Cerebral misery perfusion diagnosed using hypercapnic blood-oxygenation-level-dependent contrast functional magnetic resonance imaging: a case report

Introduction Cerebral misery perfusion represents a failure of cerebral autoregulation. It is animportant differential diagnosis in post-stroke patients presenting with collapses in the presence of haemodynamically significant cerebrovascular stenosis. This is particularly the case when cortical or internal watershed infarcts are present. When this condition occurs, further investigation should be done immediately. Case presentation A 50-year-old Caucasian man presented with a stroke secondary to complete occlusion of his left internal carotid artery. He went on to suffer recurrent seizures. Neuroimaging demonstrated numerous new watershed-territory cerebral infarcts. No source of arterial thromboembolism was demonstrable. Hypercapnic blood-oxygenation-level-dependent-contrast functional magnetic resonance imaging was used to measure his cerebrovascular reserve capacity. The findings were suggestive of cerebral misery perfusion. Conclusions Blood-oxygenation-level-dependent-contrast functional magnetic resonance imaging allows the inference of cerebral misery perfusion. This procedure is cheaper and more readily available than positron emission tomography imaging, which is the current gold standard diagnostic test. The most evaluated treatment for cerebral misery perfusion is extracranial-intracranial bypass. Although previous trials of this have been unfavourable, the results of new studies involving extracranial-intracranial bypass in high-risk patients identified during cerebral perfusion imaging are awaited. Cerebral misery perfusion is an important and under-recognized condition in which emerging imaging and treatment modalities present the possibility of practical and evidence-based management in the near future. Physicians should thus be aware of this disorder and of recent developments in diagnostic tests that allow its detection.

Evaluating tests for convergence of economic series using Monte Carlo methods with an application to real GDP's per head.

Doutoramento em Economia.

A novel concept-level approach for ultra-concise opinion summarization

The Web 2.0 has resulted in a shift as to how users consume and interact with the information, and has introduced a wide range of new textual genres, such as reviews or microblogs, through which users communicate, exchange, and share opinions. The exploitation of all this user-generated content is of great value both for users and companies, in order to assist them in their decision-making processes. Given this context, the analysis and development of automatic methods that can help manage online information in a quicker manner are needed. Therefore, this article proposes and evaluates a novel concept-level approach for ultra-concise opinion abstractive summarization. Our approach is characterized by the integration of syntactic sentence simplification, sentence regeneration and internal concept representation into the summarization process, thus being able to generate abstractive summaries, which is one the most challenging issues for this task. In order to be able to analyze different settings for our approach, the use of the sentence regeneration module was made optional, leading to two different versions of the system (one with sentence regeneration and one without). For testing them, a corpus of 400 English texts, gathered from reviews and tweets belonging to two different domains, was used. Although both versions were shown to be reliable methods for generating this type of summaries, the results obtained indicate that the version without sentence regeneration yielded to better results, improving the results of a number of state-of-the-art systems by 9%, whereas the version with sentence regeneration proved to be more robust to noisy data.

Objective evaluation of surgical competency for minimally invasive surgery with a collection of simple tests

Objective: This study aims at determining if a collection of 16 motor tests on a physical simulator can objectively discriminate and evaluate practitioners' competency level, i.e. novice, resident, and expert. Methods: An experimental design with three study groups (novice, resident, and expert) was developed to test the evaluation power of each of the 16 simple tests. An ANOVA and a Student Newman-Keuls (SNK) test were used to analyze results of each test to determine which of them can discriminate participants' competency level. Results: Four of the 16 tests used discriminated all of the three competency levels and 15 discriminated at least two of the three groups (α= 0.05). Moreover, other two tests differentiate beginners\' level from intermediate, and other seven tests differentiate intermediate level from expert. Conclusion: The competency level of a practitioner of minimally invasive surgery can be evaluated by a specific collection of basic tests in a physical surgical simulator. Reduction of the number of tests needed to discriminate the competency level of surgeons can be the aim of future research.

