The use of transvaginal synthetic mesh for anterior vaginal wall prolapse repair: a randomized controlled trial

The aim of the study was to compare the efficacy and safety of transvaginal trocar-guided polypropylene mesh insertion with traditional colporrhaphy for treatment of anterior vaginal wall prolapse.This is a randomized controlled trial in which women with advanced anterior vaginal wall prolapse, at least stage II with Ba a parts per thousand yenaEuro parts per thousand+1 cm according to the Pelvic Organ Prolapse Quantification (POP-Q) classification, were randomly assigned to have either anterior colporrhaphy (n = 39) or repair using trocar-guided transvaginal mesh (n = 40). the primary outcome was objective cure rate of the anterior compartment (point Ba) assessed at the 12-month follow-up visit, with stages 0 and I defined as anatomical success. Secondary outcomes included quantification of other vaginal compartments (POP-Q points), comparison of quality of life by the prolapse quality of life (P-QOL) questionnaire, and complication rate between the groups after 1 year. Study power was fixed as 80 % with 5 % cutoff point (p < 0.05) for statistical significance.The groups were similar regarding demographic and clinical preoperative parameters. Anatomical success rates for colporrhaphy and repair with mesh placement groups were 56.4 vs 82.5 % (95 % confidence interval 0.068-0.54), respectively, and the difference between the groups was statistically significant (p = 0.018). Similar total complication rates were observed in both groups, with tape exposure observed in 5 % of the patients. There was a significant improvement in all P-QOL domains as a result of both procedures (p < 0.001), but they were not distinct between groups (p > 0.05).Trocar-guided transvaginal synthetic mesh for advanced anterior POP repair is associated with a higher anatomical success rate for the anterior compartment compared with traditional colporrhaphy. Quality of life equally improved after both techniques. However, the trial failed to detect differences in P-QOL scores and complication rates between the groups.

Dacriocistografia em cães com o emprego da ressonância magnética (DCG-RM) e da tomografia computadorizada (DCG-TC)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

