bluuebunny/crossref_metadata_2025 huggingface dataset:
Processamento da casca de mandioca na alimentação de ovinos: desempenho, características de carcaça, morfologia ruminal e eficiência econômica
Authors: Faria Peter Bitencourt , Silva Jeovane Nascimento , Rodrigues Alisson Queiroz , Teixeira Priscilla Dutra , Melo Leandra Queiroz de , Costa Suely de Fátima , Rocha Maira Freitas Marques , Pereira Alcilene de Abreu
Published: January 2012

Avaliou-se o efeito de diferentes formas de processamento da casca de mandioca na alimentação sobre o desempenho e as características de carcaça, a morfologia ruminal e a viabilidade técnico-econômica da criação de ovinos. Foram utilizados 20 ovinos machos da raça Santa Inês, desmamados, com peso inicial de 19,02±0,21 kg e 90 dias de vida. O delineamento experimental foi inteiramente casualizado com cinco repetições por dieta. Durante o período experimental de 84 dias, incluindo 14 dias de adaptação, os animais foram mantidos em sistema de semiconfinamento em pastagem de Brachiaria decumbens. Foram avaliadas quatro formas de processamento da casca de mandioca: desidratada triturada em peneira de 12 ou de 5 mm; úmida triturada e ensilada; e úmida triturada e hidrolisada com 0,5% de cal virgem (óxido de cálcio - CaO). O peso médio ao abate foi 30,72±1,46 kg. Não houve influência do tipo de processamento da casca sobre as características de desempenho analisadas, as características quantitativas de carcaça e a morfologia ruminal, sendo influenciado somente o rendimento de paleta. A casca de mandioca hidrolisada foi a que promoveu melhor eficiência econômica. Os tipos de processamento da casca de mandioca não alteram o desempenho, as características de carcaça, os rendimentos de corte e a morfologia ruminal dos ovinos Santa Inês.
Composição regional e centesimal da carcaça de cordeiros criados nos sistemas de produção orgânico e convencional
Authors: Zeola Nivea Maria Brancacci Lopes , Silva Sobrinho Américo Garcia da , Manzi Gabriela Milani
Published: January 2012

Este trabalho foi realizado para avaliar o rendimento dos cortes de carcaça, a área de olho-de-lombo, a composição centesimal e o perfil de ácidos graxos da carne proveniente de cordeiros submetidos aos sistemas de produção orgânico e convencional. Foram utilizados 48 animais Ile de France, com peso corporal médio de 15 kg, distribuídos em dois sistemas de produção, orgânica e convencional e abatidos aos 32 kg de peso corporal. Os sistemas de produção não influenciaram o peso nem o rendimento dos cortes de carcaça, entretanto o comprimento máximo do músculo longissimus dorsi dos cordeiros criados no sistema orgânico foi superior ao dos animais do sistema convencional, assim como a espessura máxima de gordura de cobertura. A profundidade máxima do músculo, a espessura mínima de gordura de cobertura e a área de olho-de-lombo não diferiram entre os tratamentos. Na composição centesimal do músculo longissimus dorsi, apenas a matéria mineral foi influenciada, pois foi menor nos animais do sistema orgânico em relação ao convencional. Para os parâmetros umidade, proteína bruta e gordura, não houve influência dos sistemas de produção. O perfil de ácidos graxos saturados e monoinsaturados não foi influenciado pelos sistemas de produção, entretanto o ácido graxo poliinsaturado C18:2 (linoleico) foi maior na carne dos cordeiros criados no sistema orgânico em comparação aos do sistema convencional. O peso e a porcentagem dos cortes da carcaça são semelhantes entre os cordeiros submetidos aos sistemas de produção orgânico e convencional. A carne daqueles criados no sistema orgânico apresenta maior largura máxima no músculo longissimus dorsi (medida A) e porcentagem do ácido graxo poliinsaturado linoleico e menor teor de matéria mineral.
Relação entre a cinética do consumo de oxigênio e a estratégia de corrida em uma prova de 10km
Authors: Damasceno Mayara Vieira , Bertuzzi Rômulo Cássio de Moraes , Pires Flavio de Oliveira , Oliveira Carlos Rafaell Correia de , Barros Ronaldo Vilela , Gagliardi João Fernando Laurito , Silva Thays de Ataíde e , Kiss Maria Augusta Peduti Dal Molin , Lima-Silva Adriano Eduardo
Published: January 2012

Este estudo examinou a influência da cinética on do consumo de oxigênio (O2) sobre a estratégia de corrida adotada durante uma corrida de 10km em corredores com diferentes níveis de desempenho. Vinte e um corredores (28,5 ± 5,3 anos; 172,6 ± 7,3cm; 66,3 ± 9,3kg) realizaram: 1) um teste com incrementos de 1,2km.h-1 a cada três min até a exaustão; 2) um teste de seis minutos de velocidade constante a 9km.h-1 para identificar a cinética do O2; e 3) uma simulação de prova de 10km. Os sujeitos foram divididos em moderada (MP) e baixa (BP) performance de acordo com o tempo gasto para completar a prova de 10km. A velocidade média (MP = 16,9 ± 0,8 vs. BP = 14,9 ± 1km.h-1) na prova de 10km diferenciou significativamente (p < 0,05) entre os grupos. Não foram encontradas diferenças (p > 0,05) entre os grupos em nenhum dos parâmetros cinéticos analisados. Entretanto, a amplitude de aumento do O2 (parâmetro A1) foi inversamente correlacionado com a velocidade média (r = -0,48, p < 0,05) e com as parciais de velocidade na prova (r entre -0,44 e -0,48, p < 0,05), exceto no último trecho (r = -0,19, p > 0,05). Em conclusão, a cinética do O2 parece não interferir na estratégia de corrida adotada em grupos de corredores com diferentes níveis de performance. Contudo, a correlação do parâmetro A1 com as parciais de velocidade sugere uma influência da economia de corrida sobre a estratégia adotada durante a prova de 10km.
Índice-H dos artigos citantes: uma contribuição para a avaliação da produção científica de pesquisadores experientes
Authors: Araújo Claudio Gil Soares de , Sardinha Aline
Published: January 2012

