Interesting case from Argentina: Kidney transplant recipient with skin lesions-A Latin American perspective.

This is a case of a kidney transplant recipient who presented with skin lesions, low-grade fevers, and pancytopenia 2 months after his transplant.

Arsenic pools in soils under native vegetation on a steatite outcrop in Brazil.

Pristine soils under native vegetation can present high levels of potentially toxic elements when developed from the weathering of some unusual parent materials, especially ultramafic rocks and some metal ores. Here, we used various selective extractions in order to study the partition and potential availability of As in eight soils developed from steatite (a talc-rich rock) on an ultramafic hill in Brazil. Soils varied from shallow Entisols on the summit to Inceptisols and Oxisols on slopes and footslopes, where total As contents (determined by X-ray fluorescence) reached levels as high as 225 mg kg-1, which might raise concerns about their potential agricultural use and occupation. Despite these high values for pristine soils, water- and Mehlich-available As were nil or negligible in all soils, whereas oxalate-extractable As reached a maximum 4.2 mg kg-1, and the highest semi-total (nitric acid digestion) was 9.3 mg kg-1. However, As relative availability (compared to total As) varied widely among soils, with one Inceptisol (with a total 11-19 mg kg-1) reaching 100% of its total As extractable by nitric acid, whereas an Oxisol showed <0.1% in nitric acid extract. Generally, we can conclude that, in soils with the highest total As concentrations, most As is contained within resistant, coarse phases such as primary magnetite, chromite and others, and a minor but still considerable part is bound to secondary Fe oxides. Thus, despite the unusually high As contents for soils under pristine savannic and forest native vegetations, the different As pools assessed here apparently do not raise immediate concerns where ultramafic rocks rich in Fe oxides give rise to soils under tropical climate. However, it is theoretically possible that subsoil saturation and Fe oxide reduction release some As in ground- and surface waters, which deserves further investigation.

Effect of staining layer on roughness after progressive wear of monolithic ceramics.

PURPOSE: The aim of this study was to evaluate staining layer behavior applied to high-translucency zirconia (YZHT), feldspathic ceramics (FD), and zirconia-reinforced lithium silicate (ZLS) surfaces against different antagonists. METHODS AND MATERIALS: Monolithic ceramic discs (n = 120) (ø 12 mm; thickness, 1.2 mm; ISO 6872) were obtained, 30 from YZHT and FD, and 60 from ZLS CAD/CAM blocks (staining layer applied before or after the crystallization procedure). The specimens were divided into 12 subgroups (n = 10) according to the antagonists: steatite, polymer-infiltrated ceramic, or zirconia. Mechanical cycling (1.5 × 104 cycles; 15 N; horizontal displacement, 6 mm; 1.7 Hz) and flexural strength tests (1 mm/min-1000 kg cell) were performed. The differences between final and initial roughnesses (Ra, Rz, and Rsm), the mass loss, and the flexural strength data were individually analyzed by two-way ANOVA and Tukey's test (α = 0.05). RESULTS: The roughnesses of all ceramics did not present a statistically significant difference before wear simulation: Ra (p = 0.3348), Rz (p = 0.5590), and Rsm (p = 0.5330). After the wear simulation, the Ra parameter was not affected by an interaction between ceramic and antagonist (p = 0.595). The Rz and Rsm parameters were affected only by the antagonist pistons (both, p = 0.000). The ceramics used in this study showed statistically significant differences in mass loss after the wear test (p < 0.0001). The additional firing (2 steps) of the ZLS2 led to a higher lost mass quantity. CONCLUSION: All ceramics presented similar initial roughnesses and similar roughnesses after the wear simulation. The zirconia antagonist showed better performance against ceramics with high crystalline content. CLINICAL SIGNIFICANCE: It is clear that restorative materials must be carefully selected by dental practitioners according to indications, properties, and antagonists. The steatite antagonist, that is, an enamel analog, showed better performance against vitreous ceramics, while the zirconia antagonist showed better performance against ceramics with high crystalline content. Wear affects the surface roughnesses of the ceramics. Additional firing for the staining of the zirconia-reinforced lithium silicate ceramic led to a greater loss of mass.

