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Education Institutions have deployed technology accelerated learning systems and innovations for effective learning outcomes. Evaluating student’s performance in these systems must align with the cognitive, affective, and psychomotor learning domains. In this research, a Hybrid soft computing system comprising of the Clustering Algorithm, Machine learning technique, and Optimization algorithm were hybridized and implemented to evaluate student academic performance using academic, social, and economic data of students. The proposed model demonstrated the best results with the lowest mean square error (MSE) and root mean square error (RMSE) values of 0.17 and 0.41, respectively. Additionally, the GANFIS model achieved values of 0.25 and 0.50, respectively, which slightly outperformed the proposed FCM-PSOANFIS model. The proposed model works better with bigger datasets, and it de-livers higher predictive findings under settings that depict student learning capacities while assessing student academic achievement.

Blockchain is a trending technology that has paved way to solving various challenges in different sectors. It has received much inter-est from researchers over the years, as it is known to be a trans-parent, secured, no third party and tamper-proof public records repository system for documents, contracts, properties and assets. Land title has been a major challenge in Nigeria due to the fact that existing system, digital archives, used to manage the sector is not effective, thus brought about issues such as, double spending, pos-sibility of tampering, third party interference and non-transparency of opera-tions. Hence the need for blockchain technology. Blockchain has characteristics, such as decentralization, security, immutability, smart contract, it is therefore expected to improve land title man-agement. This paper applies a content-analysis based literature re-view blockchain technology and existing method of land title in Ni-geria. This paper propose five benefits. Blockchain can help to im-prove proper land record keeping, information transparency, ac-countability, anonymity and avoidance of double spending.

The morphology of virgin reactor powder (RP) of high-density polyethylene (HDPE) with MW = 160,000 g/mol was investigated using DSC, SEM, SAXS, and WAXS methods. The morphological SEM analysis showed that the main morphological units of RP are macro- and micro-shish-kebab structures with significantly different geometric dimensions, as well as individual lamellae of folded chain crystals. A quantitative analysis of an asymmetric SAXS reflection made it possible to reveal the presence of several periodic morphoses in the RP with long periods ranging from 20 nm to 60 nm, and to correlate them with the observed powder morphology. According to the DSC crystallinity data, the thickness of the lamellae in each long period was estimated. Their surface energy was calculated in the framework of the Gibbs—Thompson theory. The presence of regular and irregular folds on the surface of different shish-kebab lamellae was discussed. The percentage of identified morphoses in the RP was calculated. It has been suggested that the specific structure of HDPE RP is due to the peculiarity of polymer crystallization during suspension synthesis in a quasi-stationary regime, in which local overheating and inhomogeneous distribution of shear stresses in a chemical reactor are possible.

Objetivo: analisar as ações dos profissionais de saúde durante a primeira visita domiciliar ao binômio mãe-bebê. Método: pesquisa descritiva, abordagem qualitativa, realizada de fevereiro a junho de 2016, por meio de entrevista semiestruturada com 11 mães de recém-nascidos que receberam a visita domiciliar no período neonatal por profissionais de saúde que atuam nas unidades de saúde da família no município de João Pessoa. Os dados foram submetidos à análise temática. Resultados: percebem-se fragilidades nas ações com a mãe, pois limitam-se aos cuidados com a ferida cirúrgica, no caso de cesarianas. Entre as ações voltadas ao bebê, destaca-se que foram abrangentes, envolvendo o exame físico, imunização, incentivo ao aleitamento materno, agendamento de consultas na unidade de saúde e orientações como propõe a Primeira Semana Saúde Integral. Conclusão: embora haja potencialidades na realização da visita domiciliar, as fragilidades na atuação dos profissionais no cuidado ao binômio mãe-bebê comprometem a integralidade da atenção, fazendo-se necessário investir em capacitação ABSTRACT Objective: to analyze the actions of health professionals during first mother-and-infant home visits. Method: this qualitative, descriptive study was conducted from February to June 2016, drawing on semi-structured interviews of 11 mothers of newborns, who were visited at home during the neonatal period by health professionals working at family health clinics in the city of João Pessoa-PB, Brazil. The resulting data were subjected to thematic analysis. Results: weaknesses were found in care for the mothers, which was limited to care for the surgical wound in caesarean cases. Care actions towards the babies were notably comprehensive, involving physical examination, immunization, promotion of breastfeeding, scheduling of appointments at the health care facility, and guidance as pro- posed by the First Comprehensive Health Week. Conclusion: although there is potential in making home visits, weaknesses in health personnel’s performance of mother-and-child care undermines the comprehensiveness of care making it necessary to invest in training. RESUMEN Objetivo: analizar las acciones de los profesionales de la salud durante la primera visita domiciliaria del binomio madre-bebé. Método: investigación descriptiva, con enfoque cualitativo, llevada a cabo entre febrero y junio de 2016, por medio de entrevistas semiestructuradas junto a 11 madres de los neonatos que recibieron visitas domiciliarias durante el período neonatal de profesionales de la salud que trabajan en las Unidades de Salud de la Familia en la ciudad João Pessoa. Los datos fueron sometidos al análisis temático. Resultados: se perciben las debilidades en las acciones en cuanto a la madre ya que se limitan al cuidado de la herida quirúrgica, en el caso de cesáreas. Entre las acciones volcadas al bebé, se pone de relieve que fueron de gran alcance, incluyendo el examen físico, la inmunización, el incentivo a la lactancia, la programación de citas en la unidad de salud y directrices según propone la Primera Semana Salud Integral. Conclusión: a pesar de que existe un potencial en la realización de visitas domiciliarias, las debilidades en el trabajo de los profesionales en el cuidado al binomio madre-hijo comprometen la integralidad de la atención, por lo que es necesario invertir en la formación.

