Heart failure disease management program experience in 4,545 heart failure admissions to a community hospital

Background Disease management programs (DMPs) are developed to address the high morbi-mortality and costs of congestive heart failure (CHF). Most studies have focused on intensive programs in academic centers. Washington County Hospital (WCH) in Hagerstown, MD, the primary reference to a semirural county, established a CHF DMP in 2001 with standardized documentation of screening and participation. Linkage to electronic records and state vital statistics enabled examination of the CHF population including individuals participating and those ineligible for the program. Methods All WCH inpatients with CHF International Classification of Diseases, Ninth Revision code in any position of the hospital list discharged alive. Results Of 4,545 consecutive CHF admissions, only 10% enrolled and of those only 52.2% made a call. Enrollment in the program was related to: age (OR 0.64 per decade older, 95% CI 0.58-0.70), CHF as the main reason for admission (OR 3.58, 95% CI 2.4-4.8), previous admission for CHF (OR 1.14, 95% CI 1.09-1.2), and shorter hospital stay (OR 0.94 per day longer, 95% CI 0.87-0.99). Among DMP participants mortality rates were lowest in the first month (80/1000 person-years) and increased subsequently. The opposite mortality trend occurred in nonenrolled groups with mortality in the first month of 814 per 1000 person-years in refusers and even higher in ineligible (1569/1000 person-years). This difference remained significant after adjustment. Re-admission rates were lower among participants who called consistently (adjusted incidence rate ratio 0.62, 95% CI 0.52-0.77). Conclusion Only a small and highly select group participated in a low-intensity DMP for CHF in a community-based hospital. Design of DMPs should incorporate these strong selective factors to maximize program impact. (Am Heart J 2009; 15 8:459-66.)

THE EFFECT OF DIFFERENT VOLUMES OF ACUTE RESISTANCE EXERCISE ON ELDERLY INDIVIDUALS WITH TREATED HYPERTENSION

Scher, LML, Ferriolli, E, Moriguti, JC, Scher, R, and Lima, NKC. The effect of different volumes of acute resistance exercise on elderly individuals with treated hypertension. J Strength Cond Res 25(4): 1016-1023, 2011-Acute resistance exercise can reduce the blood pressure (BP) of hypertensive subjects. The aim of this study was to evaluate the effect of different volumes of acute low-intensity resistance exercise over the magnitude and the extent of BP changes in treated hypertensive elderly individuals. Sixteen participants (7 men, 9 women), with mean age of 68 6 5 years, performed 3 independent randomized sessions: Control (C: 40 minutes of rest), Exercise 1 (E1: 20 minutes, 1 lap in the circuit), and Exercise 2 (E2: 40 minutes, 2 laps in the circuit) with the intensity of 40% of 1 repetition maximum. Blood pressure was measured before (during 20 minutes) and after each session (every 5 minutes during 60 minutes) using both a mercury sphygmomanometer and a semiautomatic device (Omrom-HEM-431). After that, 24-hour ambulatory blood pressure monitoring was performed (Dyna-MAPA). Blood pressure decreased during the first 60 minutes (systolic: p < 0.01, diastolic: p < 0.05) after all exercise sessions. Only the highest volume session promoted a reduction of mean systolic 24-hour BP and awake BP (p, 0.05) after exercise, with higher diastolic BP during sleep (p, 0.05). Diastolic 24-hour BP and both systolic and diastolic BP during sleep were higher after E1 (p, 0.05). Concluding, acute resistive exercise sessions in a circuit with different volumes reduced BP during the first 60 minutes after exercise in elderly individuals with treated hypertension. However, only the highest volume promoted a reduction of mean 24-hour and awake systolic BP.