The challenge of ceramic restorations on dark substrate: a case report.

The use of dental ceramics on anterior teeth is associated with predictable and long-lasting esthetic results. However, treatment on darkened substrates is challenging. Various conservative options, including ceramic veneers, are available to change the shape and color of anterior teeth. The aim of this case report is to describe the esthetic rehabilitation of a darkened central incisor in a maxillary anterior region that had irregular gingival contours, multiple composite resin restorations, and unsatisfactory tooth shapes. Harmony was restored through periodontal recontouring surgery, placement of a lithium disilicate crown (consisting of a veneer cemented to a coping) on the darkened central incisor, and placement of lithium disilicate veneers on the other maxillary anterior teeth.

Identification of sex-specific genetic associations in response to opioid analgesics in a White, non-Hispanic cohort from Southeast Minnesota.

The study of sex-specific genetic associations with opioid response may improve the understanding of inter-individual variability in pain treatments. We investigated sex-specific associations between genetic variation and opioid response. We identified participants in the RIGHT Study prescribed codeine, tramadol, hydrocodone, and oxycodone between 01/01/2005 and 12/31/2017. Prescriptions were collapsed into codeine/tramadol and hydrocodone/oxycodone. Outcomes included poor pain control and adverse reactions within six weeks after prescription date. We performed gene-level and single-variant association analyses stratified by sex. We included 7169 non-Hispanic white participants and a total of 1940 common and low-frequency variants (MAF > 0.01). Common variants in MACROD2 (rs76026520), CYP1B1 (rs1056837, rs1056836), and CYP2D6 (rs35742686) were associated with outcomes. At the gene level, FAAH, SCN1A, and TYMS had associations for men and women, and NAT2, CYP3A4, CYP1A2, and SLC22A2 had associations for men only. Our findings highlight the importance of considering sex in association studies on opioid response.

Ectopic autologous transplantation of ovarian tissue as a feasible technique to assess ovarian morphophysiology.

The cryopreservation of murine ovarian tissue and its transplantation can be a promising technique for the preservation of fertility and an alternative for the future reconstitution of scientific valuable strains of mice. Accordingly, the aim of this study was to describe the entire surgical procedure for ovariectomy and dorsal subcutaneous autotransplantation in mice, and also some data about the efficiency of this procedure. Female C57Bl/6J mice (n = 18) were anaesthetised and bilaterally ovariectomized. After surgery, ovaries were autotransplanted in small subcutaneous pouches in the dorsal region of the forelimbs. The animals were inspected daily and, 23 days after transplantation, euthanasia and recovery of ovarian tissues were performed. Postoperative recovery, oestrous cyclicity, and folliculogenesis progression were evaluated. At 23 days after transplantation, the recovery of the ovaries was feasible, all classes (primordial to antral) of follicles were observed. Additionally, satisfactory efficiency rates were obtained, with 100% of anaesthesia survival rate, survival, graft recovery, folliculogenesis progression and oestrous cyclicity. In general, this short article describes ovarian ectopic autologous transplantation as an effective technique for maintaining rodent oogenesis and endocrine ovarian function. Even more broadly, we can still assume that the application of this technique may reduce the number of breeding matrices and experimental animals in the near future.

Effects of cis-9, trans-11 and trans-10, cis-12 conjugated linoleic acid supplementation on maternal reproductive parameters.

