Solid-State Fermentation as Green Technology to Improve the Use of Plant Feedstuffs as Ingredients in Diets for European Sea Bass (Dicentrarchus labrax) Juveniles.

This study aimed to evaluate the utilization by juvenile European sea bass of a SSFed PF mixture with Aspergillus niger CECT 2088. A 22-day digestibility and a 50-day growth trial were performed testing four diets, including 20 or 40% of an unfermented or SSFed PF mixture (rapeseed, soybean, rice bran, and sunflower seed meals, 25% each). SSF of the PF added cellulase and ß-glucosidase activity to the diets. Mycotoxin contamination was not detected in any of the experimental diets except for residual levels of zearalenone and deoxynivalenol (100 and 600 times lower than that established by the European Commission Recommendation-2006/576/EC). In diets including 20% PF, SSF did not affect growth but increased apparent digestibility coefficients of protein and energy, feed efficiency, and protein efficiency ratio. On the contrary, in diets including 40% PF, SSF decreased growth performance, feed intake, feed and protein efficiency, and diet digestibility. SSF decreased the intestinal amylase activity in the 40% SSFed diet, while total alkaline proteases decreased in the 20% and 40% SSFed diets. Hepatic amino acid catabolic enzyme activity was not modulated by SSF, and plasma total protein, cholesterol, and triglyceride levels were similar among dietary treatments. In conclusion, dietary inclusion of moderate levels of the SSFed PF, up to 20%, improves the overall feed utilization efficiency without negatively impacting European sea bass growth performance. The replacement of PF with the SSFed PF mixture may contribute to reducing the environmental footprint of aquaculture production.

Enrichment of a Plant Feedstuff Mixture's Nutritional Value through Solid-State Fermentation.

Plant feedstuffs are the main ingredients of animal feed. Owing to food-feed competition, increasing the utilization efficiency of these feedstuffs is important for animal nutrition. This can be achieved via solid-state fermentation (SSF). SSF of a plant feedstuff mixture (PFM) (25% rapeseed meal, soybean meal, rice bran, and sunflower meal) by three fungi (Aspergillus ibericus MUM 03.29, Aspergillus niger CECT 2088, and Aspergillus niger CECT 2915) resulted in an increase in protein content by 5%, irrespective of fungi, a reduction in cellulose content by 9 to 11%, and of hemicellulose content by 21 to 34%, relative to unfermented PFM. Enzyme production was measured: the highest cellulase (123.7 U/g), xylanase (431.8 U/g), and beta-glucosidase (117.9 U/g) activity were achieved with A. niger CECT 2088. Principal component analysis showed a positive correlation between all fermented PFMs and enzyme production, protein content, digestibility, and fiber reduction. Bioprocessing of the PFM by SSF increased its nutritional value and digestibility, making it more appealing for animal feeds.

SERS-active substrates using DVD-R coated in silver thin films: A preliminary study for detection of commercial glyphosate.

Glyphosate (GLP) is the herbicide with the highest level of global commercialization and historical use. Even though numerous studies have found this substance to be harmless, current research demonstrates that GLP might affect human health. For this reason, researcher efforts are concentrating on alternatives for analytical quantification, such as Surface Enhanced Raman Spectroscopy (SERS). In this work, a DVD-R@AgNPs SERS substrate was produced by the Cathodic Cage Plasma Deposition (CCPD) technique, which allowed a thin film layer deposition of silver nanoparticles (AgNPs) on the PC grating structure from Digital Video/Versatile Disc Recordable (DVD-R). Scanning Electron Microscopy with energy-dispersive X-ray spectroscopy was used to characterize the substrate and chemical changes on the surface after AgNPs deposition. The DVD-R@AgNPs substrate was used to detect standard crystal violet (CV), GLP, and RoundupTM GLP (GLP-RU) using Raman Spectroscopy. The CV was used as a control sample for SERS measurement, allowing the calculation of the substrate enhancement factor, which was in the order of âˆ¼ 105. To evaluate the efficiency of the SERS substrate, the limit of detection was calculated and showed values of âˆ¼ 10-10 mol/L for CV, 10-7 and 10-8 mol/L for GLP, and 10-6 mol/L for GLP-RU. Thus, the DVD-R@AgNPs SERS sensor is a low-cost substrate that analyzes traces of pesticides such as commercial GLP, demonstrating high SERS sensitivities and many applications.

