484 resultados para Rib hump


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We tested whether the distribution of three common springtail species (Gressittacantha terranova, Gomphiocephalus hodgsoni and Friesea grisea) in Victoria Land (Antarctica) could be modelled as a function of latitude, longitude, altitude and distance from the sea.

Victoria Land, Ross Dependency, Antarctica.

Generalized linear models were constructed using species presence/absence data relative to geographical features (latitude, longitude, altitude, distance from sea) across the species' entire ranges. Model results were then integrated with the known phylogeography of each species and hypotheses were generated on the role of climate as a major driver of Antarctic springtail distribution.

Based on model selection using Akaike's information criterion, the species' distributions were: hump-shaped relative to longitude and monotonic with altitude for Gressittacantha terranova; hump-shaped relative to latitude and monotonic with altitude for Gomphiocephalus hodgsoni; and hump-shaped relative to longitude and monotonic with latitude, altitude and distance from the sea for Friesea grisea.

No single distributional pattern was shared by the three species. While distributions were partially a response to climatic spatial clines, the patterns observed strongly suggest that past geological events have influenced the observed distributions. Accordingly, present-day spatial patterns are likely to have arisen from the interaction of historical and environmental drivers. Future studies will need to integrate a range of spatial and temporal scales to further quantify their respective roles.

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AIMS: To determine the incidence and predictive factors of rib fracture and chest wall pain after lung stereotactic ablative radiotherapy (SABR).

MATERIALS AND METHODS: Patients were treated with lung SABR of 48-60 Gy in four to five fractions. The treatment plan and follow-up computed tomography scans of 289 tumours in 239 patients were reviewed. Dose-volume histogram (DVH) metrics and clinical factors were evaluated as potential predictors of chest wall toxicity.

RESULTS: The median follow-up was 21.0 months (range 6.2-52.1). Seventeen per cent (50/289) developed a rib fracture, 44% (22/50) were symptomatic; the median time to fracture was 16.4 months. On univariate analysis, female gender, osteoporosis, tumours adjacent (within 5 mm) to the chest wall and all of the chest wall DVH metrics predicted for rib fracture, but only tumour location adjacent to the chest wall remained significant on the multivariate model (P < 0.01). The 2 year fracture-free probability for those adjacent to the chest wall was 65.6%. Among those tumours adjacent to the chest wall, only osteoporosis (P = 0.02) predicted for fracture, whereas none of the chest wall DVH metrics were predictive. Eight per cent (24/289) experienced chest wall pain without fracture.

CONCLUSIONS: None of the chest wall DVH metrics independently predicted for SABR-induced rib fracture when tumour location is taken into account. Patients with tumours adjacent (within 5 mm) to the chest wall are at greater risk of rib fracture after lung SABR, and among these, an additional risk was observed in osteoporotic patients.

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AIMS: To determine whether Abl immunoreactivity correlates with grade and cell kinetics (apoptosis and mitosis) in chondrosarcoma.

METHODS: Sections from 16 chondrosarcomas were stained immunohistochemically using a polyclonal antibody to the c-Abl/Bcr-Abl oncoprotein. Apoptotic indices and mitotic indices were assessed in all tumours. Sections from 24 paraffin wax blocks of human fetal rib (gestational ages, 15-42 weeks) were also stained to determine whether the Abl protein is synthesised consistently throughout endochondral ossification.

RESULTS: Abl staining in immature fetal rib chondrocytes at all stages of development was predominantly nuclear, and 70% of cells showed moderate to strong staining. Abl immunoreactivity was minimal or absent in hypertrophic chondrocytes about to undergo apoptosis at the growth plate. There was strong Abl staining in grade 1 and grade 2 chondrosarcomas but staining was greatly reduced or absent in grade 3 chondrosarcomas. There was a very significant linear correlation between apoptotic index (mean, 0.68%; range, 0-3.2%) and mitotic index (mean, 0.23%; range, 0-0.9%), and both indices were significantly lower in grade 1 than in grade 2 and grade 3 chondrosarcomas.