Conjugated linoleic acid (CLA) is a mixture of positional isomers of linoleic acid found in ruminant products and meat. The diet supplementing with CLA is an emerging area, requiring studies to elucidate its effects on animals and human reproduction, as well as its side effects. Therefore, the aim of this study was to evaluate the effects of CLA gastric administration, during the pregestational and gestational period in biometric and reproductive parameters, as well as in ovarian morphophysiology. Animals were distributed in three groups: (1) control (n = 10); (2) fish oil (n = 10); and (3) CLA (n = 10), that daily received, by gavage, phosphate-buffered saline, fish oil and CLA, respectively, carried out over 50 days (before mating, mating and pregnancy). There was an increment in the nasoanal distance and Lee index of the CLA and fish oil-treated groups during the first weeks (P > 0.05). CLA administration did not affect the ovarian follicle mobilization (P > 0.05), the number of follicles (P > 0.05) and the integrated density of lipid content of oocytes included in antral follicles (P > 0.05). There was no effect of CLA administration on the litter weight (P > 0.05; F2 and F3), however, an increment (P < 0.05) in the number of pups per litter (F2) was observed. Overall, this study demonstrated the absence of side effects of the CLA gastric administration on mice reproductive performance and suggests that this treatment would transgenerationally enhance fertility in this species.

Correlations Between Medicine Ball Throw With Wheelchair Mobility and Isokinetic Tests in Basketball Para-Athletes.

CONTEXT: A detailed analysis of wheelchair basketball skills in beginner wheelchair basketball players (WBP) can provide practitioners with important indications regarding the selection and prospective development of potential sports talents. A comprehensive WBP evaluation can be very time consuming, mainly during the initial phases of the training processes, which could be a barrier in clinical and practical settings. Moreover, the large number and the turnover of beginner WBP attending rehabilitation centers make the applicability of field and strength tests unfeasible. OBJECTIVE: To verify the relationships between the medicine ball throw (MBT) and wheelchair basketball mobility performance field tests and the shoulder and trunk peak torque in male and female beginner WBP. DESIGN: Cross-sectional study. SETTING: Rehabilitation Hospital Network, Paralympic Program. PARTICIPANTS: Thirty-seven female and male beginner WBP. MAIN OUTCOMES MEASURES: Participants performed wheelchair basketball field tests (speed, agility, strength, and power tests) and the maximum strength test in the isokinetic dynamometer. The outcomes were correlated with the MBT results. RESULTS: The MBT presented significantly very high and perfect correlations with all wheelchair basketball field tests assessed (5-m sprint, 20-m sprint, and zig-zag agility test with and without a ball), and peak torque (R2 ranging from .810 to .995; P ≤ .05) for male and female athletes. CONCLUSIONS: The MBT, a simple and feasible test, can be used for estimating and determining the wheelchair mobility performance of female and male beginner WBP. It is suggested to measure the distance of a 5-kg medicine ball thrown by athletes during training and testing routines to follow the players' progression.

Neuroinvasive chikungunya in a liver transplant recipient.

The influence of chronic immunosuppression on the course of chikungunya virus (CHIKV) infection in recipients of solid organ transplantation (SOT) is still unsettled. Scarce data suggest that the course of CHIKV infection is generally benign in this population. In addition, the occurrence of severe atypical manifestations associated with CHIKV has not been well documented among SOT recipients. In this report, we describe a 64-year-old male liver transplant recipient who was admitted with fever, headache, arthralgia, left palpebral ptosis, mydriasis, and right hemiparesis. Cranial magnetic resonance imaging did not reveal any alteration suggestive of acute infection. Nevertheless, CHIKV was detected in the cerebrospinal fluid (CSF) with a real-time reverse transcriptase assay. Other PCR assays carried out in CSF were negative for HSV-1 and 2, cytomegalovirus, dengue virus (DENV), and Zika virus (ZIKV). CHIKV viremia was also detected while PCR assays for ZIKV and DENV in the blood were negative. ZIKV viruria was simultaneously present in this case. All neurologic manifestations waned within 2 weeks after the onset. This report shows that chikungunya must be considered in the differential diagnosis of acute neurologic disease in SOT recipients who live in or have recently traveled to endemic areas.

Adverse event load, onset, and maximum grade: A novel method of reporting adverse events in cancer clinical trials.

