Quasinormal modes and shadow of noncommutative black hole.

In this paper we investigate quasinormal modes (QNM) for a scalar field around a noncommutative Schwarzschild black hole. We verify the effect of noncommutativity on quasinormal frequencies by applying two procedures widely used in the literature. The first is the Wentzel-Kramers-Brillouin (WKB) approximation up to sixth order. In the second case we use the continuous fraction method developed by Leaver. Besides, we also show that due to noncommutativity, the shadow radius is reduced when we increase the noncommutative parameter. In addition, we find that the shadow radius is nonzero even at the zero mass limit for finite noncommutative parameter.

An study on the influence of collagen fiber directions in TAVs performance using FEM.

Transcatheter Aortic Valve Implantation (TAVI) or Replacement (TAVR) is a promising treatment for aortic valve stenosis, consisting of a procedure to replace a damaged native aortic valve by a bioprosthetic one. This replacement valve control the flow of blood using leaflets that are similar to the ones of a native aortic valve. Commonly manufactured using bovine or porcine pericardium, it is a tissue histologically composed of collagen fibers embedded into a nearly-isotropic matrix, where their distribution makes the pericardium behave as an anisotropic hyperelastic material. Because of such complicated behavior, bioprosthetic pericardium valves are, as expected, sensitive to the distribution and orientation of these fibers in such device. Therefore, the objective of this work is a thorough systematic study on the influence of these fibers' distribution. First, a Finite Element model of a bioprosthetic valve is generated; then, a material routine to accurately describe the behavior of pericardium is implemented in a commercial software package; in addition, a dedicated algorithm to specify the direction of fibers is developed. Finally, a systematic study on the influence that fiber orientations have on the overall behavior of the TAV is performed. As a result of this study, two extreme behaviors are highlighted depending on the preferential orientation of collagen fibers; namely, one with fibers in circumferential direction and the opposite with fibers in an axial orientation. Then, it is concluded that the behavior of fibers in circumferential direction is very sensitive to small variations of the orientation angle, whereas such orientation is not as determining when the aim is to achieve a behavior near to the one corresponding with axial orientation.

Numerical Assessment of a Safety System to Minimize Injuries during a Cyclist Run-Over.

BACKGROUND: The World Health Organization has reported that 1.35 million people die on the roads every year due to road traffic accidents. This paper focuses on exploring a passive safety system that reduces lesions in the overtaking run-over scenario. METHODS: Head Injury Criterion (HIC) and Combined Thoracic Index (CTI) were evaluated through numerical simulations using LS-Dyna®; in order to compare the computed results, three different speed scenarios were carried out (velocity of running over 40, 50, 60 km/h). RESULTS: The computed results were divided into groups, A for the run-over test without a passive security system and B for the run-over test with a passive security system. For case A.1, the HIC15 was 3325. For case A.2, the HIC15 was 1510, and for case A.3, the HIC 15 was 1208. For case B.1, the HIC15 2605, for case B.2, the HIC15 was 1282, and for case B.3, the HIC was 730. CONCLUSION: The comparative results show that the passive safety system installed on the bicycle has an increased benefit impact on the severity of the injury on vulnerable road users, decreasing the probability of cranioencephalic lesions in all study cases. In addition, the thorax injuries are cut down only in the impact scenario at a speed of 40 km/h.

Deciphering lead tolerance mechanisms in a population of the plant species Biscutella auriculata L. from a mining area: Accumulation strategies and antioxidant defenses.

The uptake and distribution of Pb and the mechanisms involved in the metal tolerance have been investigated in a mine population of Biscutella auriculata. Seedlings were exposed to 125 µM Pb(NO3)2 for 15 days under semihydroponic conditions. The results showed an increase in the size of Pb-treated seedlings and symptoms of toxicity were not observed. ICP-OES analyses showed that Pb accumulation was restricted to root tissue. Imaging of Pb accumulation by dithizone histochemistry revealed the presence of the metal in vacuoles and cell wall in root cells. The accumulation of Pb in vacuoles could be stimulated by an increase in phytochelatin PC2 content. Pb did not promote oxidative damage and this is probably due the increase of antioxidative defenses. In the leaves, Pb produced a significant increase in superoxide dismutase activity, while in roots an increase in catalase and components of the Foyer- Halliwell-Asada cycle were observed. The results indicated that Biscutella auriculata has a high capacity to tolerate Pb and this is mainly due to a very efficient mechanism to sequester the metal in roots and a capacity to avoid oxidative stress. This species could therefore be very useful for phytostabilization and repopulation of areas contaminated with Pb.

