Le sommeil comme marqueur du déclin cognitif dans la maladie de Parkinson

La maladie de Parkinson (MP) est une maladie neurodégénérative qui se caractérise principalement par la présence de symptômes moteurs. Cependant, d’autres symptômes, dits non moteurs, sont fréquents dans la MP et assombrissent le pronostic; ceux ci incluent notamment les désordres du sommeil et les troubles cognitifs. De fait, sur une période de plus de 10 ans, jusqu’à 90 % des patients avec la MP développeraient une démence. L’identification de marqueurs de la démence dans la MP est donc primordiale pour permettre le diagnostic précoce et favoriser le développement d’approches thérapeutiques préventives. Plusieurs études ont mis en évidence la contribution du sommeil dans les processus de plasticité cérébrale, d’apprentissage et de consolidation mnésique, notamment l’importance des ondes lentes (OL) et des fuseaux de sommeil (FS). Très peu de travaux se sont intéressés aux liens entre les modifications de la microarchitecture du sommeil et le déclin cognitif dans la MP. L’objectif de cette thèse est de déterminer, sur le plan longitudinal, si certains marqueurs électroencéphalographiques (EEG) en sommeil peuvent prédire la progression vers la démence chez des patients atteints de la MP. La première étude a évalué les caractéristiques des OL et des FS durant le sommeil lent chez les patients avec la MP selon qu’ils ont développé ou non une démence (MP démence vs MP sans démence) lors du suivi longitudinal, ainsi que chez des sujets contrôles en santé. Comparativement aux patients MP sans démence et aux sujets contrôles, les patients MP démence présentaient au temps de base une diminution de la densité, de l’amplitude et de la fréquence des FS. La diminution de l’amplitude des FS dans les régions postérieures était associée à de moins bonnes performances aux tâches visuospatiales chez les patients MP démence. Bien que l’amplitude des OL soit diminuée chez les deux groupes de patients avec la MP, celle ci n’était pas associée au statut cognitif lors du suivi. La deuxième étude a évalué les marqueurs spectraux du développement de la démence dans la MP à l’aide de l’analyse quantifiée de l’EEG en sommeil lent, en sommeil paradoxal et à l’éveil. Les patients MP démence présentaient une diminution de la puissance spectrale sigma durant le sommeil lent dans les régions pariétales comparativement aux patients MP sans démence et aux contrôles. Durant le sommeil paradoxal, l’augmentation de la puissance spectrale en delta et en thêta, de même qu’un plus grand ratio de ralentissement de l’EEG, caractérisé par un rapport plus élevé des basses fréquences sur les hautes fréquences, était associée au développement de la démence chez les patients avec la MP. D’ailleurs, dans la cohorte de patients, un plus grand ralentissement de l’EEG en sommeil paradoxal dans les régions temporo occipitales était associé à des performances cognitives moindres aux épreuves visuospatiales. Enfin, durant l’éveil, les patients MP démence présentaient au temps de base une augmentation de la puissance spectrale delta, un plus grand ratio de ralentissement de l’EEG ainsi qu’une diminution de la fréquence dominante occipitale alpha comparativement aux patients MP sans démence et aux contrôles. Cette thèse suggère que des anomalies EEG spécifiques durant le sommeil et l’éveil peuvent identifier les patients avec la MP qui vont développer une démence quelques années plus tard. L’activité des FS, ainsi que le ralentissement de l’EEG en sommeil paradoxal et à l’éveil, pourraient donc servir de marqueurs potentiels du développement de la démence dans la MP.

O argumento de inclusão enquanto política de acesso à universidade pública

There are a great number of evidences showing that education is extremely important in many economic and social dimensions. In Brazil, education is a right guaranteed by the Federal Constitution; however, in the Brazilian legislation the right to the three stages of basic education: Kindergarten, Elementary and High School is better promoted and supported than the right to education at College level. According to educational census data (INEP, 2009), 78% of all enrolments in College education are in private schools, while the reverse is found in High School: 84% of all matriculations are in public schools, which shows a contradiction in the admission into the universities. The Brazilian scenario presents that public universities receive mostly students who performed better and were prepared in elementary and high school education in private schools, while private universities attend students who received their basic education in public schools, which are characterized as low quality. These facts have led researchers to raise the possible determinants of student performance on standardized tests, such as the Brazilian Vestibular exam, to guide the development of policies aimed at equal access to College education. Seeking inspiration in North American models of affirmative action policies, some Brazilian public universities have suggested rate policies to enable and facilitate the entry of "minorities" (blacks, pardos1, natives, people of low income and public school students) to free College education. At the Federal University of the state Rio Grande do Norte (UFRN), the first incentives for candidates from public schools emerged in 2006, being improved and widespread during the last 7 years. This study aimed to analyse and discuss the Argument of Inclution (AI) - the affirmative action policy that provides additional scoring for students from public schools. From an extensive database, the Ordinary Least Squares (OLS) technique was used as well as a Quantile Regression considering as control the variables of personal, socioeconomic and educational characteristics of the candidates from the Brazilian Vestibular exam 2010 of the Federal University of the state Rio Grande do Norte (UFRN). The results demonstrate the importance of this incentive system, besides the magnitude of other variables

