Pain threshold is achieved at intensity above anaerobic threshold in patients with intermittent claudication

PURPOSE: Walking training is considered as the first treatment option for patients with peripheral arterial disease and intermittent claudication (IC). Walking exercise has been prescribed for these patients by relative intensity of peak oxygen uptake (VO(2)peak), ranging from 40% to 70% VO(2)peak, or pain threshold (PT). However, the relationship between these methods and anaerobic threshold (AT), which is considered one of the best metabolic markers for establishing training intensity, has not been analyzed. Thus, the aim of this study was to compare, in IC patients, the physiological responses at exercise intensities usually prescribed for training (% VO(2) peak or % PT) with the ones observed at AT. METHODS: Thirty-three IC patients performed maximal graded cardiopulmonary treadmill test to assess exercise tolerance. During the test, heart rate (HR), VO(2), and systolic blood pressure were measured and responses were analyzed at the following: 40% of VO(2)peak; 70% of VO(2)peak; AT; and PT. RESULTS: Heart rate and VO(2) at 40% and 70% of VO(2)peak were lower than those at AT (HR: -13 +/- 9% and -3 +/- 8%, P < .01, respectively; VO(2): -52 +/- 12% and -13 +/- 15%, P < .01, respectively). Conversely, HR and VO(2) at PT were slightly higher than those at AT (HR: +3 +/- 8%, P < .01; VO(2): + 6 +/- 15%, P = .04). None of the patients achieved the respiratory compensation point. CONCLUSION: Prescribing exercise for IC patients between 40% and 70% of VO(2)peak will induce a lower stimulus than that at AT, whereas prescribing exercise at PT will result in a stimulus above AT. Thus, prescribing exercise training for IC patients on the basis of PT will probably produce a greater metabolic stimulus, promoting better cardiovascular benefits.

Greenhouse gas emissions from alternative futures of deforestation and agricultural management in the southern Amazon

The Brazilian Amazon is one of the most rapidly developing agricultural areas in the world and represents a potentially large future source of greenhouse gases from land clearing and subsequent agricultural management. In an integrated approach, we estimate the greenhouse gas dynamics of natural ecosystems and agricultural ecosystems after clearing in the context of a future climate. We examine scenarios of deforestation and postclearing land use to estimate the future (2006-2050) impacts on carbon dioxide (CO(2)), methane (CH(4)), and nitrous oxide (N(2)O) emissions from the agricultural frontier state of Mato Grosso, using a process-based biogeochemistry model, the Terrestrial Ecosystems Model (TEM). We estimate a net emission of greenhouse gases from Mato Grosso, ranging from 2.8 to 15.9 Pg CO(2)-equivalents (CO(2)-e) from 2006 to 2050. Deforestation is the largest source of greenhouse gas emissions over this period, but land uses following clearing account for a substantial portion (24-49%) of the net greenhouse gas budget. Due to land-cover and land-use change, there is a small foregone carbon sequestration of 0.2-0.4 Pg CO(2)-e by natural forests and cerrado between 2006 and 2050. Both deforestation and future land-use management play important roles in the net greenhouse gas emissions of this frontier, suggesting that both should be considered in emissions policies. We find that avoided deforestation remains the best strategy for minimizing future greenhouse gas emissions from Mato Grosso.

Per capita versus adult-equivalent estimates of calorie availability in household budget surveys

This study aims to estimate an adult-equivalent scale for calorie requirements and to determine the differences between adult-equivalent and per capita measurements of calorie availability in the Brazilian population. The study used data from the 2002-2003 Brazilian Household Budget Survey. The calorie requirement for a reference adult individual was based on the mean requirements for adult males and females (2,550kcal/day). The conversion factors were defined as the ratios between the calorie requirements for each age group and gender and that of the reference adult. The adult-equivalent calorie availability levels were higher than the per capita levels, with the largest differences in rural and low-income households. Differences in household calorie availability varied from 22kcal/day (households with adults and an adolescent) to 428kcal/day (households with elderly individuals), thus showing that per capital measurements can underestimate the real calorie availability, since they overlook differences in household composition.