CONCLUSIONS: These data suggest that abl gene expression is associated with differentiation and apoptosis inhibition in fetal and neoplastic chondrocytes. However, these putative effects cannot be ascribed solely to the Abl protein, because several additional factors contribute to the regulation of both differentiation and apoptosis.

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The development of mining activities over thousands of years in the region of Aljustrel is nowadays visible as a vast area of ore tailings, slag and host rocks of sulphides mineralization. The generation of acidic waters by the alteration of pyritic minerals - Acid Mine Drainage (AMD) - causes a significant impact on the river system both in the south of the village (Rib ª. Água Forte) and in the north of it (Rib ª. Água Azeda and Barranco do Farrobo), which is reflected in extremely low pH values (< 3) and high concentrations of As, Cd, Cu, Fe, Mn, Pb, Zn and sulphates. This study aimed to assess the environmental impacts extent, integrating geochemical (surface waters and stream sediments) and biological (diatoms) parameters. Three groups of sites were defined, based on sediments and water analysis, which integration with diatom data showed the same association of groups: Group 1- impacted, with acidic pH (1.9-5.1), high metal contents (0.4-1975 mg L-1) and Fe-Mg-sulphate waters, being metals more bioavailable in waters in cationic form (Me2+); mineralogically the sediments were characterized by phyllosilicates and sulphates/oxy-hydroxysulphate phases, easily solubilized, retaining a high amount of metals when precipitated; dominant taxon was Pinnularia aljustrelica (a new species); Group 2- slightly impacted, weak acid to neutral pH (5.0-6.8), metal contents not so high (0.2-25 mg L-1) and Fe-Mg-sulphate to Mg-chloride waters; dominant taxa were Brachysira neglectissima and Achnanthidium minutissimum; Group 3- unimpacted, alkaline pH (7.0-8.4), low metal contents (0-7 mg L-1) with Mg-chloride waters. In this group, metals were associated to the primary phases (e.g. sulphides), not so easily available; the existence of high chloride contents explained the presence of typical taxa of brackish/marine (e.g. Entomoneis paludosa) waters. Taxonomical aspects of the diatoms were studied (discovery of a new species: Pinnularia aljustrelica Luis, Almeida et Ector sp. nov.), as well as morphometric (size decrease of diatoms valves, as well as the appearance of deformed valves of Eunotia exigua in Group 1 and A. minutissimum in Group 2) and physiological (effective to assess the effects of metals/acidity in the photosynthetic efficiency through PAM Fluorometry) aspects. A study was carried out in an artificial river system (microcosm) that aimed to mimic Aljustrel’s extreme conditions in controlled laboratory conditions. The chronic effects of Fe, SO42- and acidity in field biofilms, inoculated in the artificial rivers, were evaluated as well as their contribution to the communities’ tolerance to metal toxicity, through acute tests with two metals (Cu and Zn). In general, the effects caused by low pH values and high concentrations of Fe and SO42- were reflected at the community level by the decrease in diversity, the predominance of acidophilic species, the decrease in photosynthetic efficiency and the increase of enzymatic (e.g. catalase, superoxide dismutase) and non-enzymatic activities (e.g. total glutathione and total phytochelatins). However, it was possible to verify that acidity performed a protective effect in the communities, upon Cu and Zn addition. A comparative study between Aljustrel mining area and New Brunswick mining area was carried out, both with similar mining and geological conditions, reflected in similar diatom communities in both mines, but in very different geographic and climatic areas.

