Efeitos imediatos da plataforma vibratória no desempenho neuromuscular do quadríceps femoral, após reconstrução do LCA: ensaio controlado, randomizado e cego

Objective: to investigate the immediate effect of the vibrating platform on the neuromuscular performance of the quadriceps femoris and on the postural oscillation of subjects submitted to Anterior Cruciate Ligament (ACL) reconstruction. Materials and methods: this study is a randomized and blind clinical trial. Forty-four male volunteers (average age of 27,4 ±6,2 IMC of 26,85± 3,8 Kg/m² and post surgery timeframe of 17± 1,4 weeks) were randomized into two groups: OFF platform (n=22, protocol of exercise over the vibrating platform off) and ON platform (n=22 protocol of exercise over the vibrating platform on, 50Hz frequency and 4mm of amplitude). All volunteers were submitted to assessment the isokinetic evaluation of the quadriceps femoris (isometric and isokinetic at 60°/s) and of the electromyography activity of the muscles Vasto Lateralis (VL) and Vasto Medialis (VM), besides the postural oscillation (baropodometry) in two distinct moments: before and immediately after the intervention protocol. The data was analyzed through the SPSS 20.0 software, with a 5% significance level. To verify the homogeneity of the groups it was used an ANOVA one way, and a ANOVA mixed model to compare the intra and inter groups. Results: it was observed differences between the pre and the post, to latero lateral velocity, isometric torque peak and total work in comparison with intragroup. However, it wasn’t verified any difference in comparing the intergroup in the preevaluation and in the post-evaluation protocol over the vibrating platform. Conclusion: the use of the vibrating platform doesn’t change as an immediate manner the isokinetic performance of the quadriceps femoris, the electromyography activity of the VL and the VM, also doesn’t interfere with the postural oscillation of individuals that were submitted to the ACL reconstruction.

Outlier effects on robust joint modelling of longitudinal and survival data

Robust joint modelling is an emerging field of research. Through the advancements in electronic patient healthcare records, the popularly of joint modelling approaches has grown rapidly in recent years providing simultaneous analysis of longitudinal and survival data. This research advances previous work through the development of a novel robust joint modelling methodology for one of the most common types of standard joint models, that which links a linear mixed model with a Cox proportional hazards model. Through t-distributional assumptions, longitudinal outliers are accommodated with their detrimental impact being down weighed and thus providing more efficient and reliable estimates. The robust joint modelling technique and its major benefits are showcased through the analysis of Northern Irish end stage renal disease patients. With an ageing population and growing prevalence of chronic kidney disease within the United Kingdom, there is a pressing demand to investigate the detrimental relationship between the changing haemoglobin levels of haemodialysis patients and their survival. As outliers within the NI renal data were found to have significantly worse survival, identification of outlying individuals through robust joint modelling may aid nephrologists to improve patient's survival. A simulation study was also undertaken to explore the difference between robust and standard joint models in the presence of increasing proportions and extremity of longitudinal outliers. More efficient and reliable estimates were obtained by robust joint models with increasing contrast between the robust and standard joint models when a greater proportion of more extreme outliers are present. Through illustration of the gains in efficiency and reliability of parameters when outliers exist, the potential of robust joint modelling is evident. The research presented in this thesis highlights the benefits and stresses the need to utilise a more robust approach to joint modelling in the presence of longitudinal outliers.

Inteligência Emocional e Desempenho Académico em Estudantes do Ensino Superior

A presente investigação examina o papel da inteligêncial emocional (IE) no desempenho académico, numa amostra de 111 estudantes em frequência do ensino universitário português. No presente trabalho faz-se uma revisão bibliográfica do tema da IE e dos factores contributivos para o desempenho académico, bem como uma breve visita a outros trabalhos desenvolvidos nesta área de investigação. Para medição da IE assumiu-se o modelo misto, tendo-se avaliado as seguintes seis dimensões: 1) auto-encorajamento (uso das emoções); 2) compreensão das emoções próprias; 3) autocontrolo perante as críticas; 4)compreensão das emoções dos outros; 5) empatia e contágio emocional; 6) autocontrolo emocional (regulação das emoções). O desempenho académico foi calculado a partir das médias das classificações obtidas pelos estudantes no final do primeiro semestre do ano lectivo 2009/2010. Os resultados evidenciam que os alunos com melhores desempenhos académicos denotam níveis superiores de inteligência emocional, se bem que não foram encontradas associações significativas entre a IE e o desempenho académico, sugerindo a necessidade de mais estudos com vista ao aprofundamento desta jovem e controversa área de pesquisa. / The research investigates the role of emotional intelligence (EI)in academic achivement in a sample of 111 students that attend Portuguese universities. In this work we review the issue of EI and the factors that contibute to academic achievement, at the same time making a brief visit to other works done on this area. In order to measure EI, the mixed model was used, evaluating through the following six dimensions: 1) self-encouragement (use of emotions); 2) understanding of self emotions; 3) self-control in response to criticism; 4) understanding of emotions in others; 5) empathy and emotional contagion; 6) emotional self-control (regulation of emotions). Academic achievement was evaluated by the average of the grades obtained by the students at the end of the first semester of the academic year 2009/2010. The results show that students with better academic outcomes demonstrate higher emotional intelligence, though there were no significative associations between EI and academic achievement, suggesting the need for further studies in order to deepen this young and controversial area of research.

