Reliability and differentiation capability of dynamic and static kinematic measurements of rearfoot eversion in patellofemoral pain

Excessive rearfoot eversion is thought to be a risk factor for patellofemoral pain development, due to the kinesiological relationship with ascendant adaptations. Individuals with patellofemoral pain are often diagnosed through static clinical tests, in scientific studies and clinical practice. However, the adaptations seem to appear in dynamic conditions. Performing static vs. dynamic evaluations of widely used measures would add to the knowledge in this area. Thus, the aim of this study was to determine the reliability and differentiation capability of three rearfoot eversion measures: rearfoot range of motion, static clinical test and static measurement using a three-dimensional system. A total of 29 individuals with patellofemoral pain and 25 control individuals (18-30 years) participated in this study. Each subject underwent three-dimensional motion analysis during stair climbing and static clinical tests. Intraclass correlation coefficient and standard error measurements were performed to verify the reliability of the variables and receiver operating characteristic curves to show the diagnostic accuracy of each variable. In addition, analyses of variance were performed to identify differences between groups. Rearfoot range of motion demonstrated higher diagnostic accuracy (an area under the curve score of 0.72) than static measures and was able to differentiate the groups. Only the static clinical test presented poor and moderate reliability. Other variables presented high to very high values. Rearfoot range of motion was the variable that presented the best results in terms of reliability and differentiation capability. Static variables do not seem to be related to patellofemoral pain and have low accuracy values.

Reduced knee flexion is a possible cause of increased loading rates in individuals with patellofemoral pain

Stair ascent is an activity that exacerbates symptoms of individuals with patellofemoral pain. The discomfort associated with this activity usually results in gait modification such as reduced knee flexion in an attempt to reduce pain. Although such compensatory strategy is a logical approach to decrease pain, it also reduces the normal active shock absorption increasing loading rates and may lead to deleterious and degenerative changes of the knee joint. Thus, the aims of this study were (i) to investigate whether there is reduced knee flexion in adults with PFP compared to healthy controls; and (ii) to analyze loading rates in these subjects, during stair climbing. Twenty-nine individuals with patellofemoral pain and twenty-five control individuals (18-30years) participated in this study. Each subject underwent three-dimensional kinematic and kinetic analyses during stair climbing on two separate days. Between-groups analyses of variance were performed to identify differences in peak knee flexion and loading rates. Intraclass correlation coefficient was performed to verify the reliability of the variables. On both days, the patellofemoral pain group demonstrated significantly reduced peak knee flexion and increased loading rates. In addition, the two variables obtained high to very high reliability. Reduced knee flexion during stair climbing as a strategy to avoid anterior knee pain does not seem to be healthy for lower limb mechanical distributions. Repeated loading at higher loading rates may be damaging to lower limb joints.

Q-angle static or dynamic measurements, which is the best choice for patellofemoral pain?

The elevated Q-angle seems to be one of the most suggested factors contributing to patellofemoral pain. Females with patellofemoral pain are often evaluated through static clinical tests in clinical practice. However, the adaptations seem to appear more frequently in dynamic conditions. Performing static vs. dynamic evaluations of widely used measures would add to the knowledge in this area. Therefore, the aim of this study was to determine the reliability and discriminatory capability of three Q-angle measurements: a static clinical test, peak dynamic knee valgus during stair ascent and a static measurement using a three-dimensional system. Twenty-nine females with patellofemoral pain and twenty-five pain-free females underwent clinical Q-angle measurement and static and dynamic knee valgus measurements during stair ascent, using a three-dimensional system. All measurements were obtained and comparisons between groups, reliability and discriminatory capability were calculated. Peak dynamic knee valgus was found to be greater in the patellofemoral pain group. On the other hand, no significant effects were found for static knee valgus or clinical Q-angle measurements between groups. The dynamic variable demonstrated the best discriminatory capability. Low values of reliability were found for clinical Q-angle, in contrast to the high values found for the three-dimensional system measurements. Based on our findings, avoiding or correcting dynamic knee valgus during stair ascent may be an important component of rehabilitation programs in females with patellofemoral pain who demonstrate excessive dynamic knee valgus. Q-angle static measurements were not different between groups and presented poor values of discriminatory capability.

