Dissipative nonlinear structures in fiber optics

Optical fiber materials exhibit a nonlinear response to strong electric fields, such as those of optical signals confined within the small fiber core. Fiber nonlinearity is an essential component in the design of the next generation of advanced optical communication systems, but its use is often avoided by engineers because of its intractability. The application of nonlinear technologies in fiber optics offers new opportunities for the design of photonic systems and devices. In this chapter, we make an overview of recent progress in mathematical theory and practical applications of temporal dissipative solitons and self-similar nonlinear structures in optical fiber systems. The design of all-optical high-speed signal processing devices, based on nonlinear dissipative structures, is discussed.

Dissipative nonlinear structures in fiber optics

Optical fiber materials exhibit a nonlinear response to strong electric fields, such as those of optical signals confined within the small fiber core. Fiber nonlinearity is an essential component in the design of the next generation of advanced optical communication systems, but its use is often avoided by engineers because of its intractability. The application of nonlinear technologies in fiber optics offers new opportunities for the design of photonic systems and devices. In this chapter, we make an overview of recent progress in mathematical theory and practical applications of temporal dissipative solitons and self-similar nonlinear structures in optical fiber systems. The design of all-optical high-speed signal processing devices, based on nonlinear dissipative structures, is discussed.

Psychophysiological responses to visceral and somatic pain in functional chest pain identify clinically relevant pain clusters

Background: Despite chronic pain being a feature of functional chest pain (FCP) its experience is variable. The factors responsible for this variability remain unresolved. We aimed to address these knowledge gaps, hypothesizing that the psychophysiological profiles of FCP patients will be distinct from healthy subjects. Methods: 20 Rome III defined FCP patients (nine males, mean age 38.7 years, range 28-59 years) and 20 healthy age-, sex-, and ethnicity-matched controls (nine males, mean 38.2 years, range 24-49) had anxiety, depression, and personality traits measured. Subjects had sympathetic and parasympathetic nervous system parameters measured at baseline and continuously thereafter. Subjects received standardized somatic (nail bed pressure) and visceral (esophageal balloon distension) stimuli to pain tolerance. Venous blood was sampled for cortisol at baseline, post somatic pain and post visceral pain. Key Results: Patients had higher neuroticism, state and trait anxiety, and depression scores but lower extroversion scores vs controls (all p < 0.005). Patients tolerated less somatic (p < 0.0001) and visceral stimulus (p = 0.009) and had a higher cortisol at baseline, and following pain (all p < 0.001). At baseline, patients had a higher sympathetic tone (p = 0.04), whereas in response to pain they increased their parasympathetic tone (p ≤ 0.008). The amalgamating the data, we identified two psychophysiologically distinct 'pain clusters'. Patients were overrepresented in the cluster characterized by high neuroticism, trait anxiety, baseline cortisol, pain hypersensitivity, and parasympathetic response to pain (all p < 0.03). Conclusions & Inferences: In future, such delineations in FCP populations may facilitate individualization of treatment based on psychophysiological profiling. © 2013 John Wiley & Sons Ltd.

Supporting inclusiveness through concepts of gender

Some dads wear nail polish! Is the tooth fairy a boy or a girl? My Grade Two students’ voices were integral in developing each of the action research cycles as students became co-creators of knowledge. I gathered data through a personal journal, observations, reflections, work samples, interviews and classroom artifacts. The research question was focused on creating a safe and caring classroom environment by selecting appropriate instructional strategies based on developing my students’ concept of gender. Findings included students’ acceptance of differences, emulation of gender stereotypes, the significance of role models and student empowerment. Conclusions examined the influence that behaviour has on instructional strategies, creating allies among primary students, the importance of teacher training and the influence that students have in their classroom. Thoughts towards future research include the need for further parent engagement and more exploration of the impact that the school environment has in the classroom.

