Ventricularisation of the left atrium: a rare cause of left ventricular dysfunction in a patient with mitral valve prolapse

Case: A 11 yo girl with Marfan syndrome was referred to cardiac MR (CMR) to measure the size of her thoracic aorta. She had a typical phenotype with arachnodactyly, abnormally long arms, and was tall and slim (156 cm, 28 kg, body mass index 11,5 kg/m2). She complained of no symptoms. Cardiac auscultation revealed a prominent mid-systolic click and an end-systolic murmur at the apex. A recent echocardiogram showed a moderately dilated left ventricle with normal function and a mitral valve prolapse with moderate mitral valve regurgitation. CMR showed a dilatation of the aortic root (38 mm, Z-score 8.9) and a severe prolapse of the mitral valve with regurgitation. The ventricular cavity was moderately dilated (116 ml/m2) and its contraction was hyperdynamic (stroke volume (SV): 97 ml; LVEF 72%, with the LV volumes measured by modified Simpson method from the apex to the mitral annulus). In this patient however, the mitral prolapse was characterized by a severe backward movement of the valve toward the left atrium (LA) in systole and the dyskinetic movement of the atrioventricular plane caused a ventricularisation of a part of the LA in systole (Figure). This resulted in a significant reduction of LVEF: more than ¼ of the apparent SV was displaced backwards into the ventricularized LA volume, reducing the effective LVEF to 51% (effective SV 69ml). Moreover, by flow measurement, the SV across the ascending aorta was 30 ml (cardiac index 2.0 l/min/m2) allowing the calculation of a regurgitant fraction across the mitral valve of 56%, which was diagnostic for a severe mitral valve insufficiency. Conclusion: This case illustrates the phenomenon of a ventricularisation of the LA where the severe prolapse gives the illusion of a higher attachement of the mitral leaflets within the atrial wall. Besides the severe mitral regurgitation, this paradoxical backwards movement of the valve causes an intraventricular unloading during systole reducing the apparent LVEF of 72% to an effective LVEF of only 51%. In addition, forward flow fraction is only 22% after accounting for the regurgitant volume, as well. This combined involvement of the mitral valve could explain the discrepancy between a low output state and an apparently hyperdynamic LV contraction. Due to its ability to precisely measure flows and volumes, CMR is particularly suited to detect this phenomenon and to quantify its impact on the LV pump function.

Motivacions i barreres en la població de Canovelles de 65 a 84 anys al Complex Esportiu Municipal Thalassa

El present estudi s’emmarca en una investigació centrada en les persones grans de 65 a 84 anys del municipi de Canovelles. L’objectiu d’aquesta recerca és conèixer les principals motivacions i barreres d’aquest col·lectiu a l’hora d’anar al Complex Esportiu Municipal – Thalassa. Lligat amb els objectius marcats, la finalitat és relacionar els resultats amb possibles propostes de millora, per tal de minimitzar les barreres i potenciar les motivacions. Per obtenir els resultats s’ha passat un qüestionari a 40 persones demanant les raons per les quals van o no al complex. Un cop analitzats podem extreure, a tall de conclusions, que la principal motivació va relacionada amb temes de salut i la principal barrera amb temes econòmic, el cost mensual de la instal·lació per un abonat.

Uso del cigarrillo elctrónico en la población adulta de la ciudad de Barcelona: estudio mixto de diseño trasversal y de corte etnográfico