Neuromuscular efficiency of the vastus lateralis and biceps femoris muscles in individuals with anterior cruciate ligament injuries

To analyze strength and integrated electromyography (IEMG) data in order to determine the neuromuscular efficiency (NME) of the vastus lateralis (VL) and biceps femoris (BF) muscles in patients with anterior cruciate ligament (ACL) injuries, during the preoperative and postoperative periods; and to compare the injured limb at these two times, using the non-operated limb as a control. EMG data and BF and VL strength data were collected during three maximum isometric contractions in knee flexion and extension movements. The assessment protocol was applied before the operation and two months after the operation, and the NME of the BF and VL muscles was obtained. There was no difference in the NME of the VL muscle from before to after the operation. On the other hand, the NME of the BF in the non-operated limb was found to have increased, two months after the surgery. The NME provides a good estimate of muscle function because it is directly related to muscle strength and capacity for activation. However, the results indicated that two months after the ACL reconstruction procedure, at the time when loading in the open kinetic chain within rehabilitation protocols is usually started, the neuromuscular efficiency of the VL and BF had still not been reestablished.

Indicadores diagnósticos da síndrome metabólica, butirilcolinesterase e estado de condicionamento físico em adolescentes obesos e eutróficos: uma breve explanação do atual estado da arte

Damage to health caused by excess body fat also generating a negative economic impact, with significant increase in public spending. The metabolic syndrome, which also gets several other names, such as plurimetabolic syndrome or syndrome X, is nothing more than the combined incidence of some diseases or metabolic disorders in which obesity, besides being one of them, seems to promote parallel effects that contribute to the development of other chronic diseases such as diabetes and cardiovascular disease. Researchers agree that hyper caloric diets associated with a sedentary lifestyle are the main triggers of disease, including the increasing on genetic predisposition to this disease in children and adolescents. In the case of children and adolescents the diagnosis is complicated by the lack of a consensus accepted by the scientific community. In addition to behavioral and environmental factors unfavorable to health, in a more detailed analysis also found hereditary aspects or simply genetic, such as hepatic enzyme Butyrylcholinesterase. When compared to eutrophic, obese adolescents, like adults obese, have higher serum concentration values as well as major activity for this enzyme. Increasing evidence suggests that excess body weight assumes an important role in the variation of metabolic functions in adolescents, favoring the emergence of early diagnostic indicators of metabolic syndrome.

Potential endocrinedisruptor activity of drinking water samples

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Procedimento para homologação de sistemas ecoeficientes para obtenção de créditos de carbono

This paper deals with the homologation process for obtaining carbon credits through the Clean Development Mechanism (CDM), that regulates the greenhouse gases reductions under the rules of the Kyoto Protocol. The CDM evaluates projects through a project cycle, which begins with the preparation of the Project Design Document (PDD) until the project certification to receive Certified Emission Reductions (CERs), popularly known as carbon credits. This study analyzed the implementation of the system Burner Recorder System for Low Flows of Biogas (QRBBV), developed by Marcelino Junior & Godoy (2009), in an eco-friendly wastewater treatment mini-plant (miniEETERA), built at the site of UNESP - Guaratinguetá SP. The QRBBV system is low cost and high reliability, developed to burn the methane generated at sites of low and variable production of biogas, which is not economically justified their energy recovery. Currently, almost all wastewater generated at the site of the campus is being treated by miniEETERA and, as a result, the biogas originated by this activity is being released into the atmosphere. Therefore, the project activity aims to capture and burn the biogas generated by miniEETERA, reducing the negative effects caused by the methane emissions into the atmosphere and, thus, claim to receive carbon credits. This work aimed to demonstrate the project applicability under CDM through the study and preparation of the PDD, as well as an analysis of the entire project cycle required for homologation. The result of the work obtained an estimate of only 20 CERs per year and proved to be economically unviable for approval through the CDM, since the spending with the approval process would not be compensated with the sale of CERs, mainly due the low carbon price in the world market. From an environmental standpoint, the project is perfectly... (Complete abstract click electronic access below)

Procedimento para homologação de sistemas ecoeficientes para obtenção de créditos de carbono