Commercial enzyme-linked immunosorbent assay versus polymerase chain reaction for the diagnosis of chronic Chagas disease: a systematic review and meta-analysis

Chronic Chagas disease diagnosis relies on laboratory tests due to its clinical characteristics. The aim of this research was to review commercial enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) diagnostic test performance. Performance of commercial ELISA or PCR for the diagnosis of chronic Chagas disease were systematically searched in PubMed, Scopus, Embase, ISI Web, and LILACS through the bibliography from 1980-2014 and by contact with the manufacturers. The risk of bias was assessed with QUADAS-2. Heterogeneity was estimated with the I2 statistic. Accuracies provided by the manufacturers usually overestimate the accuracy provided by academia. The risk of bias is high in most tests and in most QUADAS dimensions. Heterogeneity is high in either sensitivity, specificity, or both. The evidence regarding commercial ELISA and ELISA-rec sensitivity and specificity indicates that there is overestimation. The current recommendation to use two simultaneous serological tests can be supported by the risk of bias analysis and the amount of heterogeneity but not by the observed accuracies. The usefulness of PCR tests are debatable and health care providers should not order them on a routine basis. PCR may be used in selected cases due to its potential to detect seronegative subjects.

Variability in the international normalised ratio (INR) in patients with antiphospholipid syndrome and positive lupus anticoagulant: should the INR targets be higher?

El síndrome antifosfolípido es un desorden autoinmune caracterizado por hipercoagulabilidad que requiere terapia anticoagulante como pilar fundamental, siendo la warfarina el tratamiento de elección en los casos que requieren manejo por largos periodos. Sin embargo, los pacientes con anticoagulante lúpico positivo representan un reto porque tienen mayor riesgo de presentar eventos trombóticos, sumado a que el seguimiento con el International Normalized Ratio (INR) no es confiable, ya que estos anticuerpos generan interferencia con las pruebas de laboratorio basadas en fosfolípidos, como es el caso del tiempo de protrombina (PT) con INR basal prolongado, incluso antes del inicio de la terapia anticoagulante. Por tal razón, se ilustra el caso de una paciente con síndrome antifosfolípido primario y anticoagulante lúpico positivo quien ha presentado múltiples episodios trombóticos, a pesar de recibir terapia anticoagulante. Además se hace una revisión de la literatura disponible y se postulan nuevas metas de INR en estos pacientes diferentes de las que se plantean actualmente.

The Analogy as a Cognitive Strategy that Encourages Reading Comprehension in Expository Texts

This research arises from the current state of reading in Mexico, because the contextual situation to local and national level has become critical on this issue. Results on standardized tests such as ENLACE (National Assessment of Academic Achievement in Schools) and PISA (Program for International Student Assessment) have shown that Mexican basic level students have text comprehension problems. Given this reality, this is a qualitative descriptive study on the use of analogies in reading as a strategy for reading comprehension, through application of an ethnographic survey, a questionnaire and the application of a pedagogical model for the use of analogies in reading. The study incorporates the theoretical tenets of Constructivism, referring to Piaget (1969), Vygotsky (1997) and Ausubel (2002). The results show that the use of analogies promotes reading comprehension in 4th grade students, from an expository text that compares the evolution of man and the metamorphosis of a butterfly.