Scratch and Wear Behaviour of Co-Cr-Mo Alloy in Ringer's Lactate Solution.

Cobalt-chromium-molybdenum (Co-Cr-Mo) alloy is a material recommended for biomedical implants; however, to be suitable for this application, it should have good tribological properties, which are related to grain size. This paper investigates the tribological behaviour of a Co-Cr-Mo alloy produced using investment casting, together with electromagnetic stirring, to reduce its grain size. The samples were subjected to wear and scratch tests in simulated body fluid (Ringer's lactate solution). Since a reduction in grain size can influence the behaviour of the material, in terms of resistance and tribological response, four samples with different grain sizes were produced for use in our investigation of the behaviour of the alloy, in which we considered the friction coefficient, wear, and scratch resistance. The experiments were performed using a tribometer, with mean values for the friction coefficient, normal load, and tangential force acquired and recorded by the software. Spheres of Ti-6Al-4V and 316L steel were used as counterface materials. In addition, to elucidate the influence of grain size on the mechanical properties of the alloy, observations were conducted via scanning electron microscopy (SEM) with electron backscatter diffraction (EBSD). The results showed changes in the structure, with a reduction in grain size from 5.51 to 0.79 mm. Using both spheres, the best results for the friction coefficient and wear volume corresponded to the sample with the smallest grain size of 0.79 mm. The friction coefficients obtained were 0.37 and 0.45, using the Ti-6Al-4V and 316L spheres, respectively. These results confirm that the best surface finish for Co-Cr-Mo alloy used as a biomedical implant is one with a smaller grain size, since this results in a lower friction coefficient and low wear.

Sputtering of micro-carbon-silver film (µC-Ag) for endotracheal tubes to mitigate respiratory infections.

Polyurethane (PU) substrates are biocompatible materials widely used to manufacture endotracheal tubes. However, in common with other biomedical materials, they are liable to the formation of microbial films. The occurrence of pneumonia in intubated patients treated at intensive care units often takes the form of ventilator-associated pneumonia (VAP). The issue relates to the translocation of pathogenic microorganisms that colonize the oropharyngeal mucosa, dental plaque, stomach, and sinuses. New protective materials can provide a more effective therapeutic approach to mitigating bacterial films. This work concerns microcrystalline carbon film containing dispersed silver nanoparticles (µC-Ag) deposited on PU substrates using a physical vapor deposition sputtering process. For the first time, carbon paper was used to produce a carbon target with holes exposing a silver disk positioned under the carbon paper, forming a single target for use in the sputtering system. The silver nanoparticles were well distributed in the carbon film. The adherence characteristics of the µC-Ag film were evaluated using a tape test technique, and electron dispersive x-ray mapping was performed to analyze the residual particles after the tape test. The microbicidal effect of the thin film was also investigated using speciesS. aureus, a pathogenic microorganism responsible for most infections of the lower respiratory tract involving VAP and ventilator-associated tracheobronchitis (VAT). The results demonstrated that µC-Ag films on PU substrates are promising materials for mitigating pathogenic microorganisms on endotracheal tubes.

Solid-State Fermentation of Plant Feedstuff Mixture Affected the Physiological Responses of European Seabass (Dicentrarchus labrax) Reared at Different Temperatures and Subjected to Salinity Oscillation.