Increasing the power of genome wide association studies in natural populations using repeated measures : evaluation and implementation

1. Genomewide association studies (GWAS) enable detailed dissections of the genetic basis for organisms' ability to adapt to a changing environment. In long-term studies of natural populations, individuals are often marked at one point in their life and then repeatedly recaptured. It is therefore essential that a method for GWAS includes the process of repeated sampling. In a GWAS, the effects of thousands of single-nucleotide polymorphisms (SNPs) need to be fitted and any model development is constrained by the computational requirements. A method is therefore required that can fit a highly hierarchical model and at the same time is computationally fast enough to be useful. 2. Our method fits fixed SNP effects in a linear mixed model that can include both random polygenic effects and permanent environmental effects. In this way, the model can correct for population structure and model repeated measures. The covariance structure of the linear mixed model is first estimated and subsequently used in a generalized least squares setting to fit the SNP effects. The method was evaluated in a simulation study based on observed genotypes from a long-term study of collared flycatchers in Sweden. 3. The method we present here was successful in estimating permanent environmental effects from simulated repeated measures data. Additionally, we found that especially for variable phenotypes having large variation between years, the repeated measurements model has a substantial increase in power compared to a model using average phenotypes as a response. 4. The method is available in the R package RepeatABEL. It increases the power in GWAS having repeated measures, especially for long-term studies of natural populations, and the R implementation is expected to facilitate modelling of longitudinal data for studies of both animal and human populations.

Spatial modeling of data with excessive zeros applied to reindeer pellet-group counts

We analyze a real data set pertaining to reindeer fecal pellet-group counts obtained from a survey conducted in a forest area in northern Sweden. In the data set, over 70% of counts are zeros, and there is high spatial correlation. We use conditionally autoregressive random effects for modeling of spatial correlation in a Poisson generalized linear mixed model (GLMM), quasi-Poisson hierarchical generalized linear model (HGLM), zero-inflated Poisson (ZIP), and hurdle models. The quasi-Poisson HGLM allows for both under- and overdispersion with excessive zeros, while the ZIP and hurdle models allow only for overdispersion. In analyzing the real data set, we see that the quasi-Poisson HGLMs can perform better than the other commonly used models, for example, ordinary Poisson HGLMs, spatial ZIP, and spatial hurdle models, and that the underdispersed Poisson HGLMs with spatial correlation fit the reindeer data best. We develop R codes for fitting these models using a unified algorithm for the HGLMs. Spatial count response with an extremely high proportion of zeros, and underdispersion can be successfully modeled using the quasi-Poisson HGLM with spatial random effects.

Planeamento e execução de estruturas para abastecimento em linhas de montagem numa empresa do ramo automóvel

O presente trabalho foi desenvolvido na empresa Renault CACIA e tem como fundamento a implementação de um fluxo de abastecimento com 4 horas de autonomia em todas as linhas de montagem no departamento de fabricação de componentes mecânicos. No entanto, estas linhas deverão ter condições para poder armazenar esse abastecimento, pelo que terão de ser implementadas estruturas que o suportem. Com o objetivo de eliminar o excesso de stock existente na linha de montagem de bombas de óleo, a mais crítica da instalação, e as atividades que não acrescentam valor ao produto final, organizar o espaço disponível, melhorar as condições ergonómicas, propõem-se soluções que serão uma mais-valia para as empresas de fabricação. Durante o desenvolvimento do trabalho foi realizado um estudo aprofundado da linha de montagem e dos problemas existentes no processo de abastecimento e, posteriormente, foi determinada a quantidade necessária de embalagens de componentes para a autonomia requerida. Recorreu-se à ferramenta CAD 3D, Solidworks®, para o planeamento das estruturas, e ao software de simulação Arena®, para testar o funcionamento da linha de montagem com a implementação das estruturas para abastecimento. Verificaram-se melhorias conseguidas através da implementação das soluções sugeridas. A linha de montagem ficou mais organizada e arrumada, tendo-se reduzido cerca de 86,96% de stock global existente. Associado a este, existiam atividades realizadas pelo operador de montagem que não acrescentavam valor ao produto final, tendo-se obtido um incremento da produção na ordem de 1%.