Expectations of nursing degree students: A longitudinal analysis.

BACKGROUND: The expectations of students regarding their studies have a strong influence on their academic performance and personal training, and they are closely related with their academic and professional future. OBJECTIVES: To analyze initial expectations and how they are fulfilled, in a cohort of nursing students during the four years of their degree program. DESIGN: Creation and validation of a questionnaire and longitudinal study. SETTING: University nursing school in Catalonia (Spain). PARTICIPANTS: 339 students of the nursing degree. METHODS: Two questionnaires were constructed with 10 items each, of a mixed nature: some items were previously validated in prior studies while other new items were made and included, following a review of the literature. The questionnaires were designed to assess the expectations of the students at the beginning of the academic year (CUDEX questionnaire) and the fulfillment of these at the end of the year (CUDEX-C questionnaire). RESULTS: Internal consistency (Cronbach's alpha) for the CUDEX questionnaire and the CUDEX-C was 0.70. Factorial analysis of the expectations questionnaires suggested a three-factor model, with an acceptable internal consistency for each of the factors. Statistically significant differences were found between the initial expectations and their fulfillment at the end of the academic year for all the factors and in all four years of the degree program. CONCLUSIONS: The three-factor model of the expectations (Academic adaptation, personal development, and academic performance) shows a good fit for the several samples and time points. The nursing students feel that not all of their expectations were fulfilled during their studies, and there were significant differences between their initial expectations and those fulfilled, in terms of all three factors.

Characterization of mechanisms involved in tolerance and accumulation of Cd in Biscutella auriculata L.

Biscutella auriculata L. is one of the rare species that is able to grow in a very contaminated mining area in Villamayor de Calatrava (Ciudad Real, Spain). In an effort to understand the mechanisms involved in the tolerance of this plant to high metal concentrations, we grew B. auriculata in the presence of 125 µM Cd(NO3)2 for 15 days and analysed different parameters associated with plant growth, nitric oxide and reactive oxygen species metabolism, metal uptake and translocation, photosynthesis rate and biothiol (glutathione and phytochelatins) content. Treatment with Cd led to growth inhibition in both the leaves and the roots, as well as a reduction of photosynthetic parameters, transpiration and stomatal conductance. The metal was mainly accumulated in the roots and in the vascular tissue, although most Cd was detected in areas surrounding their epidermal cells, while in the leaves the metal accumulated mainly in spongy mesophyll, stomata and trichrome. Based on the Cd bioaccumulation (5.93) and translocation (0.15) factors, this species denoted enrichment of the metal in the roots and its low translocation to the upper tissues. Biothiol analysis showed a Cd-dependent increase of reduced glutathione (GSH) as well as the phytochelatins (PC2 and PC3) in both roots and leaves. Cd-promoted oxidative damage occurred mainly in the leaves due to disturbances in enzymatic and nonenzymatic antioxidants, while the roots did not show significant damage as a result of induction of antioxidant defences. It can be concluded that B. auriculata is a new Cd-tolerant plant with an ability to activate efficient metal-sequestering mechanisms in the root surface and leaves and to induce PCs, as well as antioxidative defences in roots.

Characterization of hyperelastic and damage behavior of tendons.

In this paper, we characterized the hyperelastic and damage behavior of the Extensor Digitorum Longus (EDL) human tendon under loading conditions. The study was conducted in both categories of models, phenomenological and physically motivated, to allow the prediction and the macroscopic response of the tendon under specific loading conditions, assuming that its response follows a hyperelastic anisotropic model in conjunction with damage law. We benchmarked multiple hyperelastic and damage models to fit the response of the tendons in uniaxial tensile loading conditions, and by employing a genetic algorithm, we obtained the material parameters for both elastic and damage models. The objective of this study was to explore different mathematical models to determine which would be the best option to predict the behavior of tendons and ligaments in complex biological systems using Finite Elements (FE) models. Therefore, we took into account accuracy as well as computational features. We considered the model proposed by Shearer and coupled it with a sigmoid function, which governs the evolution of damage in tendons, as the most appropriate for the fitting of the experimental data. The achieved solution shows to be of high interest attributable to the simplicity of the damage law function and its low computational cost.