This study aimed to evaluate the effects of dietary inclusion of plant feedstuff mixture (PFM) pre-treated by solid-state fermentation (SSF) on the physiological responses of European seabass. For that purpose, two diets were formulated to contain: 20% inclusion level of non-fermented plant ingredients mixture (20Mix) and 20Mix fermented by A. niger in SSF conditions (20Mix-SSF). Seabass juveniles (initial body weight: 20.9 ± 3.3 g) were fed the experimental diets, reared at two different temperatures (21 and 26 °C) and subjected to weekly salinity oscillations for six weeks. Growth performance, digestive enzyme activities, humoral immune parameters, and oxidative stress indicators were evaluated. A reduction in weight gain, feed intake, and thermal growth coefficient was observed in fish fed the fermented diet (20Mix-SSF). Salinity oscillation led to an increase in weight gain, feed efficiency, daily growth index, and thermal growth coefficient, regardless of dietary treatment. Higher rearing temperatures also increased daily growth index. No dietary effect was observed on digestive enzymes activities, whereas rearing temperature and salinity oscillation modulated digestive enzyme activities. Oxidative stress responses were significantly affected by experimental diets, temperature, and salinity conditions. Catalase and glutathione peroxidase activities showed an interactive effect. Fish reared at 21 °C showed higher enzymatic activity when fed the 20Mix-SSF. Conversely, fish reared at 26 °C showed higher GPx activity when fed the 20Mix diet. Fish reared at 26 °C showed reduced peroxidase and lysozyme activities, while salinity fluctuation led to increased lysozyme activity and decreased ACH50 activity. ACH50 activity increased in fish fed the 20Mix-SSF. Overall, the dietary inclusion of PFM fermented by A. niger was unable to mitigate the impact of environmental stress on physiological performance in European seabass. In fact, fermented feed caused an inhibition of growth performances and an alteration of some physiological stress indicators.

Peripheral blood stem cells collection by apheresis in very low-weight children with malignant diseases-A single center experience.

BACKGROUND: Hematopoietic stem cell transplantation is used in the treatment of children with malignant and non-malignant diseases. However, apheresis of peripheral blood stem cells (PBSC) represents a challenge in children below 10 kg. METHODS: A retrospective trial was conducted in the Cellular Therapy Department of Portuguese Oncology Institute of Porto. INCLUSION CRITERIA: children with body weight inferior to 10 kg who underwent autologous PBSC apheresis until 2021. Demographic and clinical data were collected and our institutional protocol was described. COBE Spectra apheresis system (TerumoBCT, Lakewood, Colorado) until 2012 and then Spectra Optia (TerumoBCT) were used. RESULTS: Sixteen leukocytaphereses were performed in 13 patients-nine females (69%). Mean age and weight were 13.31 months (±5.26) and 8.31 kg (±1.17), respectively. The initial CD34+ cells/µL in peripheral blood was 70.8 (±61.9). A central venous catheter (CVC) was exclusively used in all but one patient, in whom a peripheral vein was also required. In 10 procedures, both heparin and anticoagulant citrate dextrose solution-formula A (ACD-A) were used; in the remaining ones, only ACD-A was employed. The median duration of each procedure was 168 minutes (±45) and 2.96 blood volumes (±0.31) were processed. Median CD34+ cells yield per leukocytapheresis was 6.52 × 106 /kg (±9.87 × 106 ). CD34+ cell extraction rates were not significantly different between the two apheresis systems. Platelet and magnesium levels were significantly lower after collection (P < .001 and P = .009, respectively). CONCLUSIONS: Although recommendations are lacking, we have successfully and safely performed leukocytaphereses in children with body weight below 10 kg. The authors believe that a permanent and dynamic comprehensive evaluation of each child is paramount for attaining good results.

Prevalence of hepatitis B virus and immunity status among healthcare workers in Beira City, Mozambique.

BACKGROUND: Hepatitis B virus (HBV) infection can be prevented by vaccination. Exposure to blood or body fluids poses a high risk of transmission of HBV in health care workers (HCWs). This study aimed to determine the prevalence of markers of exposure, susceptibility, and protection to HBV infection in HCWs in Beira, Mozambique. METHODS: A cross-sectional study was conducted between June and August 2020 in Beira City, Mozambique, in HCWs based on self-administered questionnaires and blood samples. Plasma samples were tested for HBV surface antigen (HBsAg), antibodies to HBV core antigen (anti-HBc), antibodies to HBsAg (anti-HBs) and HBV viral load (HBV DNA). RESULTS: Most of the 315 HCWs in the study were nurses (125; 39.7%). Of the HCWs, 5.1% (16; 95% Confidence Interval (CI): 2.9 to 8.1%) were infected by HBV (HBsAg and/or HBV DNA positive). Occult HBV infection (OBI) (HBV DNA positive and HBsAg negative) was found in 0.3% (1; 95% CI: 0.0 to 1.8%) of participants; 27.9% (88; 95% CI: 23.1 to 33.2%) were susceptible (negative for all markers), 6.3% (20; 95% CI: 3.9 to 9.6) were immune due to natural infection (anti-HBs and anti-HBc positive only), while 60% (189; 95% CI: 54.4 to 65.5) were immune due to vaccination (anti-HBs positive only). CONCLUSION: This study showed a high intermediate prevalence of chronic hepatitis B among healthcare workers in Beira City, Central Mozambique, and one-third of healthcare workers were susceptible to HBV infection. There is a need to implement a national hepatitis B screening and vaccination strategy among healthcare workers in Mozambique.

