55 resultados para Elective surgery of small-to-medium scope
em Biblioteca Digital da Produção Intelectual da Universidade de São Paulo (BDPI/USP)
Resumo:
Purpose: The effects of anxiety on the patient and his/her family are known to be the main factors that influence health recovery in child surgery. When the whole family can be prepared and supported by psychologic intervention, the damage to child behavior and family anxiety is attenuated. Methods: This study was conducted in children between 2 and 6 years old, divided into 2 groups of 10 pairs each. The experimental group received psychologic intervention, whereas the control group did not. One month after the surgery, they were reevaluated and compared with the same instruments used in the beginning of the study. The instruments used were as follows: the State-Trait Anxiety Inventory with the mothers and the Rutter`s Child Behavior A2 Scale and the Posthospital Behavior Questionnaire with the children. Results: The results were compared by the Wilcoxon and Mann-Whitney nonparametric tests for independent samples, both at the P <.05 significance levels. Mothers stated that anxiety was different in the postsurgery period, showing a significant decrease when comparing the experimental and control groups. Both instruments to measure child behavior also showed that prepared children had less habit changes than the control group, which showed increased levels of inadequate behavior. Conclusions: These data confirm reports in literature regarding child preparation before medical intervention and reinforces the importance of specialized presurgery planning procedures by the proper professional interfaced with the surgical colleagues, all aiming toward the best recovery for the children. (C) 2009 Elsevier Inc. All rights reserved.
Resumo:
This paper reports a research that evaluated the product development methodologies used in Brazilian small and medium-sized metal-mechanic enterprises (SMEs), in a specific region of Sao Paulo. The tool used for collecting the data was a questionnaire, which was developed and applied through interviews conducted by the researchers in 32 companies. The main focus of this paper can be condensed in the synthesis-question ""Is only the company responsible for the development?"" which was analyzed thoroughly. The results obtained from this analysis were evaluated directly (through the respective percentages of answers) and statistically (through the search of an index which demonstrates if two questions are related). The results point to a degree of maturity in SMEs, which allows product development to be conducted in cooperation networks. (C) 2007 Elsevier Ltd. All rights reserved.
Resumo:
This article presents a proposal of a systemic model composed for the micro and small companies (MSE) of the region of Ribeiro Preto and the agents which influenced their environment. The proposed model was based on Stafford Beer`s (Diagnosing the system for organizations. Chichester, Wiley, 1985) systemic methodologies VSM (Viable System Model) and on Werner Ulrich`s (1983) CSH (Critical Systems Heuristics). The VSM is a model for the diagnosis of the structure of an organization and of its flows of information through the application of the cybernetics concepts (Narvarte, In El Modelo del Sistema Viable-MSV: experiencias de su aplicacin en Chile. Proyecto Cerebro Colectivo del IAS, Santiago, 2001). On the other hand, CSH focus on the context of the social group applied to the systemic vision as a counterpoint to the organizational management view considered by the VSM. MSE of Ribeiro Preto and Sertozinho had been analyzed as organizations inserted in systems that relate and integrate with other systems concerning the public administration, entities of representation and promotion agencies. The research questions: which are the bonds of interaction among the subsystems in this process and who are the agents involved? The systemic approach not only diagnosed a social group, formed by MSE of Ribeiro Preto and Sertozinho, public authorities and support entities, but could also delineate answers that aimed the clarification of obscure questions generating financial assistance to the formularization of efficient actions for the development of this system.
Resumo:
We investigate the impact of the existence of a primordial magnetic field on the filter mass, characterizing the minimum baryonic mass that can form in dark matter (DM) haloes. For masses below the filter mass, the baryon content of DM haloes are severely depressed. The filter mass is the mass when the baryon to DM mass ratio in a halo is equal to half the baryon to DM ratio of the Universe. The filter mass has previously been used in semi-analytic calculations of galaxy formation, without taking into account the possible existence of a primordial magnetic field. We examine here its effect on the filter mass. For homogeneous comoving primordial magnetic fields of B(0) similar to 1 or 2 nG and a re-ionization epoch that starts at a redshift z(s) = 11 and is completed at z(r) = 8, the filter mass is increased at redshift 8, for example, by factors of 4.1 and 19.8, respectively. The dependence of the filter mass on the parameters describing the re-ionization epoch is investigated. Our results are particularly important for the formation of low-mass galaxies in the presence of a homogeneous primordial magnetic field. For example, for B(0) similar to 1 nG and a re-ionization epoch of z(s) similar to 11 and z(r) similar to 7, our results indicate that galaxies of total mass M similar to 5 x 108 M(circle dot) need to form at redshifts z(F) greater than or similar to 2.0, and galaxies of total mass M similar to 108 M(circle dot) at redshifts z(F) greater than or similar to 7.7.
