pp. 1383-1384Ausubel, F.M., Brent, R., Kingston, R.E., Struhl, K., Moore, D.D., Smith, J.Á., (1988) Current Protocols in Molecular Biology, , Brooklyn: Greene Publishing AssociatesSambrook, J., Fritsch, E.F., Maniatis, T., (1989) Molecular Cloning: A Laboratory Manual, , 2nd edn. New York: Gold Spring Harbor Laboratory PressYeh, F.C., Yang, R.C., Boyle, T., Popgene, Version 1.31. Microsoft Windows-Based Freeware for Population Genetic Analysis, , http://www.ualberta.ca/~fyeh/Almeida, M.T., Silva, R.M., Donaire, L.M., Moreira, L.E., Martinez, M.R., Enteropathogens associated with acute diarrheal disease in children (1998) J Pediatr, 74, pp. 291-298de Andrade, J.A., de Oliveira, J.O., Fagundes, N.U., Lethality in hospitalized infants with acute diarrhea: Risk factors associated with death (1999) Rev Assoc Med Bras, 45, pp. 121-127Fagundes-Neto, U., de Andrade, J.A., Acute diarrhea and malnutrition: Lethality risk in hospitalized infants (1999) J Am Coll Nutr, 18, pp. 303-308Fernandes, M.R., Trabulsi, L.R., Infectious resistance in pathogenic enteric organisms isolated in São Paulo, Brasil (Preliminary report) (1968) Rev Inst Med Trop São Paulo, 10, pp. 52-53Gomes, T.A., Rassi, V., MacDonald, K.L., Ramos, S.R., Trabulsi, L.R., Vieira, M.A., Enteropathogens associated with acute diarrheal disease in urban infants in São Paulo, Brazil (1991) J Infect Dis, 164, pp. 331-337Medeiros, L.C., Hillers, V.N., Kendall, P.A., Mason, A., Food safety education: What should we be teaching to consumers? (2001) J Nutr Educ, 33, pp. 108-113Piechaud, D., Szturm-Rubinsten, S., Pessoa, G., Diversity of resistance types among Shigelia in São Paulo (Brasil) (author's transl) (1974) Ann Microbiol, 125, pp. 581-584Zuliani, M.E., Trabulsi, L.R., In vitro sensitivity of 166 Shigella strains isolated in São Paulo, Brazil, to sulphadiazine and five antibiotics (1968) Rev Inst Med Trop São Paulo, 10, pp. 70-77Sears, C.L., Kaper, J.B., Enteric bacterial toxins: Mechanisms of action and linkage to intestinal secretion (1996) Microbiol Rev, 60, pp. 167-215Oplustil, C.P., Nunes, R., Mendes, C., Multicenter evaluation of resistance patterns of Klebsiella pneumoniae, Escherichia coli, Salmonenella spp and Shigella spp isolated from clinical specimens in Brazil: RESISTNET Surveillance Program (2001) Braz J Infect Dis, 5, pp. 8-12Casalino, M., Nicoletti, M., Salvia, A., Colonna, B., Pazzani, C., Calconi, A., Characterization of endemic Shigella flexneri strains in Somalia: Antimicrobial resistance, plasmid profiles, and serotype correlation (1994) J Clin Microbiol, 32, pp. 1179-118