Abstract A numerical investigation is performed here using a NURBS-based finite element formulation applied to classical Computational Fluid Dynamics (CFD) and Fluid-Structure Interaction (FSI) problems. Model capabilities related to refinement techniques are analyzed using a finite element formulation with NURBS (non uniform rational B-splines) basis functions, where B-splines and low-order Lagrangian elements can be considered as particular cases. An explicit two-step Taylor-Galerkin model is utilized for discretization of the fundamental flow equations and turbulence is considered using Large Eddy Simulation (LES) and the Smagorinsky’s sub-grid scale model. FSI is considered using an ALE kinematic formulation and a conservative partitioned coupling scheme with rigid body approach for large rotations is adopted. CFD and FSI applications are analyzed to evaluate the accuracy associated with the different refinement procedures utilized. Results show that high order basis functions with appropriate refinement and non-uniform parameterization lead to better predictions, compared with low-order Lagrangian models.

ABSTRACT Objective: To evaluate the influence of an application technique of a glass-fiber post using self-adhesive resin cements on the push-out bond strength and the presence of bubbles in the root thirds. The cements were either applied according to the manufacturer's instruction or using a commercial delivering system (Centrix), at which the cement pastes were collected and applied after manipulation. Material and Methods: Self-adhesive resin cements (RelyX U200/3M ESPE-U200; Maxcem Elite/Kerr-MAX; Clearfil SA Cement/Kuraray-CSA) and a conventional cement (RelyX ARC/3M ESPE-ARC) were used to cement a post and applied either based on the manufacturer's instructions or using a Centrix syringe to deliver the cements directly onto the post of choice, or directly into canal. The roots were scanned with a micro-computed tomography (μCT) and then sectioned into nine 1-mm thick slices for a push-out bond strength test. The μCT images showed the percentage of bubbles in the root thirds (cervical, medium, and apical). Data were analyzed with three-way ANOVA/Tukey (α=0.05). Results: Triple interaction was not significant (p>0.05). The interaction “material” vs “root third” was not significant. A significant interaction was observed between “material” vs “application technique” (p<0.05). For ARC, U200, and MAX, significantly lower percentages of bubbles were observed when the Centrix syringe delivered the cements. Equivalent percentages of voids were observed for CSA, irrespective of the application technique (p>0.05). Significantly higher bond strength was observed when the self-adhesive resin cements were applied using the Centrix delivery system, in comparison with the manufacturer's instructions (p<0.05). Bond strength varied with the root third: cervical>medium>apical (p<0.05). No correlations were found between the bond strength and voids. Conclusions: Bond strength and voids are negatively influenced by the conventional application technique for luting fiber posts. The delivery system (Centrix) seems to produce better results when cementing fiber posts.

este artigo apresenta um recorte de uma pesquisa de doutorado, com alunos que apresentam deficiência intelectual, matriculados em uma escola regular da rede pública do Rio de Janeiro, entre os anos de 2009 e 2012. A pesquisa-ação colaborativa e a abordagem histórico-cultural foram as bases teórico-metodológicas para investigar a elaboração dos processos de ensino e aprendizagem e a formação de conceitos por um aluno com deficiência intelectual. Os episódios da interação professor aluno, filmados na sala de aula e na sala de recursos, indicaram possibilidades de ações pedagógicas com vistas a situações de ensino conducente à construção de conceitos pelo aluno com deficiência intelectual. Além disso, constatou-se que a abordagem teórico-metodológica foi favorável à organização, de forma colaborativa, das atividades de ensino, pelas professoras de sala de aula e da sala de recursos, com procedimentos de ensino mais adequados ao processo de aprendizagem do aluno com deficiência intelectual, na escola regular.Tal proposta se coaduna com a perspectiva de ensino de qualidade para todos.

This article presents part of a doctoral study with students who have learning disabilities, who were enrolled in a regular public school in Rio de Janeiro between the years 2009 and 2012. Collaborative action research and cultural-historical approach were the theoretical and methodological bases to investigate the development of both processes of teaching and learning and the formation of concepts by a student with intellectual disabilities. From episodes filmed in the classroom and in the resource room, the data collected and analyzed indicated possibilities of pedagogical action aimed at concept construction situations by students with intellectual disabilities. Furthermore, it was found that the theoretical-methodological approach was favorable to cooperative organization of educational activities by teachers in the classroom as well as in there source room, with the most suitable teaching procedures to ensure learning conditions for students with intellectual disabilities in regular school. This proposal is consistent with the perspective of quality education for all.