BACKGROUND: Current adverse event reporting practices do not document longitudinal characteristics of adverse effects, and alternative methods are not easily interpretable and have not been employed by clinical trials. Introducing time parameters in the evaluation of safety that are comprehensive yet easily interpretable could allow for a better understanding of treatment quality. In this study, we developed and applied a novel adverse event reporting method based on longitudinal adverse event changes to aid describing, summarizing, and presenting adverse event profile. We termed it the "Adverse Event Load, Onset, and Maximum Grade" method. METHODS: We developed two adverse event summary metrics to complement the traditional maximum grade report. Onset time indicates the time period in which the maximum grade for a specific adverse event occurred and was defined as "early" (i.e. maximum grade happened for the first time before 6 weeks) or "late" (i.e. after the 6th week). Adverse event load indicates the overall severity of a specific adverse event over the entire treatment. Higher adverse event load indicates a worse overall experience. These metrics can be calculated for adverse events with different maximum grades, in treatments with planned changes (e.g. dosage changes), using data sets with different number of adverse event data points between treatments (e.g. treatments with longer cycle lengths may have less adverse event data points) and on data sets with different adverse event data availability (e.g. cycle basis and patient-outcome reports). We tested the utility of this method using individual patient data from two major backbone therapies ("Irinotecan" and "Oxaliplatin") from the N9741 trial available in the Fondation ARCAD database (fondationarcad.org). We investigated profiles of diarrhea, neutropenia/leukopenia, and nausea/vomiting. RESULTS: Our method provided additional information compared to traditional adverse event reports. For example, for nausea/vomiting, while patients in Irinotecan had a higher risk of experiencing maximum grade 3-4 (15.6% vs 7.6%, respectively; p < 0.001), patients in both groups experienced similar severity over time (adverse effect load = 0.102 and 0.096, respectively; p = 0.26), suggesting that patients in Oxaliplatin experienced a lower-grade but more persistent nausea/vomiting. For neutropenia/leukopenia, more patients in Irinotecan experienced their maximum grade for the first time early in the treatment compared to patients in Oxaliplatin (67.9% vs 41.7%; p < 0.001), regardless of maximum grade. Longitudinal information can help compare treatments or guide clinicians on choosing appropriate interventions for low-grade but persistent adverse event or early adverse event onset. CONCLUSION: We developed an adverse event reporting method that provides clinically relevant information about treatment toxicity by incorporating two longitudinal adverse event metrics to the traditional maximum grade approach. Future research should establish clinical benchmarks for metrics included in this adverse event reporting method.

Influence of different endodontic sealers on bond strength of fiber posts to weakened roots after resin restoration.

OBJECTIVES: To assess the influence of different sealers used in root canal filling, in terms of bond strength (BS) to dentin, after restoration of weakened roots using resin composite (RC) and fiber posts. MATERIAL AND METHODS: Roots of 39 maxillary incisors were used. After root canal preparation, root dentin was flared to produce a space between fiber post and root canal walls. The root canals were randomly distributed into three groups (n = 13), according to the sealer used: Endofill, AH Plus, and Acroseal. After removing the filling material to a depth of 12 mm, the flared roots were adhesively restored using RC. Posts were cemented and, after 24 h, roots were sectioned transversely producing 1-mm-thick slices. The slices from 30 roots were used for push-out test, and failure modes were noted. The remaining slices were analyzed by scanning electron microscopy (SEM). RESULTS: Statistical analysis by 2-way ANOVA showed a significant difference among sealers (p = 0.001) and among root regions (p < 0.001). The BS mean of Endofill was lower and significantly different from the others. Overall, the coronal region presented higher BS mean values, followed by the middle and apical regions of the reinforced roots. The most frequent failure type was the adhesive failure between RC and dentin. SEM analysis showed the formation of a hybrid layer and many tags in the coronal and middle regions, while the apical region exhibited remnants of the endodontic sealers in all groups. CONCLUSIONS: AH Plus and Acroseal sealer groups presented similar results, and the Endofill sealer negatively affected the BS of fiber post to restored root dentin. CLINICAL RELEVANCE: Weakened dentin walls are often found in teeth undergoing endodontic treatment, so the sealer used must allow or at least not interfere the bonding between restorative materials and root dentin.