STATISTICAL METHODS FOR ADVANCED ECONOMETRIC MODELS WITH APPLICATIONS TO VEHICLE HOLDING AND SPEED QUANTILES DISTRIBUTION

This dissertation proposes statistical methods to formulate, estimate and apply complex transportation models. Two main problems are part of the analyses conducted and presented in this dissertation. The first method solves an econometric problem and is concerned with the joint estimation of models that contain both discrete and continuous decision variables. The use of ordered models along with a regression is proposed and their effectiveness is evaluated with respect to unordered models. Procedure to calculate and optimize the log-likelihood functions of both discrete-continuous approaches are derived, and difficulties associated with the estimation of unordered models explained. Numerical approximation methods based on the Genz algortithm are implemented in order to solve the multidimensional integral associated with the unordered modeling structure. The problems deriving from the lack of smoothness of the probit model around the maximum of the log-likelihood function, which makes the optimization and the calculation of standard deviations very difficult, are carefully analyzed. A methodology to perform out-of-sample validation in the context of a joint model is proposed. Comprehensive numerical experiments have been conducted on both simulated and real data. In particular, the discrete-continuous models are estimated and applied to vehicle ownership and use models on data extracted from the 2009 National Household Travel Survey. The second part of this work offers a comprehensive statistical analysis of free-flow speed distribution; the method is applied to data collected on a sample of roads in Italy. A linear mixed model that includes speed quantiles in its predictors is estimated. Results show that there is no road effect in the analysis of free-flow speeds, which is particularly important for model transferability. A very general framework to predict random effects with few observations and incomplete access to model covariates is formulated and applied to predict the distribution of free-flow speed quantiles. The speed distribution of most road sections is successfully predicted; jack-knife estimates are calculated and used to explain why some sections are poorly predicted. Eventually, this work contributes to the literature in transportation modeling by proposing econometric model formulations for discrete-continuous variables, more efficient methods for the calculation of multivariate normal probabilities, and random effects models for free-flow speed estimation that takes into account the survey design. All methods are rigorously validated on both real and simulated data.

Role of climate on barn owls road-kill likelihood and the effect on population viability in future climate change

Roads represent a new source of mortality due to animal-vehicle risk of collision threatening log-term populations’ viability. Risk of road-kill depends on species sensitivity to roads and their specific life-history traits. The risk of road mortality for each species depends on the characteristics of roads and bioecological characteristics of the species. In this study we intend to know the importance of climatic parameters (temperature and precipitation) together with traffic and life history traits and understand the role of drought in barn owl population viability, also affected by road mortality in three scenarios: high mobility, high population density and the combination of previous scenarios (mixed) (Manuscript). For the first objective we correlated the several parameters (climate, traffic and life history traits). We used the most correlated variables to build a predictive mixed model (GLMM) the influence of the same. Using a population model we evaluated barn owl population viability in all three scenarios. Model revealed precipitation, traffic and dispersal have negative relationship with road-kills, although the relationship was not significant. Scenarios showed different results, high mobility scenario showed greater population depletion, more fluctuations over time and greater risk of extinction. High population density scenario showed a more stable population with lower risk of extinction and mixed scenario showed similar results as first scenario. Climate seems to play an indirect role on barn owl road-kills, it may influence prey availability which influences barn owl reproductive success and activity. Also, high mobility scenario showed a greater negative impact on viability of populations which may affect their ability and resilience to other stochastic events. Future research should take in account climate and how it may influence species life cycles and activity periods for a more complete approach of road-kills. Also it is important to make the best mitigation decisions which might include improving prey quality habitat.