钙催化剂在生物降解脂肪族聚酯合成中的应用

生物降解高分子在环境保护以及组织工程、药物控制释放、骨固定等医药领域有着广泛的应用。特别是以聚丙交酷（PLA）、聚乙交酯（PGA）、聚。一己内酯（PCL）以及它们的共聚物为代表的化学合成生物降解高分子材料，由于具有优异的性能、可以大规模生产、成本较低等优点，得到了人们广泛的关注。作为生物医用材料，对无毒性的要求很严。而现在所用的脂肪族聚酯大都是用金属盐、金属有机化合物等作为催化剂合成出来的，不可避免残留一些催化剂所用的金属元素。研究表明，即使是已经获得美国FDA批准的，现在用得最普遍的辛酸亚锡所残留的锡也可能引起一些细胞毒性。因此对毒性小且活性高的催化剂的研究是非常有意义。钙离子对人体是没有毒性的，因而这几年已引起了人们的兴趣，但文献中报道的钙催化剂，如CaHZ等，催化活性尚不够让人满意。本文对高效的钙催化剂在生物降解脂肪族聚酯中的应用进行详细的研究，得到了一些有意义的结论：1、用EO和PO处理的有机氨钙催化剂（Ca／EO和Ca／PO）聚合了CL和LLA。发现CL聚合速度很快，M／I=650时70℃反应3h后收率已达到90％以上，LLA的聚合速度比CL要慢，M／I=650、70℃反应10h后收率才达到90％以上。以上聚合反应有明显的活性聚合的特点：反应初期Mv和收率和聚合时间呈线性关系；Mv在一定范围内和M／I成线性关系。2、用红外、原子吸收和核磁共振等分析手段阐明了有机氨钙催化剂的结构：结构，而且这两个催化剂的活性中心分别是均是Ca-O键。CL和LLA的开环聚合可能是以配位一插入的机理进行的。3、用C。／PO催化剂聚合LLA时有一定程度的消旋化反应发生，曳NMR研究表明相当于88％的LLA和12％外消旋以共聚。提高反应温度到110℃时比旋光度只有-125℃说明消旋化反应比较严重。4、用C。／PO催化剂先聚合CL再聚合LLA的方法合成了PCL-PLA两嵌段共聚物，并用泊NMR，13C NMR，GPC，DSC，WAXD进行了表征。其绝对和相对分子量可以通过M／I和投料比进行控制。定量碳谱图表明有较严重的消旋化反应发生，相当于84％的LLA和16％外消旋LA共聚。DSC和似XD分析表明，PLA段的分子量小时PLA段不结晶，当PLA段的分子量达到一定程度（3000以上）后PCL一PLA嵌段共聚物有相分离现象发生。5、以各种分子量的PEG为引发剂用氨钙催化剂和开环聚合CL，合成了一系列PCL-PEG-PCL三嵌段共聚物，并用妞NMR，laCNMR，GPC，DSC，做XD进行了表征。聚合物的结构可以通过改变PEG的分子量和CL／PEG投料比来调整。从DSC和wAXD分析可以得出以下几个结论：PCL-PEG-PCL嵌段共聚物有相分离现象发生，形成PCL和PEG微相区域；PEG段的结晶行为受先结晶的PCL段的影响；PCL段的分子量越大PEG段的Tc和Tm越低，其结晶度越低。6、以各种分子量的PEG为引发剂用氨钙催化剂80℃下开环聚合LLA24小时，合成了一系列PLA-PEG-PLA三嵌段共聚物，和别的催化剂比起来温度低得多，反应时间也短得多。可以通过改变PEG的分子量和CL／PEG投料比来调整聚合物的结构。DSC和WAXD分析表明，PLA-PEG-PLA三嵌段共聚物中PEG段的结晶能力受PLA段的影响非常大：当PEG段的分子量很小时（如1000）很难结晶；即使当PEG段的分子量较大时如果PLA段的分子量达到一定程度时PEG段同样也不结晶；而且PLA段的结晶行为受本身分子量的影响比较大，其Tc和伽随着分子量增加有较大的提高。7、合成了MPEG-PLA两嵌段共聚物，发现合成PLA段的分子量大的聚合物比较困难，MPEG-PCL两嵌段共聚物很难合成。DsC和WAXD分析表明，PLA段对MPEG段结晶有一定程度的影响，但是比三嵌段共聚物的影响要小得多。8、用荧光光谱和IHNMR研究了上面合成出的几个样品的胶束行为。发现cmc由大到小的顺序为MPEG（5000）-PLA（5100），PLA（3050）-PEG（4600）-PLA（3050），PCL（2270）-PEG（5000）-PCL（2270），PCL（4600）-PEG（4600）-PCL（4600）。PCL-PEG-PCL三嵌段共聚物在水中形成了具有核一壳结构的胶束。9、以苯甲醇处理的有机氨钙催化剂开环聚合了CL。泊NMR谱图表明得到的聚合物具有苯端基。这一结果为用硝苯基乙醇代替苯甲醇制备催化剂，然后开环聚合CL或LA得到硝基苯端基的脂肪族聚酯打下了实验基础。

半结晶性嵌段共聚物自组装与薄膜微相分离

本论文以半结晶性的PLLA-b-PS为研究对象，主要研究两个方面的问题。首先研究聚合物结晶对嵌段共聚物在稀溶液中的自组装行为的影响。在此基础上，研究薄膜状态下，聚合物结晶与微相分离之间的相互作用。首先，我们系统地研究了PLLA-b- PS在不同溶剂中的自组装结构。通过调节溶剂选择性由中性向弱选择性和选择性改变，PLLA-b-PS分别形成类旋节图案，松散的胶束结构和典型的胶束核壳结构。使用混合溶剂，实现了从结晶性的球形胶束向结晶性的片状胶束的转变。标度理论分析和实验结果表明，溶剂与胶束结晶核心之间的界面能的增加是发生这一转变的主要原因。为了研究薄膜中的微相分离与结晶之间的相互作用，我们比较了三种薄膜条件下的相分离与结晶过程。均匀平坦的PLLA-b-PS薄膜是旋节不稳定的，在几以上时，分子链发生微相分离，形成旋节图案，表面诱导分子链的伸展有序化过程促使PLLA分子链发生折叠结晶，形成非经典的亚稳态凸出结构，相分离层间距增大50％。结晶过程为一级动力学。在薄膜中引入成核剂时，PLLA在几以上即开始结晶，同时实现了PLLA与P3之间的相分离，薄膜的旋节不稳定性得到了松弛。结晶使薄膜收缩，形成大量的裂纹。在PLLA熔点以上时，以裂纹为核，在薄膜中形成大量的孔洞。孔洞的生长为经典的动力学过程。我们利用自组装方法在薄膜中引入半结晶性的开放的纳米棒。在几以上时，PLLA在纳米棒中发生结晶，诱导薄膜中的分子链向纳米棒迁移，从而在薄膜中形成孔洞结构。同时，薄膜中的未结晶分子链被表面和界面诱导取向，这种取向结构利于PLLA结晶，结晶被加速，从而孔洞的生长也被加速。也就是说，结晶与孔洞的生长相互促进。在相分离薄膜中，PLLA的结晶形态与结晶温度有关。To＜TgPS时，结晶被束缚在相结构中，相分离结构不变；TgPs＜Tc＜Tm以及Tc→Tm时，结晶对相结构有一定的破坏，相分离片层结构的层间距增大，薄膜收缩，形成大量的裂纹和缺陷。在180℃时，PLLA形成不稳定的晶体结构；PLLA与PS之间的相分离强度被减弱，在线张力作用下，岛状结构的相对高度大幅度增加；在岛状结构的边缘，线张力驱使部分分子链穿越已有的相结构，形成多层岛状结构。

