Changing trends in causes and patterns of facial fractures in children

OBJECTIVE: To review the epidemiology of facial fractures in children and to analyze whether it has changed over time. STUDY DESIGN: Retrospective review of records of children aged < or = 15 years diagnosed for fracture during 2 10-year periods. RESULTS: A total of 378 children were diagnosed with fractures, 187 in 1980-1989 and 191 in 1993-2002. The proportion of children with mandibular fractures decreased by 13.6 percentage-points from the first period to the second, whereas the proportion of patients with midfacial fractures increased by 18.7 percentage-points. Assault as a causative factor increased by 5.5 percentage-points, almost exclusively among children aged 13-15 years, with a high percentage (23.5%). CONCLUSIONS: Recognition of a change in fracture patterns over time is probably due to the increased use of computerized tomographic scanning.

Application of the general linear model to assess the effect of missing data on bone marrow mononuclear cell therapy with infusion timing and follow-up MRI

With most clinical trials, missing data presents a statistical problem in evaluating a treatment's efficacy. There are many methods commonly used to assess missing data; however, these methods leave room for bias to enter the study. This thesis was a secondary analysis on data taken from TIME, a phase 2 randomized clinical trial conducted to evaluate the safety and effect of the administration timing of bone marrow mononuclear cells (BMMNC) for subjects with acute myocardial infarction (AMI).^ We evaluated the effect of missing data by comparing the variance inflation factor (VIF) of the effect of therapy between all subjects and only subjects with complete data. Through the general linear model, an unbiased solution was made for the VIF of the treatment's efficacy using the weighted least squares method to incorporate missing data. Two groups were identified from the TIME data: 1) all subjects and 2) subjects with complete data (baseline and follow-up measurements). After the general solution was found for the VIF, it was migrated Excel 2010 to evaluate data from TIME. The resulting numerical value from the two groups was compared to assess the effect of missing data.^ The VIF values from the TIME study were considerably less in the group with missing data. By design, we varied the correlation factor in order to evaluate the VIFs of both groups. As the correlation factor increased, the VIF values increased at a faster rate in the group with only complete data. Furthermore, while varying the correlation factor, the number of subjects with missing data was also varied to see how missing data affects the VIF. When subjects with only baseline data was increased, we saw a significant rate increase in VIF values in the group with only complete data while the group with missing data saw a steady and consistent increase in the VIF. The same was seen when we varied the group with follow-up only data. This essentially showed that the VIFs steadily increased when missing data is not ignored. When missing data is ignored as with our comparison group, the VIF values sharply increase as correlation increases.^

(Table 1, page 24), Geochemical cmposition of nodules and crust from the Indain Ocean recovered from R/V Marion Dufresne expeditions

Mineralogical analysis of manganese nodules and crusts collected from Indian ocean aboard Marion Dufresne points to a depth and regional control upon the manganese oxide association: vernadite - birnessite and vernadite - todorokite. Moreover, progressive changes in the vernadite/birnessite ratio as a function of time is clearly seen. Magnetite and titano-magnetite in quantities similar to those of framboidal pyrite in manganese nodules are outlined for the first time. Study of the distribution of metals (Mn, Fe, Ni, Cu, Co) shows a strong latitudinal and regional dependence that may be connected to high productivity zones and to bottom water properties. The problem of mineralogical control on the chemical composition is approached. Finally, it results that any interpretations taking into account all these data haveway to give to the variability of sea-water properties (pH, oxygenation, motions) the prominent control upon manganese nodules composition.

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Uniform cost system for apparel manufacturers,

Mode of access: Internet.

Differentiation between protective reflexes: Cardiac defense and startle

Rise time and duration are two parametric characteristics of the eliciting stimulus frequently used to differentiate among psychophysiological reflexes. The present research varied the duration (study 1) and rise time (study 2) of an intense acoustic stimulus to dissociate cardiac defense and cardiac startle using the eyeblink response as the external criterion of startle. In each study, 100 participants were presented with five white noise stimuli of 105 dB under one of five duration (50, 100, 250, 500, and 1000 ms) or rise time (0, 24, 48, 96, and 240 ms) conditions. Cardiac defense was affected by stimulus duration, present only in the 500- and 1000-ms conditions, but not by stimulus rise time, present in all rise time conditions. Rise time affected blink startle, but did not selectively alter the short latency accelerative component of the heart rate response, thus questioning whether it reflects startle.