Epidemiology and genetic architecture of blood pressure: a family based study of Generation Scotland

Hypertension is a major risk factor for cardiovascular disease and mortality, and a growing global public health concern, with up to one-third of the world’s population affected. Despite the vast amount of evidence for the benefits of blood pressure (BP) lowering accumulated to date, elevated BP is still the leading risk factor for disease and disability worldwide. It is well established that hypertension and BP are common complex traits, where multiple genetic and environmental factors contribute to BP variation. Furthermore, family and twin studies confirmed the genetic component of BP, with a heritability estimate in the range of 30-50%. Contemporary genomic tools enabling the genotyping of millions of genetic variants across the human genome in an efficient, reliable, and cost-effective manner, has transformed hypertension genetics research. This is accompanied by the presence of international consortia that have offered unprecedentedly large sample sizes for genome-wide association studies (GWASs). While GWAS for hypertension and BP have identified more than 60 loci, variants in these loci are associated with modest effects on BP and in aggregate can explain less than 3% of the variance in BP. The aims of this thesis are to study the genetic and environmental factors that influence BP and hypertension traits in the Scottish population, by performing several genetic epidemiological analyses. In the first part of this thesis, it aims to study the burden of hypertension in the Scottish population, along with assessing the familial aggregation and heritialbity of BP and hypertension traits. In the second part, it aims to validate the association of common SNPs reported in the large GWAS and to estimate the variance explained by these variants. In this thesis, comprehensive genetic epidemiology analyses were performed on Generation Scotland: Scottish Family Health Study (GS:SFHS), one of the largest population-based family design studies. The availability of clinical, biological samples, self-reported information, and medical records for study participants has allowed several assessments to be performed to evaluate factors that influence BP variation in the Scottish population. Of the 20,753 subjects genotyped in the study, a total of 18,470 individuals (grouped into 7,025 extended families) passed the stringent quality control (QC) criteria and were available for all subsequent analysis. Based on the BP-lowering treatment exposure sources, subjects were further classified into two groups. First, subjects with both a self-reported medications (SRMs) history and electronic-prescription records (EPRs; n =12,347); second, all the subjects with at least one medication history source (n =18,470). In the first group, the analysis showed a good concordance between SRMs and EPRs (kappa =71%), indicating that SRMs can be used as a surrogate to assess the exposure to BP-lowering medication in GS:SFHS participants. Although both sources suffer from some limitations, SRMs can be considered the best available source to estimate the drug exposure history in those without EPRs. The prevalence of hypertension was 40.8% with higher prevalence in men (46.3%) compared to women (35.8%). The prevalence of awareness, treatment and controlled hypertension as defined by the study definition were 25.3%, 31.2%, and 54.3%, respectively. These findings are lower than similar reported studies in other populations, with the exception of controlled hypertension prevalence, which can be considered better than other populations. Odds of hypertension were higher in men, obese or overweight individuals, people with a parental history of hypertension, and those living in the most deprived area of Scotland. On the other hand, deprivation was associated with higher odds of treatment, awareness and controlled hypertension, suggesting that people living in the most deprived area may have been receiving better quality of care, or have higher comorbidity levels requiring greater engagement with doctors. These findings highlight the need for further work to improve hypertension management in Scotland. The family design of GS:SFHS has allowed family-based analysis to be performed to assess the familial aggregation and heritability of BP and hypertension traits. The familial correlation of BP traits ranged from 0.07 to 0.20, and from 0.18 to 0.34 for parent-offspring pairs and sibling pairs, respectively. A higher correlation of BP traits was observed among first-degree relatives than other types of relative pairs. A variance-component model that was adjusted for sex, body mass index (BMI), age, and age-squared was used to estimate heritability of BP traits, which ranged from 24% to 32% with pulse pressure (PP) having the lowest estimates. The genetic correlation between BP traits showed a high correlation between systolic (SBP), diastolic (DBP) and mean arterial pressure (MAP) (G: 81% to 94%), but lower correlations with PP (G: 22% to 78%). The sibling recurrence risk ratio (λS) for hypertension and treatment were calculated as 1.60 and 2.04 respectively. These findings confirm the genetic components of BP traits in GS:SFHS, and justify further work to investigate genetic determinants of BP. Genetic variants reported in the recent large GWAS of BP traits were selected for genotyping in GS:SFHS using a custom designed TaqMan® OpenArray®. The genotyping plate included 44 single nucleotide polymorphisms (SNPs) that have been previously reported to be associated with BP or hypertension at genome-wide significance level. A linear mixed model that is adjusted for age, age-squared, sex, and BMI was used to test for the association between the genetic variants and BP traits. Of the 43 variants that passed the QC, 11 variants showed statistically significant association with at least one BP trait. The phenotypic variance explained by these variant for the four BP traits were 1.4%, 1.5%, 1.6%, and 0.8% for SBP, DBP, MAP, and PP, respectively. The association of genetic risk score (GRS) that were constructed from selected variants has showed a positive association with BP level and hypertension prevalence, with an average effect of one mmHg increase with each 0.80 unit increases in the GRS across the different BP traits. The impact of BP-lowering medication on the genetic association study for BP traits has been established, with typical practice of adding a fixed value (i.e. 15/10 mmHg) to the measured BP values to adjust for BP treatment. Using the subset of participants with the two treatment exposure sources (i.e. SRMs and EPRs), the influence of using either source to justify the addition of fixed values in SNP association signal was analysed. BP phenotypes derived from EPRs were considered the true phenotypes, and those derived from SRMs were considered less accurate, with some phenotypic noise. Comparing SNPs association signals between the four BP traits in the two model derived from the different adjustments showed that MAP was the least impacted by the phenotypic noise. This was suggested by identifying the same overlapped significant SNPs for the two models in the case of MAP, while other BP traits had some discrepancy between the two sources