高Tc超导体R_1Ba_2Cu_3O_(2-x)(R-rare earth)的磁性和超异电性研究

本论文合成了R_1Ba_2Cu_3O_(2-x) (R = La、Nd、Sm、Eu、Gd、Dr、Ho、Er、Tm、Yb)、Y_2Ba_2Cu_3O_(2-x) (x = 0.10～1.17)和Y_1Ba_2Cu_3O_(7-x)S_x (x = 0～2)，并对磁性和超导电性进行了较为系统的研究。R_1Ba_2Cu_3O_(2-x)的磁化率在T > Tc的很宽的温度范围内服从Curic-Weiss定律，求得的有效磁矩略大于理论值，差值与Y_1Ba_2Cu_3O_(2-x)中Cu~(2+)磁矩相近，说明Cu~(2+)的磁矩对体系磁性有额外贡献，这贡献随R~(3+)离子中自旋平行的电子权的增多而增大。其高温下的磁化率CT > 700K)相对Curic-Weiss定律发生较大偏离，这偏离可能的来源有三个：高温下稀土离子发生较大的能级反转效应，高温下结构相变对磁性的影响，高温下氧含量减少造成Cu~(2+)磁矩增大。R_1Ba_2Cu_3O_(2-x)磁化率在T < Tc时也服从Curic-Weiss定律，R~(3+)磁矩是定域的，表明超导与磁性相互独立。互不相关，稀土磁矩与传导电子间无相互作用。用Sr取代R_1Ba_2Cu_3O_(2-x)中的Ba，没能使体系产生磁有序的变化，但却使有效磁矩增大，并完全破坏了样品的超导电性。Sm~(3+)磁化率不服从Curic-Weiss定律，在Sm_1Ba_2Cu_3O_(2-x)中Sm~(3+)显示了典型Van VlccK离子的特性。Y_1Ba_2Cu_3O_(2-x)随氧含量减少发生超导体一半导体一绝缘体的转化，当氧含量由6.90减小至6.49时发生由正交到四方的结构相变。当(7-x) = 5.83时有较多杂质相出现，123相开始分解。样品磁化率均服从Curic-Weiss定律，并随氧含量增大磁化率－温度曲线越来越趋于平缓（直线），当(7-x) = 6.90时磁化率基本不随温度变化，这时Pauli顺磁性占主导地位，这说明氧含量增加定域磁矩减少，求得的有效磁矩Peff随氧含量增大总趋势减小。提出了电子“巡游”的观点，较好地解释了上述现象，并推测出Cu(2)的d电子是离域的，对样品磁矩没有贡献，样品Peff来源于部分Cu(1)的定域Cu~(2+)的磁矩，上述推测被EPR结果证实。正交相Y_1Ba_2Cu_3O_(2-x)的EPR谱显示了中心对称成准立方晶场中Cu~(2+)(d~9, S = 1/2, I = 3/2)的EPR物性。而四方相样品的EPR谱却出现了明显的各向异性，说明观察到的为Cu(1)的EPR信号，由Cu(1)~(2+)的写域磁矩产生。Y_1Ba_2Cu_3O_(2-x)的EPR信号束源于本体相，而非Y_2Cu_2O_5、BaCuO_2、Y_2BaCuO_5等杂质相。各样品EPR信号的自旋浓度远小于1spin/cu，并随氧含量减小而增大，当(7-x) = 6.49、6.40时自旋浓度出现陡增，这时伴随由正交到四方的转化，证明了电子“巡游”观点的正确。用硫部分取代Y_1Ba_2Cu_3O_2g中的氧，当Y_1Ba_2Cu_3O_(2-x)Sx中x = 0.11时Tc = 92.6K，比Y_1Ba_2Cu_3O_(7-x)升高2K，但由于杂质相的存在，ΔTc加宽。其他样品多为半导体和绝缘体。硫取代0，当x = 0.04，0.06，0.11和1.20时磁化率服从Curic-Weiss定律，并且x = 0.87，1.2时分别在230K、240K出现反铁磁有序。其他样品由于Cu被还原为＋1价而变成抗磁性。x = 0.11 (Tc = 92.6K)，EPR谱为正交场中Cu~(2+)的信号。自旋浓度与温度无关。当所有Cu均为Cu~(1+)时，测问的是-s-的EPR信号，而Cu为混合价态(+1和+2时)测问是上述两种信号的叠加。

