Global Epidemiology of Lung Cancer.

While lung cancer has been the leading cause of cancer-related deaths for many years in the United States, incidence and mortality statistics - among other measures - vary widely worldwide. The aim of this study was to review the evidence on lung cancer epidemiology, including data of international scope with comparisons of economically, socially, and biologically different patient groups. In industrialized nations, evolving social and cultural smoking patterns have led to rising or plateauing rates of lung cancer in women, lagging the long-declining smoking and cancer incidence rates in men. In contrast, emerging economies vary widely in smoking practices and cancer incidence but commonly also harbor risks from environmental exposures, particularly widespread air pollution. Recent research has also revealed clinical, radiologic, and pathologic correlates, leading to greater knowledge in molecular profiling and targeted therapeutics, as well as an emphasis on the rising incidence of adenocarcinoma histology. Furthermore, emergent evidence about the benefits of lung cancer screening has led to efforts to identify high-risk smokers and development of prediction tools. This review also includes a discussion on the epidemiologic characteristics of special groups including women and nonsmokers. Varying trends in smoking largely dictate international patterns in lung cancer incidence and mortality. With declining smoking rates in developed countries and knowledge gains made through molecular profiling of tumors, the emergence of new risk factors and disease features will lead to changes in the landscape of lung cancer epidemiology

Psicologia e formação docente : indicios de uma relação

Orientador: Ana Maria Falcão de Aragão SadallaDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de EducaçãoResumo: A articulação entre Psicologia e formação docente é o ponto de partida desta pesquisa, que toma por base o próprio desenvolvimento da Psicologia Educacional, marcado por um deslocamento gradativo em que a ênfase no processo de aprendizagem vai abrindo espaço para as questões do ensino. A Psicologia passa a ocupar um papel privilegiado no processo de formação docente. Sua função passa a ser, entre outras, contribuir com os futuros professores para o desenvolvimento de uma perspectiva psicológica que auxilie sua prática. Diante disto, nosso objetivo é analisar como vem se delineando a interface entre Psicologia e formação docente, tendo como pano de fundo alguns dos elementos que o Paradigma da Pós-Modernidade coloca em debate. Para tanto, analisamos artigos brasileiros sobre Psicologia e Educação, selecionados a partir da BBE (Biblioteca Brasileira de Educação do INEP) e do Qualis (avaliação de revistas científicas realizada pela Anpepp e pela Anped), abrangendo o período de 1997 a 2003. Com base neste material buscamos identificar: -A natureza das contribuições da Psicologia para a formação de professores; -Os sistemas teóricos subjacentes a estas contribuições; - A especificidade das relações estabelecidas. A análise dos dados, a partir do Paradigma Indiciário, permitiu compreender estes que se tornaram nossos eixos de análise, fornecendo indícios a respeito do estatuto epistemológico que a Psicologia assume diante das questões educativas e de formação, das teorias que fundamentam esta relação, das possibilidades de interlocução que a partir daí surgem como proposta. Acreditamos, com este estudo, oferecer uma efetiva contribuição no sentido de estreitar e enriquecer esta que se apresenta como uma importante relação na formação de professores críticos e reflexivosAbstract: The interrelationship between Psychology and Teachers Education is the starting point of this research, based upon the very development of Educational Psychology, marked by a gradual drift, where an emphasis in the learning process opens room to the subject of teaching. Psychology steps forward towards a privilege position in the process of teacher's education. l1's function becomes, among others, to contribute to the development of a psychological standpoint of the future professor, which will assist in the professional practice. In view of this, our purpose is to analyze how the interface between Psychology and Teacher's Education is sketched, having as a background some of concepts that the PostModem Paradigm brings in debate. With this aim, we analyze Brazilian papers on Psychologyand Education, selected from the BBE (Brazilian Library of Education of the INEP) and Qualis ( evaluation of scientific magazines made by Anpepp and Anped), comprising the period between 1997 to 2003. Based on these material we tried to identify: -The nature of the contributions of Psychology and Teacher's Education, -The underlying theoretical systems of this contributions, -The specific characteristics of the established relationships. Data analysis based on the Evidential Paradigm, let us understand the above items, which, thus become our analytical frame, giving us hints regarding the epistemological status assumed by Psychology with reference to educational topics, the theories that establish the bases of this relationship, as well as the proposed possible dialogs that thereby arises. We believe that this study offers a real contribution towards tightening and enriching this, which shows itself as an important relationship in the education of critical and reflective professorsMestradoEnsino, Avaliação e Formação de ProfessoresMestre em Educaçã

Is Natural Ventilation a Useful Tool to Prevent the Airborne Spread of TB?