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Dissertação de mest., Gestão e Desenvolvimento em Turismo, Faculdade de Economia, Universidade do Algarve, 2009

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Dissertação de mest., Gerontologia Social, Escola Superior de Educação e Comunicação, Univ. do Algarve, 2011

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Tese de doutoramento, Física, Universidade de Lisboa, Faculdade de Ciências, 2014

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contribuindo para o aumento da gordura abdominal, e consequentes complicações metabólicas. O exercício físico permite quebrar este ciclo através da estimulação da lipólise e da utilização de ácidos gordos. Objetivo: Verificar os efeitos de um programa de exercícios no domicílio, em indivíduos com doença arterial coronária, na composição corporal, gordura abdominal, perfil lipídico, glicose, e nível de atividade física. Métodos: Estudo experimental composto por 20 indivíduos, aleatorizados grupo experimental (GE) e grupo de controlo (GC), ambos com 10, tendo o GE sido sujeito ao programa durante 8 semanas. Realizou-se uma avaliação inicial e final, através da bioimpedância, Tomografia Computorizada (TC) abdominal, perimetria, adipometria, análises sanguíneas e acelerómetro. Resultados: Numa análise intergrupal, verificouse uma diminuição da percentagem (%) de gordura total (GT) calculado pela adipometria (p<0.01), na prega supra-ilíaca (p=0.005), na prega abdominal horizontal (p=0.001) e vertical (p=0.003) no GE, e da % de tempo em atividades moderadas no GC (p=0.035). Após 8 semanas o GE diminuiu a %GT (p=0.008); a massa gorda (MG) (p=0.002); perímetro abaixo da última costela (p=0.037) e acima das cristas-ilíacas (p=0.021); %GT calculado (p=0.002); pregas supra-ilíaca (p=0.008), abdominal horizontal (p=0.002) e vertical (p=0.033); TC abdominal subcutâneo (p=0.031) e %de tempo em atividades vigorosas (p=0.031). O GC diminuiu a %GT (p=0.002) e MG (p=0.008); aumentou o perímetro ao nível dos grandes trocânteres (p=0.008), diminuiu o rácio cintura/anca (p=0.002), e a %de tempo em atividades moderadas (p=0.031) e vigorosas (p=0.008). Parece existir uma tendência no GE para diminuição do rácio cintura/anca, c-LDL, triglicerídeos e aumento do nível de atividade moderado. Conclusão: O programa de exercícios no domicílio demonstrou uma diminuição da gordura abdominal, alteração da composição corporal, e parece promover uma melhoria no perfil lipídico e no aumento do nível de atividade física moderado.

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RESUMO - Estudos anteriores nos Cuidados de Saúde Primários (CSP) apontam para um incremento da Deteção Precoce (DP) e Intervenções Breves (IB) em pacientes com Problemas Ligados ao Álcool (PLA) após formação apropriada dos profissionais de saúde (com melhoria das suas atitudes). Este estudo quasi experimental, exploratório, é pioneiro no âmbito da Saúde Ocupacional (SO) para a implementação de Rastreio/DP e IB nos PLA. O objetivo principal foi avaliar se uma formação sobre Rastreio/DP e IB pode melhorar as atitudes dos profissionais de SO ao lidar com os PLA em Meio Laboral (PLAML). Foi aplicado um questionário em duas partes: Q1/pré-formação (variáveis sociodemográficas, profissionais, competências em alcoologia, experiência pessoal com álcool/familiares com PLA, dificuldades em lidar com trabalhadores com PLA, AUDIT-C e SAAPPQ) e Q2/pós-formação (avaliação da formação e das atitudes SAAPPQ - Adequação, Legitimidade, Motivação, Autoestima e Satisfação). Os resultados na amostra (N=39) revelaram um aumento sobretudo na Adequação e Satisfação. No entanto, naqueles com níveis baixos das atitudes pré-formação constou-se melhoria das atitudes à excepção da Autoestima e foram encontradas algumas associações com as características do perfil inicial dos participantes. Sugerem-se estudos posteriores para identificação de pacotes formativos mais efetivos e propostas para um Plano integrador de RIB para PLAML

