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Abstract High-latitude regions store large amounts of carbon trapped by ice sheets, permafrost and gas hydrates, yet joint evolution of these climate components is poorly understood. Covered by a cold-based ice-sheet during the last glaciation, the seafloor of the northeastern Barents Sea reveals one of the largest known glacitectonic provinces in the Arctic. Up to 200-m high glacitectonic landforms are cratered and overlie faults associated with ‘bright spots’ indicative of subsurface gas accumulations. However, sediment samples show low pore gas concentrations and no present-day gas seepage. We combine new observations and ice-sheet - hydrate modelling to propose that during the Late Weichselian, glacitectonism was caused by patchy substrate stiffening due to gradual growth of subglacial gas hydrates and permafrost. Ice decay led to rapid destabilisation and full drainage of shallow hydrate reservoirs and permafrost thaw, causing craterisation which was likely accompanied by large fluxes of carbon released into the water column. This study shows that these processes were more widespread across glaciated margins, also highlighting sensitivity and potential for abrupt changes of high-latitude carbon pools in response to complex interactions between the cryosphere, ocean, and solid earth.

Abstract Background Species identification and antifungal susceptibility tests were carried out on 212 Candida isolates obtained from bloodstream infections, urinary tract infections and dialysis-associated peritonitis, from cases attended at a Brazilian public tertiary hospital from January 1998 to January 2005. Findings Candida albicans represented 33% of the isolates, Candida parapsilosis 31.1%, Candida tropicalis 17.9%,Candida glabrata 11.8%, and others species 6.2%. In blood culture, C. parapsilosis was the most frequently encountered species (48%). The resistance levels to the antifungal azoles were relatively low for the several species, except for C. tropicalis and C. glabrata. Amphotericin B resistance was observed in 1 isolate of C. parapsilosis. Conclusions The species distribution and antifungal susceptibility herein observed presented several epidemiological features common to other tertiary hospitals in Latin American countries. It also exhibited some peculiarity, such as a very high frequency of C. parapsilosis both in bloodstream infections and dialysis-associated peritonitis. C. albicans also occurred in an important number of case infections, in all evaluated clinical sources. C. glabrata presented a high proportion of resistant isolates. The data emphasize the necessity to carry out the correct species identification accompanied by the susceptibility tests in all tertiary hospitals.

Abstract Background Peritonitis continues to be the most frequent cause of peritoneal dialysis (PD) failure, with an important impact on patient mortality. Gram-positive cocci such as Staphylococcus epidermidis, other coagulase-negative staphylococci (CoNS), and Staphylococcus aureus are the most frequent etiological agents of PD-associated peritonitis worldwide. The objective of the present study was to compare peritonitis caused by S. aureus and CoNS and to evaluate the factors influencing outcome. Methods Records of 86 new episodes of staphylococcal peritonitis that occurred between 1996 and 2000 in the Dialysis unit of a single university hospital were studied (35 due to S. aureus, 24 to S. epidermidis and 27 to other CoNS). The production of slime, lipase, lecithinase, nuclease (DNAse), thermonuclease (TNAse), α- and β-hemolysin, enterotoxins (SEA, SEB, SEC, SED) and toxic shock syndrome toxin-1 (TSST-1) was studied in S. aureus and CoNS. Antimicrobial susceptibility was evaluated based on the minimal inhibitory concentration determined by the E-test. Outcome predictors were evaluated by two logistic regression models. Results The oxacillin susceptibility rate was 85.7% for S. aureus, 41.6% for S. epidermidis, and 51.8% for other CoNS (p = 0.001). Production of toxins and enzymes, except for enterotoxin A and α-hemolysin, was associated with S. aureus episodes (p < 0.001), whereas slime production was positive in 23.5% of CoNS and 8.6% of S. aureus strains (p = 0.0047). The first model did not include enzymes and toxins due to their association with S. aureus. The odds of resolution were 9.5 times higher for S. epidermidis than for S. aureus (p = 0.02) episodes, and were similar for S. epidermidis and other CoNS (p = 0.8). The resolution odds were 68 times higher for non-slime producers (p = 0.001) and were not influenced by oxacillin resistance among vancomycin-treated cases (p = 0.89). In the second model, the resolution rate was similar for S. aureus and S. epidermidis (p = 0.70), and slime (p = 0.001) and α-hemolysin (p = 0.04) production were independent predictors of non-resolution. Conclusion Bacterial species and virulence factors rather than antibiotic resistance influence the outcome of staphylococcal peritonitis.