INTRODUÇÃO: Há um crescente interesse e necessidade em avaliar a qualidade da produção científica dos pesquisadores. Para tal, as métricas mais importantes são: número de citações, número médio de citações por artigo indexado e o índice-H. Contudo, essas métricas apresentam limitações na avaliação do potencial de impacto das publicações de um pesquisador, especialmente dentre aqueles mais produtivos. OBJETIVO: Propor e demonstrar a utilização de uma nova métrica científica - índice-H dos artigos citantes, que permite refinar a discriminação do impacto das publicações de pesquisadores experientes sobre o conhecimento existente em sua área. MÉTODOS: Foram analisados dados da Web of Science de 13 dentre os pesquisadores doutores brasileiros mais produtivos na área de exercício físico e esporte, incluindo: número de artigos publicados, número de citações, número médio de citações por artigos, índice-H e o índice-H dos artigos citantes, ou seja, o índice-H obtido a partir da ordenação decrescente dos artigos que citaram artigos publicados pelo pesquisador. Dados de quatro outros pesquisadores - brasileiros e estrangeiros - foram usados como marcos de referência para comparações. RESULTADOS: Os índice-H do pesquisador e o dos artigos citantes são associados (r = 0,92; p > 0,01), porém, quando são analisados os seis pesquisadores mais produtivos, com índices-H acima de 7, a associação entre os dois índices-H desaparece (r = 0,35; p = 0,49). CONCLUSÃO: O índice-H dos artigos citantes pode contribuir para diferenciar a produção científica de pesquisadores com um grande número de artigos publicados. Sugere-se a adoção de sua mensuração pelas agências brasileiras e estrangeiras de fomento e de avaliação da produção científica.
Instrumental e comunicativo no ensino de línguas: mesma abordagem, nomes diferentes?
Authors: Borges Elaine Ferreira do Vale
Published: January 2012

O uso dos termos abordagem comunicativa e abordagem instrumental tem sido recorrente no contexto brasileiro. Isso gera dúvidas quanto a serem abordagens diferentes ou nomes diferentes para uma mesma abordagem. Este artigo objetiva expor a compreensão que se tem dessas concepções nos contextos nacional e internacional de ensino de línguas. Atenção também será dada ao termo abordagem comunicacional. Serão explicitadas e discutidas as principais publicações da área sobre o tema, iniciando em Palmer (1917) e incluindo depoimentos de especialistas de renome, como Widdowson e Prabhu _ coletados em 2006 _, culminando em Borges (2009). Este artigo chama a atenção para um "afrouxamento" no tratamento de um tema que se mostra um contexto profícuo para a compreensão do surgimento e desenvolvimento de paradigmas e metaparadigmas na Linguística Aplicada.
Collaborative tasks and learning occasions in English as a foreign language
Authors: Lima Marília dos Santos
Published: January 2012

The study reported here forms part of a program of qualitative research focusing on the use of collaborative tasks in learning English as a foreign language in Brazil. The research examines the concept of collaborative dialogue (SWAIN, 2000), understood as dialogue that constructs linguistic knowledge within a sociocultural view of language learning. The results indicated that the learners reflected upon the target language, tested hypotheses and reformulated their production in order to promote mutual comprehension in the learning process. The results also revealed that the interaction established during the production of the collaborative dialogue stimulated foreign language learning as the students noticed linguistic gaps in the target language, and sought solutions together.
O trabalho com línguas para fins específicos em uma perspectiva interacionista sociodiscursiva
Authors: Beato-Canato Ana Paula Marques
Published: January 2012

Aparentemente em caminho oposto à proposta de ensino de línguas para fins específicos, que pressupõe rapidez, o interacionismo sociodiscursivo (ISD) (BRONCKART, 2003; 2006; 2008; SCHNEUWLY, DOLZ, 2004) postula um trabalho processual, organizado em sequências didáticas que visam o desenvolvimento de capacidades de linguagem necessárias para agir em contextos específicos. Esse trabalho pode demandar diversas horas de estudo em torno de um gênero textual específico para garantir que a língua seja compreendida como prática social e o texto como instrumento semiótico para agir nesses contextos. Alinhado a essa perspectiva, os desafios deste artigo são analisar e exemplificar as adaptações possíveis e necessárias na proposta didática genebrina para que possa ser aplicada em contextos de ensino-aprendizagem de línguas para fins específicos.
Análise linguístico-discursiva do genero introdução de artigo de pesquisa (para fins específicos): Teste ANPAD
Authors: Coelho Juliana Guimarães Rodrigues
Published: January 2012