A procedure to evaluate environmental rehabilitation in limestone quarries

A procedure to evaluate mine rehabilitation practices during the operational phase was developed and validated. It is based on a comparison of actually observed or documented practices with internationally recommended best practices (BP). A set of 150 BP statements was derived from international guides in order to establish the benchmark. The statements are arranged in six rehabilitation programs under three categories: (1) planning (2) operational and (3) management, corresponding to the adoption of the plan-do-check-act management systems model to mine rehabilitation. The procedure consists of (i) performing technical inspections guided by a series of field forms containing BP statements; (ii) classifying evidences in five categories; and (iii) calculating conformity indexes and levels. For testing and calibration purposes, the procedure was applied to nine limestone quarries and conformity indexes were calculated for the rehabilitation programs in each quarry. Most quarries featured poor planning practices, operational practices reached high conformity levels in 50% of the cases and management practices scored moderate conformity. Despite all quarries being ISO 14001 certified, their management systems pay low attention to issues pertaining to land rehabilitation and biodiversity. The best results were achieved by a quarry whose expansion was recently submitted to the environmental impact assessment process, suggesting that public scrutiny may play a positive role in enhancing rehabilitation practices. Conformity indexes and levels can be used to chart the evolution of rehabilitation practices at regular intervals, to establish corporate goals and for communication with stakeholders. (C) 2010 Elsevier Ltd. All rights reserved.

Validation of a root water uptake model to estimate transpiration constraints

Experimental results obtained from a greenhouse trial with common bean (Phaseolus vulgaris L) plants performed to test model hypotheses regarding the onset of limiting hydraulic conditions and the shape of the transpiration reduction curve in the falling rate phase are presented. According to these hypotheses based on simulations with an upscaled single-root model, the matric flux potential at the onset of limiting hydraulic conditions is as a function of root length density and potential transpiration rate, while the relative transpiration in the falling rate phase equals the relative matric flux potential. Transpiration of bean plants in water stressed pots with four different soils was determined daily by weighing and compared to values obtained from non-stressed pots. This procedure allowed determining the onset of the falling rate phase and corresponding soil hydraulic conditions. At the onset of the falling rate phase, the value of matric flux potential M(I) showed to differ in order of magnitude from the model predicted value for three out of four soils. This difference between model and experiment can be explained by the heterogeneity of the root distribution which is not considered by the model. An empirical factor to deal with this heterogeneity should be included in the model to improve predictions. Comparing the predictions of relative transpiration in the falling rate phase using a linear shape with water content, pressure head or matric flux potential, the matric flux potential based reduction function, in agreement with the hypothesis, showed the best performance, while the pressure head based equation resulted in the highest deviations between observed and predicted values of relative transpiration rates. (C) 2010 Elsevier B.V. All rights reserved.

Does management accounting play role in planning process?

This study examines the relationship between management accounting and planning profiles in Brazilian companies. The main goal is to understand the consequences of not including a fully structured management accounting scheme in the planning process. The authors conducted a field research among medium and large-sized companies, using a probabilistic sample from a population of 2281 companies. Using analytic hierarchy process (AHP) and statistical cluster analysis, the authors grouped the entities` strategic budget planning processes into five profiles, after which the authors applied statistical tests to assess the five clusters. The study concludes that poor or fully implemented strategic and budget-planning processes relate to the management accounting profiles of the Brazilian organizations studied. (C) 2009 Elsevier Inc. All rights reserved.

Rehabilitation of executive dysfunction: A controlled trial of an attention and problem solving treatment group

In this study, the effectiveness of a group-based attention and problem solving (APS) treatment approach to executive impairments in patients with frontal lobe lesions was investigated. Thirty participants with lesions in the frontal lobes, 16 with left frontal (LF) and 14 with right frontal (RF) lesions, were allocated into three groups, each with 10 participants. The APS treatment was initially compared to two other control conditions, an information/education (IE) approach and treatment-as-usual or traditional rehabilitation (TR), with each of the control groups subsequently receiving the APS intervention in a crossover design. This design allowed for an evaluation of the treatment through assessment before and after treatment and on follow up, six months later. There was an improvement on some executive and functional measures after the implementation of the APS programme in the three groups. Size, and to a lesser extent laterality, of lesion affected baseline performance on measures of executive function, but there was no apparent relationship between size, laterality or site of lesion and level of benefit from the treatment intervention. The results were discussed in terms of models of executive functioning and the effectiveness of domain specific interventions in the rehabilitation of executive dysfunction.