Modeling height-diameter relationship in pinus pinaster ait. in the forest intervention zone of Lomba, NE-Portugal

In this work, the relationship between diameter at breast height (d) and total height (h) of individual-tree was modeled with the aim to establish provisory height-diameter (h-d) equations for maritime pine (Pinus pinaster Ait.) stands in the Lomba ZIF, Northeast Portugal. Using data collected locally, several local and generalized h-d equations from the literature were tested and adaptations were also considered. Model fitting was conducted by using usual nonlinear least squares (nls) methods. The best local and generalized models selected, were also tested as mixed models applying a first-order conditional expectation (FOCE) approximation procedure and maximum likelihood methods to estimate fixed and random effects. For the calibration of the mixed models and in order to be consistent with the fitting procedure, the FOCE method was also used to test different sampling designs. The results showed that the local h-d equations with two parameters performed better than the analogous models with three parameters. However a unique set of parameter values for the local model can not be used to all maritime pine stands in Lomba ZIF and thus, a generalized model including covariates from the stand, in addition to d, was necessary to obtain an adequate predictive performance. No evident superiority of the generalized mixed model in comparison to the generalized model with nonlinear least squares parameters estimates was observed. On the other hand, in the case of the local model, the predictive performance greatly improved when random effects were included. The results showed that the mixed model based in the local h-d equation selected is a viable alternative for estimating h if variables from the stand are not available. Moreover, it was observed that it is possible to obtain an adequate calibrated response using only 2 to 5 additional h-d measurements in quantile (or random) trees from the distribution of d in the plot (stand). Balancing sampling effort, accuracy and straightforwardness in practical applications, the generalized model from nls fit is recommended. Examples of applications of the selected generalized equation to the forest management are presented, namely how to use it to complete missing information from forest inventory and also showing how such an equation can be incorporated in a stand-level decision support system that aims to optimize the forest management for the maximization of wood volume production in Lomba ZIF maritime pine stands.

Desenvolvimento de solenóides para eletroválvulas hidráulicas

Os solenóides para eletroválvulas, em conjunto com outros produtos e equipamentos, permitem a automação dos sistemas de distribuição de águas não potáveis, como, por exemplo, em sistemas de rega. Deste modo é possível controlar diversos parâmetros, como o caudal e a pressão da água que passa na válvula, podendo estes ser fiscalizados à distância. Neste trabalho, foram desenvolvidos solenóides para acoplar a válvulas que se destinam à rega agrícola, comercializadas pela empresa JPrior, Fábrica de Plásticos, Lda. Para o efeito, foram definidos vários processos necessários para a criação de uma linha piloto de pré industrialização destes dispositivos. Etapas como a conceção do dispositivo, prototipagem, testes de temperatura, consumo de corrente, estabilidade eletromecânica e testes de desempenho associados a diferentes valores de pressão e de caudal de funcionamento, foram essenciais para este desenvolvimento, assim como, análises estruturais e morfológicas do material que constitui o núcleo dos solenóides. Além disso, procurou-se responder às necessidades do mercado numa perspetiva mais completa do que a existente. Para isso, foram produzidos dois tipos de solenóides de 24 V AC, com pressões máximas de funcionamento de 4 bar e de 12 bar.