A new DTL-electrode holder for recording of electroretinograms in animals

Purpose: Contact lens electrodes (CLEs) are frequently used to register electroretinograms (ERGs) in small animals such as mice or rats. CLEs are expensive to buy or difficult to be produced individually. In addition, CLE`s have been noticed to elicit inconstant results and they carry potential to injure the cornea. Therefore, a new electrode holder was constructed based on the clinically used DTL-electrode and compared to CLEs. Material and methods: ERGs were recorded with both electrode types in nine healthy Brown-Norway rats under scotopic conditions. For low intensity responses a Naka-Rushton function was fitted and the parameters V(max), k and n were analyzed. The a-wave, b-wave and oscillatory potentials were analyzed for brighter flash intensities (1-60 scot cd s/m(2)). Repeatability was assessed for both electrode types in consecutive measurements. Results: The new electrode holder was faster in setting up than the CLE and showed lower standard deviations. No corneal alterations were observed. Slightly higher amplitudes were recorded in most of the measurements with the new electrode holder (except amplitudes induced by 60 cd s/m(2)). A Bland-Altman test showed good agreement between the DTL holder and the CLE (mean difference 35.2 mu V (Holder-CLE)). Pearson`s correlation coefficient for test-retest-reliability was r = 0.783. Conclusions: The DTL holder was superior in handling and caused far less corneal problems than the CLE and produced comparable or better electrophysiological results. The minimal production costs and the possibility of adapting the DTL holder to bigger eyes, such as for dogs or rabbits, offers with broader application prospects. (C) 2010 Elsevier B.V. All rights reserved.

Effect of laser phototherapy on the release of fibroblast growth factors by human gingival fibroblasts

The effects of laser phototherapy on the release of growth factors by human gingival fibroblasts were studied in vitro. Cells from a primary culture were irradiated twice (6 h interval), with continuous diode laser [gallium-aluminum-arsenium (GaAlAs), 780 nm, or indium-gallium-aluminum-phosphide (InGaAlP),_660 nm] in punctual and contact mode, 40 mW, spot size 0.042 cm(2), 3 J/cm(2) and 5 J/cm(2) (3 s and 5 s, respectively). Positive [10% fetal bovine serum (FBS)] and negative (1%FBS) controls were not irradiated. Production of keratinocyte growth factor (KGF) and basic fibroblast growth factor (bFGF) was quantified by enzyme-linked immunosorbent assay (ELISA). The data were statistically compared by analysis of variance (ANOVA) followed by Tukey`s test (P a parts per thousand currency signaEuro parts per thousand 0.05). The characterization of the cell line indicated a mesenchymal nature. KGF release was similar in all groups, while that of bFGF was significantly greater (1.49-times) in groups treated with infra-red laser. It was concluded that increased production of bFGF could be one of the mechanisms by which infra-red laser stimulates wound healing.

Fluid shifts resulting from exercise in rats as detected by bioelectrical impedance

Purpose: This study was designed to investigate the immediate effect of exercise intensity and duration on body fluid volumes in rats throughout a 3-wk exercise program. Methods: Changes in the extracellular water (ECW) and total body water (TBW) volumes of rats were measured preexercise and postexercise using multiple frequency bioelectrical impedance analysis. Groups of rats were exercised at two intensities (6 m.min(-1) and 12 m.min(-1)) for two exercise times (60 min and 90 min) 5 d.wk(-1) during a 3-wk period. Changes in plasma electrolytes, glucose, and lactate resulting from the exercise were also measured on 3 d of each week. Results: Each group of animals showed significant losses in ECW and TBW as a direct result of daily exercise. The magnitude of fluid loss was directly related to the intensity of the exercise, bur not to exercise duration; although the magnitude of daily fluid loss at the higher intensity exercise (12 m.min(-1)) decreased as the study progressed, possibly indicating a training effect. Conclusion: At low-intensity exercise, there is a small bur significant loss in both TBW and ECW fluids, and the magnitude of these losses does not change throughout a 3-wk exercise program. At moderate levels of exercise intensity, there is a greater loss of both TBW and ECW fluids. However, the magnitudes of these losses decrease significantly during the 3-wk exercise program, thus demonstrating a training effect.