Patients Receiving Physical Rehabilitation: Records of Sexual Function Before the Introduction of Erectogenic Drugs

The objective of this study is to evaluate the entries associated to the sexual function of patients undergoing physical disability rehabilitation, as well as the course of changes and medical approach through a retrospective review of medical charts. Methods: Medical records referring to the period between July and September, 1998 were evaluated. The data was divided into two groups, records containing physician`s entries on sexual function and/or entries of other health care professionals. The following aspects were investigated: whether complaints were spontaneously voiced by the patient, and whether diagnosis had been reached, with corresponding management. Results: Out of 245 medical records investigated, 17 (6.9%) contained clinical observations on the sexual function; out of those, 14 reached diagnosis. Twelve records (4.9%) had information by non-medical healthcare professionals. Out of 17 entries by doctors, 16 referred to male patients, which was found to be significant (p = 0.0202). Conclusions: Records for the sexual function of patients undergoing physical rehabilitation are scarce. In this population, the sexual function of male patients had more extensive investigation on the part of physicians when compared to other health care professionals.

Vestibular rehabilitation with biofeedback in patients with central imbalance

Central Nervous System disorders may cause important functional unbalance in the maintenance of balance and posture. There is no effective rehabilitation for these symptoms until now. Objective: The aim of this paper is to evaluate the use of tongue electrotactile stimulation on patients with central imbalance using BrainPort. Materials and Methods: This is a prospective case series study. We evaluated 8 patients with central imbalance, 6 men and 2 women, with mean age of 67.75 years. The patients were submitted to Computed Dynamic Posturography (CDP) and then received 18 sessions of electrotactile stimulation by BrainPort (R) device for 20 minutes, twice a day. Then they were submitted to a new CDP test and to a self-perception scale to assess symptom remission, partial improvement and no improvement at all. Results: 75% of the patients reported being more stable. There was no improvement in the balance control of the mass center in these patients. Conclusion: The patients were able to use the electrotactile stimulus to improve their balance control.

Management of a multiple dentoalveolar trauma in permanent dentition with avulsion of a canine: A 4-year follow-up

Traumatic dental injuries are relatively frequent accidents that typically involve teeth in the maxillary anterior segment. The emergency treatment and the clinical decisions must be efficiently made at the time of injury, and there is a need for long-term follow-up because of the high incidence of complications. The aim of this article was to present the emergency and rehabilitation treatments of a multiple dentoalveolar trauma in the permanent dentition involving different extensions of enamel-dentin crown fracture, pulp exposure, and the avulsion of a canine. The treatment outcomes are reported up to the 4-year follow-up, and the clinical approaches and their rationale are discussed.

Formulation of a tropical town energy budget (t-TEB) scheme

This work describes the tropical town energy budget (t-TEB) scheme addressed to simulate the diurnal occurrence of the urban heat island (UHI) as observed in the Metropolitan Area of Rio de Janeiro (MARJ; -22A degrees S; -44A degrees W) in Brazil. Reasoning about the tropical urban climate have guided the scheme implementation, starting from the original equations from Masson (Bound-Lay Meteorol 94:357-397, 2000). The modifications include (a) local scaling approaches for obtaining flux-gradient relationships in the roughness sub-layer, (b) the Monin-Obukhov similarity framework in the inertial sub-layer, (c) increasing aerodynamic conductance toward more unstable conditions, and (d) a modified urban subsurface drainage system to transfer the intercepted rainwater by roofs to the roads. Simulations along 2007 for the MARJ are obtained and compared with the climatology. The t-TEB simulation is consistent with the observations, suggesting that the timing and dynamics of the UHI in tropical cities could vary significantly from the familiar patterns observed in mid-latitude cities-with the peak heat island intensity occurring in the morning than at night. The simulations are suggesting that the thermal phase shift of this tropical diurnal UHI is a response of the surface energy budget to the large amount of solar radiation, intense evapotranspiration, and thermal response of the vegetated surfaces over a very humid soil layer.