Este artigo é um recorte de um estudo que analisou o gênero textual `introdução de artigo de pesquisa' sob a ótica retórico-discursiva. Os princípios teórico-metodológicos que orientaram esta pesquisa foram: inglês instrumental, leitura e gêneros textuais. A pesquisa realizada é de natureza descritiva focalizada (LARSEN-FREEMAN; LONG, 1991), e o corpus utilizado é formado por introduções de artigo de pesquisa da prova de inglês do teste ANPAD. Neste artigo, será apresentada uma análise linguístico-discursiva das introduções desse corpus. Os resultados mostraram que as evidências linguísticas nem sempre correspondem a um determinado movimento retórico (SWALES, 1990) presente nos textos das introduções analisadas. O estudo teve finalidade pedagógica, pois evidenciou os marcadores linguísticos e as estruturas verbais que realmente ocorrem nesse gênero.
Concept Maps powered by computer software: a strategy for enhancing reading comprehension in English for Specific Purposes
Authors: Dias Reinildes
Published: January 2012

This paper focuses on the procedures of an action-research (STRINGER, 2007) that was conducted with undergraduates enrolled in an ESP course at Faculdade de Letras (UFMG). The impelling drive was the creation of a means to solve an educational problem, namely, the enhancement of students' reading comprehension of texts in English for academic purposes. The problem-solving process involved the use of concept maps (NOVAK; CAÑAS, 2008) powered by the CMap Tools software (CAÑAS et al., 2004) to meet the educational needs of a localized teaching situation. Data indicate that concept mapping, facilitated by computer software, can be a useful strategy to improve comprehension. Support for the investigation comes from the theories underlying the ESP approach, meaningful learning, learning as a social enterprise, and collaborative learning.
Course design, action research and the use of computers: challanges in an ESP course
Authors: Damião Silvia Matravolgyi
Published: January 2012

This paper presents the results of an action research project that focused on the design and teaching of an ESP course and on the collaborative construction and development of a website. In the first year of the study, the course plan was modified due to the feedback given by the students and the same happened to the site, which was uploaded and modified according to the students' productions within the period. The course plan was reformulated in the second year of the study based on the experience acquired in the first year, and tasks were introduced to fulfill the students' academic and future professional needs. At the end of the second year of the study, it was possible to confirm that the course plan, with the modifications that were introduced, was adequate, and that the site reflected the tasks prepared by the students within the period, therefore reaching the objectives proposed at the beginning of the study. It was also possible to propose new directions for ESP teaching at the Institution where the research was carried out.
O papel do professor no ensino de alemão para o fim específico da leitura
Authors: Stanke Roberta Cristina Sol Fernandes
Published: January 2012

Este artigo tem por objetivo abordar o papel do professor em um curso de alemão, cujo fim específico é o desenvolvimento da habilidade de leitura nesta língua estrangeira (LE). Os resultados da pesquisa, realizada com bas eem notas de campo em um curso de alemão para leitura, diários, entrevistas, questionários, análise documental e gravações em áudio e vídeo, demonstraram o papel multifacetado do professor de LE para fins específicos que, além de ensinar a língua-alvo, analisa as necessidades da situação-alvo e da situação de aprendizagem, seleciona e elabora material didático, conscientiza seu aprendiz sobre o que significa a atividade de leitura e fomenta o desenvolvimento das estratégias de leitura.
Panorama dos estudos sobre a linguagem da aviação
Authors: Bocorny Ana Eliza Pereira
Published: January 2012

A carência de estudos descritivos sobre a linguagem especializada da aviação dificulta a criação e o desenvolvimento de cursos de Inglês para Fins Específicos (doravante ESP) para essa área de conhecimento. A pesquisa aqui apresentada busca suprir em parte tal carência, na medida em que faz uma revisão de trabalhos que já foram produzidos sobre língua e aviação. Assim, o objetivo deste artigo é, ao analisar o surgimento e a evolução de estudos relacionados à linguagem da aviação, identificar as principais temáticas enfocadas por pesquisadores e escritores desde o surgimento da "arte de voar" até hoje, relacionando-as às diferentes áreas da Linguística Aplicada. Para tanto, livros, artigos e documentos foram identificados, listados, relacionados aos principais fatos históricos do período e categorizados conforme seus focos de estudo. Por fim, foi organizado um quadro referencial com os principais focos de estudo identificados.
Molecular Alterations Between the Primary Breast Cancer and the Subsequent Locoregional/Metastatic Tumor
Authors: Macfarlane Robyn , Seal Melanie , Speers Caroline , Woods Ryan , Masoudi Hamad , Aparicio Samuel , Chia Stephen K.
Published: January 2012

Learning Objectives:

After completing this course, the reader will be able to: Describe the rate of discordance of predictive marker phenotype (i.e., ER/PR, HER2) between the primary and the relapsed/metastatic breast cancer lesion.Explain the impact of a change in predictive marker phenotype between the primary and relapsed/metastatic lesion on treatment options for these patients.

This article is available for continuing medical education credit at CME.TheOncologist.com

Background.

Metastatic breast cancers have historically been presumed to have the same predictive biomarkers as the initial primary tumor. We compared the expression of these biomarkers in a large paired tissue microarray (TMA) series of primary and subsequent relapsed tumors.

Methods.

Using the British Columbia Cancer Agency Breast Cancer Outcomes Unit database, patients with biopsy-proven relapses were identified and linked to a large TMA series of primary breast cancers from 1986–1992. Charts were reviewed, and tissue blocks of the metastatic cancer were collected to create a separate TMA. Immunohistochemical assessment with the same antibodies and conditions was performed for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER)-2 on both the primary and relapsed tumors.

Results.