A hydrophobic grid membrane filtration – Shiga toxin immunoblot method was used to examine the prevalence of Shiga toxin-producing Escherichia coli (STEC) in four watersheds located in the Lower Mainland of British Columbia, Canada, a region characterized by rapid urbanization and intensive agricultural activity. STEC were recovered from 21.6, 23.2, 19.5 and 9.2 % of surface water samples collected monthly from five sites in each watershed over a period of one year. Overall prevalence was subject to seasonal variation however, ranging between 13.3 % during fall months and 34.3 % during winter months. STEC were also recovered from 23.8 % of sediment samples collected in one randomly selected site. One hundred distinct STEC isolates distributed among 29 definitive and 4 ambiguous or indeterminate serotypes were recovered from water and sediments, including isolates from Canadian priority serogroups O157 (3), O26 (4), O103 (5) and O111 (7). Forty seven isolates were further characterized by analysis of whole genome sequences to detect Shiga toxin gene (stx 1 and stx 2), intimin gene (eaeA) allelic variants and acquired virulence factors. These analyses collectively showed that surface waters from the region support highly diverse STEC populations that include strains with virulence factors commonly associated with human pathotypes. The present work served to characterize the microbiological hazard implied by STEC to support future assessments of risks to public health arising from non-agricultural and agricultural uses of surface water resources in the region.

What is the relationship between different sciences or research approaches that deal with the same phenomena, for instance, with the phenomena of the human mind? Answers to this question range from a monist perspective according to which one of these approaches is privileged over the others, through an integrationist perspective according to which they must strive to form a unity greater than the sum of its parts, to an isolationist perspective according to which each of them has its own autonomous sphere of validity. In order to assess these perspectives in this article, I discuss the debates about the unity of science and about explanatory pluralism. The most pressing issue turns out to be the choice between the integrative and the isolationist perspective: the question is whether the integrative tendencies in science should be fully indulged in, or whether they should be held in check by acknowledging that a certain amount of isolation is necessary. I argue that the issue can be further distilled into the question of whether two true explanations of the same fact can ever fail to be combinable into one single explanation. I show that this can indeed be the case, namely when the explanations have incompatible counterfactual consequences, something that is often the case when we try to combine explanations from different sciences or research approaches. These approaches thus embody perspectives on the world that are to a certain extent autonomous. This leads to the conclusion that although interdisciplinarity may have many advantages, we should not take the project of integration too far. At the end of the day, the different research approaches with their different perspectives and insights must remain precisely that: different and somewhat disunified.

International accreditation of business schools has become dominated by the ‘big three’ of accreditation agencies – AACSB, EQUIS, and AMBA. Accreditation provides public notification that an institution or program meets benchmark standards, and reflects an institution committed to self-study, external peer-review, and continuous improvement. However, from the perspective of the more than 12,000 business schools worldwide that do not, and most likely will never, meet ‘big three’ imposed benchmarks, accreditation is an exclusion mechanism providing comparative advantage to accredited schools. This is more than a differentiator between accredited and non-accredited business schools – it reinforces the economic ‘great divide’ between developed and less-developed countries, since over 90% of accredited business schools are in developed countries. Consequently, accreditation becomes a moral and ethical imperative that should sit uneasy with anyone concerned with equality and social justice. In response, the Asian Forum on Business Education (AFBE) has designed an inclusive international accreditation system that is affordable, and fosters quality improvement at institutions that may initially be some considerable distance from meeting ‘big three’ standards. This paper provides an insight into one such accreditation process at a business school in Kazakhstan, and demonstrates the remarkable progress that can be achieved when quality improvement, rather than mere certification, is the guiding principle.

Spinocerebellar Ataxia Type 2 (SCA2) is a rare genetic disorder producing cerebellar degeneration and affecting motor abilities. Neuroimaging studies also show neurodegeneration in subcortical and cortical regions related to emotional and social processes. From social neuroscience it is suggested that motor and social abilities can be influenced by particular cultural dynamics so, culture is fundamental to understand the effect of brain related alterations. Here we present the first analysis about the cultural elements related to the SCA2 disorder in 15 patients previously evaluated with neuroimaging and psychometric instruments, and their nuclear relationships distributed in six geographical and cultural regions in Mexico. Ethnographic records and photographic and video archives about the quotidian participant’s routine were obtained from the patients, their relatives and their caregivers. The information was categorized and interpreted taking into consideration cultural issues and patients’ medical files. Our analyses suggest that most of the participants do not understand the nature of the disease and this misunderstanding favors magic and non-medical explanations. Patients’ testimonies suggest a decrease in pain perception as well as motor alterations that may be related to interoceptive dysfunctions. Relatives’ testimonies indicate patients’ lack of social and emotional interests that may be related to frontal, temporal and cerebellar degeneration. In general, participants use their religious beliefs to deal with the disease and only a few of them trust the health system. Patients and their families are either openly rejected and ignored, tolerated or even helped by their community accordingly to different regional traits. We propose that ethnography can provide social representations to understand the patients’ alterations, to formulate neurobiological hypotheses, to develop neurocognitive interventions, and to improve the medical approach to the disease.

An ability to produce rhythmic activity is ubiquitous for locomotor pattern generation and modulation. The role that the rhythmogenesis capacity of the spinal cord plays in injured populations has become an area of interest and systematic investigation among researchers in recent years, despite its importance being long recognized by neurophysiologists and clinicians. Given that each individual interneuron, as a rule, receives a broad convergence of various supraspinal and sensory inputs and may contribute to a vast repertoire of motor actions, the importance of assessing the functional state of the spinal locomotor circuits becomes increasingly evident. Air-stepping can be used as a unique and important model for investigating human rhythmogenesis since its manifestation is largely facilitated by a reduction of external resistance. This article aims to provide a review on current issues related to the ‘locomotor’ state and interactions between spinal and supraspinal influences on the central pattern generator circuitry in humans, which may be important for developing gait rehabilitation strategies in individuals with spinal cord and brain injuries.