Resumo:
A smooth inflaton potential is generally assumed when calculating the primordial power spectrum, implicitly assuming that a very small oscillation in the inflaton potential creates a negligible change in the predicted halo mass function. We show that this is not true. We find that a small oscillating perturbation in the inflaton potential in the slow-roll regime can alter significantly the predicted number of small halos. A class of models derived from supergravity theories gives rise to inflaton potentials with a large number of steps and many trans-Planckian effects may generate oscillations in the primordial power spectrum. The potentials we study are the simple quadratic (chaotic inflation) potential with superimposed small oscillations for small field values. Without leaving the slow-roll regime, we find that for a wide choice of parameters, the predicted number of halos change appreciably. For the oscillations beginning in the 10(7)-10(8) M(circle dot) range, for example, we find that only a 5% change in the amplitude of the chaotic potential causes a 50% suppression of the number of halos for masses between 10(7)-10(8) M(circle dot) and an increase in the number of halos for masses <10(6) M(circle dot) by factors similar to 15-50. We suggest that this might be a solution to the problem of the lack of observed dwarf galaxies in the range 10(7)-10(8) M(circle dot). This might also be a solution to the reionization problem where a very large number of Population III stars in low mass halos are required.
Resumo:
Certification of an ISO 14001 Environmental Management System (EMS) is currently an important requirement for those enterprises wishing to sell their products in the context of a global market. The system`s structure is based on environmental impact evaluation (EIE). However, if an erroneous or inadequate methodology is applied, the entire process may be jeopardized. Many methodologies have been developed for making of EIEs, some of them are fairly complex and unsuitable for EMS implementation in an organizational context, principally when small and medium size enterprises (SMEs) are involved. The proposed methodology for EIE is part of a model for implementing EMS. The methodological approach used was a qualitative exploratory research method based upon sources of evidence such as document analyses, semi-structured interviews and participant observations. By adopting a cooperative implementation model based on the theory of system engineering, difficulties relating to implementation of the sub-system were overcome thus encouraging SMEs to implement EMS. (C) 2007 Elsevier Ltd. All rights reserved.
Resumo:
Treatment of large petroclival meningiomas causing brain stem compression is surgical removal followed by radiotherapy or radiosurgery if the lesion was partially resected. The management of small petroclival meningiomas is, however, controversial. Clinical observation, radiosurgery and surgical removal are the options of treatment. The natural history of these tumours is not well known. Published series of patients treated with radiosurgery are not comparable with surgical series because the latter also includes large size tumours. In this paper we present a series of 18 patients with small petroclival meningiomas (diameter <= 2.8cm) treated with radical surgical removal. Total resection (Simpson`s Grade 1) [43] was possible with minimal morbidity and no mortality. Background. We present a series of small petroclival meningiomas (SPM) treated by radical surgical removal and compare the outcome with other management modalities proposed for these lesions. Methods. Eighteen patients with SPM were surgically treated at our department of neurological surgery. The tumours were classified as small when they had a diameter < 3.0cm. Headaches (n = 12), diplopia (n = 8), facial hypoaesthesia (n = 3) and tinnitus (n = 6) were the most frequent symptoms at presentation. The approaches used were retrosigmoid (n = 14), fronto-orbito-zygomatic (n = 3) and presigmoid (n = 1). The post-operative follow-up ranged from 1 to 110 months (mean 41.8 months). Findings. Radical tumour resection (Simpson`s Grades 1 and 2) was achieved in all patients. There was no major morbidity or mortality related to the surgical procedure. Transient abducent nerve palsy was the only post-operative complication. The pre-operative cranial nerves deficits improved after surgery. Only one patient had persistent diplopia postoperatively. Conclusion. Radical surgical removal of SPM is possible with minimal morbidity and may cure the patient. The effectiveness and outcome of surgery for small petroclival meningiomas should be compared with series treated by radiosurgery.