Ossidazione anodica al plasma della lega di alluminio A357 prodotta mediante Laser - Powder Bed Fusion: microstruttura e comportamento tribologico

In questo elaborato è stato analizzato il comportamento tribologico della lega di alluminio A357 realizzata tramite Laser Powder Bed Fusion (L-PBF). In particolare, è stato studiato l’effetto del processo di anodizzazione ECO (ElectroChemical Oxidation) su tale lega, sia allo stato as-built che dopo trattamento termico T6R, in termini di attrito e usura a temperatura ambiente (i.e. 25°C) e a 200°C. Lo studio tribologico è stato svolto mediante prove di strisciamento non lubrificato in moto reciprocante (geometria ball-on-disc contro allumina). Nella prima parte del lavoro sono state effettuate prove a temperatura ambiente, su strati ECO a rugosità variabile, con carichi applicati nell’intervallo 1-8N. Nella seconda parte l’attività sperimentale si è invece rivolta al confronto nel comportamento tribologico della lega a 25°C e 200°C, mantenendo il carico invariato pari a 1 N e analizzando la risposta in termini di attrito e usura, sia per campioni rivestiti ECO che per campioni non rivestiti. Il rivestimento anodico ha mostrato a temperatura ambiente una maggiore resistenza ad usura quando applicato su superfici pre-lucidate, nonostante un maggiore coefficiente di attrito, dando luogo a cedimento completo ad un carico di 8 N (contro i 5 N del non lucidato). Dalla seconda fase di questo studio è invece risultato come il rivestimento ECO abbia notevolmente migliorato la resistenza ad usura rispetto al materiale non rivestito, sia a 25°C che a 200°C, mantenendo invariato il coefficiente d’attrito all’aumentare della temperatura, al contrario dei campioni A357 non rivestiti, che hanno invece manifestato un aumento del coefficiente di attrito di circa il doppio. Vale inoltre la pena notare come la pre-lucidatura ed il trattamento termico dei campioni A357 ECO siano risultati superflui in termini di comportamento tribologico; i campioni a superficie rugosa hanno dato luogo addirittura a minori coefficienti di attrito sia a 25°C che a 200°C, a parità di profondità d’usura.

Design and implementation of a synchronous interleaved boost converter for fuel cell-powered catamaran

The present work describes the different stages of design, implementation, and validation procedures for an interleaved DC-DC boost converter intended for the 2022 Futura, a fuel cell-powered racing catamaran developed by the UniBoAT team. The main goal of the entire design has been the significant reduction of the weight of the converter by removing heat sinks and reducing component size while increasing its efficiency by adopting high-end power switches and the interleaved architecture operated with a synchronous control strategy. The obtained converter has been integrated into the structure containing the fuel cell stack obtaining a fully integrated system. The realized device has been based on an interleaved architecture with six phases controlled digitally through the average current mode control. The design has been validated through simulations carried out using the software LT-Spice, whereas experimental validations have been performed by means of laboratory bench tests and on-field tests. Detailed thermal and efficiency analyses are provided with the bench tests under the two synchronous and non-synchronous operating modes and with the adoption of the phase shedding technique. The prototype implementation and its performance in real operating conditions are also discussed. Eventually, it is underlined as the designed converter can be used in other applications requiring a voltage-controlled boost converter.

Validation of an experimental polyurethane model for biomechanical studies on implant supported prosthesis - tension tests

OBJECTIVES: The complexity and heterogeneity of human bone, as well as ethical issues, frequently hinder the development of clinical trials. The purpose of this in vitro study was to determine the modulus of elasticity of a polyurethane isotropic experimental model via tension tests, comparing the results to those reported in the literature for mandibular bone, in order to validate the use of such a model in lieu of mandibular bone in biomechanical studies. MATERIAL AND METHODS: Forty-five polyurethane test specimens were divided into 3 groups of 15 specimens each, according to the ratio (A/B) of polyurethane reagents (PU-1: 1/0.5, PU-2: 1/1, PU-3: 1/1.5). RESULTS: Tension tests were performed in each experimental group and the modulus of elasticity values found were 192.98 MPa (SD=57.20) for PU-1, 347.90 MPa (SD=109.54) for PU-2 and 304.64 MPa (SD=25.48) for PU-3. CONCLUSION: The concentration of choice for building the experimental model was 1/1.