High-Tribological-Performance Polymer Nanocomposites: An Approach Based on the Superlubricity State of the Graphene Oxide Agglomerates.

Here, nanocomposites of high-molecular-weight polyethylene (HMWPE) and HMWPE-UHMWPE (80/20 wt.%) containing a low amount of multilayer graphene oxide (mGO) (≤0.1 wt.%) were produced via twin-screw extrusion to produce materials with a higher tribological performance than UHMWPE. Due to the high viscosity of both polymers, the nanocomposites presented a significant concentration of agglomerates. However, the mechanical (tensile) and tribological (volumetric loss) performances of the nanocomposites were superior to those of UHMWPE. The morphology of the nanocomposites was investigated using differential scanning calorimetry (DSC), microtomography, and transmission electron microscopy (TEM). The explanation for these results is based on the superlubricity phenomenon of mGO agglomerates. It was also shown that the well-exfoliated mGO also contained in the nanocomposite was of fundamental importance as a mechanical reinforcement for the polymer. Even with a high concentration of agglomerates, the nanocomposites displayed tribological properties superior to UHMWPE's (wear resistance up to 27% higher and friction coefficient up to 57% lower). Therefore, this manuscript brings a new exception to the rule, showing that agglomerates can act in a beneficial way to the mechanical properties of polymers, as long as the superlubricity phenomenon is present in the agglomerates contained in the polymer.

HIV-exposed infant follow-up in Mozambique: formative research findings for the design of a cluster randomized controlled trial to improve testing and ART initiation.

BACKGROUND: Early infant diagnosis (EID) of HIV-exposed and initiation of HIV-positive infants on anti-retroviral therapy (ART) requires a well-coordinated cascade of care. Loss-to-follow-up (LTFU) can occur at multiple steps and effective EID is impeded by human resource constraints, difficulty with patient tracking, and long waiting periods. The objective of this research was to conduct formative research to guide the development of an intervention to improve the pediatric HIV care cascade in central Mozambique. The study was conducted in Manica and Sofala Provinces where the adult HIV burden is higher than the national average. The research focused on 3 large clinics in each province, along the highly populated Beira corridor. METHODS: The research was conducted in 2014 over 3 months at six facilities and consisted of 1) patient flow mapping and collection of health systems data from postpartum, child-at-risk, and ART service registries, 2) measurement of clinic waiting times, and 3) patient and health worker focus groups. RESULTS: HIV testing and ART initiation coverage for mothers tends to be high, but EID and pediatric ART initiation are hampered by lack of patient tracking, long waiting times, and inadequate counseling to navigate the care cascade. About 76% of HIV-positive infants were LTFU and did not initiate ART. CONCLUSIONS: Effective interventions to reduce LTFU in EID and improve pediatric ART initiation should focus on patient tracking, active follow-up of defaulting patients, reduction in EID turn-around times for PCR results, and initiation of ART by nurses in child-at-risk services. TRIAL REGISTRATION: Retrospectively registered, ISRCTN67747315, July 24, 2019.

Unprecedented Fe delivery from the Congo River margin to the South Atlantic Gyre.

Rivers are a major supplier of particulate and dissolved material to the ocean, but their role as sources of bio-essential dissolved iron (dFe) is thought to be limited due to rapid, efficient Fe removal during estuarine mixing. Here, we use trace element and radium isotope data to show that the influence of the Congo River margin on surface Fe concentrations is evident over 1000 km from the Congo outflow. Due to an unusual combination of high Fe input into the Congo-shelf-zone and rapid lateral transport, the Congo plume constitutes an exceptionally large offshore dFe flux of 6.8 ± 2.3 × 108 mol year-1. This corresponds to 40 ± 15% of atmospheric dFe input into the South Atlantic Ocean and makes a higher contribution to offshore Fe availability than any other river globally. The Congo River therefore contributes significantly to relieving Fe limitation of phytoplankton growth across much of the South Atlantic.