Interval training program optimization in highly trained endurance cyclists

Purpose: The purpose of this study was to examine the influence of three different high-intensity interval training (HIT) regimens on endurance performance in highly trained endurance athletes. Methods: Before, and after 2 and 4 wk of training, 38 cyclists and triathletes (mean +/- SD; age = 25 +/- 6 yr; mass = 75 +/- 7 kg; (V)over dot O-2peak = 64.5 +/- 5.2 mL.kg(-1).min(-1)) performed: 1) a progressive cycle test to measure peak oxygen consumption ((V)over dotO(2peak)) and peak aerobic power output (PPO), 2) a time to exhaustion test (T-max) at their (V)over dotO(2peak) power output (P-max), as well as 3) a 40-kin time-trial (TT40). Subjects were matched and assigned to one of four training groups (G(1), N = 8, 8 X 60% T-max P-max, 1:2 work:recovery ratio; G(2), N = 9, 8 X 60% T-max at P-max, recovery at 65% HRmax; G(3), N = 10, 12 X 30 s at 175% PPO, 4.5-min recovery; G(CON), N = 11). In addition to G(1) G(2), and G(3) performing HIT twice per week, all athletes maintained their regular low-intensity training throughout the experimental period. Results: All HIT groups improved TT40 performance (+4.4 to +5.8%) and PPO (+3.0 to +6.2%) significantly more than G(CON) (-0.9 to + 1.1 %; P < 0.05). Furthermore, G(1) (+5.4%) and G(2) (+8.1%) improved their (V)over dot O-2peak significantly more than G(CON) (+ 1.0%; P < 0.05). Conclusion: The present study has shown that when HIT incorporates P-max as the interval intensity and 60% of T-max as the interval duration, already highly trained cyclists can significantly improve their 40-km time trial performance. Moreover, the present data confirm prior research, in that repeated supramaximal HIT can significantly improve 40-km time trial performance.

Effect of a control burn on lizards and their structural environment in a eucalypt open-forest

The composition of an open-forest lizard assemblage in eastern Australia was examined before and after a low-intensity controlled fire and concurrently compared with that in an adjoining unburnt area. The effect of fire on the available structural environment and the habitat used by two focal species, Carlia vivax and Lygisaurus foliorum, was also examined. Lizard species richness was unaffected by the controlled burn as was the abundance of most species. C. vivax was the only species to display a significant reduction in abundance after fire. While the low-intensity fire resulted in significant changes to the available structural environment, there were no compensatory shifts in the habitat preferences of either C. vivax or L. foliorum. The reduction in abundance of C. vivax was congruent with this species' avoidance of burnt areas. C. vivax displayed a non-random preference for ground cover and litter cover, which were reduced in burnt areas. Changes in the availability of preferred structural habitat features are likely to contribute to changes in the abundance of some lizard species. Therefore, even low-intensity disturbances can have an impact on lizard assemblages if critical habitat features are lost or become limiting.

A practical method of estimating energy expenditure during tennis play

This study aimed to develop a practical method of estimating energy expenditure (EE) during tennis. Twenty-four elite female tennis players first completed a tennis-specific graded test in which five different intensity levels were applied randomly. Each intensity level was intended to simulate a game of singles tennis and comprised six 14 s periods of activity alternated with 20 s of active rest. Oxygen consumption (VO2) and heart rate (HR) were measured continuously and each player's rate of perceived exertion (RPE) was recorded at the end of each intensity level. Rate of energy expenditure (EEVO2) during the test was calculated using the sum of VO2 during play and the 'O-2 debt' during recovery, divided by the duration of the activity. There were significant individual linear relationships between EEVO2 and RPE, EEVO2 and HR, (rgreater than or equal to0.89 rgreater than or equal to0.93; p

Unexpected clobetasol propionate profile in human stratum corneum after topical application in vitro