This paper deals with the homologation process for obtaining carbon credits through the Clean Development Mechanism (CDM), that regulates the greenhouse gases reductions under the rules of the Kyoto Protocol. The CDM evaluates projects through a project cycle, which begins with the preparation of the Project Design Document (PDD) until the project certification to receive Certified Emission Reductions (CERs), popularly known as carbon credits. This study analyzed the implementation of the system Burner Recorder System for Low Flows of Biogas (QRBBV), developed by Marcelino Junior & Godoy (2009), in an eco-friendly wastewater treatment mini-plant (miniEETERA), built at the site of UNESP - Guaratinguetá SP. The QRBBV system is low cost and high reliability, developed to burn the methane generated at sites of low and variable production of biogas, which is not economically justified their energy recovery. Currently, almost all wastewater generated at the site of the campus is being treated by miniEETERA and, as a result, the biogas originated by this activity is being released into the atmosphere. Therefore, the project activity aims to capture and burn the biogas generated by miniEETERA, reducing the negative effects caused by the methane emissions into the atmosphere and, thus, claim to receive carbon credits. This work aimed to demonstrate the project applicability under CDM through the study and preparation of the PDD, as well as an analysis of the entire project cycle required for homologation. The result of the work obtained an estimate of only 20 CERs per year and proved to be economically unviable for approval through the CDM, since the spending with the approval process would not be compensated with the sale of CERs, mainly due the low carbon price in the world market. From an environmental standpoint, the project is perfectly... (Complete abstract click electronic access below)

Participative site-specific agriculture analysis for smallholders

Site-specific agriculture has been adopted in a high-tech context using, for instance, in situ sensors, satellite images for remote sensing analysis, and some other technological devices. However, farmers and smallholders without the economic resources and required knowledge to use and to access the latest technology seem to find an impediment to precision agricultural practices. This article discusses the possibility of adopting precision agriculture (PA) principles for site-specific management but in a low technology context for such farmers. The proposed methodology to support PA combines low technology dependency and a participatory approach by involving smallholders, farmers and experts. The case studies demonstrate how the interplay of low technology and a participative approach may be suitable for smallholders for site-specific agriculture analysis.

Glycerol as a by-product of biodiesel production in Brazil: Alternatives for the use of unrefined glycerol

On January 1 2008, Brazil included yet another element into its energy matrix: biodiesel. The predominant biodiesel production process involves a phase of transesterification that yields glycerol as a by-product. The use of this glycerol is limited since it is considered an unrefined raw material that must be refined for its various types of use. Several studies have addressed identification of possible uses for unrefined glycerol. Given the diversity of uses, an overview is necessary. The purpose of this work is to present alternatives currently being considered for the use of unrefined glycerol as a by-product of biodiesel production, aiming to contribute to the sustainable consolidation of the biofuel market. Exploratory research was carried out to identify these viable alternatives for the use of this by-product. The possibilities include the production of chemical products, fuel additives, production of hydrogen, development of fuel cells, ethanol or methanol production, animal feed, co-digestion and co-gasification, and waste treatment among others. The present research reveals that there are promising possibilities for the use of unrefined glycerol, which may help consolidate the sustainability of the biofuel market. (C) 2012 Elsevier Ltd. All rights reserved.

Prevalence and risk factors of Hepatitis C virus infection in Brazil, 2005 through 2009: a cross-sectional study

Abstract Background Hepatitis C chronic liver disease is a major cause of liver transplant in developed countries. This article reports the first nationwide population-based survey conducted to estimate the seroprevalence of HCV antibodies and associated risk factors in the urban population of Brazil. Methods The cross sectional study was conducted in all Brazilian macro-regions from 2005 to 2009, as a stratified multistage cluster sample of 19,503 inhabitants aged between 10 and 69 years, representing individuals living in all 26 State capitals and the Federal District. Hepatitis C antibodies were detected by a third-generation enzyme immunoassay. Seropositive individuals were retested by Polymerase Chain Reaction and genotyped. Adjusted prevalence was estimated by macro-regions. Potential risk factors associated with HCV infection were assessed by calculating the crude and adjusted odds ratios, 95% confidence intervals (95% CI) and p values. Population attributable risk was estimated for multiple factors using a case–control approach. Results The overall weighted prevalence of hepatitis C antibodies was 1.38% (95% CI: 1.12%–1.64%). Prevalence of infection increased in older groups but was similar for both sexes. The multivariate model showed the following to be predictors of HCV infection: age, injected drug use (OR = 6.65), sniffed drug use (OR = 2.59), hospitalization (OR = 1.90), groups socially deprived by the lack of sewage disposal (OR = 2.53), and injection with glass syringe (OR = 1.52, with a borderline p value). The genotypes 1 (subtypes 1a, 1b), 2b and 3a were identified. The estimated population attributable risk for the ensemble of risk factors was 40%. Approximately 1.3 million individuals would be expected to be anti-HCV-positive in the country. Conclusions The large estimated absolute numbers of infected individuals reveals the burden of the disease in the near future, giving rise to costs for the health care system and society at large. The known risk factors explain less than 50% of the infected cases, limiting the prevention strategies. Our findings regarding risk behaviors associated with HCV infection showed that there is still room for improving strategies for reducing transmission among drug users and nosocomial infection, as well as a need for specific prevention and control strategies targeting individuals living in poverty.