Fear of Falling and Balance Confidence in Older Adults with Diabetes Mellitus

Several determinants of fear of falling (FoF) and low balance confidence overlap with the consequences/complications of diabetes mellitus (DM). FoF is strongly associated with low balance confidence, and balance confidence mediates the relationship between FoF and balance and physical function. The purpose of this thesis was two-fold: (1) to examine the prevalence, severity and determinants of FoF in older adults (aged≥65) with DM, and (2) to evaluate the validity of the short version of the Activities-specific Balance Confidence scale (ABC-6) and its association with balance and postural control in older adults with DM. Three separate studies were conducted of older adults with DM (DM-group) and without DM (noDM-group). Study I revealed that although FoF prevalence adjusted for age and sex was not different between-groups, the DM-group had 8.8% fewer participants in the low and 8.4% more in the high Falls-Efficacy Scale International categories when compared to the noDM-group. Higher FoF severity in the DM-group was associated with poor physical performance, being female, fall history and clinical depressive symptoms. Study II provided evidence of convergent, discriminant and concurrent validity of the ABC-6 for use in older adults with DM with and without diabetic peripheral neuropathy (DPN). Notably, the ABC-6 was more sensitive in detecting subtle differences in balance confidence between the DM-group and noDM-group when compared to the original ABC scale (ABC-16), and can be administered in less time. Study III explored balance confidence (ABC-6) and its association with balance and postural control in older adults with DM. Subtle differences in axial segmental control (i.e., lower trunk roll velocity and higher head-trunk correlations) while walking and lower balance confidence were apparent in the DM-group, even in the absence of DPN, when compared to the noDM-group. Balance confidence partially explained the variance in head-trunk stiffening between-groups, and consequently low balance confidence in older adults with DM may contribute to the dependence on postural control strategies that are normally only utilized in high-risk situations. Findings from this thesis will help to guide the development of protocols for screening and intervention recommendations of patient education and targeted rehabilitation programs for older adults with DM.

Melhoria de uma linha de montagem pela aplicação da filosofia Lean

Este relatório descreve o desenvolvimento de um projecto de melhoria numa linha de montagem de autocarros, numa das empresas do Grupo Salvador Caetano: a CaetanoBus. Sustentado teoricamente pelos pressupostos da filosofia lean, o projecto visou sobretudo uma organização mais eficiente dos recursos humanos e materiais, de modo a alcançar uma redução do lead time e, por conseguinte, uma diminuição simultânea de desperdícios associados ao processo e do número de colaboradores afectos a determinado modelo de autocarro. A metodologia adoptada envolveu fundamentalmente operações relativas ao estudo de tempos, balanceamento e estabelecimento de standard works. Por outro lado, outros conceitos associados ao lean, como kaizen e yamazum chart, integraram igualmente a linha estruturante de pensamento que orientou o campo das acções. Um plano de melhorias baseado no uso das ferramentas lean sugere ganhos produtivos, muito embora o término da produção do modelo, alvo de análise, tivesse impedido a sua confirmação prática nesta matéria.

Rediseño de productos: de los productos modularizados a la distribución de planta para una familia de productos

Esta investigación pretende evidenciar como el rediseño de un producto, específicamente el rediseño modular, puede generar cambios en la distribución de planta incrementando los niveles de producción de una empresa -- Dicho incremento se logró implementando una nueva metodología, que será ampliamente descrita en este trabajo, y que contempla todo el proceso del rediseño de productos, desde el desensamble hasta la distribución de la planta -- Para esta investigación se utilizaron herramientas conocidas como el Análisis Funcional, la Matriz de Interacción, El Diseño para el Ensamble (DFA), el Diagrama de Operaciones y algunos conceptos de la gestión de plataforma de un producto modular -- Como ejemplo ilustrativo, se rediseñaron dos productos ya existentes, una licuadora SAMURAI modelo FACICLIC negra y un procesador de alimentos HAMILTON BEACH modelo 70740, los cuales sirvieron de base para evidenciar cómo al transformar un producto en uno más modular se mejora significativamente la distribución de planta, logrando un incremento en la producción de éste, al tiempo que se reducen los tiempos de ensamble y se optimiza la disposición de los puestos de trabajo en la planta para conformar el producto final -- Para llevar a cabo esta investigación, fue indispensable crear una nueva ruta metodológica que nos permitiera rediseñar un producto inicial como un producto modularizado y terminar con el rediseño de la distribución de planta de una familia de productos modulares -- Esta nueva ruta metodológica, que hace parte de nuestros resultados de investigación, consta de tres fases -- La primera fase, se basa principalmente en modularizar cada uno de los productos que se quieren integrar dentro de la familia de productos, la segunda fase, logra identificar los módulos comunes entre los productos modularizados para generar la plataforma, y por último, la fase tres genera una nueva distribución de planta para el ensamble de la familia de productos generada -- Esta investigación constata, entre otras cosas, como el rediseño modular de productos es una herramienta fundamental en el planteamiento de una familia de productos en una empresa -- Partiendo de productos que ya pasaron por un proceso de modularización previo, se propuso una métrica que permite definir la similitud entre módulos, considerando la mayor cantidad de sus propiedades, la forma física y la función de cada uno de ellos, complementando así la metodología propuesta por Katja Hölttä en su tesis doctoral -- Finalmente se propuso una distribución de planta que permite un ensamble más eficiente tanto en tiempo como en número de operarios necesarios para la producción, incrementando así la versatilidad y las tasas de producción de la empresa