Purpose. The validity of using drug amount-depth profiles in stratum corneum to predict uptake of clobetasol propionate into stratum corneum and its transport into deeper skin layers was investigated. Methods. In vitro diffusion experiments through human epidermis were carried out using Franz-type glass diffusion cells. A saturated solution of clobetasol propionate in 20% (V/V) aqueous propylene glycol was topically applied for 48 h. Steady state flux was calculated from the cumulative amount of drug permeated vs. time profile. Epidermal partitioning was conducted by applying a saturated drug solution to both sides of the epidermis and allowing time to equilibrate. The tape stripping technique was used to define drug concentration-depth profiles in stratum corneum for both the diffusion and equilibrium experiments. Results. The concentration-depth profile of clobetasol propionate in stratum corneum for the diffusion experiment is biphasic. A logarithmic decline of the drug concentration over the first four to five tape strips flattens to a relatively constant low concentration level in deeper layers. The drug concentration-depth profile for the equilibrium studies displays a similar shape. Conclusions. The shape of the concentration-depth profile of clobetasol propionate is mainly because of the variable partitioning coefficient in different stratum corneum layers.

As políticas da insegurança : da Scuderie Detetive Le Cocq às masmorras do novo Espírito Santo

A presente dissertação tem como objetivo a análise das políticas de segurança pública e justiça criminal no Espírito Santo entre 1989 e 2013, utilizando metodologia historiográfica e observando a distância entre os objetivos oficiais e as consequências práticas. No primeiro capítulo, me concentro na contextualização histórica das políticas criminais, analisando a formação organizacional do sistema punitivo brasileiro. Coloco ênfase, de um lado, no processo de militarização, isto é, a adoção de hierarquia, disciplina e formação militares nas agências de segurança pública, e de outro lado, e nas sucessivas legislações penais aprovadas pelo Congresso Nacional. Tais processos nacionais se refletem no Espírito Santo, onde se difundiram “grupos de extermínio” como a Scuderie Le Cocq, mas não havia política de segurança pública. A primeira surge em meio a grave crise política, entre 1999 e 2002. Mas os seus propósitos são mais avançados com o processo de reforma administrativa após 2003, quando o governo se esforça por impôr modelos de gestão empresariais e parcerias público privadas à administração estadual, incluindo a segurança pública e sistema penitenciário. Com isto, ocorre uma rápida expansão do encarceramento seletivo em condições extremas de superlotação e violência, desenvolvendo uma indústria carcerária. No segundo capítulo, realizo uma análise na qual relaciono informações criminais, penitenciárias, econômicas e demográficas, tanto no contexto do Brasil quanto do Espírito Santo. Constato que a repressão estatal tem “preferência” por homens, negros, jovens e de baixa escolaridade; por crimes de drogas e contra o patrimônio, com a utilização cada vez maior da prisão provisória. No Espírito Santo o encarceramento seletivo cresce em maior velocidade que na média nacional, o que se reflete no perfil da população carcerária, sendo esta ainda mais negra, jovem, de baixa escolaridade e presa por tráfico e drogas e em regime provisório, com frequentes denúncias fundamentadas de torturas, mortes e desaparecimentos forçados entre as populações criminalizadas.

