A systematic review with procedural assessments and meta-analysis of Low Level Laser Therapy in lateral elbow tendinopathy (tennis elbow)

Abstract Background Recent reviews have indicated that low level level laser therapy (LLLT) is ineffective in lateral elbow tendinopathy (LET) without assessing validity of treatment procedures and doses or the influence of prior steroid injections. Methods Systematic review with meta-analysis, with primary outcome measures of pain relief and/or global improvement and subgroup analyses of methodological quality, wavelengths and treatment procedures. Results 18 randomised placebo-controlled trials (RCTs) were identified with 13 RCTs (730 patients) meeting the criteria for meta-analysis. 12 RCTs satisfied half or more of the methodological criteria. Publication bias was detected by Egger's graphical test, which showed a negative direction of bias. Ten of the trials included patients with poor prognosis caused by failed steroid injections or other treatment failures, or long symptom duration or severe baseline pain. The weighted mean difference (WMD) for pain relief was 10.2 mm [95% CI: 3.0 to 17.5] and the RR for global improvement was 1.36 [1.16 to 1.60]. Trials which targeted acupuncture points reported negative results, as did trials with wavelengths 820, 830 and 1064 nm. In a subgroup of five trials with 904 nm lasers and one trial with 632 nm wavelength where the lateral elbow tendon insertions were directly irradiated, WMD for pain relief was 17.2 mm [95% CI: 8.5 to 25.9] and 14.0 mm [95% CI: 7.4 to 20.6] respectively, while RR for global pain improvement was only reported for 904 nm at 1.53 [95% CI: 1.28 to 1.83]. LLLT doses in this subgroup ranged between 0.5 and 7.2 Joules. Secondary outcome measures of painfree grip strength, pain pressure threshold, sick leave and follow-up data from 3 to 8 weeks after the end of treatment, showed consistently significant results in favour of the same LLLT subgroup (p < 0.02). No serious side-effects were reported. Conclusion LLLT administered with optimal doses of 904 nm and possibly 632 nm wavelengths directly to the lateral elbow tendon insertions, seem to offer short-term pain relief and less disability in LET, both alone and in conjunction with an exercise regimen. This finding contradicts the conclusions of previous reviews which failed to assess treatment procedures, wavelengths and optimal doses.

Composição química de aguardentes de cana-de-açúcar fermentadas por diferentes cepas de levedura Saccharomyces cerevisiae

The aim of this study was to evaluate the chemical composition of sugar cane spirits, fermented by different commercial Saccharomyces cerevisiae yeast strains and double distilled by pot still. Sugar cane juices were separately fermented by yeasts CA-11, Y-904, BG-1, PE-2, SA-1 and CAT-1 and distilled by pot still according to the methodology used for whisky production. The alcoholic liquids from first and second distillations were analyzed for concentrations of ethanol, volatile acidity, aldehydes, esters, furfural, higher alcohols and methanol. The sugar cane spirits derived from fermentation by the different yeast strains presented distinct chemical compositions.

Prevalência e fatores de risco de leptospirose bovina no Estado do Maranhão

Foram investigados a prevalência e os fatores de risco da leptospirose bovina no Estado do Maranhão. O Estado foi dividido em quatro circuitos amostrais com base em parâmetros de produção distintos que variam conforme os diferentes sistemas de produção, as práticas de manejo, a finalidade de exploração, o tamanho médio dos rebanhos e os sistemas de comercialização. Objetivou-se estudar as características epidemiológicas da leptospirose bovina no Estado do Maranhão, de modo a determinar a prevalência em bovinos e em rebanhos, detectar as sorovariedades de Leptospira spp. presentes, identificar os fatores de risco eventualmente associados à leptospirose em bovinos e diferenciar os circuitos pecuários entre si no que se refere à prevalência de leptospirose. A pesquisa foi realizada em 136 propriedades rurais pertencentes ao circuito I, no qual 841 fêmeas bovinas com idade igual ou superior a 24 meses foram analisadas; 238 do circuito II, com 2.582 fêmeas analisadas; 122 do circuito III, com 869 fêmeas analisadas; e 77 do circuito IV, com 540 fêmeas analisadas; no total, 573 propriedades e 4.832 fêmeas foram estudadas. A presença de anticorpos contra Leptospira spp. foi verificada pela técnica de soroaglutinação microscópica (SAM). Das 4.832 fêmeas bovinas analisadas, 1.904 (35,94%; IC 95% = 33,01% - 38,98%) foram reagentes. Das 573 propriedades analisadas, 380 (64,81%; IC 95% = 61,10% - 68,35%) foram consideradas positivas. As sorovariedades Hardjo e Wolffi foram as mais frequentes em todo o Estado. O circuito III foi o que apresentou menor prevalência de leptospirose em todas as comparações. As variáveis identificadas como fatores de risco de leptospirose foram: presença de equinos (p = 0,000), presença de capivaras (p = 0,034) e rebanhos bovinos com 32 ou mais fêmeas adultas (p = 0,002).