In early HIV infection, the virus population escapes from multiple CD8+ cell responses. The later an escape mutation emerges, the slower it outgrows its competition, i. e. the escape rate is lower. This pattern could indicate that the strength of the CD8+ cell responses is waning, or that later viral escape mutants carry a larger fitness cost. In this paper, we investigate whether the pattern of decreasing escape rate could also be caused by genetic interference among different escape strains. To this end, we developed a mathematical multi-epitope model of HIV dynamics, which incorporates stochastic effects, recombination and mutation. We used cumulative linkage disequilibrium measures to quantify the amount of interference. We found that nearly synchronous, similarly strong immune responses in two-locus systems enhance the generation of genetic interference. This effect, combined with densely spaced sampling times at the beginning of infection and sparse sampling times later, leads to decreasing successive escape rate estimates, even when there were no selection differences among alleles. These predictions are supported by experimental data from one HIV-infected patient. Thus, interference could explain why later escapes are slower. Considering escape mutations in isolation, neglecting their genetic linkage, conceals the underlying haplotype dynamics and can affect the estimation of the selective pressure exerted by CD8+ cells. In systems in which multiple escape mutations appear, the occurrence of interference dynamics should be assessed by measuring the linkage between different escape mutations.

Rural areas in developing countries are characterized by lack of resources, low population density and scarcity of communications infrastructure. These circumstances make it difficult to provide appropriate healthcare services. This paper explains research results achieved by EHAS (Enlace Hispano Americano de Salud - Hispano American Health Link) and how they have contributed to improve healthcare in isolated areas of developing countries through the use of Information and Communication Technologies (ICT). As the first step, EHAS always collaborates with public health systems to identify its communication and information needs. Based on the analysis of needs, EHAS does research on appropriate technologies to provide communication in each context and on information systems suited to needs of health personnel. In parallel, EHAS has worked to provide applications that, making use of the communications services installed, could improve the healthcare services in these remote areas. In this line, solutions to improve epidemiological surveillance or to provide telemedicine services (like a digital stethoscope or a tele-microscopy system) have been developed. EHAS has also performed several researches trying to ensure the sustainability of their solutions and has summarized them in a Management Framework for Sustainable e-Healthcare Provision. Finally, the effort to spread acquired knowledge has crystallized in a book that details all the technologies and procedures previously mentioned.

Dengue virus has four serotypes and is endemic globally in tropical countries. Neither a specific treatment nor an approved vaccine is available, and correlates of protection are not established. The standard neutralization assay cannot differentiate between serotype-specific and serotype cross-reactive antibodies in patients early after infection, leading to an overestimation of the long-term serotype-specific protection of an antibody response. It is known that the cross-reactive response in patients is temporary but few studies have assessed kinetics and potential changes in serum antibody specificity over time. To better define the specificity of polyclonal antibodies during disease and after recovery, longitudinal samples from patients with primary or secondary DENV-2 infection were collected over a period of one year. We found that serotype cross-reactive antibodies peaked three weeks after infection and subsided within one year. Since secondary patients rapidly produced antibodies specific for the virus envelope (E) protein, an E-specific ELISA was superior compared to a virus particle-specific ELISA to identify patients with secondary infections. Dengue infection triggered a massive activation and mobilization of both naïve and memory B cells possibly from lymphoid organs into the blood, providing an explanation for the surge of circulating plasmablasts and the increase in cross-reactive E protein-specific antibodies.

Normal motility of the colon is critical for quality of life and efforts to normalize abnormal colon function have had limited success. A better understanding of control systems of colonic motility is therefore essential. We report here a hypothesis with supporting experimental data to explain the origin of rhythmic propulsive colonic motor activity induced by general distention. The theory holds that both networks of interstitial cells of Cajal (ICC), those associated with the submuscular plexus (ICC-SMP) and those associated with the myenteric plexus (ICC-MP), orchestrate propagating contractions as pacemaker cells in concert with the enteric nervous system (ENS). ICC-SMP generate an omnipresent slow wave activity that causes propagating but non-propulsive contractions (rhythmic propagating ripples) enhancing absorption. The ICC-MP generate stimulus-dependent cyclic depolarizations propagating anally and directing propulsive activity (rhythmic propulsive motor complexes). The ENS is not essential for both rhythmic motor patterns since distention and pharmacological means can produce the motor patterns after blocking neural activity, but it supplies the primary stimulus in vivo. Supporting data come from studies on segments of the rat colon, simultaneously measuring motility through spatiotemporal mapping of video recordings, intraluminal pressure and outflow measurements.

Background: Ceramic industry workers are subjected to several factors, such as high temperature, dust and work in standing position, which in greater or lesser degree might cause discomfort and work-related disorders., Objective: To investigate the quality of life and functional capacity of ceramic industry workers., Methods: The present study had a quantitative cross-sectional design. A total of 189 ceramic industry workers were analyzed. Muscle strength was assessed by means of dynamometry, and the following questionnaires were applied: WHOQOL-Bref for quality of life; Nordic Questionnaire of Musculoskeletal Symptoms, pain Visual Analog Scale (VAS), Oswestry Low Back Pain Disability Questionnaire (ODQ 2.0) and Disabilities of the Arm, Shoulder and Hand (DASH)., Results: Overall, 115 (60.8%) participants described their quality of life as average. The lumbar spine was the body segment most often mentioned as the location of pain 68 (36.0%) participants reported occurrence of pain in the past 12 months and 38 (20.1%) in the past 7 days. A total of 107 (56.6%) participants exhibited upper limb muscle weakness., Conclusion: The results evidenced a higher prevalence of pain compared to other professional categories. Muscle weakness, mainly affecting the upper limbs, and self-perceived quality of life as predominantly average show that the state of health of a part of the sample was partially impaired, and while it was not associated with disability, it was perceived as having impact in their personal and professional lives.

Purpose: To assess the association between hypertension in pregnancy and women's quality of life (QoL) and the variation in the quality of life over gestational trimesters., Method: A questionnaire was applied to 194 hypertensive pregnant women and 195 pregnant women without complications. The questionnaire was composed of two parts: socioeconomic profile and specifically QoL, using the instrument Ferrans & Powers Quality of Life Index. All women included underwent a physical examination., Results: Blood pressure was found to be approximately 20 mmHg higher in hypertensive pregnant women compared to pregnant women without complications. All QoL domains of hypertensive pregnant women had lower scores than those of pregnant women without complications, with health/functioning rated the lowest, averaging 17.63. The least affected domain was family, having the best average score (26.0). The QoL had no significant variations in relation to gestational trimesters., Conclusions: Pregnancy causes intense changes, both physical and psychological, in women's lives and hypertension was found to be a factor of high interference in pregnant woman's QoL, causing lower scores in all QoL domains of hypertensive pregnant women, compared with pregnant woman without complications.