Does mercury presence in soils promote their microbial activity? The Almadenejos case (Almadén mercury mining district, Spain).

Mercury is considered a very toxic element and important efforts are currently being made aimed at reduce or even eliminating its usage. Despite this trend, there are still sites where contamination by this metal is very marked, especially in the mining environment of Almadén where it has been exploited for thousands of years. The several forms in which Hg occurs in the soil interact differently with the organisms that live in/on it. The soil is a place where many biotic and abiotic variables act together. Through a detailed study of the edaphic characteristics of a decommissioned metallurgical enclosure, the presence of different chemical forms of Hg, the study of microbial activity (DHA) and, finally, parameters of the vegetation cover, such as specific distribution and biomass, we have tried to elucidate the effect of the presence of Hg in this precinct with a very high Hg pollution. The obtained results showed the affection patterns by which the different measured parameters vary, with special incidence to the microbial activity of the topsoil and to the specific distribution of the plants found in the studied area. The statistical multivariate analysis showed that significant correlations have been found between soil Hg fractions and between Hg fractions in plants; furthermore, soil conditions seem to be not related with Hg transfer from soils to plants. Biomass and DHA data indicate that the studied area is not affected by the presence of Hg species and lacks the expected toxic effects on the living organisms.

Perception of dental students on risk factors of musculoskeletal disorders.

OBJECTIVE: To evaluate the validity and reliability of the Job Factors Questionnaire, and the influence of gender, academic level and pain/discomfort on dental students' perception regarding risk factors of musculoskeletal disorders. METHODS: One hundred forty-five dental students from Stony Brook School of Dental Medicine participated voluntarily in this study. The survey was organised in two sections: (i) Job Factors Questionnaire with 15 items that evaluated students' perceptions about job/study environmental risk factors and their potential contribution to musculoskeletal disorders. The tri-factorial structure (repetitiveness, work posture and external factors) was used; (ii) Part of the Nordic Questionnaire with questions referring to 9 body areas: Neck, shoulders, upper back, elbows, lower back, wrists/hands, hips, knees and ankles/feet. Students answered if they have had a job-related pain/discomfort in any of these body areas in the previous 12 months. The data were evaluated statistically by confirmatory factor analysis, convergent and discriminant validities, internal consistency and Z-test (α = .05). RESULTS: The tri-factorial structure was considered valid and reliable for the sample after excluding item 8 and inserting correlations between items 11 and 12, and between 14 and 15. The academic level presented a significant effect on the factors "Work Posture" (P = .02) and "External Factors" (P = .01). Most of the students reported pain in their neck (73.79%), lower back (62.06%) and shoulders (53.10%) in the previous 12 months. CONCLUSION: The Work Posture and External Factors were influenced only by academic level. The lower the students' academic level, the higher their perception for both factors of musculoskeletal disorders.

Ergonomics in dentistry: experiences of the practice by dental students.

OBJECTIVE: The aim of this study was to qualitatively evaluate the experiences of students enrolled in the last year of dentistry school with ergonomic practice. METHODS: This is a qualitative, observational and cross-sectional study, with a non-probabilistic sample design. The sample comprised students enrolled in the last year of dentistry in Araraquara-UNESP (n = 29). The data were collected by means of open semi-structured and individual interviews, captured by a digital voice recorder. The students were interviewed in their own university at a time that was previously scheduled, and care was taken to provide a private and welcoming environment to carry out the interviews. A script containing questions related to practices in ergonomics was prepared at the university. Data analysis was carried out using the qualitative-quantitative Collective Subject Discourse technique with the aid of Qualiquantisoft® software program. RESULTS: It was found that more than half of the students (58.6%) believe that adopting an ergonomic posture is important to prevent future problems, pain and occupational diseases, and 62.1% of the students confirm having difficulties in adopting ergonomic postures due to the types of treatment required and the regions of the mouth being treated. The main reasons stated for the fact that their colleagues do not adopt ergonomic postures are lack of attention, practice and forgetfulness (44.8%) and difficulty in visualising the operatory field or the procedure performed (27.6%). CONCLUSION: It is possible to conclude that the students interviewed know ergonomic principles and their importance in occupational health. However, they found it difficult to put these principles into practice.

Validation of the Geriatric Oral Health Assessment Index in complete denture wearers.