Resumo:
This article aims to discuss the space, revealing its powerful in the comprehension of modem world, from the thesis which the geographic space consists itself as condition, medium and product of society reproduction in its totality, evolving several temporal-spatial scales and several levels of reality, that should prolong Marx's work, having in view the construction of a ""social theory of space"" in the sense of a radical critical geography. This argumentation allows to understand, in the limits of geography, the passage of the notion ""production of space"" as condition of the accumulation of capital to the notion ""production of space"" as condition of present reproduction in front of the accumulation crisis. As a starting point, a discussion about some David Harvey's works, who supports the thesis that accumulation crisis of capital would be solved, in the modem world, through the spatial fix.
Resumo:
We use multiwavelength data (H I, FUV, NUV, R) to search for evidence of star formation in the intragroup medium of the Hickson Compact Group 100. We find that young star-forming regions are located in the intergalactic H I clouds of the compact group which extend to over 130 kpc away from the main galaxies. A tidal dwarf galaxy (TDG) candidate is located in the densest region of the H I tail, 61 kpc from the brightest group member and its age is estimated to be only 3.3 Myr. Fifteen other intragroup H II regions and TDG candidates are detected in the Galaxy Evolution Explorer (GALEX) FUV image and within a field 10' x 10' encompassing the H I tail. They have ages <200 Myr, H I masses of 10(9.2-10.4) M(circle dot), 0.001
Resumo:
Background: We have previously demonstrated that four members of the family of small leucine-rich-proteoglycans (SLRPs) of the extracellular matrix (ECM), named decorin, biglycan, lumican and fibromodulin, are deeply remodeled in mouse uterine tissues along the estrous cycle and early pregnancy. It is known that the combined action of estrogen (E2) and progesterone (P4) orchestrates the estrous cycle and prepares the endometrium for pregnancy, modulating synthesis, deposition and degradation of various molecules. Indeed, we showed that versican, another proteoglycan of the ECM, is under hormonal control in the uterine tissues. Methods: E2 and/or medroxiprogesterone acetate (MPA) were used to demonstrate, by real time PCR and immunoperoxidase staining, respectively, their effects on mRNA expression and protein deposition of these SLRPs, in the uterine tissues. Results: Decorin and lumican were constitutively expressed and deposited in the ECM in the absence of the ovarian hormones, whereas deposition of biglycan and fibromodulin were abolished from the uterine ECM in the non-treated group. Interestingly, ovariectomy promoted an increase in decorin, lumican and fibromodulin mRNA levels, while biglycan mRNA conspicuously decreased. Hormone replacement with E2 and/or MPA differentially modulates their expression and deposition. Conclusions: The patterns of expression of these SLRPs in the uterine tissues were found to be hormone-dependent and uterine compartment-related. These results reinforce the existence of subpopulations of endometrial fibroblasts, localized into distinct functional uterine compartments, resembling the organization into basal and functional layers of the human endometrium.
Resumo:
X-ray multiple diffraction experiments with synchrotron radiation were carried out on pure and doped nonlinear optical crystals: NH(4)H(2)PO(4) and KH(2)PO(4) doped with Ni and Mn, respectively. Variations in the intensity profiles were observed from pure to doped samples, and these variations correlated with shifts in the structure factor phases, also known as triplet phases. This result demonstrates the potential of X-ray phase measurements to study doping in this type of single crystal. Different methodologies for probing structural changes were developed. Dynamical diffraction simulations and curve fitting procedures were also necessary for accurate phase determination. Structural changes causing the observed phase shifts are discussed.
Resumo:
The analysis of Macdonald for electrolytes is generalized to the case in which two groups of ions are present. We assume that the electrolyte can be considered as a dispersion of ions in a dielectric liquid, and that the ionic recombination can be neglected. We present the differential equations governing the ionic redistribution when the liquid is subjected to an external electric field, describing the simultaneous diffusion of the two groups of ions in the presence of their own space charge fields. We investigate the influence of the ions on the impedance spectroscopy of an electrolytic cell. In the analysis, we assume that each group of ions have equal mobility, the electrodes perfectly block and that the adsorption phenomena can be neglected. In this framework, it is shown that the real part of the electrical impedance of the cell has a frequency dependence presenting two plateaux, related to a type of ambipolar and free diffusion coefficients. The importance of the considered problem on the ionic characterization performed by means of the impedance spectroscopy technique was discussed. (c) 2008 American Institute of Physics.