O artigo teve o propósito de analisar os 37 trabalhos que versaram sobre procedimentos e recursos de ensino destinados a alunos com deficiência apresentados no GT 15 de Educação Especial da ANPEd, entre 1996 e 2010. Esses artigos representam 17% do total de 216 trabalhos apresentados nessas 15 reuniões anuais do GT. A perspectiva sociohistórica de Vigotsky fundamentou teoricamente a maioria dos estudos, sobretudos aqueles dedicados à educação de surdos. A população alvo mais estudada foi a de alunos com deficiência intelectual, seguida da surdez, sobretudo no período de 1996 a 2000; estudos dedicados a outras deficiências - física, visual e múltipla - foram menos frequentes. Os estudos descritivos, privilegiando dados qualitativos, envolvendo estudos de caso e etnográficos constituíram a maioria dos trabalhos. Os trabalhos experimentais englobaram delineamentos de grupo e delineamentos intrassujeito. Os estudos foram eloquentes em mostrar a necessidade de o professor observar mais o processo de aprendizagem do que o produto da mesma e a enfatizar o papel essencial da mediação. O processo de desenvolvimento do aluno com deficiência não ocorre da mesma forma que do aluno sem deficiência, não pela condição de deficiência exatamente, mas porque o olhar do outro nem sempre lhe confere a possibilidade para aprender e se desenvolver.

The purpose of this paper was to analyze 37 papers regarding teaching procedures and resources designed for students with special needs presented at ANPEd Special Education Work Group, during the 1996-2000 period. These articles represent 17% of the 216 papers presented in the last 15 annual ANPEd meetings. Vygotsky social historical perspective served as the theoretical basis for the majority of the studies, especially those concerning education for the deaf. Students with intellectual disabilities were the target population of most studies, followed by students with deafness, mainly during the 1996-2000 period; papers about physical, visual and multiple disabilities were less frequent. Descriptive studies, focusing on qualitative data, involving both case and ethnographic investigations constitute the majority of the articles. Experimental studies included group design as well as single subject designs. The articles were eloquent in both showing the need for teachers to pay more attention to the learning process than to the product of learning and in emphasizing the critical role of mediation. The development process of students with disabilities does not occur in the same way as their typically developing peers. This occurs mainly because of the lack of learning opportunities given to students with special needs, rather than the disabling condition.

The objective of this multicenter study was to determine tigeeyeline susceptibility rates, measured by agar diffusion, in nine hospitals in Santiago and to compare these rates with other antimicrobials. Each center studied 20 strains per month. All intermedíate and fully resistant strains as well as 10% of susceptibile strains were also studied by the broth microdilution method. Overall, 2301 strains were studied displaying the foliowing susceptibility rates for tigeeyeline: 100% for Streptococcus sp, Enterococcus sp, and E. coli respectively, 99.8% for Staphylococcus sp, 93% for Klebsiella and 80% for Acinetobacter baumarmii. For Proteus, Providencia and Morganella the susceptibility rates were 4%. For cefotaxime-resistant Klebsiella and imipenem-resistant A. baumarmii susceptibility rates were 95% and 80% respectively. The agar diffusion and broth dilution method were 100% concordant for tigeeyeline susceptible strains but only 27% for resistant or intermedíate strains represented mostly by Acinetobacter baumannii. The majority of these strains (57/59) proved to be susceptible after retesting. The great majority (96,6%) of strains tested from nine Chilean hospitals proved to be susceptible to tigeeyeline with exception for Proteus, Providencia and Morganella (66% resistance). Using the agar diffusion method for measuring tigeeyeline susceptibility to A. baumannii may be misleading.