To perform a validation of the Geriatric Oral Health Assessment Index (GOHAI) for complete denture wearers and present a proposal for estimation of perceived oral health. This is a cross-sectional study with non-probabilistic sampling. A total of 211 subjects with a mean age of 62·5 (s.d. = 11·4) years participated, being 169 female. The GOHAI was applied in a personal interview. The construct/convergent/discriminant validity was tested using structural equation modelling. Confirmatory factor analysis was used to verify the fit of three proposals of the GOHAI: three-factor, one-factor and second-order hierarchical models. The stability of the models was evaluated in independent samples. The three-factor model presented an inadequate fit, and items 3, 4 and 9 were removed. The new structure presented an acceptable fit and strong invariance in independent samples. The convergent, discriminant validity and internal consistency were below adequate. The one-factor model presented an adequate fit to the sample. Convergent validity was compromised. A strong invariance of the one-factor model was observed. To calculate the overall scores of the GOHAI factors (three-factor model) or of the oral health perception (one-factor model), a matrix of regression weights for each item in the model was presented as a suggestion. We found an adequate fit of the both structures of the GOHAI for denture wearers, but the three-factor structure was more parsimonious. We suggested considering the weights of the regression model to calculate the overall score of perceived oral health or of its factors in different samples.

Psychometric Properties of the Oral Health Impact Profile and New Methodological Approach.

OBJECTIVE: Evaluate the validity, reliability, and factorial invariance of the complete Portuguese version of the Oral Health Impact Profile (OHIP) and its short version (OHIP-14). METHODS: A total of 1,162 adults enrolled in the Faculty of Dentistry of Araraquara/UNESP participated in the study; 73.1% were women; and the mean age was 40.7 ± 16.3 yr. We conducted a confirmatory factor analysis, where χ(2)/df, comparative fit index, goodness of fit index, and root mean square error of approximation were used as indices of goodness of fit. The convergent validity was judged from the average variance extracted and the composite reliability, and the internal consistency was estimated by Cronbach standardized alpha. The stability of the models was evaluated by multigroup analysis in independent samples (test and validation) and between users and nonusers of dental prosthesis. RESULTS: We found best-fitting models for the OHIP-14 and among dental prosthesis users. The convergent validity was below adequate values for the factors "functional limitation" and "physical pain" for the complete version and for the factors "functional limitation" and "psychological discomfort" for the OHIP-14. Values of composite reliability and internal consistency were below adequate in the OHIP-14 for the factors "functional limitation" and "psychological discomfort." We detected strong invariance between test and validation samples of the full version and weak invariance for OHIP-14. The models for users and nonusers of dental prosthesis were not invariant for both versions. CONCLUSION: The reduced version of the OHIP was parsimonious, reliable, and valid to capture the construct "impact of oral health on quality of life," which was more pronounced in prosthesis users.

The association between restorative pre-clinical activities and musculoskeletal disorders.

OBJECTIVE: To evaluate the risk of development of musculoskeletal disorders in the upper limbs of undergraduate dentistry students during the execution of pre-clinical laboratory activities based on gender, type of dental procedure and area of the mouth under treatment. METHODS: Male and female undergraduate students in the second year of the Araraquara Dental School, UNESP, were enrolled in this study. Digital photographs were obtained whilst the subjects performed laboratory activities. The working postures adopted by each student were evaluated using the Rapid Upper Limb Assessment (RULA). The photos were analysed by a calibrated researcher (k = 0.89), and a final risk score was attributed to each analysed procedure (n = 354). Descriptive statistical analyses were performed, and the associations of interest were analysed by the chi-square test (P = 0.05). RESULTS: During most of the laboratory procedures performed, the risk of developing musculoskeletal disorders was high (64.7%; - IC95% : 59.7-69.7%), with no significant association between the RULA final score and gender (χ(2)  = 1.100; P = 0.577), type of dental procedure (χ(2)  = 5.447, P = 0.244) and mouth area treated (χ(2) =4.150; P = 0.126). CONCLUSIONS: The risk of developing musculoskeletal disorders was high in undergraduate dentistry students; this risk was not related to gender, type of dental procedure and region of the mouth being treated.