Efeitos do treinamento resistido com máquinas pneumáticas e resistência elástica progressiva na força, capacidade funcional e equilíbrio em mulheres idosas : um ensaio clínico randomizado

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Educação Física, Programa de Pós-Graduação Strictu-Sensu em Educação Física, 2015.

Estudo do processo de combustão in-situ usando poços horizontais como produtores de óleo (Toe-to-Hell Air Injection)

The method "toe-to-heel air injection" (THAITM) is a process of enhanced oil recovery, which is the integration of in-situ combustion with technological advances in drilling horizontal wells. This method uses horizontal wells as producers of oil, keeping vertical injection wells to inject air. This process has not yet been applied in Brazil, making it necessary, evaluation of these new technologies applied to local realities, therefore, this study aimed to perform a parametric study of the combustion process with in-situ oil production in horizontal wells, using a semi synthetic reservoir, with characteristics of the Brazilian Northeast basin. The simulations were performed in a commercial software "STARS" (Steam, Thermal, and Advanced Processes Reservoir Simulator), from CMG (Computer Modelling Group). The following operating parameters were analyzed: air rate, configuration of producer wells and oxygen concentration. A sensitivity study on cumulative oil (Np) was performed with the technique of experimental design, with a mixed model of two and three levels (32x22), a total of 36 runs. Also, it was done a technical economic estimative for each model of fluid. The results showed that injection rate was the most influence parameter on oil recovery, for both studied models, well arrangement depends on fluid model, and oxygen concentration favors recovery oil. The process can be profitable depends on air rate

Evaluation of the risk factors contributing to the African swine fever occurrence in Sardinia, Italy

This study assesses the relation between hypothesized risk factors and African swine fever virus (ASFV) distribution in Sardinia (Italy) after the beginning of the eradication program in 1993, using a Bayesian multivariable logistic regression mixed model. Results indicate that the probability of ASFV occurrence in Sardinia was associated to particular socio-cultural, productive and economical factors found in the region, particularly to large number of confined (i.e., closed) farms (most of them backyard), high road density, high mean altitude, large number of open fattening farms, and large number of pigs per commune. Conversely, large proportion of open farms with at least one census and large proportion of open farms per commune, were found to be protective factors for ASFV. Results suggest that basic preventive and control strategies, such as yearly census or registration of the pigs per farm and better control of the public lands where pigs are usually raised, together with endanced effords of outreach and communication with pig producers should help in the success of the eradication program for ASF in the Island. Methods and results presented here will inform decision making to better control and eradicate ASF in Sardinia and in all those areas with similar management and epidemiological conditions.

Pelvic-Floor Rehabilitation, Part 1 : Comparison of Two Surface Electrode Placements During Stimulation of the Pelvic-Floor Musculature in Women Who Are Continent Using Bipolar Interferential Currents

Background and Purpose. Electrical stimulation of the pelvic floor is used as an adjunct in the conservative treatment of urinary incontinence. No consensus exists, however, regarding electrode placements for optimal stimulation of the pelvic-floor musculature. The purpose of this study was to compare two different bipolar electrode placements, one suggested by Laycock and Green (L2) the other by Dumoulin (D2), during electrical stimulation with interferential currents of the pelvic-floor musculature in continent women, using a two-group crossover design. Subjects. Ten continent female volunteers, ranging in age from 20 to 39 years (X̅=27.3, SD=5.6), were randomly assigned to one of two study groups. Methods. Each study group received neuromuscular electrical stimulation (NMES) of the pelvic-floor musculature using both electrode placements, the order of application being reversed for each group. Force of contraction was measured as pressure (in centimeters of water [cm H2O]) exerted on a vaginal pressure probe attached to a manometer. Data were analyzed using a two-way, mixed-model analysis of variance. Results. No difference in pressure was observed between the two electrode placements. Differences in current amplitude were observed, with the D2 electrode placement requiring less current amplitude to produce a maximum recorded pressure on the manometer. Subjective assessment by the subjects revealed a preference for the D2 electrode placement (7 of 10 subjects). Conclusion and Discussion. The lower current amplitudes required with the D2 placement to obtain recordings comparable to those obtained with the L2 technique suggest a more comfortable stimulation of the pelvic-floor muscles. The lower current amplitudes required also suggest that greater increases in pressure might be obtained with the D2 placement by increasing the current amplitude while remaining within the comfort threshold. These results will help to define treatment guidelines for a planned clinical study investigating the effects of NMES and exercise in the treatment of urinary stress incontinence in women postpartum.