One hundred sixty cases were received that had tumor adequate for analyses. Of these, 71.9% had no changes in either the ER or PR status or HER-2 status. Of the 45 (28.1%; 95% confidence interval [CI], 21.2%–35.1%) tumors that did have changes in receptor status, 7.5% were in-breast recurrences or new breast primaries, 4.4% had changes in PR status only and were therefore deemed clinically irrelevant, and 19.4% (95% CI, 13.3%–25.5%) had changes in either the ER or HER-2 status from regional or distant relapses. Five percent of tumors had a receptor status change going from ER+ or PR+ to ER− or PR−; 9.4% went from ER− or PR− to ER+ or PR+. With regard to HER-2 status, 3.8% of tumors went from positive to negative and 1.3% went from negative to positive. For all discordant cases, biopsies of the relapsed lesion were obtained prior to initiation of first-line treatment for metastatic disease. In the primary tumors that were ER+, time to relapse was significantly shorter in the discordant relapsed cases than in the concordant ones (p = .0002). Changes in loss or gain of either biomarker were seen across the discordant cases.

Conclusions.

A significant proportion of relapsed tumors had changes in either ER or HER-2 status, which would dramatically alter treatment recommendations and clinical behavior. This study suggests that biopsies of relapsed and metastatic breast cancers should be performed routinely in clinical practice.
Genomewide Pharmacogenetics of Bisphosphonate-Induced Osteonecrosis of the Jaw: The Role of RBMS3
Authors: Nicoletti Paola , Cartsos Vassiliki M. , Palaska Penelope K. , Shen Yufeng , Floratos Aris , Zavras Athanasios I.
Published: January 2012

Learning Objectives

After completing this course, the reader will be able to: Explain the association between bisphosphonates and osteonecrosis of the jaw.Describe the role of RBMS3 in the risk of BRONJ development.

This article is available for continuing medical education credit at CME.TheOncologist.com

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a serious adverse drug reaction. We conducted a genomewide association study to search for genetic variants with a large effect size that increase the risk for BRONJ.

Methods.

We ascertained BRONJ cases according to the diagnostic criteria of the American Association of Oral and Maxillofacial Surgeons. We genotyped cases and a set of treatment-matched controls using Illumina Human Omni Express 12v1 chip (733,202 markers). To maximize the power of the study, we expanded the initial control set by including population and treatment-tolerant controls from publicly available sources. Imputation at the whole-genome level was performed to increase the number of single nucleotide polymorphisms (SNPs) investigated. Tests of association were carried out by logistic regression, adjusting for population structure. We also examined a list of candidate genes comprising genes potentially involved in the pathogenesis of BRONJ and genes related to drug absorption, distribution, metabolism, and excretion.

Results.

Based on principal component analysis, we initially analyzed 30 white cases and 17 treatment-tolerant controls. We subsequently expanded the control set to include 60 genetically matched controls per case. Association testing identified a significant marker in the RBMS3 gene, rs17024608 (p-value < 7 × 10−8); individuals positive for the SNP were 5.8× more likely to develop BRONJ (odds ratio, 5.8; 95% confidence interval, 3.1–11.1). Candidate gene analysis further identified SNPs in IGFBP7 and ABCC4 as potentially implicated in BRONJ risk.

Conclusion.

Our findings suggest that genetic susceptibility plays a role in the pathophysiology of BRONJ, with RBMS3 having a significant effect in the risk.
Phase II Trial of Simple Oral Therapy with Capecitabine and Cyclophosphamide in Patients with Metastatic Breast Cancer: SWOG S0430
Authors: Schott Anne F. , Barlow William E. , Albain Kathy S. , Chew Helen K. , Wade James L. , Lanier Keith S. , Lew Danika L. , Hayes Daniel F. , Gralow Julie R. , Livingston Robert B. , Hortobagyi Gabriel N.
Published: January 2012

Learning Objectives

After completing this course, the reader will be able to: Compare outcomes in patients treated with capecitabine plus CPA with those of capecitabine monotherapy and combination therapy with bevacizumab, sorafenib, or ixabepilone.Identify patients for whom single-agent capecitabine is recommended.

This article is available for continuing medical education credit at CME.TheOncologist.com

Background.

Interest in oral agents for the treatment of metastatic breast cancer (MBC) has increased because many patients prefer oral to i.v. regimens. We evaluated a simple oral combination of capecitabine with cyclophosphamide (CPA) for MBC.

Methods.

The trial was designed to determine whether or not combination therapy would achieve a 42% response rate (RR) using the Response Evaluation Criteria in Solid Tumors (RECIST) in MBC. Patients with two or fewer prior chemotherapy regimens for MBC were eligible. Those with estrogen receptor–positive MBC had to have progressed on endocrine therapy. Patients had measurable disease or elevated mucin (MUC)-1 antigen and received CPA, 100 mg daily on days 1–14, and capecitabine, 1,500 mg twice daily on days 8–21, in 21-day cycles.

Results.

In 96 eligible patients, the median progression-free survival (PFS) interval was 5.9 months (95% confidence interval [CI], 3.7–8.0 months) and median overall survival (OS) time was 18.8 months (95% CI, 13.1–22.0 months). The RR was 36% (95% CI, 26%–48%) in 80 patients with measurable disease. The MUC-1 antigen RR was 33% (95% CI, 20%–48%), occurring in 15 of 46 patients with elevated MUC-1 antigen. Toxicity was mild, with no treatment-related deaths.

Conclusions.