The aim of this study was to evaluate the effects of therapeutic pulsed ultrasound with gold nanoparticles on oxidative stress parameters after traumatic muscle injury in Wistar rats. The animals were randomly divided into nine groups (n = 6 each): sham (uninjured muscle); muscle injury without treatment; muscle injury and treatment with dimethyl sulfoxide (15 mg/kg); muscle injury and treatment with gold nanoparticles (27 µg); muscle injury and treatment with dimethyl sulfoxide + gold nanoparticles (Plus); muscle injury and therapeutic pulsed ultrasound; muscle injury and therapeutic pulsed ultrasound + dimethyl sulfoxide; muscle injury and therapeutic pulsed ultrasound + gold nanoparticles; and muscle injury and therapeutic pulsed ultrasound + Plus. Gastrocnemius injury was induced by a single-impact blunt trauma. Therapeutic pulsed ultrasound (6-min application, frequency 1.0 MHz, intensity 0.8 W/cm(2)) was used 2, 12, 24, and 48 h after trauma. Mitochondrial superoxide generation, lipid peroxidation, and protein carbonylation, and the activities of superoxide dismutase, glutathione peroxidase, and catalase were evaluated. The increase in the superoxide production and TBARS and carbonyl levels observed in the control group after muscle damage were reduced in animals exposed to therapeutic pulsed ultrasound plus nanoparticles. Similarly, antioxidants enzymes showed a decreased activity with the same treatment. Our work suggest that therapeutic pulsed ultrasound + dimethyl sulfoxide + gold nanoparticles has beneficial effects on the muscle healing process by inducing a decrease in oxidative stress parameters and most likely decreasing the deleterious effects of the inflammatory response.

Objective: To evaluate peripheral respiratory system resistance and reactance (Rrs and Xrs, respectively) in obese individuals., Methods: We recruited 99 individuals, dividing them into four groups by body mass index (BMI): < 30.0 kg/m2 (control, n = 31); 30.0-39.9 kg/m2 (obesity, n = 13); 40.0-49.9 kg/m2 (severe obesity, n = 28); and ≥ 50.0 kg/m2 (morbid obesity, n = 13). Using impulse oscillometry, we measured total Rrs, central Rrs, and Xrs. Peripheral Rrs was calculated as the difference between total Rrs and central Rrs. All subjects also underwent spirometry., Results: Of the 99 individuals recruited, 14 were excluded because they failed to perform forced expiratory maneuvers correctly during spirometry. The individuals in the severe obesity and morbid obesity groups showed higher peripheral Rrs and lower Xrs in comparison with those in the two other groups., Conclusions: Having a BMI ≥ 40 kg/m2 was associated with a significant increase in peripheral Rrs and with a decrease in Xrs.

Background: The ankle-brachial index (ABI) is a simple, non-invasive, and inexpensive method used in the diagnosis of peripheral arterial disease (PAD) and can identify individuals at risk for cardiovascular disease in other arteries of the body, especially the coronary and carotid arteries. The primary objective of this study was to assess whether patients with an ABI < 0.9 have more severe coronary artery disease detected on coronary angiography compared to patients with a normal ABI., Methods: This is a prospective, analytical, cross-sectional study that was performed from July 1, 2013 to June 31, 2014 that recruited 163 patients (101 men (62%) and 62 women (38%)) according to the inclusion and exclusion criteria. All patients underwent coronary angiography, and then ABI measurements were performed. Pearson's Chi-square and Student's t -tests were used to compare variables between groups. The Poisson regression model was used to evaluate whether ABI was an independent predictor of stenoses > 50%., Results: The prevalence of ABI < 0.9 was 9.8%. Patients with an ABI < 0.9 had a higher prevalence of stenoses ≥ 50% in the left anterior descendant (LAD) (68.7% vs. 36%, P = 0.02) and left main (8.7% vs. 0.6%, P < 0.001) than those with a normal ABI. On multivariate Poisson regression, an ABI < 0.9 was an independent predictor of stenosis ≥ 50% in the LAD (odds ratio (OR): 2.05 (1.39 - 3.04), P < 0.001)., Conclusions: Patients with an ABI < 0.9 had a higher prevalence of stenoses ≥ 50% in the LAD and left main than those with a normal ABI. An abnormal ABI was an independent predictor of lesions ≥ 50% in LAD.