Laser therapy and pain-related behavior after injury of the inferior alveolar nerve: possible involvement of neurotrophins

Nerve-related complications have been frequently reported in dental procedures, and a very frequent type of occurrence involves the inferior alveolar nerve (IAN). The nerve injury in humans often results in persistent pain accompanied by allodynia and hyperalgesia. In this investigation, we used an experimental IAN injury in rats, which was induced by a Crile hemostatic clamp, to evaluate the effects of laser therapy on nerve repair. We also studied the nociceptive behavior (von Frey hair test) before and after the injury and the behavioral effects of treatment with laser therapy (emitting a wavelength of 904 nm, output power of 70 Wpk, a spot area of *0.1 cm2, frequency of 9500 Hz, pulse time 60 ns and an energy density of 6 J/cm2). As neurotrophins are essential for the process of nerve regeneration, we used immunoblotting techniques to preliminarily examine the effects of laser therapy on the expression of nerve growth factor (NGF) and brainderived neurotrophic factor (BDNF). The injured animals treated with laser exhibited an improved nociceptive behavior. In irradiated animals, there was an enhanced expression of NGF (53%) and a decreased BDNF expression (40%) after laser therapy. These results indicate that BDNF plays a locally crucial role in pain-related behavior development after IAN injury, increasing after lesions (in parallel to the installation of pain behavior) and decreasing with laser therapy (in parallel to the improvement of pain behavior). On the other hand, NGF probably contributes to the repair of nerve tissue, in addition to improving the pain-related behavior.

Visceral leishmaniasis in Brazil: trends and challenges

The urbanization of visceral leishmaniasis in Brazil has been related to environmental changes, migration, interaction and spread of sylvatic reservoirs and infected dogs to areas with no transmission, and adaptation of the vector Lutzomyia longipalpis to the peridomiciliary environment. From 1980 to 2005, Brazil recorded 59,129 cases of visceral leishmaniasis, 82.5% of which in the Northeast region. Visceral leishmaniasis gradually spread to other regions of the country: in 1998 these other regions reported 15% of all cases, but by 2005 this proportion had increased to 44%. From 1998 to 2005, indigenous cases were reported in 1,904 different municipalities of the country (34.2%). Reservoir and vector control pose major challenges for disease control, since there is a need for better knowledge of vector behavior in urban areas, and control activities involve high operational costs. In recent years the Brazilian Ministry of Health has supported research on the laboratory diagnosis of infection and disease in humans and dogs, treatment of patients, evaluation of the effectiveness of control strategies, and development of new technologies that could contribute to the surveillance and control of visceral leishmaniasis in the country.

Prediction of clinical toxicity in locally advanced head and neck cancer patients by radio-induced apoptosis in peripheral blood lymphocytes (PBLs)