Effect of DLC Films with and without Silver Nanoparticles Deposited On Titanium Alloy.

Diamond-like carbon (DLC) film is a biocompatible hard coating material that can prevent the leaching of metal ions. This study evaluates the structural characteristics of DLC, with and without silver nanoparticles, deposited by plasma (PECVD) on titanium alloy (Ti-6Al-4V) and bone formation in contact with DLC films. Sixty Ti-6Al-4V samples were used divided in: uncoated, coated with DLC and coated with DLC-Ag. After structural characterization, samples were fixed bilaterally at the rabbit's mandible. After 15 and 90 days, samples were characterized again and bone formation in the area was analyzed by histomorphometry. Statistical analysis was performed by two-way ANOVA. Both the DLC and DLC-Ag films were firmly adhered and showed a high electrical resistance without significant changes in the Raman spectrum after in vivo integration. After 15 days, there were immature bone trabeculae in the interface and partially covering the surface. After 90 days, mature bone filled the interface and coved the surface. There was no statistically significant difference among the three groups in both periods. In conclusion, osseointegration with DLC, DLC-Ag and uncoated Ti-6Al-4V is similar. However, DLC and DLC-Ag coverings have the advantage of electrical insulation and can presumably control bacterial activity and ion leaching.

Effect of dlc films with and without silver nanoparticles deposited on titanium alloy

Abstract Diamond-like carbon (DLC) film is a biocompatible hard coating material that can prevent the leaching of metal ions. This study evaluates the structural characteristics of DLC, with and without silver nanoparticles, deposited by plasma (PECVD) on titanium alloy (Ti-6Al-4V) and bone formation in contact with DLC films. Sixty Ti-6Al-4V samples were used divided in: uncoated, coated with DLC and coated with DLC-Ag. After structural characterization, samples were fixed bilaterally at the rabbit's mandible. After 15 and 90 days, samples were characterized again and bone formation in the area was analyzed by histomorphometry. Statistical analysis was performed by two-way ANOVA. Both the DLC and DLC-Ag films were firmly adhered and showed a high electrical resistance without significant changes in the Raman spectrum after in vivo integration. After 15 days, there were immature bone trabeculae in the interface and partially covering the surface. After 90 days, mature bone filled the interface and coved the surface. There was no statistically significant difference among the three groups in both periods. In conclusion, osseointegration with DLC, DLC-Ag and uncoated Ti-6Al-4V is similar. However, DLC and DLC-Ag coverings have the advantage of electrical insulation and can presumably control bacterial activity and ion leaching.

Resumo O filme de carbono semelhante a diamante (DLC) é um material de revestimento duro e biocompatível que pode impedir a corrosão com liberação de íons metálicos. Este estudo avaliou as características estruturais do filme de DLC, com e sem nanopartículas de prata (Ag), depositadas por plasma (PECVD) em liga de titânio (Ti-6Al-4V) e formação óssea em contato com filmes de DLC. Foram utilizadas 60 amostras de Ti-6Al-4V divididas em: não recobertas, recobertas com DLC e recobertas com DLC-Ag. Após caracterização estrutural, amostras foram fixadas bilateralmente na mandíbula de coelhos. Após 15 e 90 dias, as amostras foram novamente caracterizadas e a formação óssea na área foi analisada por histomorfometria. A análise estatística foi realizada por ANOVA dois fatores. Ambos os filmes DLC e DLC-Ag foram firmemente aderidos e mostraram uma alta resistência elétrica sem alterações significativas no espectro Raman após a osseointegração in vivo. Após 15 dias, havia trabéculas ósseas imaturas na interface e cobrindo parcialmente a superfície. Após 90 dias, o osso maduro preencheu a interface e a superfície. Não houve diferença estatisticamente significante entre os três grupos nos dois períodos. Em conclusão, a osseointegração com DLC, DLC-Ag e Ti-6Al-4V não revestido é similar. No entanto, os revestimentos DLC e DLC-Ag têm a vantagem do isolamento elétrico e podem presumivelmente controlar a atividade bacteriana e a corrosão com liberação de íons.

Flexible camphor diamond-like carbon coating on polyurethane to prevent Candida albicans biofilm growth.