Para conocer la susceptibilidad a tigeciclina por difusión en agar en nueve hospitales de Santiago y comparar la susceptibilidad con otros antimicrobianos, se diseñó este estudio multicéntrico. Cada centro estudió 20 cepas mensualmente. Las intermedias, resistentes y 10%o de las susceptibles se re-testearon y estudiaron por microdilución en caldo. Se incluyeron 2.304 cepas. Fueron susceptibles a tigeciclina Strep-tococcus sp (100%o), Enterococcus sp (100%), E. coli (100%o), Staphylococcus sp (99,8%), Klebsiella pneumoniae (93%) y Acinetobacter baumannii (80%). En Proteus, Providencia y Morganella la susceptibilidad fue 4%o. Klebsiella resistente a cefotaxima y Acinetobacter resistente a imipenem, 95%o y 80%o fueron susceptibles a tigeciclina, respectivamente. La concordancia en cepas susceptibles y en las enviadas como resistentes o intermedias (A. baumannii) fue 100%o y 27%o respectivamente. El re-testeo confirmó que la mayoría eran susceptibles. Los patrones de susceptibilidad bacteriana muestran muy buena actividad in vitro a tigeciclina. La resistencia in vitro de A. baumannii por difusión en agar debe interpretarse con precaución.

Background: Metallo-ß-lactamases (MBL) confer high resistance to carbapenems in Pseudomonas aeruginosa (Psae). They are encoded in mobile elements of different genes (VIM, IMP, SMP, GIM), along with other resistance genes. Aim: To detect the presence of MBL in imipenem resistant Psae strains. Material and methods: Fifty-nine imipenem resistant Psae strains isolated from January 2004 to August 2005 in a University Clinical Hospital, were included. The presence of MBL was studied by Etest (phenotypic) and genotypic polymerase chain reaction (PCR) methods. To rule out a nosocomial outbreak, MBL positive strains, were studied by pulse field gel electrophoresis. Results: The presente of MBL was detected in eleven strains. AH were type VIM and were not clonally related. There was no concordance between phenotypic and genotypic MBL detecting methods. AH the strains were also multiresistant. Conclusions: The presence of MBL was detected in 19% of imipenem resistant Psae strains

The severity and duration of post chemotherapy neutropenia were recognized during the 1960s as main predisposing factors for infections in cancer patients. At the beginning of the 70’s a standard management approach for all febrile neutropenia (FN) episodes was proposed, based on hospitalization and intravenous empirical broad spectrum antibiotic therapy. Widespread use of this approach resulted in a significant reduction in mortality attributable to bacterial infections. During the last 10 to 15 years, reappraisal of this standard approach has been done by several research groups who question the benefit of treating all FN patients similarly without taking in to consideration differences in severity of the FN episodes. This reappraisal has led during the 1990s to the development of the concept of high and low risk FN episodes that has been the base for the adoption of selective therapies based on the risk categorization of the individual patient. The Chilean Infectious Diseases Society called upon two government National Programs responsible for the appropriate distribution of chemotherapeutic drugs to all pediatric and adults cancer patients within the public health system, and upon the Chilean Hematology Society for the development of a Consensus on Diagnosis, Treatment and Prevention of Infections during FN Episodes in Cancer patients. The need for this Consensus is based on two main aspects: the new approaches proposed during the past year for management of these episodes, and the increasing population of cancer patients receiving improved chemotherapeutic agents that has increased there survival possibilities as well as there possibility to suffer a FN episode. The topics discussed in this document are based on an updated systematic and analytic review of the medical literature including epidemiology, laboratory diagnostics, risk categorization, treatment and prophylaxis. National data was included when available in order to provide the healthcare personnel that take care of these patients with best evidence based recommendations adjusted to the Chilean reality.