The aim of this study was to analyse the effects of microcurrent and gold nanoparticles on oxidative stress parameters and the mitochondrial respiratory chain in the healing of skin wounds. Thirty 60-day old male Wistar rats (250-300 g) were divided into five groups (N=6): Control; Burn wounds; Microcurrent (MIC); Gold nanoparticle gel (GNP gel) and Microcurrent+Gold nanoparticle gel (MIC+GNP gel). The microcurrent treatment was applied for five consecutive days at a dose of 300 μA. The results demonstrate a significant decrease in the activity of complexes I, II-III and IV in the Burn Wounds group compared to the control, and the MIC+GNP gel group was able to reverse this inhibition in complexes I, III and IV. Furthermore, a significant reduction in oxidative damage parameters and a significant increase in the levels of antioxidant defence enzymes were induced in the MIC+GNP gel group compared to the Burn Wounds group. The data strongly indicate that the group receiving treatment with MIC+GNP gel had improved mitochondrial functioning and oxidative stress parameters, which contributed to tissue repair., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Background: The association between the ankle brachial index (ABI) and the measurement of intimal medial thickness (IMT) has not been fully studied., Objective: We aimed to evaluate whether the prevalence of carotid atherosclerosis was higher in patients with ABI < 0.9 than in those with ABI > 0.9., Methods: From January 2011 to December 2011, 118 patients (48 men and 70 women) were enrolled. ABI and IMT Measurements were performed in all patients. Patients were divided in Group 1 (ABI < 0.9) and Group 2 (ABI > 0.9) according to ABI values. Mann-Whitney, Chi-square and Fischer tests were used for comparison among the groups. Pearson's correlation was used to assess correlation between ABI and IMT., Results: The prevalence of ABI < 0.9 was 29.7%, whereas carotid atherosclerosis > 1.5 mm was 34.7 %. Clinical characteristics were similar between groups 1 and 2: mean age (64 ± 9 vs. 62 ± 7.2 years, p = 0.1), male gender (40% vs. 41%, p = 0.9), hypertension (74% vs. 59%, p = 0.1), diabetes mellitus (54% vs. 35%, p = 0.051), dyslipidemia (26% vs. 24%, p = 0.8), smoking (57% vs. 65%, p = 0.4). The prevalence of carotid atherosclerosis was higher in group 1 (48.6% vs. 28.9%, p = 0.04). Pearson's correlation between ABI and IMT was -0.235, with a p value = 0.01., Conclusion: Patients with ABI < 0.9 showed a higher prevalence of carotid atherosclerosis. There was a negative correlation between ABI and IMT.

Aims: To investigate the effects physical training exerts on markers of oxidative stress in rats with chronic kidney disease (CKD)., Main Methods: Twenty-four male Wistar rats were divided into four groups (n=6): sham, CKD, exercise-sham and exercise-CKD. Surgical reduction of the renal mass was performed (5/6 nephrectomized) and exercise was conducted on a treadmill (50 min/day up to 1 km/h for, 5 days/week for eight weeks). Forty-eight hours after the last exercise session, blood (1 mL) was collected from the abdominal aorta and animals were decapitated. The left kidney was surgically removed and stored at -70 °C for subsequent analysis., Key Findings: An increase was observed in creatinine and urea levels, superoxide production, antioxidant enzymes, and oxidative damage in the CKD group, as compared to sham animals (p<0.05). Physical training made superoxide production and oxidative damage decrease in the CKD group (p<0.05), increasing SOD and GPX activity, though it did not increase the antioxidant effects of CAT, and renal parameters., Significance: Even without altering renal function in animals induced to CKD model, the results show that physical training is an important component in the treatment of CKD, because it exerted a positive influence on oxidative stress parameters, especially on the reduction in superoxide production and oxidative damage, as well as an improvement in the antioxidant defense system, like SOD and GPX., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Studies have shown an exacerbated increase in proinflammatory markers during and after muscle injury. In this way, interventions that reduce inflammatory activation appear to be of great interest in muscle injury therapy. Thus, the preset study evaluated the effect of low-intensity pulsed ultrasound (LIPUS) and dimethylsulfoxide (DMSO) on the proinflammatory molecules in an animal model of traumatic muscle injury. Forty-eight 3-month old male Wistar rats were divided into six groups (n = 8/group): sham; muscle injury without treatment; muscle injury and gel-saline (0.9%); muscle injury and gel-DMSO (15 mg/kg); muscle injury and LIPUS plus gel-saline; and muscle injury and LIPUS plus gel-DMSO. Two, 12, 24 and 48 h after trauma, four groups received one of the treatments described. One hour after, Western blot was performed to quantify proinflammatory protein levels. We observed greater protein levels of TNFα (3.9 times), IL-1β (3.6 times), JNK phosphorylation (4.2 times) and NFκB (3.8 times) in muscle injury group. However, the combined LIPUS with DMSO resulted in significantly lower levels of TNFα (2.2 times), IL-1β (2.1 times), JNK phosphorylation (2.4 times), and NFκB (2.1 times). The results demonstrate that LIPUS associated with DMSO gel can attenuate TNFα, IL-1β, NFκB protein levels and JNK phosphorylation in traumatic muscle injury., (Copyright © 2012 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

Background: Nanogold has been investigated in a wide variety of biomedical applications because of the anti-inflammatory properties. The purpose of this study was to evaluate the effects of TPU (Therapeutic Pulsed Ultrasound) with gold nanoparticles (GNP) on oxidative stress parameters and the expression of pro-inflammatory molecules after traumatic muscle injury., Materials and Methods: Animals were divided in nine groups: sham (uninjured muscle); muscle injury without treatment; muscle injury + DMSO; muscle injury + GNP; muscle injury + DMSO + GNP; muscle injury + TPU; muscle injury + TPU + DMSO; muscle injury + TPU + GNP; muscle injury + TPU + DMSO + GNP. The ROS production was determined by concentration of superoxide anion, modulation of antioxidant defenses was determined by the activity of superoxide dismutase, catalase and glutathione peroxidase enzymes, oxidative damage determined by formation of thiobarbituric acid-reactive substance and protein carbonyls. The levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) were measured as inflammatory parameters., Results: Compared to muscle injury without treatment group, the muscle injury + TPU + DMSO + GNP gel group promoted a significant decrease in superoxide anion production and lipid peroxidation levels (p < 0.050). It also showed a significant decrease in TNF-α and IL-1β levels (p < 0.050) when compared to muscle injury without treatment group., Conclusions: Our results suggest that TPU + DMSO + GNP gel presents beneficial effects on the muscular healing process, inducing a reduction in the production of ROS and also the expression of pro-inflammatory molecules.