[EN] Head and neck cancer is treated mainly by surgery and radiotherapy. Normal tissue toxicity due to x-ray exposure is a limiting factor for treatment success. Many efforts have been employed to develop predictive tests applied to clinical practice. Determination of lymphocyte radio-sensitivity by radio-induced apoptosis arises as a possible method to predict tissue toxicity due to radiotherapy. The aim of the present study was to analyze radio-induced apoptosis of peripheral blood lymphocytes in head and neck cancer patients and to explore their role in predicting radiation induced toxicity. Seventy nine consecutive patients suffering from head and neck cancer, diagnosed and treated in our institution, were included in the study. Toxicity was evaluated using the Radiation Therapy Oncology Group scale. Peripheral blood lymphocytes were isolated and irradiated at 0, 1, 2 and 8 Gy during 24 hours. Apoptosis was measured by flow cytometry using annexin V/propidium iodide. Lymphocytes were marked with CD45 APC-conjugated monoclonal antibody. Radiation-induced apoptosis increased in order to radiation dose and fitted to a semi logarithmic model defined by two constants: α and β. α, as the origin of the curve in the Y axis determining the percentage of spontaneous cell death, and β, as the slope of the curve determining the percentage of cell death induced at a determined radiation dose, were obtained. β value was statistically associated to normal tissue toxicity in terms of severe xerostomia, as higher levels of apoptosis were observed in patients with low toxicity (p = 0.035; Exp(B) 0.224, I.C.95% (0.060-0.904)). These data agree with our previous results and suggest that it is possible to estimate the radiosensitivity of peripheral blood lymphocytes from patients determining the radiation induced apoptosis with annexin V/propidium iodide staining. β values observed define an individual radiosensitivity profile that could predict late toxicity due to radiotherapy in locally advanced head and neck cancer patients. Anyhow, prospective studies with different cancer types and higher number of patients are needed to validate these results.

Caratterizzazione di membrane inorganiche per la separazione di idrogeno da gas di reforming

The work of this thesis has been focused on the characterisation of inorganic membranes for the hydrogen purification from steam reforming gas. Composite membranes based on porous inorganic supports coated with palladium silver alloys and ceramic membranes have been analysed. A brief resume of theoretical laws governing transport of gases through dense and porous inorganic membranes and an overview on different methods to prepare inorganic membranes has been also reported. A description of the experimental apparatus used for the characterisation of gas permeability properties has been reported. The device used permits to evaluate transport properties in a wide range of temperatures (till 500°C) and pressures (till 15 bar). Data obtained from experimental campaigns reveal a good agreement with Sievert law for hydrogen transport through dense palladium based membranes while different transport mechanisms, such as Knudsen diffusion and Hagen-Poiseuille flow, have been observed for porous membranes and for palladium silver alloy ones with pinholes in the metal layer. Mixtures permeation experiments reveal also concentration polarisation phenomena and hydrogen permeability reduction due to carbon monoxide adsorption on metal surface.

Nonlinear/electromagnetic co-simulation of microwaves and millimeter-waves links

The Ph.D. thesis describes the simulations of different microwave links from the transmitter to the receiver intermediate-frequency ports, by means of a rigorous circuit-level nonlinear analysis approach coupled with the electromagnetic characterization of the transmitter and receiver front ends. This includes a full electromagnetic computation of the radiated far field which is used to establish the connection between transmitter and receiver. Digitally modulated radio-frequency drive is treated by a modulation-oriented harmonic-balance method based on Krylov-subspace model-order reduction to allow the handling of large-size front ends. Different examples of links have been presented: an End-to-End link simulated by making use of an artificial neural network model; the latter allows a fast computation of the link itself when driven by long sequences of the order of millions of samples. In this way a meaningful evaluation of such link performance aspects as the bit error rate becomes possible at the circuit level. Subsequently, a work focused on the co-simulation an entire link including a realistic simulation of the radio channel has been presented. The channel has been characterized by means of a deterministic approach, such as Ray Tracing technique. Then, a 2x2 multiple-input multiple-output antenna link has been simulated; in this work near-field and far-field coupling between radiating elements, as well as the environment factors, has been rigorously taken into account. Finally, within the scope to simulate an entire ultra-wideband link, the transmitting side of an ultrawideband link has been designed, and an interesting Front-End co-design technique application has been setup.