Introducció: Els cigarrets electrònics estan dissenyats per alliberar una solució líquida que conté substàncies químiques i nicotina o altres aromes mitjançant vaporització, i imiten l'estètica de la cigarreta convencional. Van ser dissenyats com a substituts del tabac per poder fumar sense córrer el risc de patir els efectes nocius d'aquest consum. El coneixement sobre aquests productes és molt escàs, i la seva comercialització i ús està creant gran controvèrsia en salut pública a causa dels interrogants sobre els possibles riscos per a la salut dels seus usuaris i no usuaris, la seva eficàcia per a la deshabituació tabàquica, i les possibles interferències del seu ús amb les activitats de control del tabac existents i l'aplicació del CMCT de l'OMS. Segons estudis, l'ús d'aquests dispositius s'ha expandit ràpidament, encara que de moment, no s'ha aconseguit definir un patró d'usuaris de cigarrets/cigarros electrònics ni del seu ús. Objectius: definir el patró sociodemogràfic dels usuaris de cigarrets electrònics i del seu ús en el grup poblacional estudiat, i analitzar la relació entre la dependència a la nicotina i el consum tabàquic amb l'ús d'aquests dispositius. Metodologia: consta de dues fases diferenciades però alhora complementàries constituint un estudi mixt, amb una primera fase quantitativa, en la qual es desenvoluparà un estudi observacional transversal, i una segona fase qualitativa, en la qual es desenvoluparà un estudi de tall etnogràfic. La primera fase, consta d'una primera etapa per reclutar els participants de l'estudi a través dels establiments registrats a la Cambra de Comerç de Barcelona i se'ls administrarà dos qüestionaris sobre les característiques sociodemogràfiques i el consum de tabac i l'ús dels cigarrets electrònics. En la segona etapa es recontactarà amb els participants fumadors i exfumadors per omplir un qüestionari sobre la dependència a la nicotina i al tabac previ a la utilització d'aquests dispositius i actual. A la segona fase, es realitzaran entrevistes en profunditat i es crearà un diari de camp per conèixer els motius pels que utilitzen aquests dispositius i la percepció que tenen sobre ells i el seu ús.

IEA Bioenergy Task 40 “Sustainable International Bioenergy Trade: Securing supply and demand” Country report of Finland 2008

This study considered the current situation of biofuels markets in Finland. The fact that industry consumes more than half of the total primary energy, widely applied combined heat and power production and a high share of solid biomass fuels in the total energy consumption are specific to the Finnish energy system. Wood is the most important source of bioenergy in Finland, representing 21% of the total energy consumption in 2006. Almost 80% of the wood-based energy is recovered from industrial by-products and residues. Finland has commitment itself to maintaining its greenhouse gas emissions at the 1990 level, at the highest, during the period 2008–2012. The energy and climate policy carried out in recent years has been based on the National Energy and Climate introduced in 2005. The Finnish energy policy aims to achieve the target, and a variety of measures are taken to promote the use of renewable energy sources and especially wood fuels. In 2007, the government started to prepare a new long-term (up to the year 2050) climate and energy strategy that will meet EU’s new targets for the reduction of green house gas emissions and the promotion of renewable energy sources. The new strategy will be introduced during 2008. The international biofuels trade has a substantial importance for the utilisation of bioenergy in Finland. In 2006, the total international trading of solid and liquid biofuels was approximately 64 PJ of which import was 61 PJ. Most of the import is indirect and takes place within the forest industry’s raw wood imports. In 2006, as much as 24% of wood energy was based on foreignorigin wood. Wood pellets and tall oil form the majority of export streams of biofuels. The indirect import of wood fuels increased almost 10% in 2004–2006, while the direct trade of solid and liquid biofuels has been almost constant.

Anàlisi i disseny eCommerce : Productes de Casa, venda de productes de la agricultura catalana

El projecte que és trobarà a continuació consisteix en l’anàlisi i desenvolupament d’una aplicació web orientada al comerç electrònic per un client que distribueix productes relacionats amb l’agricultura catalana. Aquest client ens planteja una idea respecte al model de negoci, i ens demana la realització tant de la part de Programació, com la part de documentació necessària per que pugui ser fàcil de mantenir en futures versions del software i tindre un bon punt de partida per a futures versions.

GSAI : gestió d'espais

L’aplicació GSAI et permet gestionar els diferents espais que existeixen a la teva empresa. Et dona la capacitat de crear els teus espais personalitzats. Aquests espais s’agrupen per entitats així pots diferenciar cada zona de la teva empresa. Cada usuari pot crear reserves dins d’un espai i esborrar-la si es necessari.