Effects of roads, topography, and land use on forest cover dynamics in the Brazilian Atlantic Forest

Roads and topography can determine patterns of land use and distribution of forest cover, particularly in tropical regions. We evaluated how road density, land use, and topography affected forest fragmentation, deforestation and forest regrowth in a Brazilian Atlantic Forest region near the city of Sao Paulo. We mapped roads and land use/land cover for three years (1962, 1981 and 2000) from historical aerial photographs, and summarized the distribution of roads, land use/land cover and topography within a grid of 94 non-overlapping 100 ha squares. We used generalized least squares regression models for data analysis. Our models showed that forest fragmentation and deforestation depended on topography, land use and road density, whereas forest regrowth depended primarily on land use. However, the relationships between these variables and forest dynamics changed in the two studied periods; land use and slope were the strongest predictors from 1962 to 1981, and past (1962) road density and land use were the strongest predictors for the following period (1981-2000). Roads had the strongest relationship with deforestation and forest fragmentation when the expansions of agriculture and buildings were limited to already deforested areas, and when there was a rapid expansion of development, under influence of Sao Paulo city. Furthermore, the past(1962)road network was more important than the recent road network (1981) when explaining forest dynamics between 1981 and 2000, suggesting a long-term effect of roads. Roads are permanent scars on the landscape and facilitate deforestation and forest fragmentation due to increased accessibility and land valorization, which control land-use and land-cover dynamics. Topography directly affected deforestation, agriculture and road expansion, mainly between 1962 and 1981. Forest are thus in peril where there are more roads, and long-term conservation strategies should consider ways to mitigate roads as permanent landscape features and drivers facilitators of deforestation and forest fragmentation. (C) 2009 Elsevier B.V. All rights reserved.

Fast heuristics for the Steiner tree problem with revenues, budget and hop constraints

This article describes and compares three heuristics for a variant of the Steiner tree problem with revenues, which includes budget and hop constraints. First, a greedy method which obtains good approximations in short computational times is proposed. This initial solution is then improved by means of a destroy-and-repair method or a tabu search algorithm. Computational results compare the three methods in terms of accuracy and speed. (C) 2007 Elsevier B.V. All rights reserved.

Historical carbon budget of the brazilian ethanol program

This work models the carbon neutralization capacity of Brazil`s ethanol program since 1975. In addition to biofuel, we also assessed the mitigation potential of other energy products, such as, bioelectricity, and CO(2) emissions captured during fermentation of sugar cane`s juice. Finally, we projected the neutralization capacity of sugar cane`s bio-energy system over the next 32 years. The balance between several carbon stocks and flows was considered in the model, including the effects of land-use change. Our results show that the neutralization of the carbon released due to land-use change was attained only in 1992, and the maximum mitigation potential of the sugar cane sector was 128 tonnes Of CO(2) per ha in 2006. An ideal reconstitution of the deployment of the sugar cane sector, including the full exploitation of bio-electricity`s potential, plus the capture Of CO(2) released during fermentation, shows that the neutralization of land-use change emissions would have been achieved in 1988, and its mitigation potential would have been 390 tCO(2)/ha. Finally, forecasts of the sector up to 2039 shows that the mitigation potential in 2039 corresponds to 836 tCO(2)/ha, which corresponds to 5.51 kg Of CO(2) per liter of ethanol produced, or 55% above the negative emission level. (C) 2009 Elsevier Ltd. All rights reserved.

Software maintenance project delays prediction using Bayesian Networks

Managing software maintenance is rarely a precise task due to uncertainties concerned with resources and services descriptions. Even when a well-established maintenance process is followed, the risk of delaying tasks remains if the new services are not precisely described or when resources change during process execution. Also, the delay of a task at an early process stage may represent a different delay at the end of the process, depending on complexity or services reliability requirements. This paper presents a knowledge-based representation (Bayesian Networks) for maintenance project delays based on specialists experience and a corresponding tool to help in managing software maintenance projects. (c) 2006 Elsevier Ltd. All rights reserved.