Predicting Explorative Behavior by Level of Emotional Reactivity in Bobwhite Quail Neonates (Colinus virginianus)

Tests of emotional reactivity have been used in a broad range of basic and applied research and have been primarily concerned with how rearing conditions, particularly environmental enrichment, can affect reactivity. However, assessment of how emotional reactivity can be altered during testing procedures and how it affects behaviors such as exploration is relatively uncommon. The present study assessed the explorative responses of Northern bobwhite quail (Colinus virginianus) neonates under conditions of either elevated or attenuated emotional reactivity during a maze task. Measures of emotional reactivity were compared with measures of exploration to determine their relationship with one another. Chicks that were highly emotionally reactive were generally less willing to explore during the maze task than chicks that were less emotionally reactive. Results indicate that levels of emotional reactivity and approach/avoidance motivation play a role in the speed and amount of exploration that is likely to occur in novel environments.

L'Intégration d'un Module d'Étude Internet Dans la Classe de Comptabilité: Perceptions des Élèves et les Résultats Académiques

Implemented in the context of Business Administration students enrolled in a college level three year technology program, this research investigated students’ perceptions and academic results concurrent with the implementation of an online web module designed to facilitate student self-study. The students involved in this research were enrolled in a program that, while offering a broad education in business disciplines, specialized in the field of accounting. As a result, students were enrolled in academically rigorous accounting courses in each of the six semesters of the program. The weighting of these accounting courses imposes a significant self-study component – typically matching or exceeding the time spent in class. In this context many of the students enrolled in the Business Administration Program have faced difficulties completing the self-study component of the course effectively as demonstrated in low homework completion rates, low homework grade averages and ultimately low success rates in the courses. In an attempt to address this situation this research studied the implementation of a web-based self-study module. Through this module students could access a number of learning tools that were designed to facilitate the self-study process under the premise that more effective self-study learning tools will help remove obstacles and provide more timely confirmation of learning during student self-study efforts. This research collected data from a single cohort of students drawn from the first three sequential accounting courses of the Business Administration Program. The web-based self-study module was implemented in the third of the three sequential accounting courses. The first two of these courses implemented a traditional manual self-study environment. Data collected from the three accounting courses included homework completion rates, homework, exam and final grades for the respective courses. In addition the web-study module allowed the automatic reporting of student usage of a number of specific online learning tools. To complement the academic data, students were surveyed to gain insight into their perceptions of the effectiveness of the web-based system. The research provided a number of interesting insights. First among these was a confirmation of the importance of the self-study process in the academic achievement of the learners. Regardless of the self-study environment, manual or web-enhanced, a significant positive correlation existed between the students’ self-study results, demonstrated in both homework completion rates and homework averages and the corresponding final grades. These results confirm the importance of self-study found generally in the prevailing academic literature regarding students enrolled in higher education. In addition, the web-enhanced learning environment implemented during the third accounting course coincided with significantly higher homework completion rates and corresponding homework averages: homework completion rates in particular increased from a combined average of 63% in the first two accounting courses to 93% in the web-enhanced context of the third accounting course. Moreover, the homework completion rates of the web-enhanced course were evenly distributed across the cohort of students. A quartile-based analysis was subsequently completed. Quartiles were constructed by ranking the students according to their combined average homework completion rates from the first two manual self-study courses, Accounting I and II. The quartile-based homework completion rates for the manual self-study courses Accounting I and II were subsequently compared to the results these same quartiles of students achieved in the web-based self-study within Accounting III. While the first two courses demonstrated significantly uneven homework completion rates across the quartiles ranging from 31% to 91% homework completion rates, the differences among the four quartiles within the web-enhanced module, with an average homework completion rate of 93%, were statistically insignificant. Congruent with the positive academic results observed in the third, web-enhanced course, through the corresponding survey, students expressed a strong attitude in favor of the online self-study environment. This research was designed to add to the existing research that studies the implementation of learning in an online setting. Specifically, the research was designed to explore a middle ground of online learning – a web-enhanced course – a context that supplements the classroom experience rather than replacing it. The web-enhanced accounting course demonstrated impressive favorable results, both academically and in terms of students' perception of the system; these results suggest that a web-enhanced environment can provide learning tools that facilitate the self-study process while providing a structured learning environment that can help developing learners reach their potential.