Resumo:
The study of spectral behavior of networks has gained enthusiasm over the last few years. In particular, random matrix theory (RMT) concepts have proven to be useful. In discussing transition from regular behavior to fully chaotic behavior it has been found that an extrapolation formula of the Brody type can be used. In the present paper we analyze the regular to chaotic behavior of small world (SW) networks using an extension of the Gaussian orthogonal ensemble. This RMT ensemble, coined the deformed Gaussian orthogonal ensemble (DGOE), supplies a natural foundation of the Brody formula. SW networks follow GOE statistics until a certain range of eigenvalue correlations depending upon the strength of random connections. We show that for these regimes of SW networks where spectral correlations do not follow GOE beyond a certain range, DGOE statistics models the correlations very well. The analysis performed in this paper proves the utility of the DGOE in network physics, as much as it has been useful in other physical systems.
Resumo:
The replacement of undisturbed tropical forest with cattle pasture has the potential to greatly modify the hydrology of small watersheds and the fluxes of solutes. We examined the fluxes of water, Cl(-), NO(3)(-)-N: SO(4)(2--)-S, NH(4)(+)-N, Na(+), K(+), Mg(2+) and Ca(2+) in different flow paths in similar to 1 ha catchments of undisturbed open tropical rainforest and a 20 year-old pasture established from forest in the southwestern Brazilian Amazon state of Rondonia. Storm flow discharge was 18% of incident rainfall in pasture, but only 1% in forest. Quickflow predominated over baseflow in both catchments and in both wet and dry seasons. In the pasture, groundwater and quickflow were important flow paths for the export of all solutes. In the forest, quickflow was important for NO(3)(-)-N export, but all other solutes were exported primarily by groundwater outflow. Both catchments were sinks for SO(4)(2-)-S and Ca(2+), and sources of Na(+). The pasture catchment also lost K(+) and Mg(2+) because of higher overland flow frequency and volume and to cattle excrement. These results show that forest clearing dramatically influences small watershed hydrology by increasing quickflow and water export to streams. They also indicate that tropical forest watersheds are highly conservative for most solutes but that pastures continue to lose important cations even decades after deforestation and pasture establishment. (c) 2008 Elsevier B.V. All rights reserved.
Resumo:
Blanks (flasks without substrate containing only inoculum and medium) are used in vitro to correct for gas. CH(4) and residual organic matter (OM) fermented in inoculum. However inclusion of rumen fermentation modifiers may affect fermentation of OM in the substrate and inoculum. Thus, data correction using blanks that lack additives may result in inaccurate adjustment for background fermentation. Our objective was to evaluate impacts of using blanks containing additive (i.e., specific blanks) or blanks without additive on estimation of in vitro net gas and CH(4) production. We used the semi-automatic in vitro gas production technique including monensin sodium at 2.08 mg/l of buffered rumen fluid (Experiment 1) or carvacrol, eugenol and 1,8-cineol at 667 mg/l (Experiment 2) in flasks with substrate and in blank flasks. At 16h of incubation, monensin reduced (P <= 0.02) total gas production in flasks containing substrate (162.0 ml versus 146.3 ml) and in blanks (84.4 ml versus 79.2 ml). Total methane production was also decreased (P <= 0.05) by adding monensin to flasks containing substrate (15.7 ml versus 11.9 ml) as well as in blanks (6.4 ml versus 5.0 ml). Inclusion of carvacrol or eugenol reduced (P <= 0.05) total gas and CH(4) production in flasks with substrate and in blanks, but in a more pronounced manner than monensin. For these three additives, correction for blank without additive resulted in lower net gas and CH(4) production than correction for a treatment specific blank. For instance, correcting carvacrol data using a blank without the additive resulted in negative net gas and CH(4) production (-6.5 and -1.5 ml. respectively). These biologically impossible results occurred because total gas and CH(4) production in blanks without carvacrol (46.1 and 2.1 ml, respectively) were higher than in flasks containing substrate plus carvacrol (39.7 and 0.6 ml, respectively). Results demonstrated that inclusion of rumen additives affected fermentation of OM in the substrate and the inoculum. Thus, correction of gas and CH(4) production using blanks without additives resulted in overestimation of these variables. Blanks containing the additive of interest should be included when rumen fermentation modifiers are evaluated in vitro. This paper is part of the special issue entitled: Greenhouse Gases in Animal Agriculture Finding a Balance between Food and Emissions, Guest Edited by T.A. McAllister, Section Guest Editors: K.A. Beauchemin, X. Hao, S. McGinn and Editor for Animal Feed Science and Technology, P.H. Robinson. (C) 2011 Elsevier B.V. All rights reserved.