Etablierung einer Ko-Kultur von Alveolarepithel und mikrovaskulärem Endothel als in-vitro-Modell einer humanen respiratorischen Einheit

Ziel der Promotionsarbeit war die Etablierung einer humanen respiratorischen Einheit in vitro zur Untersuchung von Wirkmechanismen einer akuten Lungenschädigung. Als Ko-Kulturmodell wurde eine Kultur humaner Alveoloarepithelzellen vom Typ II (A549, NCI H441, primäre hATII Zellen) mit mikrovaskulären Endothelzellen (ISO-HAS-1, primäre HPMEC) auf den beiden Seiten einer mikroporösen Filtermembran (Bilayer) gewählt. Ein differenzierter Monolayer von NCI H441 konnte in Bilayer-Ko-Kultur mit ISO-HAS-1 oder HPMEC durch die Zugabe von Dexamethason (1 µM) unter Verwendung eines serumhaltigen Mediums induziert werden. Dabei wurde eine von Tag 10 bis Tag 12 phänotypisch stabile Ko-Kultur mit TER-Werten um 500 Ohm x cm2 erhalten. Im Hinblick auf die Freisetzung von IL-8 und MCP-1 und die fehlende Freisetzung von RANTES nach Stimulation waren NCI H441 den hATII Zellen ähnlicher als die häufig als hATII-analog eingesetzte Zell-Linie A549, die RANTES freisetzte. Außerdem bildeten A549 trotz zahlreicher Variatione

Performance analysis of ray-tracing assisted beamforming techniques for future mm-wave wireless systems.

Il progetto di tesi riguarda principalmente la progettazione di moderni sistemi wireless, come 5G o WiGig, operanti a onde millimetriche, attraverso lo studio di una tecnica avanzata detta Beamforming, che, grazie all'utilizzo di antenne direttive e compatte, permette di superare limiti di link budget dovuti alle alte frequenze e introdurre inoltre diversità spaziale alla comunicazione. L'obiettivo principale del lavoro è stato quello di valutare, tramite simulazioni numeriche, le prestazioni di alcuni diversi schemi di Beamforming integrando come tool di supporto un programma di Ray Tracing capace di fornire le principali informazioni riguardo al canale radio. Con esso infatti è possibile sia effettuare un assessment generale del Beamforming stesso, ma anche formulare i presupposti per innovative soluzioni, chiamate RayTracing-assisted- Beamforming, decisamente promettenti per futuri sviluppi così come confermato dai risultati.

Simulation of visible light communications in vehicular networks

The rapid development in the field of lighting and illumination allows low energy consumption and a rapid growth in the use, and development of solid-state sources. As the efficiency of these devices increases and their cost decreases there are predictions that they will become the dominant source for general illumination in the short term. The objective of this thesis is to study, through extensive simulations in realistic scenarios, the feasibility and exploitation of visible light communication (VLC) for vehicular ad hoc networks (VANETs) applications. A brief introduction will introduce the new scenario of smart cities in which visible light communication will become a fundamental enabling technology for the future communication systems. Specifically, this thesis focus on the acquisition of several, frequent, and small data packets from vehicles, exploited as sensors of the environment. The use of vehicles as sensors is a new paradigm to enable an efficient environment monitoring and an improved traffic management. In most cases, the sensed information must be collected at a remote control centre and one of the most challenging aspects is the uplink acquisition of data from vehicles. My thesis discusses the opportunity to take advantage of short range vehicle-to-vehicle (V2V) and vehicle-to-roadside (V2R) communications to offload the cellular networks. More specifically, it discusses the system design and assesses the obtainable cellular resource saving, by considering the impact of the percentage of vehicles equipped with short range communication devices, of the number of deployed road side units, and of the adopted routing protocol. When short range communications are concerned, WAVE/IEEE 802.11p is considered as standard for VANETs. Its use together with VLC will be considered in urban vehicular scenarios to let vehicles communicate without involving the cellular network. The study is conducted by simulation, considering both a simulation platform (SHINE, simulation platform for heterogeneous interworking networks) developed within the Wireless communication Laboratory (Wilab) of the University of Bologna and CNR, and network simulator (NS3). trying to realistically represent all the wireless network communication aspects. Specifically, simulation of vehicular system was performed and introduced in ns-3, creating a new module for the simulator. This module will help to study VLC applications in VANETs. Final observations would enhance and encourage potential research in the area and optimize performance of VLC systems applications in the future.