Hydrothermally-altered feldspar as an environmentally-friendly technology to promote heavy metals immobilization: Batch studies and application in smelting-affected soils.

Hydrothermally-altered feldspar (HydroPotash, HYP) possesses, among other physicochemical properties, high pH buffering and cation exchange capacity. Therefore, it may potentially remove heavy metals from aqueous solutions and immobilize these metals in contaminated soil. This study aimed to evaluate the capabilities of two types of HydroPotash (HYP-1 and HYP-2) and a zeolite sample (a commercial adsorbent) for immobilizing cadmium (Cd), zinc (Zn), and lead (Pb) from both aqueous solution and contaminated soils from a Zn-smelting area (classified as soilhigh, soilintermediate, and soillow based on their level of soluble metal concentration). Sorption studies in natural suspension pH showed that HYPs removed 63.8-99.9% Zn, 20.6-40.7% Cd, and 68.4-99.7% Pb from aqueous solution. In the batch test with controlled pH (at pH 5.5), HYPs sorbed more Cd than zeolite. Analyses of scanning electron microscopy-energy dispersive X-ray spectroscopy after desorption showed the presence of Pb at HYP-2, indicating that this metal was effectively adsorbed. In soilhigh HYPs immobilized 99.9% of Zn, Cd, and Pb after one week of soil incubation with these products. The HYPs immobilization effect persisted up to 84 days of soil incubation with these products. The increased soil pH promoted by HYPs appears to be the main factor controlling metal sorption. In conclusion, HydroPotash can be used as an adsorbent/amendment to effectively immobilize heavy metals in both water and contaminated soils by precipitation and adsorption. Our findings indicate the high potential of this material for Cd, Zn, and Pb stabilization, which is of great relevance when recovering areas affected by mining/smelting activities with multi-element contamination.

Medicine Ball Throw Responsiveness to Measure Wheelchair Basketball Mobility in Male Players.

CONTEXT: Monitoring training loads and consequent fatigue responses are usually a result of personal trainers' experiences and an adaptation of methods used in sports for people without disabilities. Currently, there is little scientific evidence on the relationship between training load and fatigue resulting from training sessions in wheelchair sports. Analogous to the vertical jump, which has been associated with competitive performance and used to assess fatigue in Olympic sports, the medicine ball throw (MBT) is a fast, feasible, and accessible test that might be used to measure performance outcomes in Paralympic athletes. OBJECTIVE: To test the MBT responsiveness to detect meaningful changes after training sessions in beginner wheelchair basketball players (WBP). DESIGN: Cross-sectional study. SETTING: Rehabilitation Hospital Network, Paralympic Program. PARTICIPANTS: Twelve male WBP. MAIN OUTCOMES MEASURES: The participants performed 3 consecutive days of training sessions involving exercises of wheelchair basketball skills, strength, and power. The MBT test was performed pre and post training sessions. RESULTS: The smallest worthwhile change for MBT was 0.10 cm, and the lower and upper limits were 3.54 and 3.75 m, respectively. On the first day, the MBT started below the smallest worthwhile change lower limit and increased above the upper limit (3.53 and 3.78 m, respectively). On the second day, the MBT pretraining and posttraining session results were near the sample mean (3.62 and 3.59 m, respectively). On the third day, the WBP started the MBT test training higher than the upper limit (3.78 m) and decreased to near the mean (3.58 m). CONCLUSIONS: During 3 consecutive days of training sessions, the magnitude-based inference model presented meaningful changes in MBT test performance. The accurate association of the magnitude-based inference model with the MBT allows coaches and sports team staff to interpret the correct magnitude of change in WBP performance.

Most noninvasive prenatal screens failing due to inadequate fetal cell free DNA are negative for trisomy when repeated.