Capital Intelectual: sua divulgação no setor bancário em Portugal

The importance of intangible resources has increased dramatically in recent years comparing to tangible ones. The economy in which we live is the result of competitive pressures that have imposed the implementation of business at an international level as well as a requirement in the application of sophisticated technologies that allow us to follow this fast evolution. In this age of information and innovation organizations will only survive if they are inserted in a global network of strategic relations, generically called as the network economy by Lev (2003). The service sector has stood out against the more traditional sectors of the economy. The intensive use of knowledge and a strong customer orientation created a new reality in today’s organizations: a growing importance attached to innovation, to the quality of products and services offered, to the information and communication technologies adopted, and to the creativity and particular abilities of human resources. The concept of intangible assets is more common in an accounting language and intellectual capital is most often applied in the context of management, being associated with a more comprehensive, multidimensional approach, representing all the knowledge that the institution owns and that it applies in the form of expertise, the creativity and organizational competencies that lead to innovation and to the sustained attainment of future economic benefits. An analysis of the scope of intellectual capital is fundamental to take more appropriate management decisions so that a more appropriate accounting treatment could be given by the accounting standardization organizations. This study intends to analyse the practices of information disclosure of the intellectual capital in the banking sector in Portugal, complementing the analysis of the disclosure of intangible assets in the context of accounting standards with the disclosure of intellectual capital in the context of organizational management. In particular, our main aims are to identify the extent of disclosure of intellectual capital made by banks in Portugal and also to identify the factors that determine such a disclosure. The disclosure in the context of accounting standards will be studied by checking the disclosure of intangible assets through the items listed in the International Accounting Standard 38 developed by the International Accounting Standards Board. The context of management was analysed by means of creating a voluntary disclosure index based on assumptions of the model Intellectus, developed by the Centro de Investigación sobre la Sociedad del Conocimiento – Instituto de Administración de Empresas (CIC-IADE) of the Universidad Autónoma of Madrid, and of the model Intellectual Capital Statement (made in Europe) (InCaS), both promoted by the European Commission and that we have adapted to the banking sector. When analysing the disclosure of intangible assets based on the context of accounting standards and the voluntary disclosure of intellectual capital, this study has tried to raise awareness about the importance of issuing reports on the intellectual capital as an alternative tool to take management decisions in the existing organizations and reflects the transparency and legitimacy that these institutions seek through a more extensive and more detailed information disclosure of their intellectual capital. Based on a complimentarily of economic theories, together with social and political theories, we tried to check the extent, evolution and tendencies of the compulsory disclosure of intangible assets and of the voluntary disclosure of the intellectual capital analysed in the period 2001-2011. Banks characteristics were also analysed in order to deduce those factors that determine or promote a larger disclosure in this sector. Based on these objectives, we adopted a longitudinal approach to explore the extent and the development of the disclosure of intangible assets as well as the factors that have determined it. Furthermore, we sought to assess the impact of the adoption of IAS 38 in the financial statements of the organizations in this sector. The disclosure index created on the basis of the disclosure requirements stated in IAS 38 from IASB was applied to the consolidated financial statements of the seventeen banks that rendered their statements in Portugal from 2001 to 2009. Since the information disclosed in the context of accounting standards may not have an important role as a management tool once it was not able to reflect what really contributes to the competitiveness and organizational growth, the voluntary disclosure of the intellectual capital was analysed according to the information obtained from the 2010 annual individual reports of the banks operating in Portugal in that year and from their respective websites in 2011. We tried to analyse the extent of the voluntary disclosure of the intellectual capital and of each of its components, human capital, structural capital and relational capital. The comparative analysis of their annual reports and their web pages allowed us to assess the incidence of the disclosure and discover what channel the banking sector focuses on when disclosing their intellectual capital. Also in this analysis the study of the disclosure determinants has allowed us to conclude about the influence of particular characteristics in the voluntary disclosure of the intellectual capital. The results of the analysis to the extent of the disclosure of intangible assets in the consolidated financial statements of the banking groups in Portugal in the period 2001-2009 have shown an average information disclosure of 0.24. This information disclosure evolved from an average value of 0.1940 in 2001 to 0.2778 in 2009. The