Camphor was incorporated in diamond-like carbon (DLC) films to prevent the Candida albicans yeasts fouling on polyurethane substrates, which is a material commonly used for catheter manufacturing. The camphor:DLC and DLC film for this investigation was produced by plasma enhanced chemical vapor deposition (PECVD), using an apparatus based on the flash evaporation of organic liquid (hexane) containing diluted camphor for camphor:DLC and hexane/methane, mixture for DLC films. The film was deposited at a low temperature of less than 25°C. We obtained very adherent camphor:DLC and DLC films that accompanied the substrate flexibility without delamination. The adherence of camphor:DLC and DLC films on polyurethane segments were evaluated by scratching test and bending polyurethane segments at 180°. The polyurethane samples, with and without camphor:DLC and DLC films were characterized by Raman spectroscopy, scanning electron microscopy, atomic force microscopy, and optical profilometry. Candida albicans biofilm formation on polyurethane, with and without camphor:DLC and DLC, was assessed. The camphor:DLC and DLC films reduced the biofilm growth by 99.0% and 91.0% of Candida albicans, respectively, compared to bare polyurethane. These results open the doors to studies of functionalized DLC coatings with biofilm inhibition properties used in the production of catheters or other biomedical applications.

Assessment of linkages from HIV testing to enrolment and retention in HIV care in Central Mozambique.

INTRODUCTION: Effectiveness of the rapid expansion of antiretroviral therapy (ART) throughout sub-Saharan Africa is highly dependent on adequate enrolment and retention in HIV care. However, the measurement of both has been challenging in these settings. This study aimed to assess enrolment and retention in HIV care (pre-ART and ART) among HIV-positive adults in Central Mozambique, including identification of barriers and facilitators. METHODS: We assessed linkages to and retention in HIV care using a mixed quantitative and qualitative approach in six districts of Manica and Sofala provinces. We analyzed routine district and health facility monthly reports and HIV care registries from April 2012 to March 2013 and used single imputation and trimmed means to adjust for missing values. In eight health facilities in the same districts and period, we assessed retention in HIV care among 795 randomly selected adult patient charts (15 years and older). We also conducted 25 focus group discussions and 53 in-depth interviews with HIV-positive adults, healthcare providers and community members to identify facilitators and barriers to enrolment and retention in HIV care. RESULTS: Overall, 46% of the monthly HIV testing reports expected at the district level were missing, compared to 6.4% of the pre-ART registry reports. After adjustment for missing values, we estimated that the aggregate numbers of adults registered in pre-ART was 75% of the number of persons tested HIV-positive in the six districts. In the eight health facilities, 40% of the patient charts for adults enrolled in pre-ART and 44% in ART were missing. Of those on ART for whom charts were found, retention in treatment within 90 and 60 days prior to the study team visit was 34 and 25%, respectively. Combining these multiple data sources, the overall estimated retention was 18% in our sample. Individual-level factors were perceived to be key influences to enrolment in HIV care, while health facility and structural-level factors were perceived to be key influences of retention. CONCLUSIONS: Efforts to increase linkages to and retention in HIV care should address individual, health facility, and structural-level factors in Central Mozambique. However, their outcomes cannot be reliably assessed without improving the quality of routine health information systems.

Macrophages adhesion rate on Ti-6Al-4V substrates: polishing and DLC coating effects

Abstract Introduction Various works have shown that diamond-like carbon (DLC) coatings are able to improve the cells adhesion on prosthesis material and also cause protection against the physical wear. On the other hand there are reports about the effect of substrate polishing, in evidence of that roughness can enhance cell adhesion. In order to compare and quantify the joint effects of both factors, i.e, polishing and DLC coating, a commonly prosthesis material, the Ti-6Al-4V alloy, was used as raw material for substrates in our studies of macrophage cell adhesion rate on rough and polished samples, coated and uncoated with DLC. Methods The films were produced by PECVD technique on Ti-6Al-4V substrates and characterized by optical profilometry, scanning electron microscopy and Raman spectroscopy. The amount of cells was measured by particle analysis in IMAGE J software. Cytotoxicity tests were also carried out to infer the biocompatibility of the samples. Results The results showed that higher the surface roughness of the alloy, higher are the cells fixing on the samples surface, moreover group of samples with DLC favored the cell adhesion more than their respective uncoated groups. The cytotoxity tests confirmed that all samples were biocompatible independently of being polished or coated with DLC. Conclusion From the observed results, it was found that the rougher substrate coated with DLC showed a higher cell adhesion than the polished samples, either coated or uncoated with the film. It is concluded that the roughness of the Ti-6Al-4V alloy and the DLC coating act complementary to enhance cell adhesion.