Future water quality monitoring--adapting tools to deal with mixtures of pollutants in water resource management.

Environmental quality monitoring of water resources is challenged with providing the basis for safeguarding the environment against adverse biological effects of anthropogenic chemical contamination from diffuse and point sources. While current regulatory efforts focus on monitoring and assessing a few legacy chemicals, many more anthropogenic chemicals can be detected simultaneously in our aquatic resources. However, exposure to chemical mixtures does not necessarily translate into adverse biological effects nor clearly shows whether mitigation measures are needed. Thus, the question which mixtures are present and which have associated combined effects becomes central for defining adequate monitoring and assessment strategies. Here we describe the vision of the international, EU-funded project SOLUTIONS, where three routes are explored to link the occurrence of chemical mixtures at specific sites to the assessment of adverse biological combination effects. First of all, multi-residue target and non-target screening techniques covering a broader range of anticipated chemicals co-occurring in the environment are being developed. By improving sensitivity and detection limits for known bioactive compounds of concern, new analytical chemistry data for multiple components can be obtained and used to characterise priority mixtures. This information on chemical occurrence will be used to predict mixture toxicity and to derive combined effect estimates suitable for advancing environmental quality standards. Secondly, bioanalytical tools will be explored to provide aggregate bioactivity measures integrating all components that produce common (adverse) outcomes even for mixtures of varying compositions. The ambition is to provide comprehensive arrays of effect-based tools and trait-based field observations that link multiple chemical exposures to various environmental protection goals more directly and to provide improved in situ observations for impact assessment of mixtures. Thirdly, effect-directed analysis (EDA) will be applied to identify major drivers of mixture toxicity. Refinements of EDA include the use of statistical approaches with monitoring information for guidance of experimental EDA studies. These three approaches will be explored using case studies at the Danube and Rhine river basins as well as rivers of the Iberian Peninsula. The synthesis of findings will be organised to provide guidance for future solution-oriented environmental monitoring and explore more systematic ways to assess mixture exposures and combination effects in future water quality monitoring.

The SOLUTIONS project: challenges and responses for present and future emerging pollutants in land and water resources management.

SOLUTIONS (2013 to 2018) is a European Union Seventh Framework Programme Project (EU-FP7). The project aims to deliver a conceptual framework to support the evidence-based development of environmental policies with regard to water quality. SOLUTIONS will develop the tools for the identification, prioritisation and assessment of those water contaminants that may pose a risk to ecosystems and human health. To this end, a new generation of chemical and effect-based monitoring tools is developed and integrated with a full set of exposure, effect and risk assessment models. SOLUTIONS attempts to address legacy, present and future contamination by integrating monitoring and modelling based approaches with scenarios on future developments in society, economy and technology and thus in contamination. The project follows a solutions-oriented approach by addressing major problems of water and chemicals management and by assessing abatement options. SOLUTIONS takes advantage of the access to the infrastructure necessary to investigate the large basins of the Danube and Rhine as well as relevant Mediterranean basins as case studies, and puts major efforts on stakeholder dialogue and support. Particularly, the EU Water Framework Directive (WFD) Common Implementation Strategy (CIS) working groups, International River Commissions, and water works associations are directly supported with consistent guidance for the early detection, identification, prioritisation, and abatement of chemicals in the water cycle. SOLUTIONS will give a specific emphasis on concepts and tools for the impact and risk assessment of complex mixtures of emerging pollutants, their metabolites and transformation products. Analytical and effect-based screening tools will be applied together with ecological assessment tools for the identification of toxicants and their impacts. The SOLUTIONS approach is expected to provide transparent and evidence-based candidates or River Basin Specific Pollutants in the case study basins and to assist future review of priority pollutants under the WFD as well as potential abatement options.

Lettres sur les révolutions du globe

par Alexandre Bertrand ; rev., corr. et considérablement augm. enrichies de nouvelles notes par Arago [u.a.]