PFS, OS, and RR outcomes with capecitabine plus CPA compare favorably with those of capecitabine monotherapy and combination therapy with bevacizumab, sorafenib, or ixabepilone. The addition of these other agents to capecitabine does not improve OS time in MBC patients, and this single-arm study does not suggest that the addition of CPA to capecitabine has this potential in an unselected MBC population. When OS prolongation is the goal, clinicians should choose single-agent capecitabine.
Should the Denosumab Metastasis Prevention Trial Change Practice for Men with Nonmetastatic Prostate Cancer?
Authors: Saylor Philip J. , Michaelson M. Dror
Published: January 2012

Presentation of the Case

A 68-year-old man presents for management of prostate-specific antigen (PSA)-recurrent prostate cancer. His PSA level had become undetectable after prostatectomy for a high-risk localized tumor but began to rise 8 months later. This later led to the initiation of androgen deprivation therapy (ADT), which he has received for the last 3.5 years. After initially falling in response to ADT, his PSA level again trended steadily upward and is now 13.2. Restaging with an abdominal and pelvic computed tomography scan and a bone scan reveals no evidence of metastases. Is this man likely to benefit from denosumab?

Bone is the most common site of metastasis for advanced prostate cancer. Bone metastases can cause considerable morbidity in the form of pain, pathologic fractures, and even spinal cord compression. Two bone-targeted therapies (zoledronic acid and denosumab) have been shown to reduce the risk for skeletal events (SREs) among men with bone metastases and a rising PSA level despite a testosterone level <50 ng/dL (castration-resistant prostate cancer [CRPC]). Until recently, no therapy had been shown to reduce the risk for developing bone metastases for the first time. Denosumab 147 was a randomized, placebo-controlled, phase III trial that enrolled 1,432 men with CRPC, no bone metastases, and at least one feature consistent with a high risk for the development of bone metastases (PSA ≥8 ng/mL or PSA doubling time ≤10 months). Participants were treated every 4 weeks with s.c. denosumab (120 mg) or placebo.

The trial was positive because denosumab led to a 4.2-month significantly longer bone-metastasis-free survival time relative to placebo (median, 29.5 months versus 25.2 months; hazard ratio [HR], 0.85; 95% confidence interval [CI], 0.73–0.98; p = .028) [1]. The time to first bone metastasis and risk for symptomatic bone metastasis were also significantly better with denosumab treatment. Dror Michaelson and Philip Saylor discuss the potential implications of this trial.
Graphite metal composites with tailored physical properties
Authors: Hutsch Thomas , Schubert Thomas , Weissgaerber Thomas , Kieback Bernd
Published: January 2012

Graphite provides a good opportunity for the development of new metal matrix composites (MMCs) due to its interesting properties, including thermal conductivity, high internal damping, and low density. According to the particular application, metal–graphite composites with their tailored properties can be used in the areas of thermal management of electronic devices. Metal–graphite composites show anisotropic properties due to the orientation of the graphite flakes during consolidation. Powder metallurgical technologies can be used to manufacture composites with graphite contents up to 90 vol. %. Besides copper, other matrices were investigated like tungsten, aluminium, and iron. The thermophysical properties (thermal conductivity, thermal expansion) as well as damping properties were characterized as a function of the composition. Interesting metal–graphite composites combining tungsten and 70 vol. % graphite flakes show a thermal conductivity in two directions of 400 W/mK in combination with a physical coefficient of thermal expansion of 3·5 ppm/K and a high damping.
Clinical Course of 822 Children with Prenatally Detected Nephrouropathies
Authors: Quirino Isabel G. , Diniz Jose Silverio S. , Bouzada Maria Candida F. , Pereira Alamanda K. , Lopes Thais J. , Paixão Gabriela M. , Barros Natalia N. , Figueiredo Luisa C. , Cabral Antonio Carlos V. , Simões e Silva Ana Cristina , Oliveira Eduardo A.
Published: January 2012

Background and objectives

With the advent of fetal screening ultrasonography, the detection of congenital anomalies of the kidney and urinary tract (CAKUT) in utero has permitted early management of these conditions. This study aims to describe the clinical course of a large cohort of patients with prenatally detected nephrouropathies.

Design, setting, participants, & measurements

In this retrospective cohort study, 822 patients were prenatally diagnosed with CAKUT and systematically followed up at a tertiary Renal Unit for a median time of 43 months. Variables included in the analysis were sex, laterality, fetal ultrasonography (isolated versus associated hydronephrosis), and presence/absence of nephrouropathies. The events of interest were urinary tract infection, surgical interventions, hypertension, CKD, and death. Survival analyses were performed to evaluate time until occurrence of the events of interest.

Results

Urinary tract infection occurred in 245 (29.8%) children, with higher risk in females (hazard ratio=1.30, 95% confidence interval=1.02–1.70, P=0.05); 22 patients (2.7%) had hypertension, and 49 (6%) patients developed CKD. The risk of CKD was greater in patients with associated hydronephrosis (hazard ratio=5.20, 95% confidence interval=2.90–9.30, P<0.001). Twelve patients (1.5%) died during follow-up. Death was significantly associated with being born during the first period of the study (hazard ratio=6.00, 95% confidence interval=1.60–22.50, P<0.001), associated hydronephrosis (hazard ratio=9.30, 95% confidence interval=2.90–29.30, P<0.001), and CKD (hazard ratio=170.00, 95% confidence interval=41.00–228.00, P<0.001).

Conclusions

In our series, the clinical course of prenatally detected CAKUT was heterogeneous, and those infants with associated hydronephrosis at baseline were identified as a high-risk subgroup.
Ergocalciferol Supplementation in Children with CKD Delays the Onset of Secondary Hyperparathyroidism
Authors: Shroff Rukshana , Wan Mandy , Gullett Ambrose , Ledermann Sarah , Shute Rachel , Knott Craig , Wells David , Aitkenhead Helen , Manickavasagar Bahee , van’t Hoff William , Rees Lesley
Published: January 2012

Background and objectives

Vitamin D deficiency is an important contributor to the development of hyperparathyroidism and is independently associated with cardiovascular and bone disease. The hypothesis was that nutritional vitamin D (ergocalciferol) supplementation in children with CKD stages 2–4 delays the onset of secondary hyperparathyroidism.