Using an evidence-based online module to improve parents’ ability to manage their child with Developmental Coordination Disorder

Background : Developmental coordination disorder (DCD) is a prevalent neurodevelopmental disorder. Best practices include raising parents’ awareness and building capacity but few interventions incorporating these best practices are documented. Objective : To examine whether an evidence-based online module can increase the perceived knowledge and skills of parents of children with DCD, and lead to behavioral changes when managing their child’s health condition. Methods : A mixed-methods, before-after design guided by the theory of planned behavior was employed. Data about the knowledge, skills and behaviors of parents of children with DCD were collected using questionnaires prior to completing the module, immediately after, and three months later. Paired T-tests, sensitivity analyses and thematic analyses were performed on data as appropriate. Results: One hundred-sixteen, 81 and 58 participants respectively completed the three questionnaires. For knowledge and skills, post- and follow-up scores were significantly higher than baseline scores (p<0.01). Fifty-two (64%) participants reported an intention to change behavior post-intervention and 29 (50%) participants had tried recommended strategies at follow-up. Three themes emerged to describe parents’ behavioral change: sharing information, trialing strategies and changing attitudes. Factors influencing parents’ ability to implement these behavioral changes included clear recommendations, time, and ‘right’ attitude. Perceived outcomes associated with the parental behavioral changes involved improvement in well-being for the children at school, at home, and for the family as a whole. Conclusions : The online module increased parents’ self-reported knowledge and skills in DCD management. Future research should explore its impacts on children’s long-term outcomes.

The Proces of Curriculum and Module Design

The outcome of the inductive decision -making process of the leading project management group (PMG) was the proposal to develop three modules, Human Resource Management and Knowledge Management, Quality Management and Intercultural management, each for 10 ECTS credits. As a result of the theoretical and organisational framework and analytical phase of the project, four strategies informed the development and implemen- tation of the modules: 1. Collaboration as a principle stemming from EU collaborative policy and receiving it’s expression on all implementation levels (designing the modules, modes of learning, delivering the modules, evaluation process). 2. Building on the Bologna process masters level framework to assure ap- propriate academic level of outputs. 3. Development of value -based leadership of students through transforma- tional learning in a cross -cultural setting and continual reflection of theory in practice. 4. Continual evaluation and feedback among teachers and students as a strategy to achieve a high quality programme. In the first phase of designing the modules the collaborative strategy in particular was applied, as each module was led by one university, but members from all other universities participated in the discussions and development of the mod- ules. The Bologna process masters level framework and related standards and guidelines informed the form and method of designing the modules.

1° level of automation: the effectiveness of adaptive cruise control on driving and visual behaviour

The research activities have allowed the analysis of the driver assistance systems, called Advanced Driver Assistance Systems (ADAS) in relation to road safety. The study is structured according to several evaluation steps, related to definite on-site tests that have been carried out with different samples of users, according to their driving experience with the ACC. The evaluation steps concern: •The testing mode and the choice of suitable instrumentation to detect the driver’s behaviour in relation to the ACC. •The analysis modes and outputs to be obtained, i.e.: - Distribution of attention and inattention; - Mental workload; - The Perception-Reaction Time (PRT), the Time To Collision (TTC) and the Time Headway (TH). The main purpose is to assess the interaction between vehicle drivers and ADAS, highlighting the inattention and variation of the workloads they induce regarding the driving task. The research project considered the use of a system for monitoring visual behavior (ASL Mobile Eye-XG - ME), a powerful GPS that allowed to record the kinematic data of the vehicle (Racelogic Video V-BOX) and a tool for reading brain activity (Electroencephalographic System - EEG). Just during the analytical phase, a second and important research objective was born: the creation of a graphical interface that would allow exceeding the frame count limit, making faster and more effective the labeling of the driver’s points of view. The results show a complete and exhaustive picture of the vehicle-driver interaction. It has been possible to highlight the main sources of criticalities related to the user and the vehicle, in order to concretely reduce the accident rate. In addition, the use of mathematical-computational methodologies for the analysis of experimental data has allowed the optimization and verification of analytical processes with neural networks that have made an effective comparison between the manual and automatic methodology.