average value is 0.8286 if it is only considered the disclosure of the intangible assets that the banks possessed. The evolution of this index means an increase in the average disclosure from 0.7852 in 2001 to 0.8788 in 2009. From the first results that are related to the extent of the disclosure of intangible assets in the financial statements, we can verify that the banking groups present a low disclosure level of these resources. However, when considering the disclosure of only the intangible assets that each institution owns, the disclosure level appears to be in compliance with the disclosure requirements for this sector. An evolution in the disclosure of intangible assets for the period considered was confirmed, showing an increase in the information disclosure of intangible assets in 2005, the year in which the accounting rules for intangible assets changed. The analysis that focused on the disclosure in the context of management tried to understand the extent, the incidence and the determinants of the voluntary information disclosure of intellectual capital in the annual reports of 2010 and on their web pages in 2011, studying the 32 banks operating in Portugal in this period. The average voluntary disclosure of the intellectual capital in the 2010 annual reports is 0.4342 while that in web pages is 0.2907. A review of the components of the intellectual capital allowed us to assess the importance that the banks confer to each of these components. The data obtained show that the relational capital, and more specifically the business capital, is the most disclosed component by banks in Portugal both in the annual reports and in their institutional web pages, followed by the structural capital and, finally, by the human capital. The disclosure of the human capital and the structural capital is higher in the annual reports than that in the websites, while the relational capital is more disclosed in the websites than in the annual reports. The results have also shown that the banks make a complementary use of both sources when disclosing information about their structural capital and relational capital but they do not show any information about their human capital in their websites. We tried to prove the influence of factors that could determine the accounting disclosure and the voluntary disclosure of the intellectual capital in this sector. The change in the IASB accounting rules as from January 1st 2005 gave a greater disclosure of accounting information of intangible assets in the financial statements of banks. The bank size and corporate governance measures have statistically proved to have an influence on the extent of the accounting disclosure of intangible assets and on the voluntary disclosure of the intellectual capital. Economic and financial variables such as profitability, operating efficiency or solvency were not determinants of information disclosure. The instability that the banking sector has experienced in economic and financial indicators in recent years as a result of the global financial markets imbalance has worsen indicators such as profitability, efficiency and solvency and caused major discrepancies in the economic situation between banks in Portugal. This empirical analysis has contributed to confront the disclosure required by accounting rules performed in the financial statements of organizations with that performed in the main disclosure media which is available for entities and which is increasingly requested in the process of taking management decisions. It also allowed us to verify whether there is homogeneity between institutions in the fulfilment of the requirements for information disclosure of intangible assets. However, as for voluntary disclosure of intellectual capital, there are large disparities in the disclosure extent between organizations. Regardless of this sector specific characteristics, the voluntary disclosure of intellectual capital made by banks in Portugal follows the trends in other sectors and the practices adopted in other countries, namely regarding the amount of information disclosed, the incidence of the disclosure on the indicators of relational capital and the importance of variables such as size as determinants of disclosure of intellectual capital. For a further knowledge in this field, we created a specific index for the banking sector, considering appropriate indicators for an incisive, comprehensive analysis in order to consider the most relevant indicators of intellectual capital components. Besides, confronting the analysis of disclosure in the context of accounting standards with the study of voluntary disclosure brought a new analysis approach to the research on intellectual capital disclosure. With this study, we have also intended to raise greater awareness of the need for harmonization in the intellectual capital disclosure on the part of the regulatory banking authority by means of a demanding, consistent and transparent report of intellectual capital with simple, clear, objective indicators so that those interested in disclosing intellectual capital information in the organizations in this sector may obtain more harmonized and comparable information. A research on the disclosure quality of intellectual capital, together with the application of other analysis methodologies in this sector, might be a promising approach for future research. Applying the voluntary disclosure index to the same sector in other countries may also contribute to the knowledge of disclosure practices in different geographical environments. We highlight the relevance of further studies contributing to the harmonization and consistency in the presentation of an intellectual capital report so as to enable organizations to disclose the resources that contribute most to their competitiveness and growth.