Design, setting, participants, & measurements

A randomized, double-blinded, placebo-controlled study in children with CKD2–4 who had 25-hydroxyvitamin D [25(OH)D] deficiency was conducted. Ergocalciferol (or a matched placebo) was given daily as per Kidney Disease Outcomes Quality Initiative guidelines. The primary endpoint was the time to development of hyperparathyroidism.

Results

Seventy-two children were screened. Forty-seven children were 25(OH)D-deficient and randomly assigned to receive ergocalciferol or placebo. Twenty children in each arm completed the study; median follow-up was 12 months. Groups were well matched for age, race, estimated GFR, and season when recruited. Nine of 20 children on placebo and 3 of 20 children on ergocalciferol developed hyperparathyroidism (odds ratio, 4.64; 95% confidence interval, 1.02–21.00). The time to development of hyperparathyroidism was significantly longer with ergocalciferol treatment compared with placebo (hazard ratio, 0.30; 95% confidence interval, 0.09–0.93, P=0.05). With ergocalciferol treatment, normal 25(OH)D levels were achieved in all 8 children with CKD2, 8 of 11 children with CKD3, but not in the single patient with CKD4. There were no ergocalciferol-related adverse events. 25(OH)D levels >100 nmol/L were required to achieve normal levels of 1,25-dihydroxyvitamin D.

Conclusions

Ergocalciferol is an effective treatment that delays the development of secondary hyperparathyroidism in children with CKD2–3.
Risks of Subsequent Hospitalization and Death in Patients with Kidney Disease
Authors: Daratha Kenn B. , Short Robert A. , Corbett Cynthia F. , Ring Michael E. , Alicic Radica , Choka Randall , Tuttle Katherine R.
Published: January 2012

Background and objectives

Rates of hospitalization are known to be high in patients with kidney disease. However, ongoing risks of subsequent hospitalization and mortality are uncertain. The primary objective was to evaluate patients with kidney disease for long-term risks of subsequent hospitalization, including admissions resulting in death.

Design, setting, participants, & measurements

Patients hospitalized in Washington State between April of 2006 and December of 2008 who survived to discharge (n=676,343) were classified by International Classification of Disease codes into CKD (n=27,870), dialysis (n=6131), kidney transplant (n=1100), and reference (n=641,242) cohorts. Cox proportional hazard models controlling for age, sex, payer, comorbidity, previous hospitalization, primary diagnosis category, and length of stay were conducted for time to event analyses.

Results

Compared with the reference cohort, risks for subsequent hospitalization were increased in the CKD (hazard ratio=1.20, 99% confidence interval=1.18–1.23, P<0.001), dialysis (hazard ratio=1.76, 99% confidence interval=1.69–1.83, P<0.001), and kidney transplant (hazard ratio=1.85, 99% confidence interval=1.68–2.03, P<0.001) cohorts, with a mean follow-up time of 29 months. Similarly, risks for fatal hospitalization were increased for patients in the CKD (hazard ratio=1.41, 99% confidence interval=1.34–1.49, P<0.001), dialysis (hazard ratio=3.04, 99% confidence interval=2.78–3.31, P<0.001), and kidney transplant (hazard ratio=2.25, 99% confidence interval=1.67–3.03, P<0.001) cohorts. Risks for hospitalization and fatal hospitalization increased in a graded manner by CKD stage.

Conclusions

Risks of subsequent hospitalization, including admission resulting in death, among patients with kidney disease were substantially increased in a large statewide population. Patients with kidney disease should be a focus of efforts to reduce hospitalizations and mortality.
Erythropoietic Stimulating Agents and Quality of a Patient’s Life
Authors: Kliger Alan S. , Fishbane Steven , Finkelstein Fredric O.
Published: January 2012

Erythropoietic stimulating agents (ESAs) such as erythropoietin have been used for decades to treat the anemia of CKD. Clinical practice guidelines suggest target hemoglobin levels >10 g/dl, and average Hb levels have risen from 9.6 to 12.0 g/dl. Several studies have shown trends for higher mortality and myocardial infarction, higher BP, increased vascular access thrombosis, and strokes in patients treated to target Hb ≥13 g/dl. Patients with profound anemia suffer from symptoms of fatigue, poor energy, weakness, and shortness of breath. Such symptoms reported directly by patients, or patient-reported outcomes (PROs), may be a valuable tool to target ESA treatment in anemic CKD patients. Studies show that improvements in anemia correlate with improvements in these PRO domains in some individuals. We propose that instead of Hb targets for all patients, treatment of anemia should be directed toward improving the areas of patient-perceived quality of life most affected by anemia. PROs can be used by individual patients to prioritize the risks and benefits of ESA treatment. Patients, along with their physicians, can examine Hb level in the context of patients’ perception of their quality of life and use ESAs judiciously to improve these perceptions.
Chronic GLP-1 Receptor Activation by Exendin-4 Induces Expansion of Pancreatic Duct Glands in Rats and Accelerates Formation of Dysplastic Lesions and Chronic Pancreatitis in the KrasG12D Mouse Model
Authors: Gier Belinda , Matveyenko Aleksey V. , Kirakossian David , Dawson David , Dry Sarah M. , Butler Peter C.
Published: January 2012