Tooth wear in Irish teenagers: a laboratory and epidemiological study

Aim: To investigate the characteristics, development and determinants of toothwear among Irish schoolchildren. Methods: A cross-sectional (examination at 16-years-old) and longitudinal (examinations at 5-,12-,14-years) study were conducted. Two indices were used to measure toothwear, children/parents completed a demographic profile and questionnaire on oral hygiene and dietary practices, health, and lifestyle in both studies. Saliva was collected from consenting 16-year-olds. The explanatory variables for the cross-sectional and longitudinal study were derived from children/parents responses. Differences in salivary profiles were determined for subsets; the protein concentration was determined with Bradford protein assay and protein carbonyl concentration (a protein oxidation marker) was determined spectrophotometrically. Gel-electrophoresis and mass spectrometry determined proteins and ion chromatography inorganic ions. Statistical significance was accepted at p<0.05. Results: At 16-years-old the prevalence of toothwear with dentine visible was 44%. No difference in salivary flow rates existed. In unstimulated saliva a higher mean, protein carbonyl (p<0.0001) and total calcium concentration (p<0.002) existed for the group with moderate toothwear. In stimulated saliva the moderate toothwear group had a lower mean protein concentration(p<0.0001). The 2-DE protein spots prepared for a sub-group differed between those with toothwear and without. Mass spectrometry, identified one of the different proteins as IgA. For 16-year-olds, the self-reported factors indicated that brushing after breakfast was associated with lower toothwear scores(p<0.03). Nail-biting, being asthmatic or reporting a dry mouth were associated with higher toothwear scores(all p<0.05). Eating an apple daily or less was associated with less toothwear(p<0.002). In the longitudinal study toothwear into dentine at age five or 12-years was associated with more toothwear at age 14(all p<0.05). Discussion: The results illustrate the multifactorial aetiology of toothwear. The biochemical and physical correlates of saliva with toothwear requires further research. Conclusion: The impact of previous toothwear, salivary, dietary and personal factors on toothwear in the early permanent dentition is demonstrated.

Nucleic Acid Diagnostics using Isotachophoresis and Isothermal Amplification

Thesis (Ph.D.)--University of Washington, 2016-08

Fatal methadone intoxication in an infant listed as a homicide.

Voluntary methadone administration for the purpose of sedation eventually resulting in the infant's death is extremely infrequent, though it has been observed. In this report, we describe an autopsy case pertaining to a 32-month-old infant who was repeatedly exposed to methadone by his parents. Autopsy revealed a coarctation of the aorta with a focal stenosis located at the junction of the distal aortic arch and the descending aorta. Left ventricular hypertrophy was also observed. Both these findings were considered to not have played a role in the child's death. Methadone was detected in the femoral blood (0.633 mg/l), urine (5.25 mg/l), bile (2.64 mg/l), and gastric contents (1.08 mg). A segmental hair analysis showed the presence of methadone and morphine in both the proximal and distal portion of the lock. Methadone was also detected in nail samples. A segmental hair analysis performed on the younger brother of the deceased revealed the presence of methadone and morphine in both the proximal and distal segments, as well as the presence of 6-monoacetylmorphine exclusively in the distal portion. Though the parents denied any involvement in methadone administration or exposure for the purpose of sedation, the manner of death was listed as homicide. The case emphasizes the usefulness of hair analysis to identify threatening situations for the children of drug-dependent parents and possibly support measures by the authorities to recognize and intervene in these potentially fatal situations.

Book review: Laurel Kamada, Hybrid Identities and Adolescent Girls: Being Half in Japan. Bristol: Multilingual Matters, 2010