Introduction: Patients with chronic kidney disease (CKD) experiment a synergistic effect of the traditional and the emerging uremia-related risk factors for atherosclerosis., Objective: Draw the epidemiologic profile of a group of CKD patients who underwent cardiac evaluation., Methods: Symptomatic patients, patients with ischemia on myocardial scintigraphy and/or systolic dysfunction on echocardiography, patients older than 50 years and diabetes mellitus (DM) as a cause of CKD, and those with two or more risk factors underwent coronary angiography. Asymptomatic, non-diabetic patients and patients with no risk factors were investigated with echocardiography. Those with a single risk factor were investigated with echocardiography and scintigraphy., Results: 46 patients (58.7% men) were enrolled. Their mean age was 50.7 ± 11.7 years. 91.3% were on dialysis, for 61.96 ± 55.1 months. Hypertension was the cause of CKD in 56.5%. Of the 28 patients (60.9%) who underwent angiography, 53.6% had coronary artery disease (CAD). The patients were divided into three groups: those with CAD (A), those without CAD (B) and those who didn't undergo coronary angiography (C). A significant difference occurred only between groups B and C, as regards an abnormal ABI (p = 0.026), with no ABI abnormality in group C, and as regards the mean age, which was higher in group B (p = 0.045). In group A, 53.3% of the patients were in the preoperative stage of parathyroidectomy., Conclusion: This study confirmed the high rate of cardiovascular disorders, including CAD, in patients with CKD, especially those on dialysis.

This case series aimed to evaluate the behavior adopted by patients during the pre-hospital phase of acute myocardial infarction (AMI). A total of 115 AMI sufferers with ST-segment elevation were evaluated. The chi-square and Fisher's exact tests were applied. The individuals that did not associate the symptoms with cardiovascular disease most often attributed them to the following sources: gastrointestinal (38%), musculoskeletal (29.7%), food and/or medication poisoning (8.5%) and arising from the respiratory apparatus (6.3%). The proportion of major outcomes and of patients that arrived in the emergency department after 12 hours was higher among women, individuals with monthly income of up to one minimum wage, those who used analgesics and did not associate the symptoms with cardiovascular disease. It was found that individuals in unfavorable socioeconomic conditions, who interpreted the symptoms incorrectly, arrived later at the emergency department and had worse intra-hospital outcomes.

Many studies have demonstrated an increase in reactive oxygen species (ROS) and oxidative damage markers after muscle damage. Phonophoresis aims to achieve therapeutically relevant concentrations of the transdermally introduced drug in the tissues subjected to the procedure by the use ultrasound waves. The aim of the study was to evaluate the effects on the therapeutic pulsed ultrasound (TPU) together with gel-dimethylsulfoxide (DMSO) in the parameters of muscular damage and oxidative stress. Male Wistar rats were divided randomly into six groups (n=6): sham (uninjured muscle); muscle injury without treatment; muscle injury and treatment with gel-saline (0.9%); muscle injury and treatment with gel-DMSO (15mg/kg); muscle injury and TPU plus gel-saline; and muscle injury and TPU plus gel-DMSO. Gastrocnemius injury was induced by a single impact blunt trauma. TPU (6min duration, frequency of 1.0MHz, intensity of 0.8W/cm(2)) was used 2, 12, 24, 48, 72, 96 and 120h after muscle trauma. The CK and acid phosphatase activity in serum was used as an indicator of skeletal muscle injury. Superoxide anion, TBARS, protein carbonyls, superoxide dismutase (SOD) and catalase (CAT) activity was used as indicators of stress oxidative. Results showed that TPU and gel-DMSO improved muscle healing. Moreover, superoxide anion production, TBARS level and protein carbonyls levels, superoxide dismutase (SOD) and catalase (CAT) activity were all decreased in the group TPU plus gel-DMSO. Our results show that DMSO is effective in the reduction of the muscular lesion and in the oxidative stress after mechanical trauma only when used with TPU. (E-mail: silveira&#95;paulo2004@yahoo.com.br).

In this article, we report the effects of acute administration of ruthenium complexes, trans-[RuCl(2)(nic)(4)] (nic=3-pyridinecarboxylic acid) 180.7 micromol/kg (complex I), trans-[RuCl(2)(i-nic)(4)] (i-nic=4-pyridinecarboxylic acid) 13.6 micromol/kg (complex II), trans-[RuCl(2)(dinic)(4)] (dinic=3,5-pyridinedicarboxylic acid) 180.7 micromol/kg (complex III) and trans-[RuCl(2)(i-dinic)(4)]Cl (i-dinic=3,4-pyridinedicarboxylic acid) 180.7 micromol/kg (complex IV) on succinate dehydrogenase (SDH) and cytochrome oxidase (COX) activities in brain (hippocampus, striatum and cerebral cortex), heart, skeletal muscle, liver and kidney of rats. Our results showed that complex I inhibited SDH activity in hippocampus, cerebral cortex, heart and liver; and inhibited COX in heart and kidney. Complex II inhibited SDH in heart and hippocampus; COX was inhibited in hippocampus, heart, liver and kidney. SDH activity was inhibited by complex III in heart, muscle, liver and kidney. However, COX activity was increased in hippocampus, striatum, cerebral cortex and kidney. Complex IV inhibited SDH activity in muscle and liver; COX activity was inhibited in kidney and increased in hippocampus, striatum and cerebral cortex. In a general manner, the complexes tested in this work decrease the activities of SDH and COX in heart, skeletal muscle, liver and kidney. In brain, complexes I and II were shown to be inhibitors and complexes III and IV activators of these enzymes. In vitro studies showed that the ruthenium complexes III and IV did not alter COX activity in kidney, but activated the enzyme in hippocampus, striatum and cerebral cortex, suggesting that these complexes present a direct action on COX in brain.

The choline/N-acetyl-aspartate (Cho/NAA) ratio, obtained by the multivoxel spectroscopy with short echo time (TE), was evaluated, in the histological grading of the brain astrocytomas (grades I, II and III-IV) in comparison with the normal cerebral parenchyma. A significant increase (p<0.05) in the average ratios of Cho/NAA was observed in the three astrocytoma groups studied in relation to normal tissue, having a tendency to increase with the increase in grading, without any statistic significance, which corresponded to: 0.53+/-0.24 in the control group, 1.19+/-0.49 in grade I, 1.58+/-0.65 in grade II and 5.13+/-8.12 in the high grade group (grades III-IV), with variation in the values encountered. There was an increase in the Cho/NAA ratio in 4/5 (80%) in grade I, 5/6 (83%) in grade II and 10/20 (50%) in grades III and IV. We conclude that multivoxel spectroscopy with short TE can be used in discriminating between normal parenchyma and neoplasm tissue. However, not all neoplasm tissue studied presented an increase in Cho/NAA, especially in the group with higher grade of malignancy.