Pancreatic duct glands (PDGs) have been hypothesized to give rise to pancreatic intraepithelial neoplasia (PanIN). Treatment with the glucagon-like peptide (GLP)-1 analog, exendin-4, for 12 weeks induced the expansion of PDGs with mucinous metaplasia and columnar cell atypia resembling low-grade PanIN in rats. In the pancreata of Pdx1-Cre; LSL-KrasG12D mice, exendin-4 led to acceleration of the disruption of exocrine architecture and chronic pancreatitis with mucinous metaplasia and increased formation of murine PanIN lesions. PDGs and PanIN lesions in rodent and human pancreata express the GLP-1 receptor. Exendin-4 induced proproliferative signaling pathways in human pancreatic duct cells, cAMP–protein kinase A and mitogen-activated protein kinase phosphorylation of cAMP-responsive element-binding protein, and increased cyclin D1 expression. These GLP-1 effects were more pronounced in the presence of an activating mutation of Kras and were inhibited by metformin. These data reveal that GLP-1 mimetic therapy may induce focal proliferation in the exocrine pancreas and, in the context of exocrine dysplasia, may accelerate formation of neoplastic PanIN lesions and exacerbate chronic pancreatitis.
Peroxisome Proliferator–Activated Receptor-γ Coactivator-1α (PGC-1α) Enhances Engraftment and Angiogenesis of Mesenchymal Stem Cells in Diabetic Hindlimb Ischemia
Authors: Lu Debin , Zhang Ling , Wang Haihui , Zhang Yan , Liu Jian , Xu Jing , Liang Ziwen , Deng Wuquan , Jiang Youzhao , Wu Qinan , Li Shufa , Ai Zhihua , Zhong Yuxu , Ying Ying , Liu Hongyan , Gao Feng , Zhang Zhonghui , Chen Bing
Published: January 2012

To examine whether the peroxisome proliferator–activated receptor-γ coactivator-1α (PGC-1α), a key regulator linking angiogenesis and metabolism, could enhance the engraftment and angiogenesis of mesenchymal stem cells (MSCs) in diabetic hindlimb ischemia, we engineered the overexpression of PGC-1α within MSCs using an adenoviral vector encoding green fluorescent protein and PGC-1α, and then tested the survivability and angiogenesis of MSCs in vitro and in vivo. Under the condition of hypoxia concomitant with serum deprivation, the overexpression of PGC-1α in MSCs resulted in a higher expression level of hypoxia-inducible factor-1α (Hif-1α), a greater ratio of B-cell lymphoma leukemia-2 (Bcl-2)/Bcl-2–associated X protein (Bax), and a lower level of caspase 3 compared with the controls, followed by an increased survival rate and an elevated expression level of several proangiogenic factors. In vivo, the MSCs modified with PGC-1α could significantly increase the blood perfusion and capillary density of ischemic hindlimb of the diabetic rats, which was correlated to an improved survivability of MSCs and an increased level of several proangiogenic factors secreted by MSCs. We identified for the first time that PGC-1α could enhance the engraftment and angiogenesis of MSCs in diabetic hindlimb ischemia.
Mortality After Incident Cancer in People With and Without Type 2 Diabetes
Authors: Currie Craig J. , Poole Chris D. , Jenkins-Jones Sara , Gale Edwin A.M. , Johnson Jeffrey A. , Morgan Christopher Ll.
Published: January 2012

OBJECTIVE

Type 2 diabetes is associated with an increased risk of several types of cancer and with reduced survival after cancer diagnosis. We examined the hypotheses that survival after a diagnosis of solid-tumor cancer is reduced in those with diabetes when compared with those without diabetes, and that treatment with metformin influences survival after cancer diagnosis.

RESEARCH DESIGN AND METHODS

Data were obtained from >350 U.K. primary care practices in a retrospective cohort study. All individuals with or without diabetes who developed a first tumor after January 1990 were identified and records were followed to December 2009. Diabetes was further stratified by treatment regimen. Cox proportional hazards models were used to compare all-cause mortality from all cancers and from specific cancers.

RESULTS

Of 112,408 eligible individuals, 8,392 (7.5%) had type 2 diabetes. Cancer mortality was increased in those with diabetes, compared with those without (hazard ratio 1.09 [95% CI 1.06–1.13]). Mortality was increased in those with breast (1.32 [1.17–1.49]) and prostate cancer (1.19 [1.08–1.31]) but decreased in lung cancer (0.84 [0.77–0.92]). When analyzed by diabetes therapy, mortality was increased relative to nondiabetes in those on monotherapy with sulfonylureas (1.13 [1.05–1.21]) or insulin (1.13 [1.01–1.27]) but reduced in those on metformin monotherapy (0.85 [0.78–0.93]).

CONCLUSIONS

This study confirmed that type 2 diabetes was associated with poorer prognosis after incident cancer, but that the association varied according to diabetes therapy and cancer site. Metformin was associated with survival benefit both in comparison with other treatments for diabetes and in comparison with a nondiabetic population.
Screening for Gestational Diabetes Mellitus: Are the Criteria Proposed by the International Association of the Diabetes and Pregnancy Study Groups Cost-Effective?
Authors: Werner Erika F. , Pettker Christian M. , Zuckerwise Lisa , Reel Michael , Funai Edmund F. , Henderson Janice , Thung Stephen F.
Published: January 2012

OBJECTIVE

The International Association of the Diabetes and Pregnancy Study Groups (IADPSG) recently recommended new criteria for diagnosing gestational diabetes mellitus (GDM). This study was undertaken to determine whether adopting the IADPSG criteria would be cost-effective, compared with the current standard of care.