Relevancia del efecto de posición serial en el diagnóstico diferencial entre el deterioro cognitivo leve, la demencia de tipo Alzheimer y el envejecimiento normal / Relevance of the serial position effect in the differential diagnosis of mild cognitive impairment, Alzheimer-type dementia, and normal ageing

Los efectos de posición serial son estudiados cuando se memoriza una serie de palabras que excede el span atencional. En sujetos normales son recordadas más frecuentemente las palabras del inicio y final de una lista reflejando el funcionamiento de la memoria episódica a corto y largo plazo. Objetivos: Estudiar el efecto de principio y el de fin de lista en pacientes con deterioro cognitivo leve (DCL) y compararlo con demencia tipo Alzheimer (DTA) y sujetos con envejecimiento normal (SN). Métodos: Fueron evaluados neurológica y neuropsicológicamente 30 pacientes con DTA, 25 con DCL y 20 SN. Se utilizó el Test de aprendizaje auditivo de una lista de palabras de Rey en donde se evaluó el efecto de principio, medio y fin de lista en cada ensayo y su efecto en el recuerdo diferido. Resultados: Los sujetos con DCL mostraron un patrón general de memoria similar a los sujetos con DTA, caracterizado por una reducción en el aprendizaje, olvido acelerado y un claro efecto de fin de lista en el aprendizaje. A nivel del recuerdo diferido mostraron un patrón diferencial recordando palabras de principio y medio más cercano a los normales pero no recordando las finales de la lista como las DTA. Conclusiones: La prueba de aprendizaje de una lista de palabras es una herramienta que nos permite discriminar entre pacientes con DCL y SN. El índice de recencia en el recuerdo diferido es un indicador útil para diferenciar el envejecimiento normal de los pacientes con DCL (AU)

Serial position effects are observed when a person memorises a series of words exceeding his or her attention span. Cognitively normal individuals recall words at the beginning and end of the list more frequently than those in the middle, which reflects the way that short- and long-term episodic memory works. Objective: To study the serial position effect in patients with mild cognitive impairment (MCI) compared to subjects with Alzheimer-type dementia (AD) or normal ageing (NA). Methods: 30 AD, 25 MCI and 20 NA subjects underwent neurological and neuropsychological assessment. The Rey Auditory Verbal Learning Test (RAVLT) was used to study primacy, middle, and recency effects and delayed recall for each group. Results: The general memory pattern of MCI subjects was very similar to that of AD subjects, and was characterised by reduced learning capacity, rapid forgetfulness and clear recency effect in learning. With regard to delayed recall, however, there were differences in performance; MCI subjects’ ability to recall words at the beginning and middle of the list was similar to that of normal subjects, while their memory of words at the end of the list was poor, as in AD subjects. Conclusions: RAVLT is a tool permitting us to distinguish between MCI and NA subjects. The recency index for the delayed recall task is a valid indicator for distinguishing between MCI patients and patients with normal ageing (AU)

Comparative study of morbidity and mortality between ileal conduit and ureterosigmoidostomy after radical cystectomy for bladder neoplasm.

OBJECTIVES: Despite the growing trend in the development of orthotopic neobladders, the procedure cannot be performed in many cases, thereby retaining the validity of other techniques. We propose a comparative analysis between patients with radical cystectomy for bladder neoplasm and reconstruction using the ileal conduit (IC) or ureterosigmoidostomy (USG). PATIENTS AND METHOD: Observational retrospective study on 255 patients with radical cystectomy between 1985 and 2009, selecting group assignments by the use of IC and USG. Analysis of the demographic and preoperative characteristics, perioperative complications, pathology and medium to long-term complications. Comparison of groups using T-Student, U-Mann-Whitney and chi square tests, with P<.05 indicating statistical significance. Preparation of survival tables according to Kaplan-Meier, establishing comparisons using the log-rank test. RESULTS: There were 41 cases of IC and 55 cases of USG, with a mean patient age of approximately 61 years. USGs were performed on a greater number of females than ICs. There were no differences in the need for transfusion, with similar results as other series. There was a greater trend towards the appearance of intestinal fistulae and greater morbidity and mortality in the postoperative period in USG, although it was not significant. There was a greater long-term presence of eventrations in IC, and of pyelonephritis and the need for taking alkalinizing agents in USG. The appearance of peristomal hernias in IC was less than in previous series. With a mean follow-up greater than 50 months, the overall survival was 40% at 5 years, with no differences according to urinary diversion. CONCLUSIONS: IC and USG are two applicable urinary diversions in the event that orthotopic neobladder surgery cannot be performed. They have a similar long-term complication and survival profile in our series, although with a higher morbidity in postoperative complications for USG.

Early fetoscopic tracheal occlusion for extremely severe pulmonary hypoplasia in isolated congenital diaphragmatic hernia: preliminary results.