Characterization and management of particular classes of waste at a regional level. case study: Marche region

There are various methods to analyse waste, which differ from each other according to the level of detail of the compositio. Waste composed by plastic and used for packaging, for example, can be classified by chemical composition of the polymer used for the specific product. At a more basal level, before dividing a waste according to the specific chemical material of which it is composed it is possible and also important to classify it according to the material category. So, if the secondary aim is to consider the particular polymer that constitutes a plastic waste, or what kind of natural polymer composes a specific waste made of wood, the first aim is to classify the product category of the material that makes up the waste, so, if it is wood made, or plastic, or glass made or metal, or organic. There are not specific instruments to make this subdivision, not specific chemical tests, but only a manual recognition of the material that makes up the product or waste. The first steps of this study is a recognition of the materials of which the waste is composed, the second is a the quantification of differentiated and unsorted waste produced in the area under study, the third is a mass balance of the portions of waste sent for recovery in order to obtain information on quantities that can be effectively recovered and ready for new life cycle as raw material; the fourth and last step is an environmental assessment that provides information on the environmental cost of the recovery process. This process scheme is applied to various specific kinds of waste from separate collection generated in a specific area with the aim to find a model analysis appliable to other portions of territory in order to improve knowledge of recovery technologies.

Assessment Of The Fixation Of Mandibular Symphysis Fractures Using Conical Cannulated Screws: Mechanical And Photoelastic Tests.

The aim of this study was to use mechanical and photoelastic tests to compare the performance of cannulated screws with other fixation methods in mandibular symphysis fractures. Ten polyurethane mandibles were allocated to each group and fixed as follows: group PRP, 2 perpendicular miniplates; group PLL, 1 miniplate and 1 plate, parallel; and group CS, 2 cannulated screws. Vertical linear loading tests were performed. The differences between mean values were analyzed with the Tukey test. The photoelastic test was carried out using a polariscope. The results revealed differences between the CS and PRP groups at 1, 3, 5, and 10 millimeters of displacement. The photoelastic test confirmed higher stress concentration in all groups close to the mandibular base, whereas the CS group showed it throughout the region assessed. Conical cannulated screws performed well in mechanical and photoelastic tests.

Angiogenic Effects Of Cryosurgery With Liquid Nitrogen On The Normal Skin Of Rats, Through Morphometric Study.

Cryosurgery is an efficient therapeutic technique used to treat benign and malignant cutaneous diseases. The primary active mechanism of cryosurgery is related to vascular effects on treated tissue. After a cryosurgical procedure, exuberant granulation tissue is formed at the injection site, probably as a result of angiogenic stimulation of the cryogen and inflammatory response, particularly in endothelial cells. To evaluate the angiogenic effects of freezing, as part of the phenomenon of healing rat skin subjected to previous injury. Two incisions were made in each of the twenty rats, which were divided randomly into two groups of ten. After 3 days, cryosurgery with liquid nitrogen was performed in one of incisions. The rats' samples were then collected, cut and stained to conduct histopathological examination, to assess the local angiogenesis in differing moments and situations. It was possible to demonstrate that cryosurgery, in spite of promoting cell death and accentuated local inflammation soon after its application, induces quicker cell proliferation in the affected tissue and maintenance of this rate in a second phase, than in tissue healing without this procedure. These findings, together with the knowledge that there is a direct relationship between mononuclear cells and neovascularization (the development of a rich system of new vessels in injury caused by cold), suggest that cryosurgery possesses angiogenic stimulus, even though complete healing takes longer to occur. The significance level for statistical tests was 5% (p<0,05).

Effect Of Pitavastatin On Vascular Reactivity In Hypercholesterolemic Rabbits.