Mac protocols for linear wireless (sensor) networks

Wireless sensor networks (WSNs) consist of a large number of sensor nodes, characterized by low power constraint, limited transmission range and limited computational capabilities [1][2].The cost of these devices is constantly decreasing, making it possible to use a large number of sensor devices in a wide array of commercial, environmental, military, and healthcare fields. Some of these applications involve placing the sensors evenly spaced on a straight line for example in roads, bridges, tunnels, water catchments and water pipelines, city drainages, oil and gas pipelines etc., making a special class of these networks which we define as a Linear Wireless Network (LWN). In LWNs, data transmission happens hop by hop from the source to the destination, through a route composed of multiple relays. The peculiarity of the topology of LWNs, motivates the design of specialized protocols, taking advantage of the linearity of such networks, in order to increase reliability, communication efficiency, energy savings, network lifetime and to minimize the end-to-end delay [3]. In this thesis a novel contention based Medium Access Control (MAC) protocol called L-CSMA, specifically devised for LWNs is presented. The basic idea of L-CSMA is to assign different priorities to nodes based on their position along the line. The priority is assigned in terms of sensing duration, whereby nodes closer to the destination are assigned shorter sensing time compared to the rest of the nodes and hence higher priority. This mechanism speeds up the transmission of packets which are already in the path, making transmission flow more efficient. Using NS-3 simulator, the performance of L-CSMA in terms of packets success rate, that is, the percentage of packets that reach destination, and throughput are compared with that of IEEE 802.15.4 MAC protocol, de-facto standard for wireless sensor networks. In general, L-CSMA outperforms the IEEE 802.15.4 MAC protocol.

Characterization of integrated Bragg gratings in silicon-on-insulator

Silicon-on-insulator (SOI) is rapidly emerging as a very promising material platform for integrated photonics. As it combines the potential for optoelectronic integration with the low-cost and large volume manufacturing capabilities and they are already accumulate a huge amount of applications in areas like sensing, quantum optics, optical telecommunications and metrology. One of the main limitations of current technology is that waveguide propagation losses are still much higher than in standard glass-based platform because of many reasons such as bends, surface roughness and the very strong optical confinement provided by SOI. Such high loss prevents the fabrication of efficient optical resonators and complex devices severely limiting the current potential of the SOI platform. The project in the first part deals with the simple waveguides loss problem and trying to link that with the polarization problem and the loss based on Fabry-Perot Technique. The second part of the thesis deals with the Bragg Grating characterization from again the point of view of the polarization effect which leads to a better stop-band use filters. To a better comprehension a brief review on the basics of the SOI and the integrated Bragg grating ends up with the fabrication techniques and some of its applications will be presented in both parts, until the end of both the third and the fourth chapters to some results which hopefully make its precedent explanations easier to deal with.

Tor network forensics and hidden service deanonymization

The cybernetics revolution of the last years improved a lot our lives, having an immediate access to services and a huge amount of information over the Internet. Nowadays the user is increasingly asked to insert his sensitive information on the Internet, leaving its traces everywhere. But there are some categories of people that cannot risk to reveal their identities on the Internet. Even if born to protect U.S. intelligence communications online, nowadays Tor is the most famous low-latency network, that guarantees both anonymity and privacy of its users. The aim of this thesis project is to well understand how the Tor protocol works, not only studying its theory, but also implementing those concepts in practice, having a particular attention for security topics. In order to run a Tor private network, that emulates the real one, a virtual testing environment has been configured. This behavior allows to conduct experiments without putting at risk anonymity and privacy of real users. We used a Tor patch, that stores TLS and circuit keys, to be given as inputs to a Tor dissector for Wireshark, in order to obtain decrypted and decoded traffic. Observing clear traffic allowed us to well check the protocol outline and to have a proof of the format of each cell. Besides, these tools allowed to identify a traffic pattern, used to conduct a traffic correlation attack to passively deanonymize hidden service clients. The attacker, controlling two nodes of the Tor network, is able to link a request for a given hidden server to the client who did it, deanonymizing him. The robustness of the traffic pattern and the statistics, such as the true positive rate, and the false positive rate, of the attack are object of a potential future work.