Ice rises are areas of locally grounded, slow-moving ice adjacent to floating ice shelves. Temperature profiles measured through ice rises contain information regarding changes to their dynamic evolution and external forcings, such as past surface temperatures, past accumulation rates and geothermal heat flux. While previous work has used borehole temperature–depth measurements to infer one or two such parameters, there has been no systematic investigation of parameter sensitivity to the interplay of multiple external forcings and dynamic changes. A one-dimensional vertical heat flow forward model developed here examines how changing forcings affect temperature profiles. Further, using both synthetic data and previous measurements from the Crary Ice Rise in Antarctica, we use our model in a Markov chain Monte Carlo inversion to demonstrate that this method has potential as a useful dating technique that can be implemented at ice rises across Antarctica. However, we also highlight the non-uniqueness of previous ice rise formation dating based on temperature profiles, showing that using nominal values for forcing parameters, without taking into account their realistic uncertainties, can lead to underestimation of dating uncertainty. In particular, geothermal heat flux represents the dominant source of uncertainty in ice rise age estimation. For instance, in Crary Ice Rise higher heat flux values (i.e. about 90 mW m−2) yield grounding timing of 1400 ± 800 years, whereas lower heat flux of around 60 mW m−2 implies earlier ice rise formation and lower uncertainties in the ice rise age estimations (500 ± 250 years). We discuss the utility of this method in choosing future ice drilling sites and conclude that integrating this technique with other indirect dating methods can provide useful constraints on past forcings and changing boundary conditions from in situ temperature–depth measurements.

Abstract Caries disease can lead to strong impact in terms of pain and suffering, to functional impairment, and to negative effects on quality of life. Studies have demonstrated that the impact on quality of life increases with dental caries severity, and few studies have assessed the relationship between caries activity and children’s oral health-related quality of life (OHRQoL). This cross-sectional study aimed to assess the impact of dental caries severity and activity on the OHRQoL of schoolchildren. The study was conducted with a sample of children aged 8 to 11 years from Pelotas, southern Brazil. Children answered the Child Perceptions Questionnaire 8–10, and socioeconomic data were collected. Children’s dental caries (Kappa value of 0.95), PUFA, traumatic dental injuries, and malocclusion were examined. The Mann-Whitney, Kruskal-Wallis, and Poisson regression tests were performed. A total of 119 children were included. Children with initial (mean ratio (MR) of 1.92; 95% confidence interval (95% CI) of 1.05–3.48), moderate (MR: 2.66; 95%CI: 1.44–4.90), and severe carious lesions (MR: 2.65; 95%CI: 1.46–4.79) had a greater impact on OHRQoL compared with those without carious lesions (p =0 .047). Children with active carious lesions exhibited a greater impact on OHRQoL (MR:1.53 and 95%CI: 1.11–2.11) when compared to those without active lesions (p = 0.019). The findings demonstrate an association between dental caries severity and activity and the OHRQoL of school-aged children.

Resumo: Em 1978, os docentes da Faculdade de Medicina de Botucatu expressaram, em questionário, as habilidades indispensáveis à formação do médico geral. As respostas do bloco clínico e cirúrgico foram classificadas em habilidades cognitivas, psicomotoras, afetivas e de senso crítico. Num total de 335 itens (não repetidos), 61% relacionavam-se à área cognitiva, 31,6% à psicomotora, 4,2% à efetiva e 3,2% a de senso crítico. No bloco clínico, as habilidades cognitivas foram mencionadas quase seis vezes mais que as psicomotoras. Quanto às respostas de internos e residentes a 40 itens relativos a habilidades adquiridas ao final da graduação, verificou-se maior porcentual médio de SIM para capacitação cognitiva do que para psicomotora, com porcentual médio de afirmativas pouco maior para os residentes. A aquisição de habilidades cognitivas importantes, como diagnóstico e tratamento do choque, de distúrbios funcionais de origem psíquica e de transtornos menstruais foi poucas vezes mencionada. Habilidades técnicas, como realizar pequenas cirurgias, punção torácica, manobras de reanimação, imobilização de membros fraturados, exame ginecológico, tiveram pequena porcentagem de respostas afirmativas. Comparando-se respostas de internos e residentes, quanto ao desempenho psicomotor indispensável, segundo os docentes, conclui-se que o treinamento prático não assegurou a capacitação necessária à formação do médico geral. São discutidas hipóteses explicativas para o descompasso no treinamento nessas duas áreas.