Validation of an experimental polyurethane model for biomechanical studies on implant-supported prosthesis: compression tests

OBJECTIVES: The complexity and heterogeneity of human bone, as well as ethical issues, most always hinder the performance of clinical trials. Thus, in vitro studies become an important source of information for the understanding of biomechanical events on implant-supported prostheses, although study results cannot be considered reliable unless validation studies are conducted. The purpose of this work was to validate an artificial experimental model based on its modulus of elasticity, to simulate the performance of human bone in vivo in biomechanical studies of implant-supported prostheses. MATERIAL AND METHODS: In this study, fast-curing polyurethane (F16 polyurethane, Axson) was used to build 40 specimens that were divided into five groups. The following reagent ratios (part A/part B) were used: Group A (0.5/1.0), Group B (0.8/1.0), Group C (1.0/1.0), Group D (1.2/1.0), and Group E (1.5/1.0). A universal testing machine (Kratos model K - 2000 MP) was used to measure modulus of elasticity values by compression. RESULTS: Mean modulus of elasticity values were: Group A - 389.72 MPa, Group B - 529.19 MPa, Group C - 571.11 MPa, Group D - 470.35 MPa, Group E - 437.36 MPa. CONCLUSION: The best mechanical characteristics and modulus of elasticity value comparable to that of human trabecular bone were obtained when A/B ratio was 1:1.

Association between neuromuscular tests and kumite performance on the Brazilian Karate National Team

The aim of this study was to verify the relationship of strength and power with performance on an international level karate team during official kumite simulations. Fourteen male black belt karate athletes were submitted to anthropometric data collection and then performed the following tests on two different days: vertical jump test, bench press and squat maximum dynamic strength (1RM) tests. We also tested power production for both exercises at 30 and 60% 1RM and performed a kumite match simulation. Blood samples were obtained at rest and immediately after the kumite matches to measure blood lactate concentration. Karate players were separated by performance (winners vs. defeated) on the kumite matches. We found no significant differences between winners and defeated for strength, vertical jump height, anthropometric data and blood lactate concentration. Interestingly, winners were more powerful in the bench press and squat exercises at 30% 1RM. Maximum strength was correlated with absolute (30% 1RM r = 0.92; 60% 1RM r = 0.63) and relative power (30% 1RM r = 0.74; 60% 1RM r = 0.11, p > 0.05) for the bench press exercise. We concluded that international level karate players' kumite match performance are influenced by higher levels of upper and lower limbs power production.

Influence of a light meal on routine haematological tests

Introduction Patient-related variables such as physical exercise stress and fasting status are Important sources of variability in laboratory testing However no clear indications about tasting requirements exist for routine haematological tests nor has the influence of meals been assessed Methods We studied 17 healthy volunteers who consumed a light meal containing a standardized amount of carbohydrates, protein and lipids Blood was taken for routine haematological tests before the meal and 1 2 and 4 hours thereafter Results One hour after the meal neutrophil count and mean corpuscular haemoglobin (MHC) increased significantly whereas lymphocyte and monocyte counts red blood cell distribution width, haematocrit, and mean corpuscular volume decreased significantly A clinically significant variation was only observed for lymphocytes Two hours after the meal a significant increase was observed for neutrophils and MCH whereas lymphocytes eosinophils, haemoglobin and haematocrit decreased significantly Clinically significant variations were recorded for lymphocytes red blood cells (RBC), haemoglobin haematocrit and MCH Four hours after the meal MCH was significantly increased while lymphocytes eosinophils, RBC, haemoglobin and haematocrit were significantly decreased Clinically significant variations were recorded for neutrophils eosinophils RBC hematocrit and MCH Conclusion The significant variation of several haematological parameters after a light meal demonstrates that the fasting time needs to be carefully considered in order to interpret the results of haematological tests correctly

New constraints on the chemical evolution of the solar neighbourhood and Galactic disc(s) Improved astrophysical parameters for the Geneva-Copenhagen Survey

We present a re-analysis of the Geneva-Copenhagen survey, which benefits from the infrared flux method to improve the accuracy of the derived stellar effective temperatures and uses the latter to build a consistent and improved metallicity scale. Metallicities are calibrated on high-resolution spectroscopy and checked against four open clusters and a moving group, showing excellent consistency. The new temperature and metallicity scales provide a better match to theoretical isochrones, which are used for a Bayesian analysis of stellar ages. With respect to previous analyses, our stars are on average 100 K hotter and 0.1 dex more metal rich, which shift the peak of the metallicity distribution function around the solar value. From Stromgren photometry we are able to derive for the first time a proxy for [alpha/Fe] abundances, which enables us to perform a tentative dissection of the chemical thin and thick disc. We find evidence for the latter being composed of an old, mildly but systematically alpha-enhanced population that extends to super solar metallicities, in agreement with spectroscopic studies. Our revision offers the largest existing kinematically unbiased sample of the solar neighbourhood that contains full information on kinematics, metallicities, and ages and thus provides better constraints on the physical processes relevant in the build-up of the Milky Way disc, enabling a better understanding of the Sun in a Galactic context.