Wilson discusses a new study inPLoS Medicine that examined the effect of natural ventilation in eight hospitals in Lima, Peru upon risks of TB transmission

Probability of Trypanosoma cruzi transmission by Triatoma infestans (Hemiptera: Reduviidae) to the opossum Didelphis albiventris (Marsupialia: Didelphidae)

The probability of Trypanosoma cruzi transmission to opossums by independent events of predation and fecal contamination during feeding ("biting") with positive Triatoma infestans was estimated. Negative female opossums were challenged for 23 hr with 10 infected third and fourth instars of T. infestans, and tests for positivity for T. cruzi by xenodiagnosis were performed at 30, 60, and 90 days. From these data, seven probability parameters were estimated by maximum likelihood, and likelihood ratio statistics confidence intervals were calculated. Simultaneous estimation of p1 (probability that a "bite" will infect an opossum), p3 (probability that a bug that has been eaten by an opossum will infect it), and p6 (probability that the opossum will become infected if faced with an infected triatomine), resulted in p̂1 = 0.06, p̂3 = 0.075, and p̂6 = 0.059. On average, each opossum should be exposed to an average of 700 encounters with bugs during its life, resulting in about eight potentially infective contacts, to produce the 35% opossum prevalence found in the field.Facultad de Ciencias Naturales y Muse

Probability of Trypanosoma cruzi transmission by Triatoma infestans (Hemiptera: Reduviidae) to the opossum Didelphis albiventris (Marsupialia: Didelphidae)

The probability of Trypanosoma cruzi transmission to opossums by independent events of predation and fecal contamination during feeding ("biting") with positive Triatoma infestans was estimated. Negative female opossums were challenged for 23 hr with 10 infected third and fourth instars of T. infestans, and tests for positivity for T. cruzi by xenodiagnosis were performed at 30, 60, and 90 days. From these data, seven probability parameters were estimated by maximum likelihood, and likelihood ratio statistics confidence intervals were calculated. Simultaneous estimation of p1 (probability that a "bite" will infect an opossum), p3 (probability that a bug that has been eaten by an opossum will infect it), and p6 (probability that the opossum will become infected if faced with an infected triatomine), resulted in p̂1 = 0.06, p̂3 = 0.075, and p̂6 = 0.059. On average, each opossum should be exposed to an average of 700 encounters with bugs during its life, resulting in about eight potentially infective contacts, to produce the 35% opossum prevalence found in the field.Facultad de Ciencias Naturales y Muse

Development of a supercritical extraction pilot plant for upgrading of heavy oils and study of the asphaltene aggregation process

Orientador: Maria Regina Wolf MacielDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia QuimicaResumo: Os asfaltenos são macromoleculas aromáticas complexas, que apresentam estrutura que varia de acordo com o local de extração do óleo. Esta fração tem sido muito estudada pela indústria de petróleo, não apenas por sua contribuição às propriedades do óleo cru, mas também pelos problemas associados a sua agregação e precipitação. Com isso, foram desenvolvidos novos processos para valoração de petróleos pesados, que recuperam os asfaltenos, obtendo também óleo lubrificante. Neste trabalho foi estudado um dos processos para valoração de petróleos pesados, que utiliza fluidos supercríticos para a desasfaltação e produção de óleo lubrificante. Este processo foi estudado a partir de duas abordagens. A primeira abordagem foi o desenvolvimento de uma planta piloto de desasfaltação supercrítica, no qual o projeto de uma planta piloto construída foi adequado para o uso com petróleo. Este comissionamento foi assistido por simulações do processo realizadas em um software de simulação, no qual as variáveis de processo foram avaliadas em termos de sua influência no desempenho. Diversos testes foram feitos na planta piloto com frações pesadas de petróleos brasileiros, onde as condições operacionais foram avaliadas para a constatação das modificações de projeto necessárias. Uma vez concluída a primeira etapa, foi feita uma segunda abordagem para o processo, que representou o estudo do mecanismo de agregação e precipitação dos asfaltenos, que corresponde à primeira etapa do processo de desasfaltação. Este mecanismo foi avaliado com experimentos utilizando espalhamento de luz dinâmica, para quantificar a variação do tamanho das partículas de asfalteno com o tempo, em amostras preparadas com solventes orgânicos. Como complementação para este estudo, foi utilizada a Espectroscopia Raman Anti-Stokes Coerente para obter imagens das partículas de asfalteno no processo de agregação. Estes dados são de extrema importância, uma vez que ajudam a entender melhor o mecanismo de agregação dos asfaltenos, que ainda permanece como um grande problema sem solução na industria de petróleo e permitem o estudo e avaliação do processo de extração supercrítica para o melhor aproveitamento dos petróleos brasileiros na indústria.Abstract: Alphaltenes are complex aromatic macro-cycle molecules, with a molecular structure that varies depending on the origin of the crude oil. Apart from heir contribution to the properties of petroleum, the study of the asphaltic fraction asbecome more important, due to the problems encountered during petroleum Pro cessing caused by asphaltene precipitation, which causes pipe clogging and catalyst deactivation. Associated with the problems related to the presence of asphalthenes, the petroleum industry developed new processes for upgrading of heavy oils and residues, designed for recovering asphaltenes and lube oil from that mixture. The Residuum Oil Supercritical Extraction (ROSE¿) process is the premier deasphalting technology available in industry. This process extracts high-quality deasphalted oil (DAO) and asphaltenes from atmospheric or vacuum residues and other heavier feedstocks. In this work the extraction of asphaltenes from oil was assessed using two different approaches. The first one was the installation and commissioning of a supercritical deasphalting pilot plant, assisted by simulations using a process simulation software and a thermodynamic study of the system comprised of deasphalted oil, asphaltenes and the solvent. The second approach was the use optical strategies to analyze and model asphaltene aggregation, which is the first step of the supercritical dealphalting process. The first optical technique used was dynamic light scattering (DLS), which gave information such as to study and describe the kinetics of asphaltene aggregation in aromatic solvents, at different temperatures. Associated with the DLS results, CARS (Coherent Anti-Stokes Raman Scattering) images were acquired with different solvents, and allowed an evaluation of the behavior of asphaltenes while they aggregate. These results are very important, once they provide insightful information on the asphaltene aggregation mechanism that still remains as a great unsolved problem in the petroleum industry, allowing it to be controlled in order to reduce problems related with asphaltene precipitation in oil transport and processing and improving the performance of heavy oils upgrading processes.MestradoDesenvolvimento de Processos QuímicosMestre em Engenharia Químic