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The majority of transcatheter aortic valve implantations, structural heart procedures and the newly developed transcatheter mitral valve repair and replacement are traditionally performed either through a transfemoral or a transapical access site, depending on the presence of severe peripheral vascular disease or anatomic limitations. The transapical approach, which carries specific advantages related to its antegrade nature and the short distance between the introduction site and the cardiac target, is traditionally performed through a left anterolateral mini-thoracotomy and requires rib retractors, soft tissue retractors and reinforced apical sutures to secure, at first, the left ventricular apex for the introduction of the stent-valve delivery systems and then to seal the access site at the end of the procedure. However, despite the advent of low-profile apical sheaths and newly designed delivery systems, the apical approach represents a challenge for the surgeon, as it has the risk of apical tear, life-threatening apical bleeding, myocardial damage, coronary damage and infections. Last but not least, the use of large-calibre stent-valve delivery systems and devices through standard mini-thoracotomies compromises any attempt to perform transapical transcatheter structural heart procedures entirely percutaneously, as happens with the transfemoral access site, or via a thoracoscopic or a miniaturised video-assisted percutaneous technique. During the past few years, prototypes of apical access and closure devices for transapical heart valve procedures have been developed and tested to make this standardised successful procedure easier. Some of them represent an important step towards the development of truly percutaneous transcatheter transapical heart valve procedures in the clinical setting.

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L’Islam interdit le riba , mot arabe signifiant à la fois usure et intérêt. L’interdiction du rib figure dans la loi islamique, née dans l’Arabie du Moyen Âge. Elle est à la base de la finance islamique qui connut une expansion remarquable durant la deuxième moitié du XX e siècle. Nous nous interrogeons sur les origines de cette interdiction, sur les problèmes que connaît actuellement la finance islamique et sur ses perspectives d’avenir.

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This paper studies the persistent effects of monetary shocks on output. Previous empirical literature documents this persistence, but standard general equilibrium models with sticky prices fail to generate output responses beyond the duration of nominal contracts. This paper constructs and estimates a general equilibrium model with price rigidities, habit formation, and costly capital adjustment. The model is estimated via Maximum Likelihood using US data on output, the real money stock, and the nominal interest rate. Econometric results suggest that habit formation and adjustment costs to capital play an important role in explaining the output effects of monetary policy. In particular, impulse response analysis indicates that the model generates persistent, hump-shaped output responses to monetary shocks.

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La scoliose idiopathique de l’adolescence (SIA) est une pathologie de cause inconnue impliquant une déformation tridimensionnelle de la colonne vertébrale et de la cage thoracique. Cette pathologie affecte, entre autres, les vertèbres ainsi que les muscles paraspinaux. Ces composantes de la colonne vertébrale jouent un rôle important lors de la marche. Dix sujets témoins et neuf sujets SIA ont effectué dix essais de marche à vitesse normale sur un corridor de marche de dix mètres dans lequel était inséré deux plates-formes de force. De plus, un système de huit caméras (VICON) a permis de calculer les coordonnées tridimensionnelles des 30 marqueurs utilisés afin d’analyser la cinématique des sujets. Les variables faisant l’objet de cette étude sont les amplitudes totales, minimales et maximales des rotations des ceintures pelvienne et scapulaire dans les plans transverse et frontal de même que les coefficients de corrélation et de variation de ces segments. Des tests de Student ont été utilisés pour l’analyse statistique. Malgré le fait qu’aucune différence significative n’a été observée, dans aucun des plans, entre les amplitudes des rotations des ceintures pelvienne et scapulaire entre les groupes témoin et SIA, une différence significative en ce qui a trait aux minimums de rotations pelviennes et scapulaires, dans le plan transverse, a été observée. Cette différence suggère une asymétrie dans les rotations effectuées par ces segments à la marche à vitesse naturelle chez une population atteinte de SIA.