Market of biomass fuels in Finland : IEA Bioenergy Task 40 and EUBIONET III - Country report of Finland 2009

This study considered the current situation of solid and liquid biomass fuels in Finland. The fact that industry consumes more than half of the total primary energy, widely applied combined heat and power production and a high share of solid biomass fuels in the total energy consumption are specific to the Finnish energy system. Wood is the most important source of bioenergy in Finland, representing 20% of the total energy consumption in 2007. Almost 80% of the woodbased energy is recovered from industrial by-products and residues. As a member of the European Union, Finland has committed itself to the Union’s climate and energy targets, such as reducing its overall emissions of green house gases to at least 20% below 1990 levels by 2020, and increasing the share of renewable energy in the gross final consumption. The renewable energy target approved for Finland is 38%. The present National Climate and Energy Strategy was introduced in November 2008. The strategy covers climate and energy policy measures up to 2020, and in brief thereafter, up to 2050. In recent years, the actual emissions have exceeded the Kyoto commitment and the trend of emissions is on the increase. In 2007, the share of renewable energy in the gross final energy consumption was approximately 25% (360 PJ). Without new energy policy measures, the final consumption of renewable energy would increase to 380 PJ, which would be approximately only 31% of the final energy consumption. In addition, green house gas emissions would exceed the 1990 levels by 20%. Meeting the targets will need the adoption of more active energy policy measures in coming years. The international trade of biomass fuels has a substantial importance for the utilisation of bioenergy in Finland. In 2007, the total international trading of solid and liquid biomass fuels was approximately 77 PJ, of which import was 62 PJ. Most of the import is indirect and takes place within the forest industry’s raw wood imports. In 2007, as much as 21% of wood energy was based on foreign-origin wood. Wood pellets and tall oil form the majority of export streams of biomass fuels. The indirect import of wood fuels peaked in 2006 to 61 PJ. The foreseeable decline in raw wood import to Finland will decrease the indirect import of wood fuels. In 2004– 2007, the direct trade of solid and liquid biomass fuels has been on a moderate growth path. In 2007, the import of palm oil and export of bio-diesel emerged, as a large, 170 000 t/yr biodiesel plant came into operation in Porvoo.

Disseny d'una màquina carregadora de planxa a l'empresa Serralleria i Alumini Vilaró (S.A.V)

Les empreses sempre han buscat com optimitzar el màxim els seus recursos i ser més eficients a la hora de realitzar les tasques que li han estat encomanades. És per aquest motiu que constantment les empreses realitzen estudis i valoracions de com poder millorar dia a dia. Aquest fet no és diferenciador a l’empresa Serralleria i Alumini Vilaró (S.A.V), que dia a dia estudia com optimitzar els seus processos o de vegades introduir-ne de nous per tal d’expandir la seva oferta de serveis. L’empresa és dedica a la fabricació de peces metàl•liques el procés ja sigui només de tall i mecanitzat, plegat, soldadura, acabats en inoxidable, pintura i fins i tot embalatge pel que fa a la part productiva, respecte a la part d’oficina tècnica també ofereix serveis de desenvolupament de productes segons especificacions del client i reenginyeria de qualsevol producte, analitzant la part que és vol millorar. En l’actualitat l’empresa ha detectat una mancança que creu que es podria solucionar, el problema és que l’empresa disposa de varies màquines de tall, entre les quals hi ha una màquina de tall làser i el problema principal és que la càrrega de les planxes del calaix de magatzem a la bancada de la màquina es realitza o bé manualment o a través d’un gripper sostingut al pont grua, depenent del pes de la planxa a transportar. L’objectiu principal d’aquest treball és fer el disseny d’una màquina que permeti automatitzar el procés de transportar la planxa metàl•lica del calaix de magatzem dipositat sobre una taula mòbil a la bancada de la màquina de tall. El disseny que pretenem fer és complet començant per fer un disseny estructural de la màquina més els seus respectius càlculs, moviments que volem aconseguir, tria de components ( motors, sensors ...), elaboració d’un pressupost per poder fer una estimació i finalment la elaboració del programa de control de tota la màquina més la interacció amb la màquina a través d’una pantalla tàctil. Es a dir, el que pretenem és realitzar un projecte que puguem fabricar en la realitat utilitzant tota la informació continguda dins del mateix

La desigualdad en el consumo familiar. Diferencias de género en la España contemporánea (1850-1930)

In the last few years, Economic Theory has revised two basic ideas around the economics of the household: that family income is the result of the individual income of each of its members (income pooling), and that all family members living in the household have equal access to its resources. Unequal access to family resources (among women and men, on the one hand, and among the elderly, adults and children, on the other), is now understood as an input (for instance, that women eat less food and of worst quality than men), and as an output (for instance that women have poorer health, higher epidemic mortality, or are less tall than men as a result, among other things, of having received less food and poorer medical care, and/or of a heavier workload). Despite the fact that inequality in intra‐family consumption has become the center of attention in academic and international agencies, it can still not be found in the agenda of Economic History. In this paper we look at some of the resources consumed by Spanish families in the 19th century: food, alcoholic beverages, clothes and shoes. Medical topographies, our main source, suggest that unequal access to family resources among household members had a strong impact on their health and wellbeing.