Pitavastatin is the newest statin available in Brazil and likely the one with fewer side effects. Thus, pitavastatin was evaluated in hypercholesterolemic rabbits in relation to its action on vascular reactivity. To assess the lowest dose of pitavastatin necessary to reduce plasma lipids, cholesterol and tissue lipid peroxidation, as well as endothelial function in hypercholesterolemic rabbits. Thirty rabbits divided into six groups (n = 5): G1 - standard chow diet; G2 - hypercholesterolemic diet for 30 days; G3 - hypercholesterolemic diet and after the 16th day, diet supplemented with pitavastatin (0.1 mg); G4 - hypercholesterolemic diet supplemented with pitavastatin (0.25 mg); G5 - hypercholesterolemic diet supplemented with pitavastatin (0.5 mg); G6 - hypercholesterolemic diet supplemented with pitavastatin (1.0 mg). After 30 days, total cholesterol, HDL, triglycerides, glucose, creatine kinase (CK), aspartate aminotransferase (AST), alanine aminotransferase (ALT) were measured and LDL was calculated. In-depth anesthesia was performed with sodium thiopental and aortic segments were removed to study endothelial function, cholesterol and tissue lipid peroxidation. The significance level for statistical tests was 5%. Total cholesterol and LDL were significantly elevated in relation to G1. HDL was significantly reduced in G4, G5 and G6 when compared to G2. Triglycerides, CK, AST, ALT, cholesterol and tissue lipid peroxidation showed no statistical difference between G2 and G3-G6. Significantly endothelial dysfunction reversion was observed in G5 and G6 when compared to G2. Pitavastatin starting at a 0.5 mg dose was effective in reverting endothelial dysfunction in hypercholesterolemic rabbits.

Histologic Correlation Of Expression Of Ki-67 In Squamous Cell Carcinoma Of The Glottis According To The Degree Of Cell Differentiation.

Squamous cell carcinoma is the most common neoplasm of the larynx and glottis, and its prognosis depends on the size of the lesion, level of local invasion, cervical lymphatic spread, and presence of distant metastases. Ki-67 (MKI67) is a protein present in the core, whose function is related to cell proliferation. To evaluate the expression of marker Ki-67 in squamous cell carcinoma of the larynx and glottis and its correlation to pathological findings. Experimental study with immunohistochemistry analysis of Ki-67, calculating the percentage of the cell proliferation index in glottic squamous cell carcinomas. Sixteen cases were analyzed, with six well-differentiated and 10 poorly/moderately differentiated tumors. There was a correlation between cell proliferation index and degree of cell differentiation, with higher proliferation in poorly/moderately differentiated tumors. The cell proliferation index, as measured by Ki-67, may be useful in the characterization of histological degree in glottic squamous cell tumors.

Self-reported Diabetes In Older People: Comparison Of Prevalences And Control Measures.

The objective of this study was to analyze the prevalence of diabetes in older people and the adopted control measures. Data regarding older diabetic individuals who participated in the Health Surveys conducted in the Municipality of Sao Paulo, SP, ISA-Capital, in 2003 and 2008, which were cross-sectional studies, were analyzed. Prevalences and confidence intervals were compared between 2003 and 2008, according to sociodemographic variables. The combination of the databases was performed when the confidence intervals overlapped. The Chi-square (level of significance of 5%) and the Pearson's Chi-square (Rao-Scott) tests were performed. The variables without overlap between the confidence intervals were not tested. The age of the older adults was 60-69 years. The majority were women, Caucasian, with an income of between > 0.5 and 2.5 times the minimum salary and low levels of schooling. The prevalence of diabetes was 17.6% (95%CI 14.9;20.6) in 2003 and 20.1% (95%CI 17.3;23.1) in 2008, which indicates a growth over this period (p at the limit of significance). The most prevalent measure adopted by the older adults to control diabetes was hypoglycemic agents, followed by diet. Physical activity was not frequent, despite the significant differences observed between 2003 and 2008 results. The use of public health services to control diabetes was significantly higher in older individuals with lower income and lower levels of education. Diabetes is a complex and challenging disease for patients and the health systems. Measures that encourage health promotion practices are necessary because they presented a smaller proportion than the use of hypoglycemic agents. Public health policies should be implemented, and aimed mainly at older individuals with low income and schooling levels. These changes are essential to improve the health condition of older diabetic patients.