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La scoliose idiopathique (SI) est une déformation tridimensionnelle (3D) de la colonne vertébrale et de la cage thoracique à potentiel évolutif pendant la croissance. Cette déformation 3D entraîne des asymétries de la posture. La correction de la posture est un des objectifs du traitement en physiothérapie chez les jeunes atteints d’une SI afin d’éviter la progression de la scoliose, de réduire les déformations morphologiques et leurs impacts sur la qualité de vie. Les outils cliniques actuels ne permettent pas de quantifier globalement les changements de la posture attribuables à la progression de la scoliose ou à l’efficacité des interventions thérapeutiques. L’objectif de cette thèse consiste donc au développement et à la validation d’un nouvel outil clinique permettant l’analyse quantitative de la posture auprès de personnes atteintes d’une SI. Ce projet vise plus spécifiquement à déterminer la fidélité et la validité des indices de posture (IP) de ce nouvel outil clinique et à vérifier leur capacité à détecter des changements entre les positions debout et assise. Suite à une recension de la littérature, 34 IP représentant l’alignement frontal et sagittal des différents segments corporels ont été sélectionnés. L’outil quantitatif clinique d’évaluation de la posture (outil 2D) construit dans ce projet consiste en un logiciel qui permet de calculer les différents IP (mesures angulaires et linéaires). L’interface graphique de cet outil est conviviale et permet de sélectionner interactivement des marqueurs sur les photographies digitales. Afin de vérifier la fidélité et la validité des IP de cet outil, la posture debout de 70 participants âgés entre 10 et 20 ans atteints d'une SI (angle de Cobb: 15º à 60º) a été évaluée à deux occasions par deux physiothérapeutes. Des marqueurs placés sur plusieurs repères anatomiques, ainsi que des points de référence anatomique (yeux, lobes des oreilles, etc.), ont permis de mesurer les IP 2D en utilisant des photographies. Ces mêmes marqueurs et points de référence ont également servi au calcul d’IP 3D obtenus par des reconstructions du tronc avec un système de topographie de surface. Les angles de Cobb frontaux et sagittaux et le déjettement C7-S1 ont été mesurés sur des radiographies. La théorie de la généralisabilité a été utilisée pour déterminer la fidélité et l’erreur standard de la mesure (ESM) des IP de l’outil 2D. Des coefficients de Pearson ont servi à déterminer la validité concomitante des IP du tronc de l’outil 2D avec les IP 3D et les mesures radiographiques correspondantes. Cinquante participants ont été également évalués en position assise « membres inférieurs allongés » pour l’étude comparative de la posture debout et assise. Des tests de t pour échantillons appariés ont été utilisés pour détecter les différences entre les positions debout et assise. Nos résultats indiquent un bon niveau de fidélité pour la majorité des IP de l’outil 2D. La corrélation entre les IP 2D et 3D est bonne pour les épaules, les omoplates, le déjettement C7-S1, les angles de taille, la scoliose thoracique et le bassin. Elle est faible à modérée pour la cyphose thoracique, la lordose lombaire et la scoliose thoraco-lombaire ou lombaire. La corrélation entre les IP 2D et les mesures radiographiques est bonne pour le déjettement C7-S1, la scoliose et la cyphose thoracique. L’outil est suffisamment discriminant pour détecter des différences entre la posture debout et assise pour dix des treize IP. Certaines recommandations spécifiques résultents de ce projet : la hauteur de la caméra devrait être ajustée en fonction de la taille des personnes; la formation des juges est importante pour maximiser la précision de la pose des marqueurs; et des marqueurs montés sur des tiges devraient faciliter l’évaluation des courbures vertébrales sagittales. En conclusion, l’outil développé dans le cadre de cette thèse possède de bonnes propriétés psychométriques et permet une évaluation globale de la posture. Cet outil devrait contribuer à l’amélioration de la pratique clinique en facilitant l’analyse de la posture debout et assise. Cet outil s’avère une alternative clinique pour suivre l’évolution de la scoliose thoracique et diminuer la fréquence des radiographies au cours du suivi de jeunes atteints d’une SI thoracique. Cet outil pourrait aussi être utile pour vérifier l’efficacité des interventions thérapeutiques sur la posture.

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Réalisé en cotutelle avec l'Université Joseph Fourier École Doctorale Ingénierie pour la Santé,la Cognition et l'Environnement (France)