OBJECTIVE: We aimed to test for an association between the amount of circulating fetal cell-free DNA and trisomy, and whether NIPS failure due to low fetal fraction indicates trisomy risk. METHOD: Maternal BMI, maternal age, fetal sex, gestational age, fetal cfDNA fraction, and NIPS results was collected on 2374 pregnancies. Additional clinical information was available for 1180 research consented patients. We investigated associations between fetal fraction and available variables and determined the success rate of repeat NIPS testing. RESULTS: Fetal trisomy was marginally associated with decreased fetal fraction (P = .067). However, the proportions of trisomy events were not significantly increased in women who had failed NIPS due to low fetal fraction (<4%) (OR = 1.37 [0.3-7.4]; P = .714). 66% of repeated NIPS after a second blood draw were successful. CONCLUSION: Failure to meet the clinical cutoff of 4% fetal fraction established for NIPS accuracy did not suggest increased risk for trisomy in our cohort. Because repeat testing was successful in the majority of cases and most failures were explained by high BMI and low gestational age, a redraw may be an appropriate next step before invasive screening due to concerns for trisomic pregnancies.

Hepatitis C virus genotypes in hemodialysis patients in Angola.

To our knowledge, there are no published data on hepatitis C virus (HCV) genotypes in Angola. This study aimed at assessing the distribution of HCV genotypes in seropositive hemodialysis patients in Luanda. Among 51 HCV-positive subjects included, viremia was detected in 27 (53%). HCV genotyping was performed by bidirectional sequencing of the 5'-untranslated region by the Sanger method. HCV genotype 4 was largely predominant (20 cases; 74%), followed by genotypes 1b (5 cases; 18.5%), 1a and 2 (one case each; 3.7%). These results suggest that the distribution of HCV genotypes in Angola is similar to that reported from other Central African countries.

A q-Extension of Sigmoid Functions and the Application for Enhancement of Ultrasound Images.

This paper proposes the q-sigmoid functions, which are variations of the sigmoid expressions and an analysis of their application to the process of enhancing regions of interest in digital images. These new functions are based on the non-extensive Tsallis statistics, arising in the field of statistical mechanics through the use of q-exponential functions. The potential of q-sigmoids for image processing is demonstrated in tasks of region enhancement in ultrasound images which are highly affected by speckle noise. Before demonstrating the results in real images, we study the asymptotic behavior of these functions and the effect of the obtained expressions when processing synthetic images. In both experiments, the q-sigmoids overcame the original sigmoid functions, as well as two other well-known methods for the enhancement of regions of interest: slicing and histogram equalization. These results show that q-sigmoids can be used as a preprocessing step in pipelines including segmentation as demonstrated for the Otsu algorithm and deep learning approaches for further feature extractions and analyses.

Evaluation of peri-implant condition in periodontally compromised patients.

AIMS: The aim of the study is to evaluate the profile of peri-implant tissues in periodontally compromised patients. SETTINGS AND DESIGN: In vivo - cross sectional study design. MATERIALS AND METHODS: Fifty-eight implants were evaluated, clinically and radiographically, installed in seven individuals treated by the same team of professionals, during the years 1997 and 2005 in a private dental clinic in Vitória, ES, Brazil; that time of data collection, all implants were at least 10 years of functional loading. The variables related to the dental implants evaluated were: visible Plaque Index, Gingival Bleeding Index (GBI), probing pocket depth, bleeding on probing, and bone level, to relate them to the classification of dental implants. STATISTICAL ANALYSIS USED: The Chi-square and Kruskal-Wallis test were adopted. RESULTS: The total of 58 implants were classified: 11 (18.9%) as healthy and 12 (20.7%) as clinically stable. The other 35 implants (60.4%) had some type of peri-implant inflammation, 20 of them (34.5%) were diagnosed with peri-implant mucositis and 15 (25.9%) with peri-implantitis. Among the variables studied, the results showed statistically significant differences for implant location (P = 0.001) and GBI (P = 0.03). Most of the maxillary implants (85.7%) were classified for some type of peri-implant disease. For the implants which resulted in Score 1 for GBI, most of them (75.0%) were also classified for some type of peri-implant disease. CONCLUSIONS: Dental implants placed in periodontally compromised patients may have high long-term survival rates. However, most implants were classified with some type of peri-implant inflammation.