Barriers to adherence to COPD guidelines among primary care providers

Background: Despite efforts to disseminate guidelines for managing chronic obstructive pulmonary disease (COPD), adherence to COPD guidelines remains suboptimal. Barriers to adhering to guidelines remain poorly understood. Methods: Clinicians from two general medicine practices in New York City were surveyed to identify barriers to implementing seven recommendations from the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. Barriers assessed included unfamiliarity, disagreement, low perceived benefit, low self-efficacy, and time constraints. Exact conditional regression was used to identify barriers independently associated with non-adherence. Results: The survey was completed by 154 clinicians. Adherence was lowest to referring patients with a forced expiratory volume in 1 s (FEV_1) <80% predicted to pulmonary rehabilitation (5%); using FEV_1 to guide management (12%); and ordering pulmonary function tests (PFTs) in smokers (17%). Adherence was intermediate to prescribing inhaled corticosteroids when FEV1 <50% predicted (41%) and long-acting bronchodilators when FEV1 <80% predicted (54%). Adherence was highest for influenza vaccination (90%) and smoking cessation counseling (91%). In unadjusted analyses, low familiarity with the guidelines, low self-efficacy, and time constraints were significantly associated with non-adherence to ≥2 recommendations. In adjusted analyses, low self-efficacy was associated with less adherence to prescribing inhaled corticosteroids (OR: 0.28; 95% CI: 0.10, 0.74) and time constraints were associated with less adherence to ordering PFTs in smokers (OR: 0.31; 95% CI: 0.08, 0.99). Conclusions: Poor familiarity with recommendations, low self-efficacy, and time constraints are important barriers to adherence to COPD guidelines. This information can be used to develop tailored interventions to improve guideline adherence

Molecular characterization of cryptic and sympatric lymnaeid species from the Galba/Fossaria group in Mendoza Province, Northern Patagonia, Argentina

Background Freshwater lymnaeid snails can act as the intermediate hosts for trematode parasites such as the liver fluke Fasciola hepatica, that cause significant economic and biomedical burden worldwide, particularly through bovine fascioliasis. Transmission potential is tightly coupled to local compatibility with snail hosts, so accurate identification of lymnaeid species is crucial for understanding disease risk, especially when invasive species are encountered. Mendoza Province, in Argentina, is a center of livestock production and also an area of endemic fascioliasis transmission. However, the distribution of lymnaeid species in the region is not well known. Methods This study examined lymnaeid snails from seven localities in the Department of Malarguë, Mendoza Province, using morphological and molecular analyses and also describing ecological variables associated with snail presence. Results While morphological characters identified two species of lymnaeid, Galba truncatula and G. viatrix, molecular data revealed a third, cryptic species, G. neotropica, which was sympatric with G. viatrix. G. truncatula was exclusively found in high altitude (>1900 meters above sea level [masl]) sites, whereas mixed G. neotropica/G. viatrix localities were at middle elevations (1300–1900 masl), and G. viatrix was found alone at the lowest altitude sites (<1300 masl). Phylogenetic analysis using two mitochondrial markers revealed G. neotropica and G. viatrix to be closely related, and given their morphological similarities, their validities as separate taxonomic entities should be questioned. Conclusions This study highlights the need of a robust taxonomic framework for the identification of lymnaeid snails, incorporating molecular, morphological and ecological variables while avoiding nomenclature redundancy. As the three species observed here, including one alien invasive species, are considered hosts of varying susceptibility to Fasciola parasites, and given the economic importance of fascioliasis for livestock production, this research has critical importance for the ultimate aim of controlling disease transmission