Objective: Describe arterial blood pressure response in adolescents undergoing exercise stress testing., Methods: This was a cross-sectional study conducted with 218 adolescents (131 of whom were males), aged between 10 to 19 years, undergoing exercise stress testing. Maximum heart rate, total exercise time, maximum oxygen uptake, systolic blood pressure (SBP) and diastolic (DBP) at rest, during maximal physical exertion and at six minutes of recovery were measured., Results: At rest, SBP values were greater in males and no difference was found in DBP between genders, although both increased with age. During exercise, SBP rose and DBP fell in both genders. SBP variation was greater in men, particularly in those over 14 years of age., Conclusion: Analysis of results showed that during physical exercise, SBP had a direct relationship with the individuals age, weight, height and body mass index, whereas DBP bore a relationship to age only.

Creatine kinase is a crucial enzyme for brain, heart and skeletal muscle energy homeostasis, and a decrease of its activity has been associated with cell death. Many biological properties have been attributed to ruthenium complexes. In this context, this work was performed in order to evaluate creatine kinase activity from rat brain, heart and skeletal muscle (quadriceps) after administration of ruthenium complexes, trans-[RuCl(2)(nic)(4)] (nic=3-pyridinecarboxylic acid) 180.7 micromol/kg (complex I), trans-[RuCl(2)(i-nic)(4)] (i-nic=4-pyridinecarboxylic acid) 13.6 micromol/kg (complex II), trans-[RuCl(2)(dinic)(4)] (dinic=3,5-pyridinedicarboxylic acid) 180.7 micromol/kg (complex III) and trans-[RuCl(2)(i-dinic)(4)] (i-dinic=3,4-pyridinedicarboxylic acid) 180.7 micromol/kg (complex IV). Our results showed that complex I caused inhibition of creatine kinase activity in hippocampus, striatum, cerebral cortex, heart and skeletal muscle. Besides, complex II did not affect the enzyme activity. complexes III and IV increased creatine kinase activity in hippocampus, striatum, cerebral cortex and heart, but not in skeletal muscle. Besides, none of the complexes in vitro altered creatine kinase activity, suggesting that enzymatic activity is indirectly affected by complexes I, III and IV. It is believed that diminution of creatine kinase in brain of rats caused by complex I may be related to results from other study reporting memory impairment caused by the same complex. Further research is necessary in order to elucidate the effects of ruthenium complexes in other important metabolic enzymes.

Objective: Measure the systolic (SP), diastolic (DP) and pulse pressure (PP) using home blood pressure monitoring (HBPM) and correlate its values with the left ventricular mass index (LVMI)., Methods: In 2004, 127 individuals underwent HBPM in a private clinic. A total of 83 of these also underwent an echocardiographic study in a period shorter than 6 months. After excluding those with dilated or ischaemic cardiomyopathy and those with mitral or aortic valvopathies, 72 patients were evaluated for the correlation between SP, DP and PP (SP minus DP) and the LVMI., Results: The group's mean age was 51.9 +/- 17.3 years and the masculine gender represented 43% of their components. The mean body mass index (BMI) was 28.6 +/- 6 kg/m(2) and 53% of the patients were using antihypertensive drugs. The PS and PP correlated positively to the LVMI (r = 0.356; p = 0.002 e r = 0.429; p < 0.001, respectively). There was no correlation between DP and LVMI., Conclusion: The PS and the PP correlate positively to the LVMI.

Objective: To study the systolic and diastolic function of asymptomatic patients with severe obesity using a Doppler echocardiography., Methods: Thirty candidates for bariatric surgery, with an average BMI of 49.2 +/- 8.8 kg/m2 and no previous history of heart disease were evaluated through transthoracic echocardiography., Results: Enlarged left chambers were observed in 42.9% of the sample, diastolic dysfunction in 54.6% and left ventricular hypertrophy in 82.1%, of which 50% of the cases presented the geometric pattern of eccentric hypertrophy. Indexation of left ventricular mass to height resulted in a significantly higher number of diagnoses for hypertrophy than indexation to body surface area (p = 0.0053), demonstrating that this index is more appropriate to determine ventricular hypertrophy in obese people. Correlations between left ventricular hypertrophy with obesity duration and pressure levels were positive as well as correlations between body mass index and diastolic dysfunction indicators., Conclusion: This study demonstrated that echocardiograms performed on asymptomatic severely obese patients can detect alterations in the cardiac structure that are common in cases of obesity cardiomyopathy and can be associated with the development of heart failure, arrhythmias and sudden death, enabling the identification of patients with greater cardiovascular risk [corrected]

Objective: To estimate the absolute risk of the public transportation drivers in the city of Teresina, Piauí, to develop coronary heart disease over the course of ten years based on the Framingham risk score., Methods: An observational, descriptive, cross-sectional study using the Framingham score was conducted with 107 public transportation drivers in the city of Teresina, Piauí, to assess level of risk and its association with the Framingham predictors that include: age, total cholesterol, HDL cholesterol, systolic blood pressure, diastolic blood pressure, diabetes mellitus and smoking. The significance test used was Chi2. The prevalence rate was used as the association measurement., Results: Mean risk was 5% and the greatest majority of the participants were situated in the low risk category (85.05%). Mean values for the variables were: 42 years of age, total cholesterol 200 mg%, HDL cholesterol 49 mg%, systolic blood pressure 130 mmHg and diastolic blood pressure 85 mmHg. The associations between diabetes mellitus, smoking and HDL cholesterol with level of risk were not statistically significant; however other variables had a great influence on the level of risk obtained., Conclusion: The mean absolute risk estimate for the public transportation drivers in the city of Teresina to develop coronary heart disease over the next ten years based on the Framingham score is low. The majority of the participants in the study (85.05%) were situated in the low risk category, that is, with a relative risk less than or equal to 10%.