A New Approach to Sampling Intact Fe Plaque Reveals Si-Induced Changes in Fe Mineral Composition and Shoot As in Rice.

The Fe (oxyhydr)oxide rind, or Fe plaque, that forms on aquatic plant roots is an important sorbent of metal(loid)s and plays a role in the attenuation of metal(loid) uptake into higher plants. However, the mineral composition of Fe plaque and thus its potential to sorb metal(loid)s is affected by solution chemistry. The predominant strategy to characterize Fe plaque using dithionite-citrate-bicarbonate (DCB) extraction and elemental analysis reveals total Fe quantity but misses the mineral structure of the Fe (oxyhydr)oxide. Here, we developed a new technique using gentle sonication to sample intact Fe plaque from the root system and concentrate it for subsequent mineralogical characterization using synchrotron-based X-ray diffraction and X-ray absorption spectroscopy. We then coupled that data with conventional DCB extraction. The sample preparation method was effective at concentrating As-bound Fe plaque minerals in a uniform coating onto membranes that could easily be analyzed with X-ray techniques. Using these methods, we show that the percentage of poorly ordered Fe minerals in Fe plaque increases with increasing pore-water Si in flooded rice paddy soils. These findings have implications for understanding mineral controls on As cycling in the soil-rice nexus, and the sampling approach can be adopted for other aquatic plant systems.

Influence of Relative Strength on Functional Independence of Patients With Spinal Cord Injury.

OBJECTIVE: To investigate the influence of strength values and fat mass on functional independence of men with different spinal cord injury (SCI) levels. DESIGN: Cross-sectional study. SETTING: Hospital network. PARTICIPANTS: Men with SCI (N=45). INTERVENTIONS: Subjects were assessed in functional independence scales, a 1 repetition maximum (1RM) test, and body composition to detect absolute and relative strength: 1RM divided by body mass (BM) and lean body mass (LBM), respectively. MAIN OUTCOME MEASURES: Stepwise multiple regression analysis was used to verify the influence of predictors on functional independence (FIM and Spinal Cord Independence Measure [SCIM] scale and subscales). Receiver operating characteristic curves were created to identify cutoff points of strength for functional independence. RESULTS: The best models for FIM total, FIM mobility, and SCIM total used 1RM as the best predictor (adjusted R2=.75, .67, and .65, respectively; P<.05). Relative strength (1RM/LBM) was the best predictor for SCIM mobility (adjusted R2=.62, P<.05). A FIM score of 69 has a 1RM cutoff point of 50.1kg, and a FIM score of 76 has cutoff points of .73 for 1RM/BM and .91 for 1RM/LBM. A SCIM score of 68 has cutoff points for 1RM, 1RM/BM, and 1RM/LBM of 50.1kg, .77, and .92, respectively. CONCLUSIONS: Cutoff points of relative strength should be used as determinant variables for independence, health, or sports performance. This study may contribute to more adequate guidance of physical activity during a rehabilitation program and after discharge.

Numerical Analyses for Low Reynolds Flow in a Ventricular Assist Device.

Scientific and technological advances in blood pump developments have been driven by their importance in cardiac patient treatments and in the expansion of life quality in assisted people. To improve and optimize the design and development, numerical tools were incorporated into the analyses of these mechanisms and have become indispensable in their advances. This study analyzes the flow behavior with low impeller Reynolds number, for which there is no consensus on the full development of turbulence in ventricular assist devices (VAD). For supporting analyses, computational numerical simulations were carried out in different scenarios with the same rotation speed. Two modeling approaches were applied: laminar flow and turbulent flow with the standard, RNG and realizable κ - ε; the standard and SST κ - ω models; and Spalart-Allmaras models. The results agree with the literature for VAD and the range for transient flows in stirred tanks with an impeller Reynolds number around 2800 for the tested scenarios. The turbulent models were compared, and it is suggested, based on the expected physical behavior, the use of κ-ε RNG, standard and SST κ-ω, and Spalart-Allmaras models to numerical analyses for low impeller Reynolds numbers according to the tested flow scenarios.