Estudi de la influència del lubricant en operacions de mecanització

Els processos de mecanitzat amb arrencament de ferritja consisteixen en arrencar contínuament petits fragments de material de la peça a la que es vol donar forma mitjançant les eines de tall. En treballar amb metalls, aquestes forces de tall són importants, i provoquen el desgast de les eines així com un escalfament important de l’eina i la peça. Per aquest motiu s’introdueixen els olis de tall, amb les principals funcions de refrigerar i lubricar. Tradicionalment, aquests olis de tall s’han subministrat a raig, quedant la zona de treball inundada. Els últims anys, degut a les millores tecnològiques i per intentar estalviar amb olis de tall, s’ha ideat un nou sistema anomenat mínima quantitat de lubricant, el qual subministra petites gotes d’oli, no soluble en aigua, dins un flux d’aire a pressió. Aquest sistema, a més, s’injecta prop de la zona de treball, on és estricament necessari. Aquest sistema redueix considerablement el consum d’oli de tall, i a més, augmenta l’eficiència de lalubricació. A part, elimina els posteriors tractaments per reciclar l’oli de tall un cop perd les seves propietats. Per aquest motiu, es pretén estudiar la utilització d’un mètode semblant al de la mínima quantitat de lubricant, subministrant el mateix oli de tall que s’utilitza convencionalment però polvoritzar per tal de convertir-lo en un aerosol

Chemical characterization by GC-MS and phytotoxic potential of non-polar and polar fractions of seeds of Dioteryx odorata (Aubl.) Willd. from Venezuelan regions

Dipteryx odorata (Aubl.) Willd. is a tall arboreal species native to Central and Northern South America. This paper describes the chemical characterization and phytotoxic potential of polar and non-polar extracts from D. odorata seeds. Structural determinations were accomplished by chemical derivatization and analyzed by GC/MS. The chemical composition of the non-polar fraction (hexane and dichloromethane) presented fatty acids as major constituent. Medium polar and polar fractions (ethyl acetate and ethanol: water) contained carboxylic acid and high 6,7-Dyhidroxycoumarin-β-D-glucopyranoside content, not previously reported for seeds of D. odorata. Extracts showed a significant level of phytotoxic activity, correlated to the content of coumarin derivatives, predominantly in the polar fraction.

Nosturin kuormauselimen liitynnän suunnittelu

Paperiteollisuuden prosessituotteista paperia varastoidaan erikokoisina rullina esim. pystyrullavarastoihin. Tämän diplomityön tavoitteena oli kehittää Konecranesin prosessinosturille liityntä paperirullia käsittelevän kuormauselimen ja nosturin välille. Tavoitteena oli löytää kiinnitysmenetelmä, joka mahdollistaa nosturien joustavan käytön mahdollisimman pienin muutoksin itse nosturin standardoituun rakenteeseen. Pääasiallisena syventymisen kohteena oli alipaineella paperirullia nostettavan kuormauselimen liityntä. Liitynnän on kyettävä joustamaan ja vaimentamaan paperirullia nostavaan kuormauselimeen nosturin liikkeelle lähdöstä ja pysähtymisestä syntyvät herätteet ja voimat. Nosturin liikenopeus on kyettävä pitämään mahdollisimman suurena lyhyen rullienkäsittelyajan saavuttamiseksi. Liitynnältä vaaditaan kykyä ottaa kuormauselin vastaan mahdollisimman suurella nostonopeudella. Lisäksi kuorman ja kuormauselimen oskillaatio on vaimennettava mahdollisimman nopeasti samalla rajoittaen heilunnasta aiheutuvaa maksimi siirtymää. Liitynnän suunnittelu pohjautuu nosturin, kuormauselimen ja paperirullan muodostaman systeemin teoreettiseen tarkasteluun. Systeemistä laadittiin dynaaminen malli, jonka avulla tutkittiin oskillaation ja syntyvien kiihtyvyyksien suuruutta. Näiden teoriaan perustuvien tuloksien pohjalta suunniteltiin vaimennukseen tarvittavat vaimennuselementit ja liitynnän rakenne. Suunnittelutyön tuloksena saatiin liitynnälle alustava rakenne, joka mahdollistaa käytettävien vaimennuselementtien vaihtamisen ja siten tehokkaan heilunnan vaimmennuksen. Suunnittelutyön lähtökohtana oleva teoreettinen tarkastelu vaatii tuekseen esim. prototyypin kokeellisten tulosten saamiseksi ennen lopullisen tuotteen valmistamista. Suunnitteluprosessissa noudatettiin järjestelmällisen tuotesuunnittelun vaiheita ja menetelmiä.