Poor-fit indexes of Kupperman index: a psychometric analysis based on item response theory.

OBJECTIVE: This study aims to test the construct validity of the 11 items of the Kupperman index (KI), which has been pioneering in its attempt to quantify climacteric symptoms. METHODS: Unidimensional confirmatory factor analysis of the 11 graded items (hot flashes, paresthesia, insomnia, nervousness, melancholia, vertigo, weakness, arthralgia or myalgia, headache, palpitations, and formication), using a four-point scale (0, none; 4, severe), was used to evaluate the KI in a sample consisting of 84 women with a mean (SD) age of 54.34 (4.00) years who have been in menopause for a mean (SD) of 4.36 (2.53) years. RESULTS: The KI returned poor results on unidimensional model testing (root-mean-square error adjustment, 0.109; 90% CI, 0.075-0.142; comparative fit index, 0.871; Tucker Lewis index, 0.838; weighted root-mean-square residual, 0.971; χ(2)(44) = 87.599; P < 0.001), indicating that the set of items does not properly evaluate the underlying phenomena (climacteric symptoms). CONCLUSIONS: Our study verifies the poor fit of the KI and provides psychometric evidence that KI items warrant revision and/or that the concept underlying climacteric symptoms should be revisited.

Avaliação econômica da rubéola e de estratégia de controle em situação de surto em Fortaleza (Ceará), Brasil / Economic evaluation of rubella and control strategies during an outbreak in Fortaleza (Ceará), Brazil

Em 2007, o país vivenciou uma epidemia de rubéola, com 8.683 casos confirmados. Realizou-se uma avaliação econômica da rubéola e de uma estratégia de controle em surto ocorrido em Fortaleza em 2007. Dois estudos de avaliação econômica foram conduzidos. O primeiro foi uma análise de custo-enfermidade dos casos confirmados, e o segundo, uma análise de custo-efetividade entre duas estratégias de intervenção relacionadas à rubéola. Comparou-se o custo-efetividade da vacinação emergencial (i.e., operação limpeza) com o prestar assistência de saúde aos casos confirmados de rubéola. O estudo considerou as perspectivas econômicas do governo brasileiro por intermédio do Ministério da Saúde e também da sociedade, em que custos diretos e indiretos da prevenção e do tratamento da rubéola foram incluídos nas análises. O custo-enfermidade total dos 21 casos de rubéola foi de R$ 2.008,54 (médio R$ 95,65) e R$ 14.009,20 (médio R$ 667,10), desde as perspectivas do governo e sociedade, respectivamente. Os valores estimados para o custo-enfermidade total no país foram de aproximadamente R$ 831 mil para o governo e R$ 5.8 milhões para a sociedade. A análise de custo-efetividade incremental mostrou que a operação limpeza foi considerada dominante sobre a assistência aos casos de rubéola, produzindo maiores benefícios (i.e., redução dos casos de rubéola) a um menor custo. Esses resultados mostraram-se robustos em uma série de análises de sensibilidade. A análise de custo-efetividade nos mostrou que a alternativa de vacinação emergencial apresentou uma melhor relação de custo-efetividade e resultou em uma economia de recursos em ambas as perspectivas adotadas.

Evaluation of melatonin on the precocious puberty: a pilot study.

OBJECTIVE: To evaluate the effect of 6-sulphatoxymelatonin on the sleep quality of girls with precocious puberty. STUDY DESIGN: Ninety-nine girls were divided into three groups: GI, precocious puberty; GII, normal prepubescent; GIII, normal puberty. Questionnaires containing demographic and clinical data were applied. Blood was collected for hormonal evaluation for 6-sulphatoxymelatonin. The modified Rush Sleep Diary was used. RESULTS: The levels of 6-sulphatoxymelatonin were highest in the group without pubertal development (75.23 ± 10.84 ng/ml), second highest in the group with normal puberty (45.66 ± 3.87 ng/ml, p < 0.001) and lowest in the group with true precocious puberty (37.04 ± 5.47 ng/ml). The amount of day sleep was greater in the group without pubertal development compared to other groups. CONCLUSION: Despite the sleep data, melatonin may be involved in the precocious puberty process.