Arguably, the catalyst for the best research studies using social analysis of discourse is personal ‘lived’ experience. This is certainly the case for Kamada, who, as a white American woman with a Japanese spouse, had to deal first hand with the racialization of her son. Like many other mixed-ethnic parents, she experienced the shock and disap-pointment of finding her child being racialized as ‘Chinese’ in America through peer group taunts, and constituted as gaijin (a foreigner) in his own homeland of Japan. As a member of an e-list of the (Japan) Bilingualism Special Interest Group (BSIG), Kamada learnt that other parents from the English-speaking foreign community in Japan had similar disturbing stories to tell of their mixed-ethnic children who, upon entering the Japanese school system, were mocked, bullied and marginalized by their peers. She men-tions a pervasive Japanese proverb which warns of diversity or difference getting squashed: ‘The nail that sticks up gets hammered down’. This imperative to conform to Japanese behavioural and discursive norms prompted Kamada’s quest to investigate the impact of ‘otherization’ on the identities of children of mixed parentage. In this fascinat-ing book, she shows that this pressure to conform is balanced by a corresponding cele-bration of ‘hybrid’ or mixed identities. The children in her study are also able to negotiate their identities positively as they come to terms with contradictory discursive notions of ‘Japaneseness’, ‘whiteness’ and ‘halfness/doubleness’.The discursive construction of identity has become a central concern amongst researchers across a wide range of academic disciplines within the humanities and the social sciences, and most existing work either concentrates on a specific identity cate-gory, such as gender, sexuality or national identity, or else offers a broader discussion of how identity is theorized. Kamada’s book is refreshing because it crosses the usual boundaries and offers divergent insights on identity in a number of ways. First, using the term ‘ethno-gendering’, she examines the ways in which six mixed-ethnic girls living in Japan accomplish and manage the relationship between their gender and ethnic ‘differ-ences’ from age 12 to 15. She analyses in close detail how their actions or displays within certain situated interactions might come into conflict with how they are seen or constituted by others. Second, Kamada’s study builds on contemporary writing on the benefits of hybridity where identities are fluid, flexible and indeterminate, and which contest the usual monolithic distinctions of gender, ethnicity, class, etc. Here, Kamada carves out an original space for her findings. While scholars have often investigated changing identities and language practices of young people who have been geographi-cally displaced and are newcomers to the local language, Kamada’s participants were all born and brought up in Japan, were fluent in Japanese and were relatively proficient in English. Third, the author refuses to conceptualize or theorize identity from a single given viewpoint in preference to others, but in postmodernist spirit draws upon multiple perspectives and frameworks of discourse analysis in order to create different forms of knowledge and understandings of her subject. Drawing on this ‘multi-perspectival’ approach, Kamada examines grammatical, lexical, rhetorical and interactional features from six extensive conversations, to show how her participants position their diverse identities in relation to their friends, to the researcher and to the outside world. Kamada’s study is driven by three clear aims. The first is to find out ‘whether there are any tensions and dilemmas in the ways adolescent girls of Japanese and “white” mixed parentage in Japan identify themselves in terms of ethnicity’. In Chapter 4, she shows how the girls indeed felt that they stood out as different and consequently experienced isolation, marginalization and bullying at school – although they were able to make better sense of this as they grew older, repositioning the bullies as pitiable. The second aim is to ask how, if at all, her participants celebrate their ethnicity, and furthermore, what kind of symbolic, linguistic and social capital they were able to claim for themselves on the basis of their hybrid identities. In Chapter 5, Kamada shows how the girls over time were able to constitute themselves as insiders while constituting ‘the Japanese’ as outsiders, and their network of mixed-ethnic friends was a key means to achieve this. In Chapter 6, the author develops this potential celebration of the girls’ mixed ethnicity by investigating the privileges they perceived it afforded them – for example, having the advantage of pos-sessing English proficiency and intercultural ‘savvy’ in a globalized world. Kamada’s third aim is to ask how her participants positioned themselves and performed their hybrid identities on the basis of their constituted appearance: that is, how the girls saw them-selves based on how they looked to others. In Chapter 7, the author shows that, while there are competing discourses at work, the girls are able to take up empowering positions within a discourse of ‘foreigner attractiveness’ or ‘a white-Western female beauty’ discourse, which provides them with a certain cachet among their Japanese peers. Throughout the book, Kamada adopts a highly self-reflexive perspective of her own position as author. For example, she interrogates the fact that she may have changed the lived reality of her six participants during the course of her research study. As the six girls, who were ‘best friends’, lived in different parts of the Morita region of Japan, she had to be proactive in organizing six separate ‘get-togethers’ through the course of her three-year study. She acknowledges that she did not collect ‘naturally occurring data’ but rather co-constructed opportunities for the girls to meet and talk on a regular basis. At these meetings, she encouraged the girls to discuss matters of identity, prompted by open-ended interview questions, by stimulus materials such as photos, articles and pic-tures, and by individual tasks such as drawing self-portraits. By giving her participants a platform in this way, Kamada not only elicited some very rich spoken data but also ‘helped in some way to shape the attitudes and self-images of the girls positively, in ways that might not have developed had these get-togethers not occurred’ (p. 221). While the data she gathers are indeed rich, it may well be asked whether there is a mismatch between the girls’ frank and engaging accounts of personal experience, and the social constructionist academic register in which these are later re-articulated. When Kamada writes, ‘Rina related how within the more narrow range of discourses that she had to draw on in her past, she was disempowered and marginalized’ (p. 118), we know that Rina’s actual words were very different. Would she really recognize, understand and agree with the reported speech of the researcher? This small omission of self-reflexivity apart – an omission which is true of most lin-guistic ethnography conducted today – Kamada has written a unique, engaging and thought-provoking book which offers a model to future discourse analysts investigating hybrid identities. The idea that speakers can draw upon competing discourses or reper-toires to constitute their identities in contrasting, creative and positive ways provides linguistic researchers with a clear orientation by which to analyse the contradictions of identity construction as they occur across time in different discursive contexts