Distribution and role of macrophytes in coastal lagoons : implications of critical shifts

Crossroads, crucibles and refuges are three words that may describe natural coastal lagoon environments. The words refer to the complex mix of marine and terrestrial influences, prolonged dilution due to the semi-enclosed nature and the function of a habitat for highly diverse plant and animal communities, some of which are endangered. To attain a realistic picture of the present situation, high vulnerability to anthropogenic impact should be added to the description. As the sea floor in coastal lagoons is usually entirely photic, macrophyte primary production is accentuated compared with open sea environments. There is, however, a lack of proper knowledge on the importance of vegetation for the general functioning of coastal lagoon ecosystems. The aim of this thesis is to assess the role of macrophyte diversity, cover and species identity over temporal and spatial scales for lagoon functions, and to determine which steering factors primarily restrict the qualitative and quantitative composition of vegetation in coastal lagoons. The results are linked to patterns of related trophic levels and the indicative potential of vegetation for assessment of general conditions in coastal lagoons is evaluated. This thesis includes five field studies conducted in flads and glo-flads in the brackish water northern Baltic Sea. Flads and glo-flads are defined as a Baltic variety of coastal lagoons, which due to an inlet threshold and post-glacial landuplift slowly will be isolated from the open sea. This process shrinks inlet size, increases exposure and water retention, and is called habitat isolation. The studied coastal lagoons are situated in the archipelago areas of the eastern coast of Sweden, the Åland Islands and the south-west mainland of Finland, where land-uplift amounts to ca. 5 mm/ per year. Out of 400 evaluated sites, a total of 70 lagoons varying in inlet size, archipelago position and anthropogenic influence to cover for essential environmental variation were chosen for further inventory. Vegetation composition, cover and richness were measured together with several hydrographic and morphometric variables in the lagoons both seasonally and inter-annually to cover for general regional, local and temporal patterns influencing lagoon and vegetation development. On smaller species-level scale, the effects of macrophyte species identity and richness for the fish habitat function were studied by examining the influence of plant interaction on juvenile fish diversity. Thus, the active election of plant monoand polycultures by fish and the diversity of fish in the respective culture were examined and related to plant height and water depth. The lagoons and vegetation composition were found to experience a regime shift initiated by increased habitat isolation along with land-uplift. Vegetation composition altered, richness decreased and cover increased forming a less isolated and more isolated regime, named the vascular plant regime and charophyte regime, respectively according to the dominant vegetation. As total phosphorus in the water, turbidity and the impact of regional influences decreased in parallel, the dominance of charophytes and increasing cover seemed to buffer and stabilize conditions in the charophyte regime and indicated an increased functional role of vegetation for the lagoon ecosystem. The regime pattern was unaffected by geographical differences, while strong anthropogenic impact seemed to distort the pattern due to loss of especially Chara tomentosa L. in the charophyte regime. The regimes were further found unperturbed by short-time temporal fluctuations. In fact the seasonal and inter-annual dynamics reinforced the functional difference between the regimes by the increasing role of vegetation along habitat isolation and the resemblance to lake environments for the charophyte regime. For instance, greater total phosphorus and chlorophyll a concentrations in the water in the beginning of the season in the charophyte regime compared with the vascular plant regime presented a steeper reduction to even lower values than in the vascular plant regime along the season. Despite a regional importance and positive relationship of macrophyte diversity in relation to trophic diversity, species identity was underlined in the results of this thesis, especially with decreasing spatial scale. This result was supported partly by the increased role of charophytes in the functioning of the charophyte regime, but even more explicitly by the species-specific preference of juvenile fish for tall macrophyte monocultures. On a smaller species-level scale, tall plant species in monoculture seemed to be able to increase their length, indicating that negative selection forms preferred habitat structures, which increase fish diversity. This negative relationship between plant and fish diversity suggest a shift in diversity patterns among trohic levels on smaller scale. Thus, as diversity patterns seem complex and diverge among spatial scales, it might be ambiguous to extend the understanding of diversity relationships from one trophic level to the other. All together, the regime shift described here presents similarities to the regime development in marine lagoon environments and shallow lakes subjected to nutrient enrichment. However, due to nutrient buffering by vegetation with increased isolation and water retention as a consequence of the inlet threshold, the development seems opposite to the course along an eutrophication gradient described in marine lagoons lacking an inlet threshold, where the role of vegetation decreases. Thus, the results imply devastating consequences of inlet dredging (decreasing isolation) in terms of vegetation loss and nutrient release, and call for increased conservational supervision. Especially the red listed charophytes would suffer negatively from such interference and the consequences are likely to also deteriorate juvenile fish production. The fact that a new species to Finland, Chara connivens Salzm. Ex. Braun 1835 was discovered during this study further indicates a potential of the lagoons serving as refuges for rare species.