Assistência domiciliar a idosos: fatores associados, características do acesso e do cuidado / Asistencia domiciliaria a ancianos: factores asociados, características del acceso y del cuidado / Home health care for the elderly: associated factors and characteristics of access and health care

OBJETIVO: Avaliar fatores associados à assistência domiciliar recebida pela população idosa e suas características, segundo modelos de atenção Estratégia Saúde da Família e modelo tradicional. MÉTODOS: Estudo transversal de base populacional, com amostra representativa de 1.593 indivíduos com 60 anos ou mais, residentes na região urbana de Bagé, RS, em 2008. A amostragem foi realizada em múltiplos estágios. Os dados foram coletados em entrevistas individuais. Foram analisadas as formas de acesso aos serviços, participação dos profissionais, satisfação e situação de saúde dos usuários após o atendimento. Foi utilizado modelo de regressão de Poisson para estimar as razões de prevalência bruta e ajustada, os respectivos intervalos com 95 por cento de confiança e p-valor (teste de Wald). RESULTADOS: Assistência domiciliar foi estatisticamente associada à história prévia de acidente vascular cerebral, à presença de sinais de demência e à incapacidade para as atividades da vida diária. A família foi responsável por 75 por cento das solicitações de cuidado. Nas áreas da atenção tradicional, os médicos responderam pela maior promoção de cuidados, enquanto nas áreas da Estratégia Saúde da Família destacou-se a participação da equipe de enfermagem. Aproximadamente 78 por cento das solicitações foram atendidas em até 24 horas e 95 por cento dos usuários avaliaram positivamente o cuidado recebido. Dois terços dos idosos referiram melhora nas condições de saúde. CONCLUSÕES: As variáveis associadas ao recebimento de assistência domiciliar reiteram os indicadores de fragilidade destacados na Política Nacional de Saúde da Pessoa Idosa e fortalecem a importância da estratégia na promoção da eqüidade no cuidado dos idosos. A avaliação positiva e o impacto na situação de saúde afirmam o domicílio como ambiente terapêutico.

OBJETIVO: Evaluar los factores asociados a la asistencia domiciliaria recibida por la población anciana y sus características, según modelos de atención Estrategia Salud de la Familia y modelo tradicional. MÉTODOS: Estudio transversal de base poblacional, con muestra representativa de 1.593 individuos con 60 años o más, residentes en la región urbana de Bagé, Sur de Brasil, en 2008. El muestreo fue realizado en múltiples fases. Los datos fueron colectados en entrevistas individuales. Se analizaron las formas de acceso a los servicios, participación de los profesionales, satisfacción y situación de salud de los usuarios posterior a la atención. Fue utilizado modelo de regresión de Poisson para estimar las tasas de prevalencia bruta y ajustada, los respectivos intervalos con 95% de confianza y p-valor (prueba de Wald). RESULTADOS: Asistencia domiciliaria fue estadísticamente asociada a la historia previa de enfermedad vascular cerebral, a la presencia de señales de demencia y a la incapacidad para las actividades de la vida diaria. La familia fue responsable por 75% de las solicitudes de cuidado. En las áreas de la atención tradicional, los médicos respondieron por la mayor promoción de cuidados, mientras que en las áreas de la Estrategia Salud de la Familia, se destacó la participación del equipo de enfermeras. Aproximadamente 78% de las solicitudes fueron atendidas en hasta 24 horas y 95% de los usuarios evaluaron positivamente el cuidado recibido. Dos tercios de los ancianos refirieron mejoría en las condiciones de salud. CONCLUSIONES: Las variables asociadas al recibimiento de asistencia domiciliaria reiteran los indicadores de fragilidad destacados en la Política Nacional de Salud de la Persona Anciana y fortalece la importancia de la estrategia en la promoción de la equidad en el cuidado de los ancianos. La evaluación positiva y el impacto en la situación de salud refuerzan el domicilio como ambiente terapéu.