Abnormal primary and permanent dentitions with ectodermal symptoms predict WNT10A deficiency

BACKGROUND: The WNT10A protein is critical for the development of ectodermal appendages. Variants in the WNT10A gene may be associated with a spectrum of ectodermal abnormalities including extensive tooth agenesis. METHODS: In seven patients with severe tooth agenesis we identified anomalies in primary dentition and additional ectodermal symptoms, and assessed WNT10A mutations by genetic analysis. RESULTS: Investigation of primary dentition revealed peg-shaped crowns of primary mandibular incisors and three individuals had agenesis of at least two primary teeth. The permanent dentition was severely affected in all individuals with a mean of 21 missing teeth. Primary teeth were most often present in positions were succedaneous teeth were missing. Furthermore, most existing molars had taurodontism. Light, brittle or coarse hair was reported in all seven individuals, hyperhidrosis of palms and soles in six individuals and nail anomalies in two individuals. The anomalies in primary dentition preceded most of the additional ectodermal symptoms. Genetic analysis revealed that all seven individuals were homozygous or compound heterozygous for WNT10A mutations resulting in C107X, E222X and F228I. CONCLUSIONS: We conclude that tooth agenesis and/or peg-shaped crowns of primary mandibular incisors, severe oligodontia of permanent dentition as well as ectodermal symptoms of varying severity may be predictors of bi-allelic WNT10A mutations of importance for diagnosis, counselling and follow-up.

Tratamento de lesões profunda de cárie: caso clínico

Um paciente procura a UBS por apresentar dor, há duas semanas, ao mastigar ou quando em contato com algo frio.

Tratamento de lesões profundas de cárie

Saber diagnosticar, indicar e verificar os resultados de um tratamento mais conservador para lesões profundas de cárie em nível de atenção primária, visando reduzir o número de dentes com indicação endodôntica - nível de atenção secundária, além de rever conceitos básicos de cariologia

Melhoria da Assistência ao Pré-Natal e Puerpério na UBS Centro de Atenção Integral à Criança e ao Adolescente em Uruguaiana-RS