La intensidad y duración de la neutropenia post quimioterapia fueron identificadas en la década del 60 como los factores de mayor relevancia predisponentes a infecciones en pacientes con cáncer. A inicios de la década del 70 se estableció un manejo estandarizado para todos los episodios de neutropenia febril (NF), consistente en hospitalización y terapia antimicrobiana intravenosa empírica, de amplio espectro, lo que se tradujo en una importante disminución de la mortalidad por infecciones bacterianas en estos pacientes. En los últimos 10 a 15 años, distintos grupos de investigadores han considerado poco beneficiosas estas estrategias estandarizadas, que proporcionan un manejo uniforme a todos los pacientes con episodios de NF, independiente de la gravedad de estos. Así, se acuñaron en la década pasada los conceptos de NF de alto y bajo riesgo, lo que ha permitido implementar estrategias terapéuticas diferenciadas según el riesgo que entrañe el episodio para cada paciente en particular. La Sociedad Chilena de Infectología ha tenido la iniciativa de proponer, en un trabajo conjunto con dos programas gubernamentales: Programa Infantil de Drogas Antineoplásicas y Programa Adulto de Drogas Antineoplásicas y la Sociedad Chilena de Hematología, un consenso de diagnóstico, manejo terapéutico y prevención de NF en adultos y niños con cáncer, considerando básicamente dos aspectos: el cambio de enfoque que esta patología ha tenido en la última década, lo que obliga a una revisión sistematizada del tema, y en segundo lugar, una población creciente de pacientes oncológicos, cada vez con mejores expectativas terapéuticas para su patología de base, lo que exige ofrecer en forma acorde un muy buen manejo de esta complicación. Entregamos este documento con una completa revisión de la literatura médica sobre epidemiología, exploración de laboratorio, categorización de riesgo, enfoque terapéutico y quimioprofilaxis, con la mayor cantidad de datos nacionales disponibles, para ofrecer al equipo de salud que atiende a estos pacientes recomendaciones basadas en evidencias, y acotadas a nuestra realidad nacional

The urinary tract infection (UTI), a highly prevalent disease, must be confirmed by microbiological diagnosis. The Clinical Microbiology Committee of the Chilean Infectious Diseases Society did a retrospective survey in order to know the methodology and diagnostic criteria employed for UTI microbiological diagnosis by a representative number of clinical laboratories. The information about 49.632 urine cultures collected was obtained from fifteen public hospitals and private laboratories. All the laboratories employed the same criteria for UTI diagnosis: a microbial count > 100.000 cfu/ml. We couldn't analize lesser counts, (data was not available neither for sample collecting methods, concomitant microscopic urine analysis -urinary sediment- nor clinical symptoms). Utilizing this diagnostic criteria the yield varied among 2.3% in men and 33% in women, with more dispersed rates in children. Only the 13% of institutions processed the urine samples knowing the time transcurred since the sample collection. All the laboratories employed the same criteria to consider as contaminated a culture with: > 3 microorganisms; some of them registered 17% of contamination. Although this survey was retrospectively done diminishing the quality of the situation diagnosis, it motivated the Clinical Microbiology Advisory Committee to prepare Guidelines for the Microbiological Diagnosis of UTI

La infección del tracto urinario (ITU), patología infecciosa altamente prevalente, debe ser confirmada por un diagnostico microbiológico. El Comité de Microbiología Clínica de la Sociedad Chilena de Infectología realizó una encuesta retrospectiva para conocer la situación actual de algunos laboratorios asistenciales sobre la metodología y criterios diagnósticos empleados en el diagnóstico de ITU. Respondieron la encuesta 15 centros hospitalarios y laboratorios privados recopilándose información sobre 49.632 urocultivos. Es destacable que la totalidad de los laboratorios consideraron como criterio microbiológico de ITU un recuento microbiano > 100.000 ufc/ml. No fue posible analizar datos con recuentos inferiores por no disponerse de datos métodos sobre obtención de muestra, resultados del estudio microscópico (sedimento urinario) concomitante y sintomatología clínica. Utilizando este criterio diagnóstico la positividad varió entre 2,3% en varones y 33% en mujeres, porcentajes con una mayor dispersión en niños. Sólo 13% de las instituciones procesaron la muestra de orina en conocimiento del tiempo transcurrido desde la obtención de la muestra. Todos los laboratorios utilizaron el mismo criterio para considerar contaminada una muestra: > 3 microorganismos; algunos de ellos registraron 17% de contaminación. Si bien esta encuesta fue retrospectiva limitando la calidad del diagnóstico de situación, ella motivó al Comité de Microbiología Clínica a elaborar recomendaciones para el diagnóstico microbiológico de la infección urinaria