OBJECTIVE: To evaluate the effect of early fetoscopic tracheal occlusion (FETO) (22-24 weeks' gestation) on pulmonary response and neonatal survival in cases of extremely severe isolated congenital diaphragmatic hernia (CDH). METHODS: This was a multicenter study involving fetuses with extremely severe CDH (lung-to-head ratio < 0.70, liver herniation into the thoracic cavity and no other detectable anomalies). Between August 2010 and December 2011, eight fetuses underwent early FETO. Data were compared with nine fetuses that underwent standard FETO and 10 without fetoscopic procedure from January 2006 to July 2010. FETO was performed under maternal epidural anesthesia, supplemented with fetal intramuscular anesthesia. Fetal lung size and vascularity were evaluated by ultrasound before and every 2 weeks after FETO. Postnatal therapy was equivalent for both treated fetuses and controls. Primary outcome was infant survival to 180 days and secondary outcome was fetal pulmonary response. RESULTS: Maternal and fetal demographic characteristics and obstetric complications were similar in the three groups (P > 0.05). Infant survival rate was significantly higher in the early FETO group (62.5%) compared with the standard group (11.1%) and with controls (0%) (P < 0.01). Early FETO resulted in a significant improvement in fetal lung size and pulmonary vascularity when compared with standard FETO (P < 0.01). CONCLUSIONS: Early FETO may improve infant survival by further increases of lung size and pulmonary vascularity in cases with extremely severe pulmonary hypoplasia in isolated CDH. This study supports formal testing of the hypothesis with a randomized controlled trial.

Relevance of the serial position effect in the differential diagnosis of mild cognitive impairment, Alzheimer-type dementia, and normal ageing.

UNLABELLED: Serial position effects are observed when a person memorises a series of words exceeding his or her attention span. Cognitively normal individuals recall words at the beginning and end of the list more frequently than those in the middle, which reflects the way that short- and long-term episodic memory works. OBJECTIVE: To study the serial position effect in patients with mild cognitive impairment (MCI) compared to subjects with Alzheimer-type dementia (AD) or normal ageing (NA). METHODS: 30 AD, 25 MCI and 20 NA subjects underwent neurological and neuropsychological assessment. The Rey Auditory Verbal Learning Test (RAVLT) was used to study primacy, middle, and recency effects and delayed recall for each group. RESULTS: The general memory pattern of MCI subjects was very similar to that of AD subjects, and was characterised by reduced learning capacity, rapid forgetfulness and clear recency effect in learning. With regard to delayed recall, however, there were differences in performance; MCI subjects' ability to recall words at the beginning and middle of the list was similar to that of normal subjects, while their memory of words at the end of the list was poor, as in AD subjects. CONCLUSIONS: RAVLT is a tool permitting us to distinguish between MCI and NA subjects. The recency index for the delayed recall task is a valid indicator for distinguishing between MCI patients and patients with normal ageing.

Cross-cultural adaptation of the Portuguese version of the Patient-Generated Subjective Global Assessment.

INTRODUCTION: The cross-cultural adaptation of the Patient-Generated Subjective Global Assessment is important so it can be used with confidence in Portuguese language. OBJECTIVE: To perform a cross-cultural adaptation of the Portuguese version of the Patient-Generated Subjective Global Assessment and to estimate its intrarater reliability. MATERIAL AND METHODS: This is a validation study. Face Validity was classified by 17 health professionals and 10 Portuguese language specialists. Idiomatic, semantic, cultural and conceptual equivalences were analyzed. The questionnaire was completed by 20 patients of the Amaral Carvalho Hospital (Jaú, São Paulo, Brazil) in order to verify the Comprehension Index of each item. Therefore, 27 committee members classified each item into "essential", "useful, but not essential" and "not necessary", in order to calculate the Content Validity Ratio. After, this version of the questionnaire was applied twice to 62 patients of the hospital cited above. The intrarater reliability of the nutritional status analyzed by Patient-Generated Subjective Global Assessment was estimated by Kappa statistics. RESULTS: The Portuguese version of the Patient-Generated Subjective Global Assessment presented 10 incomprehensible expressions. The items "a year ago weight" and "dry mouth symptom" presented the lowest Content Validity Ratio. Substantial intrarater reliability (k = 0.78, p = 0.001) was observed. CONCLUSION: The cross-cultural adaptation of the Portuguese version of the Patient-Generated Subjective Global Assessment became simple and understandable for Brazilian patients. Thus, this version of the Patient-Generated Subjective Global Assessment was considered a valid and a reliable method.