O atendimento Pré-Natal está se consolidando como a melhor intervenção para garantir qualidade da saúde materna e aumento da expectativa de vida em recém-nascidos. O acompanhamento da gestação diminui os índices de mortalidade materna pela promoção de uma gravidez que não altere o estado de saúde materno, ou minimize efeitos de patologias previamente diagnosticadas. A atenção primária à saúde, com a implantação da Estratégia de Saúde da Família, vem ao encontro da necessidade de criar políticas públicas de saúde que contemplem o acompanhamento pré-natal e puerperal baseado nos princípios do SUS. O presente trabalho trata-se de uma intervenção que objetivou melhorar a qualidade da assistência ao pré-natal e puerpério da UBS CAIC, em Uruguaiana, RS. No decorrer da análise situacional, diversos dados foram coletados e questionários foram respondidos, com o objetivo de avaliar de forma completa e sistemática a estrutura física, processo de trabalho e ações programáticas na UBS. Nessa análise foram detectadas diversas falhas na qualidade da atenção ao pré-natal e puerpério. Uma intervenção foi, então, planejada e atividades incorporadas ao dia-a-dia da UBS dentro de quatro eixos temáticos: organização e gestão do serviço; monitoramento e avaliação; engajamento público; e qualificação da prática clínica. Após três meses de intervenção, passamos de 58% de gestantes (n=30) acompanhadas antes da coleta dos dados para mais de 99% (n=50) de cobertura do programa. Durante a intervenção, a UBS foi transformada em ESF, reduzindo assim a população da área de abrangência e facilitando a busca ativa das gestantes. Todas as gestantes acompanhadas no período receberam avaliação quanto ao risco gestacional, orientações sobre a importância de iniciar o pré-natal no primeiro trimestre, prescrição de sulfato ferroso e ácido fólico conforme o protocolo, solicitação de exames clínicos, ginecológicos, obstétricos e odontológicos conforme preconizado pelo Ministério da Saúde. As gestantes e puérperas foram avaliadas quanto às intercorrências no período, e sua situação biopsicossocial serviu de referencial para a realização de intervenções em situações familiares e na comunidade adstrita à unidade.

Melhoria da Atenção à Saúde Bucal dos Escolares de 4 a 18 anos, das escolas localizadas na região de abrangência da UBS “ESF II”, no município de Trindade do Sul/RS

O presente trabalho teve como objetivo melhorar as condições de saúde bucal dos escolares e pré-escolares visando torná-los adultos mais saudáveis, melhorando, dessa forma, a qualidade de vida dos mesmos. Após análise situacional sistemática, foi verificado que a condição de saúde bucal da população da área adstrita à UBS poderia ser melhorada com a realização de atividades coletivas tendo foco nos jovens em idade escolar. Foi verificado que um grande número de escolares se encontravam em uma situação de alto risco para a cárie dentária (56,5%). O presente trabalho teve como objetivo melhorar as condições de saúde bucal dos 203 pré-escolares e escolares entre 4 e 18 anos matriculados, nas cinco escolas localizadas na região de abrangência da UBS “ESF II”, no município de Trindade do Sul, Rio Grande do Sul. Foi pactuado ampliar a cobertura de atenção à saúde bucal dos escolares, melhorar a qualidade da atenção à saúde bucal dos escolares, melhorar a adesão ao atendimento em saúde bucal, melhorar o registro das informações e promover a saúde bucal dos escolares. Ao final da intervenção, foi alcançado 87,2% de cobertura dos escolares matriculados com primeira consulta odontológica realizada. A meta de fornecer orientações sobre higiene bucal aos escolares foi uma das mais priorizadas, atingindo 100% dos escolares. O tratamento odontológico foi concluído em 92% dos escolares que realizaram a primeira consulta odontológica. Conclui-se que, apesar de dificuldades como o acesso dos escolares à UBS, a realização da intervenção melhorou significativamente a saúde bucal dos escolares participantes, pois muitos tiveram nela seu primeiro contato com um cirurgião-dentista. Além disso, diversos atendimentos foram ofertados, buscando resolver e diminuir os agravos dos principais problemas de saúde bucal apresentados pelos escolares.