Transplante cardíaco (TC): a experiência do portador da doença de Chagas

O sucesso do transplante cardíaco com portadores da doença de Chagas está condicionado a cuidados especiais durante todas as fases do transplante, com necessidade de acompanhamento específico e rigoroso pela equipe de saúde. Os receptores devem estar conscientes da permanência do Trypanossoma no organismo, e das possibilidades de reativação da infecção após o transplante. Portanto, seu conhecimento dessa condição, e a sua participação ativa no próprio tratamento, têm importância fundamental. O objetivo do estudo foi investigar a experiência do transplante cardíaco vivenciada por pacientes portadores da doença de Chagas, para buscar compreender os significados que eles atribuem a esta experiência. Os procedimentos metodológicos abrangeram: a seleção dos pacientes; as entrevistas; a análise dos dados, indicando as unidades de significado e a análise individual; a busca de convergências dos discursos; e análise hermenêutica das convergências. da análise dos dados emergiram os seguintes temas: o tempo vivido pelo receptor, portador da Doença de Chagas; a concepção do TC apresentado pelo portador de Chagas; o cuidado na trajetória do TC.

Experimental Infection of Culex Annulirostris, Culex Gelidus, and Aedes Vigilax With a Yellow Fever/Japanese Encephalitis Virus Vaccine Chimera (Chimerivax TM-JE)

Australian mosquitoes from which Japanese encephalitis virus (JEV) has been recovered (Culex annulirostris, Culex gelidus, and Aedes vigilax) were assessed for their ability to be infected with the ChimeriVax-JE vaccine, with yellow fever vaccine virus 17D (YF 17D) from which the backbone of ChimeriVax-JE vaccine is derived and with JEV-Nakayama. None of the mosquitoes became infected after being fed orally with 6.1 log(10) plaque-forming units (PFU)/mL of ChimeriVax-JE vaccine, which is greater than the peak viremia in vaccinees (mean peak viremia = 4.8 PFU/mL, range = 0-30 PFU/mL of 0.9 days mean duration, range = 0-11 days). Some members of all three species of mosquito became infected when fed on JEV-Nakayama, but only Ae. vigilax was infected when fed on YF 17D. The results suggest that none of these three species of mosquito are likely to set up secondary cycles of transmission of ChimeriVax-JE in Australia after feeding on a viremic vaccinee.

A phenomenological model for the structure-composition relationship of the high Tc cuprates based on simple chemical principles

A simple phenomenological model for the relationship between structure and composition of the high Tc cuprates is presented. The model is based on two simple crystal chemistry principles: unit cell doping and charge balance within unit cells. These principles are inspired by key experimental observations of how the materials accommodate large deviations from stoichiometry. Consistent explanations for significant HTSC properties can be explained without any additional assumptions while retaining valuable insight for geometric interpretation. Combining these two chemical principles with a review of Crystal Field Theory (CFT) or Ligand Field Theory (LFT), it becomes clear that the two oxidation states in the conduction planes (typically d8 and d9) belong to the most strongly divergent d-levels as a function of deformation from regular octahedral coordination. This observation offers a link to a range of coupling effects relating vibrations and spin waves through application of Hund’s rules. An indication of this model’s capacity to predict physical properties for HTSC is provided and will be elaborated in subsequent publications. Simple criteria for the relationship between structure and composition in HTSC systems may guide chemical syntheses within new material systems.