Validity and reliability of the Portuguese version of Mandibular Function Impairment Questionnaire.

The aim of this study is to evaluate the validity and reliability of the Mandibular Function Impairment Questionnaire (MFIQ) (Portuguese version). Face and content validity of the Portuguese version were performed. To assess reproducibility of the data gathered with MFIQ, it was applied to 62 individuals who completed the questionnaire on two occasions. Validity and reliability of the data gathered with MFIQ were evaluated in a sample of 249 patients. Construct-related validity was assessed through factorial validity (by means of a confirmatory factor analysis), and convergent and discriminant validities were assessed, respectively, by the average variance extracted (AVE), composite reliability (CC) and bivariate correlations between factors. The internal consistency was estimated by the standardised Cronbach's alpha coefficient (α) and reproducibility by the intra-class correlation coefficient (ICC). All the items of MFIQ showed content validity. Reproducibility was excellent in both the 'functional capacity' dimension (D1) (ICC(D1) =0·895, 95% CI=0·832 to 0·935) and the 'feeding' dimension (D2) (ICC(D2) =0·825, 95% CI= 0·726 to 0·891). Items 1, 2, 6 and 7 of D1 had factor weights below the desired cut-off (0·5), and overall fit of the original bifactorial structure of the MFIQ was poor [(confirmatory fit index) CFI= 0·850, (goodness of fit index) GFI= 0·781, (root mean square error of approximation) RMSEA= 0·118]. Thus, these items were excluded, and the new, reduced version of the MFIQ showed good fit (CFI=0·933, GFI=0·879, RMSEA=0·099). The convergent validity was adequate (AVE≥0·5, CC≥0·7) for both factors. However, their discriminant validity was low (AVE(D1) = 0·51 and AVE(D2) = 0·66 <ρ(2) (D1D2) =0·70). The internal consistency was excellent (α(D1) =0·874; α(D2) =0·918). The Portuguese version of the reduced MFIQ produced data with good validity and reliability.

Prediction and probability of neonatal outcome in isolated congenital diaphragmatic hernia using multiple ultrasound parameters.

OBJECTIVES: To evaluate the accuracy and probabilities of different fetal ultrasound parameters to predict neonatal outcome in isolated congenital diaphragmatic hernia (CDH). METHODS: Between January 2004 and December 2010, we evaluated prospectively 108 fetuses with isolated CDH (82 left-sided and 26 right-sided). The following parameters were evaluated: gestational age at diagnosis, side of the diaphragmatic defect, presence of polyhydramnios, presence of liver herniated into the fetal thorax (liver-up), lung-to-head ratio (LHR) and observed/expected LHR (o/e-LHR), observed/expected contralateral and total fetal lung volume (o/e-ContFLV and o/e-TotFLV) ratios, ultrasonographic fetal lung volume/fetal weight ratio (US-FLW), observed/expected contralateral and main pulmonary artery diameter (o/e-ContPA and o/e-MPA) ratios and the contralateral vascularization index (Cont-VI). The outcomes were neonatal death and severe postnatal pulmonary arterial hypertension (PAH). RESULTS: Neonatal mortality was 64.8% (70/108). Severe PAH was diagnosed in 68 (63.0%) cases, of which 63 died neonatally (92.6%) (P < 0.001). Gestational age at diagnosis, side of the defect and polyhydramnios were not associated with poor outcome (P > 0.05). LHR, o/e-LHR, liver-up, o/e-ContFLV, o/e-TotFLV, US-FLW, o/e-ContPA, o/e-MPA and Cont-VI were associated with both neonatal death and severe postnatal PAH (P < 0.001). Receiver-operating characteristics curves indicated that measuring total lung volumes (o/e-TotFLV and US-FLW) was more accurate than was considering only the contralateral lung sizes (LHR, o/e-LHR and o/e-ContFLV; P < 0.05), and Cont-VI was the most accurate ultrasound parameter to predict neonatal death and severe PAH (P < 0.001). CONCLUSIONS: Evaluating total lung volumes is more accurate than is measuring only the contralateral lung size. Evaluating pulmonary vascularization (Cont-VI) is the most accurate predictor of neonatal outcome. Estimating the probability of survival and severe PAH allows classification of cases according to prognosis.