Qualificação da atenção básica para adultos portadores de hipertensão arterial sistêmica e/ou diabetes mellitus na UBS Gaspar Fernandes - Manacapuru – Amazonas

A epidemia de Hipertensão Arterial Sistêmica e o Diabetes Mellitus vem desafiado o Sistema Único de Saúde brasileiro. O objetivo do presente trabalho foi desenvolver uma intervenção a fim de melhorar a atenção aos adultos portadores de Hipertensão Arterial Sistêmica (HAS) e/ou Diabetes Mellitus (DM) na UBS Gaspar Fernandes, no município de Manacapuru - Amazonas. A intervenção foi estruturada para ser desenvolvida em um período de 04 meses. Participaram da intervenção os pacientes com HAS e/ou DM pertencentes à área de abrangência da UBS detectados pelo rastreamento da equipe de saúde da família, e também os pacientes da área de abrangência já diagnosticados como hipertensos e/ou diabéticos. Além dos atendimentos médicos e de enfermagem, foram desenvolvidas atividades de visitas domiciliares, o que elevou o número de pessoas atingidas pela intervenção, pois a população tem acesso dificultado à UBS. A assistência à saúde dessa população melhorou, apesar de pequeno o aumento da cobertura (cálculo baseado em uma área de abrangência com mais de 12.000 pessoas), em quatro meses de intervenção foram atendidos 256 adultos com 20 anos ou mais portadores de HAS e outros 76 portadores de DM. Realizamos 203 orientações sobre tabagismo para hipertensos e diabéticos, 207 orientações sobre alimentação e dieta (não contamos com nutricionista na UBS), 79 hipertensos e 38 diabéticos estavam devidamente compensados em seus níveis pressóricos e glicêmicos respectivamente e 511 hipertensos e 151 diabéticos cadastrados no Programa Farmácia Popular recebendo suas terapias regularmente. Com base nos resultados alcançados, sugere-se que a intervenção trouxe ganhos para um grande número de pessoas e as ações deveriam ser institucionalizada nesta unidade

Melhoria da Detecção do Câncer de Colo de Útero e do Câncer de Mama, na UBS Pitangui Ii, Extremoz/RN

Em muitas comunidades do Brasil encontram-se múltiplos problemas socioeconômicos, educativos, culturais e sobre todos na área da saúde, o qual explica a existência de múltiplas doenças. Na área de abrangência da UBS Pitangui II existia muita desinformação, muitos atrasos nos exames preventivos cito-patológicos e mamografias, além de falta de assistência para a grande maioria de mulheres da área, levando a uma condição preocupante e do alto grau de morbimortalidade das doenças cancerígenas de maior ocorrência em mulheres. Na área existe um total de 630 mulheres compreendidas nos grupos de idades de 25-64 anos e 201 mulheres no grupo de 50-69 anos, que estão em risco para o desenvolvimento dessas doenças. Realizamos uma intervenção que objetivou a detenção do câncer de colo de útero e do câncer de mama na UBS Pitangui II, Extremoz/RN (2015). Para isso, trabalhou-se em conjunto com uma equipe multiprofissional para uma melhor atenção e desenvolvimento de ações desenvolvidas em quatro eixos pedagógicos: organização e gestão dos serviços, monitoramento e avaliação, engajamento público e qualificação da prática clínica. A intervenção foi realizada em um período de 3 meses e 179 usuárias realizaram exames de preventivo e mamografia. Alcançamos um maior aumento de realizações de preventivos e mamografias no último mês. Propiciou-se a ampliação da cobertura da atenção à saúde das mulheres na prevenção dos cânceres de colo de útero e de mama para 22,1% (n=139) e 19,9% (n=40), respectivamente. Mais do que aumentar a cobertura, alcançamos a melhoria dos registros de todas as mulheres e a qualificação da prática clínica na equipe de saúde da UBS Pitangui II, com destaque para pesquisa de sinais de alerta, assim como orientações sobre DSTs e fatores de risco de ambos grupos. Garantimos uma implementação de ações que melhoraram significativamente o serviço, favorecendo a comunidade. Agora a equipe trabalha com melhor orientação profissional e mais união. Todas essas ações serão incorporadas à rotina do serviço após este período do intervenção. Conclui-se que a intervenção gerou um maior compromisso da equipe e excelência de qualidade aos serviços prestados à comunidade. Através da distribuição de atividades da equipe, viabilizou-se atenção a um maior número de pessoas. A população torna-se a maior beneficiada. Palavras-chave: atenção primária à saúde; saúde da família; câncer de colo de útero e de mama; saúde da mulher.