Influence of the slice position on chloride migration tests for concrete in marine conditions

Chloride migration tests are used to measure the concrete capacity to inhibit chloride attack. Many researchers carry out this test in a slice of concrete extracted from the central part of cylindrical specimens, discarding about 75% of the concrete used to mold the specimens. This fact generated the question: would it be possible to extract more slices from a same specimen without losing the confidence in the results? The main purpose of this work is to answer this question. Moreover, another aim of this study was to show the difference of chloride penetration between finished faces and the formwork surfaces of concrete beams and slabs. The results indicated that it is possible to use more slices of a single specimen for a chloride migration test. Moreover, it was demonstrated that there is a significant difference of chloride penetration between the finished surface and the formwork surface of the specimens. (C) 2008 Elsevier Ltd. All rights reserved.

Effects of elastic indenter deformation on spherical instrumented indentation tests: the reduced elastic modulus

Although the Hertz theory is not applicable in the analysis of the indentation of elastic-plastic materials, it is common practice to incorporate the concept of indenter/specimen combined modulus to consider indenter deformation. The appropriateness was assessed of the use of reduced modulus to incorporate the effect of indenter deformation in the analysis of the indentation with spherical indenters. The analysis based on finite element simulations considered four values of the ratio of the indented material elastic modulus to that of the diamond indenter, E/E(i) (0, 0.04, 0.19, 0.39), four values of the ratio of the elastic reduced modulus to the initial yield strength, E(r)/Y (0, 10, 20, 100), and two values of the ratio of the indenter radius to maximum total displacement, R/delta(max) (3, 10). Indenter deformation effects are better accounted for by the reduced modulus if the indented material behaves entirely elastically. In this case, identical load-displacement (P - delta) curves are obtained with rigid and elastic spherical indenters for the same elastic reduced modulus. Changes in the ratio E/E(i), from 0 to 0.39, resulted in variations lower than 5% for the load dimensionless functions, lower than 3% in the contact area, A(c), and lower than 5% in the ratio H/E(r). However, deformations of the elastic indenter made the actual radius of contact change, even in the indentation of elastic materials. Even though the load dimensionless functions showed only a little increase with the ratio E/E(i), the hardening coefficient and the yield strength could be slightly overestimated when algorithms based on rigid indenters are used. For the unloading curves, the ratio delta(e)/delta(max), where delta(e) is the point corresponding to zero load of a straight line with slope S from the point (P(max), delta(max)), varied less than 5% with the ratio E/E(i). Similarly, the relationship between reduced modulus and the unloading indentation curve, expressed by Sneddon`s equation, did not reveal the necessity of correction with the ratio E/E(i). The most affected parameter in the indentation curve, as a consequence of the indentation deformation, was the ratio between the residual indentation depth after complete unloading and the maximum indenter displacement, delta(r)/delta(max) (up to 26%), but this variation did not significantly decrease the capability to estimate hardness and elastic modulus based on the ratio of the residual indentation depth to maximum indentation depth, h(r)/h(max). In general, the results confirm the convenience of the use of the reduced modulus in the spherical instrumented indentation tests.

Particle size effect on abrasion resistance of mottled cast iron with different retained austenite contents

Effects of particle abrasive sizes on wear resistance of mottled cast iron with different retained austenite contents were studied. Abrasive wear tests using a pin test on alumina paper were carried out, using abrasive sizes between 16 mu m and 192 mu m. Retained austenite content of the matrix was determined by X-ray diffraction. The wear surface of samples and the alumina paper were examined by scanning electron microscopy for identifying the wear micromechanism. The results show that at lower abrasive sizes the mass loss was similar for the iron with different austenite contents. However, at higher abrasive sizes the samples with higher retained austenite content presented higher abrasion resistance. For lower abrasive sizes tested, samples with higher and lower retained austenite content both presented microcutting. On the other hand, the main wear micromechanism for the samples with higher retained austenite content and higher abrasive sizes was microploughing. The samples with lower retained austenite content presented microcutting and wedge formation at higher abrasive sizes. Higher abrasive size induced more microcutting in samples with lower retained austenite. The iron with lower retained austenite content presented wider grooves for the different abrasive sizes measured. SEM on the abrasive paper used on samples with higher retained austenite showed continuous and discontinuous microchips and the samples with lower retained austenite showed discontinuous microchips at 66 and 141 mu m. This research demonstrates the relation between abrasive size, wear resistance, groove width and wear micromechanism for mottled cast iron with different retained austenite contents. (C) 2009 Elsevier B.V. All rights reserved.