Phototransistor with nanocrystalline Si/amorphous Si bilayer channel

We report a field-effect phototransistor with a channel comprising a thin nanocrystalline silicon transport layer and a thicker hydrogenated amorphous silicon absorption layer. The semiconductor and dielectric layers were deposited by radio-frequency plasma enhanced chemical vapor deposition. The phototransistor with channel length of 24 microns and photosensitive area of 1.4 mm(2) shows an off-current of about 1 pA, and high photoconductive gain in the subthreshold region. Measurements of the quantum efficiency at different incident light intensities and biasing conditions, along with spectral-response characteristics, and threshold voltage stability characterization demonstrate the feasibility of the phototransistor for low light level detection.

Risk factors for perinatal mortality in an urban area of Southern Brazil, 1993

INTRODUCTION: Although there was a considerable reduction in infant mortality in Pelotas, Rio Grande do Sul in the last decade, its perinatal causes were reduced only by 28%. The associated factors of these causes were analised. MATERIAL AND METHOD: All hospital births and perinatal deaths were assessed by daily visits to all the maternity hospitals in the city, throughout 1993 and including the first week of 1994. RESULTS: The perinatal mortality rate was 22.1 per thousand births. The multivariate analysis showed the following risk factors: low socioeconomic level, male sex and maternal age above 35 years . Among multigravidae women, the fetal mortality rate was significantly increased for mothers with a previously low birthweight and a previous stillbirth. For early neonatal mortality the risk was significantly increased by a smaller number of antenatal visits than 5 and low birthweight. CONCLUSIONS: Main risk factors for perinatal mortality: low socioeconomic level, maternal age above 35 years and male sex. For early neonatal mortality the risk was significantly increased by a smaller number of antenatal visits than 5 and low birthweight.

Convex Total Variation Denoising of Poisson Fluorescence Confocal Images With Anisotropic Filtering

Fluorescence confocal microscopy (FCM) is now one of the most important tools in biomedicine research. In fact, it makes it possible to accurately study the dynamic processes occurring inside the cell and its nucleus by following the motion of fluorescent molecules over time. Due to the small amount of acquired radiation and the huge optical and electronics amplification, the FCM images are usually corrupted by a severe type of Poisson noise. This noise may be even more damaging when very low intensity incident radiation is used to avoid phototoxicity. In this paper, a Bayesian algorithm is proposed to remove the Poisson intensity dependent noise corrupting the FCM image sequences. The observations are organized in a 3-D tensor where each plane is one of the images acquired along the time of a cell nucleus using the fluorescence loss in photobleaching (FLIP) technique. The method removes simultaneously the noise by considering different spatial and temporal correlations. This is accomplished by using an anisotropic 3-D filter that may be separately tuned in space and in time dimensions. Tests using synthetic and real data are described and presented to illustrate the application of the algorithm. A comparison with several state-of-the-art algorithms is also presented.

The evidence of conventional physiotherapeutic interventions after exercise-induced muscle damage: systematic review and meta-analysis

Abstract Introduction: Exhaustive and/or unaccustomed exercise, mainly those involving eccentric muscle actions, induces temporary muscle damage, evidenced by Delayed Onset Muscle Soreness. Different strategies to recover the signs and symptoms of this myogenic condition have been studied by researchers, as a result a significant number of articles on this issue have been published. Purpose: A systematic review was conducted to assess the evidence of the physiotherapeutic interventions of exercise-induced muscle damage. Methods: The electronic data bases were searched, including MEDLINE (1996-2011), CINHAL (1982- 2011), EMBASE (1988-2011), PEDro (1950-2011), and SPORTDiscus (1985-2011). Systematic review was limited to randomized control trials (RCTs) studies, written in English or Portuguese, which included physiotherapeutic interventions, namely massage, cryotherapy, stretching and low-intensity exercise, on adult human subjects (18-60 years old) of either gender. Studies were excluded when the intervention could not be assessed independently. The methodological quality of RCTs was independently assessed with the PEDro Scale by three reviewers. Results: Thirty-three studies were included in the systematic review; eight analyzed the effects of the massage, ten analyzed the effects of the cryotherapy, eight the effect of stretching and seventeen focused low-intensity exercise intervention. The results suggest that massage is the most effective intervention and that there is inconclusive evidence to support the use of cryotherapy; whereas the other conventional, namely stretching and low-intensity exercise, there is no evidence to prove their efficacy. Conclusion: The results allow the conclusion that massage is the physiotherapeutic intervention that demonstrated to be the most effective in the relief of symptoms and signs of exercise-induced muscle damage, as a result, massage should still be used in the muscular recovery after sports activities.