RESEARCH DESIGN AND METHODS

We developed a decision analysis model comparing the cost-utility of three strategies to identify GDM: 1) no screening, 2) current screening practice (1-h 50-g glucose challenge test between 24 and 28 weeks followed by 3-h 100-g glucose tolerance test when indicated), or 3) screening practice proposed by the IADPSG. Assumptions included that 1) women diagnosed with GDM received additional prenatal monitoring, mitigating the risks of preeclampsia, shoulder dystocia, and birth injury; and 2) GDM women had opportunity for intensive postdelivery counseling and behavior modification to reduce future diabetes risks. The primary outcome measure was the incremental cost-effectiveness ratio (ICER).

RESULTS

Our model demonstrates that the IADPSG recommendations are cost-effective only when postdelivery care reduces diabetes incidence. For every 100,000 women screened, 6,178 quality-adjusted life-years (QALYs) are gained, at a cost of $125,633,826. The ICER for the IADPSG strategy compared with the current standard was $20,336 per QALY gained. When postdelivery care was not accomplished, the IADPSG strategy was no longer cost-effective. These results were robust in sensitivity analyses.

CONCLUSIONS

The IADPSG recommendation for glucose screening in pregnancy is cost-effective. The model is most sensitive to the likelihood of preventing future diabetes in patients identified with GDM using postdelivery counseling and intervention.
Red blood cell shape and deformability in the context of the functional evolution of its membrane structure
Authors: Svetina Saša
Published: January 2012

It is proposed that it is possible to identify some of the problems that had to be solved in the course of evolution for the red blood cell (RBC) to achieve its present day effectiveness, by studying the behavior of systems featuring different, partial characteristics of its membrane. The appropriateness of the RBC volume to membrane area ratio for its circulation in the blood is interpreted on the basis of an analysis of the shape behavior of phospholipid vesicles. The role of the membrane skeleton is associated with preventing an RBC from transforming into a budded shape, which could form in its absence due to curvature-dependent transmembrane protein-membrane interaction. It is shown that, by causing the formation of echinocytes, the skeleton also acts protectively when, in vesicles with a bilayer membrane, the budded shapes would form due to increasing difference between the areas of their outer and inner layers.
Ultrathin functional films of titanium(IV) oxide
Authors: Kluson Petr , Kment Stepan , Morozova Magdalena , Dytrych Pavel , Hejda Stanislav , Slater Morwenna , Hubicka Zdenek , Krysa Josef
Published: January 2012

Chemistry and physics of thin semiconducting layers of various types are subjects of intense research. Especially when nanotechnology methods such as self-assembly are involved, amazing structural and/or functional properties may appear. Also modern physical methods using variously organized plasma arrangements are able to produce uniform structures with distinctive functionality. In this review, based virtually on our own work, discussions on the preparation, structure, morphology, and function of titanium(IV) oxide nanoscopic thin films are presented. It was shown that structurally and functionally similar titanium(IV) oxide films can be prepared via completely different preparation techniques. Function tests were arranged as “primary”, covering the assessment of the light induced charge separation efficiency, and “secondary”, based on photocatalytic surface oxidations.
Mathematical model of aerobic stabilization of old landfills
Authors: Slezak Radoslaw , Krzystek Liliana , Ledakowicz Stanisław
Published: January 2012

A short-term aerobic stabilization of digested waste in the final methane phase was studied. The effect of aeration rate on the reduction of leachate parameters and on the rate of CO2 production and O2 assimilation was investigated. Experimental simulation of aerobic landfill stabilization was carried out using lysimeters. When testing the effect of aeration rate on the reduction of leachate indices (BOD5, COD, N-NH4+), it was reported that the most significant reduction was obtained at the highest rate of aeration and the smallest reduction of leachate indices was attained not at the lowest but at medium aeration rates. Both the rate of CO2 production and the O2 assimilation reached their highest values in the lysimeters aerated at a high rate of aeration. The proposed mathematical model which consists of a system of five differential equations describing CO2 production, O2 assimilation and the changes of organic carbon content in the leachate correspond well with the experimental data.
Investigation of kinetics of anaerobic digestion of Canary grass
Authors: Kacprzak Anna , Krzystek Liliana , Paździor Katarzyna , Ledakowicz Stanisław
Published: January 2012

The most promising technology to generate energy is the production of biogas from agricultural feedstock. This technology allows obtaining high biogas yields per hectare. Biogas of high methane content can be produced from various kinds of energy crops, animal manure, and other organic waste. This paper presents results of both biochemical methane potential (BMP) assay of Canary grass (Phalaris canariensis) and its anaerobic co-digestion with cheese whey and glycerin fraction in a large laboratory scale as well as the kinetics of both co-digestion and digestion of Canary grass alone. The suggested mathematical description of the anaerobic co-digestion process gave satisfying conformity with the experimental data.
Controlling the magnetorheological suspension of a vehicle seat including the biomechanics of the driver
Authors: Gągorowski Andrzej
Published: January 2012

This paper presents an original approach to the problem of controlling a magnetorheological suspension of a driver’s seat for optimal reduction of whole-body vibration. The concept consists in taking into consideration the individual personal features (biomechanical parameters) of the driver in the control process of a MR damper by using human generated signals. The proposed algorithm enables the adaptation of the suspension for an individual driver and specific road conditions. The actual research has focused on numerical simulations with a complex model of the human-seat-vehicle system. The human model representing a specific driver has been described by several biomechanical parameters such as masses of body structures, moments of inertia, and stiffness and damping of the spine, intervertebral discs, spinal muscles and ligaments.