Growth, leaf and stomatal traits of crabwood (Carapa guianensis Aubl.) in central Amazonia

Crabwood (Carapa guianensis Aubl.) is a fast growing tree species with many uses among Amazonian local communities. The main objective of this study was to assess the effect of seasonal rainfall pattern on growth rates, and seasonal and diurnal changes in leaf gas exchange and leaf water potential (ΨL) in crabwood. To assess the effect of rainfall seasonality on growth and physiological leaf traits an experiment was conducted in Manaus, AM (03º 05' 30" S, 59º 59' 35" S). In this experiment, six 6-m tall plants were used to assess photosynthetic traits and ΨL. In a second experiment the effect of growth irradiance on stomatal density (S D), size (S S) and leaf thickness was assessed in 0.8-m tall saplings. Stomatal conductance (g s) and light-saturated photosynthesis (Amax) were higher in the wet season, and between 09:00 and 15:00 h. However, no effect of rainfall seasonality was found on ΨL and potential photosynthesis (CO2-saturated). ΨL declined from -0.3 MPa early in the morning to -0.75 MPa after midday. It increased in the afternoon but did not reach full recovery at sunset. Growth rates of crabwood were high, and similar in both seasons (2 mm month-1). Leaf thickness and S D were 19% and 47% higher in sun than in shade plants, whereas the opposite was true for S S. We conclude that ΨL greatly affects carbon assimilation of crabwood by reducing g s at noon, although this effect is not reflected on growth rates indicating that other factors offset the effect of g s on Amax.

Formation of beetroot seedlings in different protected environments, substrates and containers in Aquidauana region, State of Mato Grosso do Sul, Brazil

This study with beetroot seedlings, cultivar Top Tall Early Wonder, was carried out at the State University of Mato Grosso do Sul (UEMS/Aquidauana), from October to November 2008. Three environments of cultivation were used: greenhouse; nursery with monofilament screen of 50 % of shading; and nursery with aluminized thermal reflective screen of 50% of shading. In these environments, three polystyrene trays of 72, 128 and 200 cells, filled with four substrates, were tested: soil; Plantmax®; coconut fiber and vermiculite. There were no replication environments and then each one was considered an experiment alone. For each environment, it was adopted a completely randomized design in factorial scheme 3x4 (three trays x four substrates), with four replications, performing individual analysis of variance and joint analysis of experiments for environment comparisons. The monofilament screen is the best environment for seedlings produced in tray of 72 cells, and the greenhouse was the best environment for seedlings produced in trays of 128 cells. The best seedlings were formed in the tray of 72 cells. Vermiculite was the best substrate.