Abstract Peritonitis due to gram-negative bacilli (GNB), particularly nonfermenting GNB (NF-GNB), is a serious complication of peritoneal dialysis with a low resolution rate. Beyond the patient’s condition, microbiological properties such as antimicrobial resistance, biofilm production and other virulence factors can explain the poor outcomes. This study aimed to evaluate the influence of patient condition, microbiological characteristics, including biofilm production, and treatment on peritonitis outcome. We reviewed the records of 62 index episodes caused by NF-GNB that occurred between 1997 and 2015 in our center. The etiologies were species of Pseudomonas (51.6%), Acinetobacter (32.2%), and other NF-GNB (16.1%). There was a high (72.9%) proportion of biofilm producer lineages. The in vitro susceptibility rate of Pseudomonas spp. to amikacin, ciprofloxacin, and ceftazidime was significantly greater than that of Acinetobacter spp. and other species; however, there was a similar low resolution rate (

Resumo: Neste trabalho os autores fazem uma avaliação sumária dos aspectos mais relevantes do Curso da Faculdade de Medicina de Botucatu - UNESP, que completou vinte e cinco anos, em 1988. Foram analisadas as características do ensino nessa instituição, em relação a: corpo discente, corpo docente e currículo, em três momentos distintos de seu desenvolvimento (1968, 1978 e 1988). Evidenciou-se elevação progressiva do número de estudantes do sexo feminino de 1963 a 1983. Registrou-se considerável ampliação do corpo docente no período, atingindo 189 em 1988, dos quais 89% em regime de dedicação integral à docência e pesquisa. Observou-se um acréscimo de 100% no número de disciplinas, de 1968 para 1978, sobretudo no 4° e 5º anos do curso, relacionadas ao surgimento de especialidades e/ou sub-especialidades, notadamente em 1988. A análise global indica a necessidade de reformulação de currículo e curso.

O presente texto refere-se ao estudo de uma sequência didática estruturada na forma de Unidade de Ensino Potencialmente Significativa (UEPS) para a abordagem de Estatística no Ensino Fundamental, avaliando a sua pertinência em termos didáticos e como favorecedora da construção de conceitos estatísticos. Tal sequência didática proposta por Moreira (2011) está subsidiada, entre outras perspectivas teóricas, na Teoria da Aprendizagem Significativa (TAS) na concepção de David Paul Ausubel. A UEPS foi estruturada em 40 períodos e envolveu o uso de algumas tendências em Educação Matemática tais como jogos, pesquisas, filmes, entre outros. A pesquisa, de cunho qualitativo e participante, toma como instrumentos para coleta de dados, os registros no diário de bordo da pesquisadora. Além disso, o estudo recorre as produções dos alunos no decorrer dos encontros, como instrumento de análise, especialmente a avaliação diagnóstica e a avaliação somativa. Os resultados apontam para a viabilidade da proposta e demonstram a importância de aproximar os conteúdos ensinados na escola ao contexto dos alunos, levando em consideração os seus conhecimentos prévios.

Author(s): Sean P. S. Gulick (corresponding author) [1]; Amelia E. Shevenell [2]; Aleksandr Montelli [1]; Rodrigo Fernandez [1]; Catherine Smith [2]; Sophie Warny [3]; Steven M. Bohaty [4]; Charlotte Sjunneskog [...]

O objetivo com este estudo foi avaliar os resultados econômicos de confinamento de bovinos com três espaços disponíveis por animal (6, 12 e 24 m2 por animal). Para as simulações considerou-se confinamentos com capacidade estática de 5.000 animais por ciclo e dois ciclos de 86 dias por ano. Os dados de desempenho foram obtidos de 1.350 bovinos não castrados. O aumento no espaço elevou o custo fixo por animal. Os custos fixos e variáveis representaram 3% e 93% do custo operacional total, respectivamente. Dos custos variáveis, cerca de 70% foi utilizado para a compra de gado e 17% para a compra de alimentos. O lucro operacional por animal foi crescente com o aumento na disponibilidade de espaço (R$ 80,90; R$ 102,00 e R$ 109,00 para 6, 12 e 24 m2 por animal, respectivamente). Os três sistemas de confinamento recuperaram o investimento inicial e apresentaram valor presente líquido positivo. Além disso, as taxas internas de retorno foram de 22%, 27% e 25%, e as probabilidades de perdas financeiras foram de 33%, 29% e 26% para as dimensões de 6, 12 e 24 m2 por animal, respectivamente. Portanto, maior concessão de espaço nos currais de confinamento melhora a rentabilidade e reduz o risco de perda financeira.