Objective: Compare the therapeutic response of symptomatic, hypertensive patients to symptomatic medication or anti-hypertensive drugs at the Emergency Unit., Methods: A randomized, blind clinical trial involving 100 (one hundred) patients assisted at the Cardiology Emergency Unit at Oswaldo Cruz University Hospital (HUOC). All patients reported symptoms associated to systolic pressure (SBP) between 180 and 200 mmHg and/or diastolic pressure (DBP) between 110 and 120 mmHg. Patients were randomized for treatment with symptomatic (dipirone or diazepan) or anti-hipertensive drug (captopril). Those reporting any associated clinical condition and in need of immediate treatment at the Emergency Unit were excluded from the study. Patients reporting no symptoms, and systolic pressure reduced to levels under 180 mmHg and diastolic pressure under 110 mmHg after the 90-minute period were considered as having met discharge criteria., Results: Mean age of population studied was 54.4 years old, most commonly females. Patients were chronic hypertensive, on irregular pharmacological treatment, with low compliance to non-pharmacologic actions, and classified as overweight and obese grade I. Headache, type D (non-angina) chest pain, and dyspnea were the most frequent complaints. The number of patients treated with symptomatic drug who reached discharge criteria was similar to that of patients treated with anti-hypertensive (p=0.165). No association was found between previous high blood pressure (HBP) diagnosis (p=0.192), pharmacological treatment (p=0.687), and non-pharmacological treatment and discharge criteria., Conclusion: Blood pressure (BP) was reduced below levels for discharge criteria for a (non-significant) higher rate of patients treated with symptomatic drug, who were turned into asymptomatic after the observation period.

Objective: To measure the serum levels of brain natriuretic peptide (BNP) in patients with chronic chagasic heart disease and in individuals with positive serology for Chagas' disease and no heart impairment, and to correlate the serum BNP levels with the degree of cardiac impairment, cardiac dimensions, presence of a pacemaker, and ejection fraction., Methods: Serum BNP concentrations were determined by use of the Triage-BNP Test produced by BIOSITE. Serum BNP was assessed in 25 patients from the Chagas' disease outpatient clinic of the Hospital Universitario Oswaldo Cruz, who were divided into 2 groups as follows: 1) G1--comprising 13 asymptomatic patients with positive serology for Chagas' disease and no heart disease detectable on electrocardiography, chest X-ray, and echocardiography; and 2) G2--comprising 12 patients with Chagas' disease and heart impairment., Results: Significantly more elevated BNP levels were detected in the chagasic patients with cardiac impairment: (G1=4.4 +/-4.4 pg/ml, G2=293.0+/-460.2 pg/ml); (P<0.01). In the 2 groups, the serum levels of BNP correlated neither with age nor with sex. The levels were directly proportional to functional class and cardiac area on chest X-ray. Although a trend towards an increment in systolic function impairment was observed, no linear correlation with the ejection fraction on echocardiography occurred. The presence of definitive pacemaker and electrocardiographic alterations did not change the serum BNP levels., Conclusion: Asymptomatic individuals with a positive serology for Chagas' disease and no evidence of ventricular dysfunction have serum BNP levels similar to those of the general population.

Objective: Evaluation of inter and intraobserver reproducibility of by the visual method interpretation of cineangiogram in a clinically based context., Methods: Five interventional cardiologists analyzed 11 segments of 8 coronary cineangiograms at a two month apart sessions. The percent luminal reduction by the lesions were analyzed by two different classifications: in one (A) the lesions were graded in 0% = absent, 1-50% = mild, 51 - 69 = moderate, and > or = 70% = severe; the other classification (B) was a dichotomic one : <70% = nonsignificant and > or = 70%=significant lesions. The agreement were measured by the kappa (k) index., Results: Interobserver agreement was moderate for classification A (1st measurement, k = 0.36 - 0.63, k m = 0.49; 2nd measurement, k = 0.39-0.68, k m = 0.52) and good for classification B (1st measurement, k = 0.55-0.73, k m = 0.63; 2nd measurement, k = 0.37-0.82, k m = 0.61). Intraobserver levels of agreement were k = 0.57-0.95 for classification A and 0.62-1.0 for classification B., Conclusion: The higher level of reproducibility obtained by adopting the dichotomous criteria usually considered for ischemic limits demonstrates that in the present clinical context, the reliability of the simple visual method is adequate for the identification of patients with clinically significant lesions and candidates for myocardial revascularization procedures.

Evidences of a possible association between endomyocardial fibrosis and schistosomiasis have been recently investigated. We describe the finding of cardiac schistosomal granulomas in a 14 year-old-girl presenting symptoms and signals of right side endomyocardial fibrosis. Refractory ascistis and progressive atrioventricular block were observed during follow-up. Endomyocardial biopsy and post mortem specimens showed inflammatory infiltrates, schistosomal granuloma and fibrosis.

A 2-year-old boy who presented with unrelated recurrent respiratory infections was found to have an enlarged cardiac silhouette on his chest roentgenogram. Clinical evaluation, echocardiography and cardiac cineangiograms failed to provide an accurate diagnosis. A left ventricular tumor was identified by exploratory thoracotomy and successful excision of an intramural fibroma of the left ventricle subsequently accomplished.

Endomyocardial fibrosis (EMF) is a severe restrictive cardiomyopathy characterized by the formation of fibrous tissue on the endocardium and to a lesser extent in the myocardium of one or both ventricles. The disease results in endocardial rigidity, atrioventricular valve dysfunction and progressive obliteration of the ventricular cavity. The clinical and pathological findings of EMF have been well established and definitive diagnosis can be made by selective cineangiocardiography. However, there are few reports concerning the phonomechanocardiographic (PMCG) patterns in this condition. In this paper we describe the PMCG findings in 12 patients with EMF which is now recognized with increasing frequency in the Northeast of Brazil.

This report describes the case of a 19-month-old boy in whom paraplegia developed spontaneously 2 days after a technically uncomplicated coarctation of the aorta repair.