The NetWorkPlace(TM) Phenomenon: any time and any place - reality or a seductive myth?

A new spatial logic encompassing redefined concepts of time and place, space and distance, requires a comprehensive shift in the approach to designing workplace environments for today’s adaptive, collaborative organizations operating in a dynamic business world. Together with substantial economic and cultural shifts and an increased emphasis on lifestyle considerations, the advances in information technology have prompted a radical re-ordering of organizational relationships and the associated structures, processes, and places of doing business. Within the duality of space and an augmentation of the traditional notions of place, organizational and institutional structures pose new challenges for the design professions. The literature reveals that there has always been a mono-organizational focus in relation to workplace design strategies and the burgeoning trend towards inter-organizational collaboration, enabled the identification of a gap in the knowledge relative to workplace design. The NetWorkPlaceTM© constitutes a multi-dimensional concept having the capacity to deal with the fluidity and ambiguity characteristic of the network context, as both a topic of research and the way of going about it.

Interfacial microstructure in Y1Ba2Cu3O7-δ high Tc superconductors

The microstructures of YBa2Cu3O7-δ ceramics prepared from freeze dried powders and containing an excess of CuO have been studied by analytical electron microscopy. Special attention has been paid to the interfacial microstructure. It was found that a liquid phase formed during sintering between 890°C and 920°C and this promoted grain growth and densification. Both clean grain boundaries and boundaries containing an amorphous intergranular film, which was rich in Cu, have been observed. Both CuO and BaCuO2 were present as secondary phases.

Early stages of growth of YBa2Cu3O7-δ high Tc superconducting films on (001) Y-ZrO2 substrates

The early stages of growth of high quality YBa2Cu 3O7-δ (YBCO) films grown on (001) Y-ZrO2 (YSZ) substrates by pulsed laser deposition have been studied using a combination of atomic force microscopy and transmission electron microscopy. A one unit cell thick YBCO layer and relatively large CuO particles formed in the initial stages. Additional YBCO grew on top of the first layer in the form of one or a few unit cell high c-axis oriented islands about 30 nm in diameter. The rounded islands subsequently coalesced into faceted domains. Elongated Y 2BaCuO5 particles nucleated after the first layer of YBCO. A highly textured BaZrO3 layer formed between the YSZ and the YBCO with a cube-on-cube dominant orientation relationship with respect to the YBCO film.

Comparison of three generations of ActiGraph (TM) activity monitors in children and adolescents

In this study, we evaluated agreement among three generations of ActiGraph (TM) accelerometers in children and adolescents. Twenty-nine participants (mean age = 14.2 +/- 3.0 years) completed two laboratory-based activity sessions, each lasting 60 min. During each session, participants concurrently wore three different models of the ActiGraph (TM) accelerometers (GT1M, GT3X, GT3X+). Agreement among the three models for vertical axis counts, vector magnitude counts, and time spent in moderate-to-vigorous physical exercise (MVPA) was evaluated by calculating intraclass correlation coefficients and Bland-Altman plots. The intraclass correlation coefficient for total vertical axis counts, total vector magnitude counts, and estimated MVPA was 0.994 (95% CI = 0.989-0.996), 0.981 (95% CI = 0.969-0.989), and 0.996 (95% CI = 0.989-0.998), respectively. Inter-monitor differences for total vertical axis and vector magnitude counts ranged from 0.3% to 1.5%, while inter-monitor differences for estimated MVPA were equal to or close to zero. On the basis of these findings, we conclude that there is strong agreement between the GT1M, GT3X, and GT3X+ activity monitors, thus making it acceptable for researchers and practitioners to use different ActiGraph (TM) models within a given study.

Playing Monopoly(TM) with 1st year property economics students

Game playing contributes to the acquisition of required skills and competencies whilst supporting collaboration, communication and problem solving. This project introduced the board game Monopoly CityTM to tie theoretical class room learning with collaborative, play based problem solving.