Patterns of sedentary behavior : insights from observational and experimental studies on body composition and energy expenditure

It is recognized that sedentary behavior (SB) has deleterious effects on numerous health outcomes and it appears that physiological mechanisms underlying these harms are distinct from the ones explaining moderate-to-vigorous physical activity (MVPA) benefits. Sedentary behavior represents a large portion of human’s life and is increasing with technological development. A new current of opinion supports the idea that the manner SB is accumulated plays an important role. This dissertation presents six research studies conducted under the scope of SB. In the methodological area, the first study highlighted the magnitude of potential errors in estimating SB and its patterns from common alternative methods (accelerometer and heart rate monitor) compared to ActivPAL. This study presented the accelerometer as a valid method at a group level. Two studies (2 and 5) were performed in older adults (the most sedentary group in the population) to test the associations for SB patterns with abdominal obesity using accelerometry. The findings showed positive graded associations for prolonged sedentary bouts with abdominal obesity and showed that those who interrupted SB more frequently were less likely to present abdominal obesity. Therefore, public health recommendations regarding breaking up SB more often are expected to be relevant. The associations between sedentary patterns and abdominal obesity were independent of MVPA in older adults. However, the low MVPA in this group makes it unclear whether this independent relationship still exists if highly active persons are analysed. Study 3 inovates by examining the association of SB with body fatness in highly trained athletes and found SB to predict total fat mass and trunk fat mass, independently of age and weekly training time. Study 4 also brings novelty to this research field by quantifying the metabolic and energetic cost of the transition from sitting to standing and then sitting back down (a break), informing about the modest energetic costs (0.32 kcal·min−1). Finally, from a successful multicomponent pilot intervention to reduce and break up SB (study 6), an important behavioral resistance to make more sit/stand transitions despite successfully reducing sitting time (~ 1.85 hours·day-1) was found, which may be relevant to inform future behavioral modification programs. The present work provides observational and experimental evidence on the relation for SB patterns with body composition outcomes and energy regulation that may be relevant for public health interventions.

An epidemiological study of the relationship between time to surgery and health status for elderly patients with a hip fracture

A hip fracture causes permanent changes to life style for older people. Further, two important mortality indicators found post operatively for this group include, the time until surgery after fracture, and pre-operative health status prior to surgery, yet no research is available investigating relationships between time to surgery and health status. The researchers aimed to establish the health status risks for patients aged over 65 years with a non-pathological hip fracture to guide nursing care interventions. A prospective cohort design was used to investigate relationships between time to surgery and measures on pre-operative health status indicators including, skin integrity risk, vigor, mental state, bowel function and continence. Twenty-nine patients with a mean age in years of 81.93 (SD,9.49), were recruited. The mean number of hours from time 1 assessment to surgery was 52.72 (SD,58.35) and the range was 1 hour to 219 hours. At Time 2, the mean scores of vigor and skin integrity risk were significantly higher, indicating poorer health status. A change in health status occurred but possibly due to the small sample size it was difficult to relate this result to time. However the results informed preoperative care prior to surgery, for this group.

Real-time simulation for power systems based on parallel computing - an empirical study

Abstract Computer simulation is a versatile and commonly used tool for the design and evaluation of systems with different degrees of complexity. Power distribution systems and electric railway network are areas for which computer simulations are being heavily applied. A dominant factor in evaluating the performance of a software simulator is its processing time, especially in the cases of real-time simulation. Parallel processing provides a viable mean to reduce the computing time and is therefore suitable for building real-time simulators. In this paper, we present different issues related to solving the power distribution system with parallel computing based on a multiple-CPU server and we will concentrate, in particular, on the speedup performance of such an approach.

Gaseous air pollution and emergency hospital visits for hypertension in Beijing, China : a time-stratified case-crossover study

Background: A number of epidemiological studies have been conducted to research the adverse effects of air pollution on mortality and morbidity. Hypertension is the most important risk factor for cardiovascular mortality. However, few previous studies have examined the relationship between gaseous air pollution and morbidity for hypertension. ---------- Methods: Daily data on emergency hospital visits (EHVs) for hypertension were collected from the Peking University Third Hospital. Daily data on gaseous air pollutants (sulfur dioxide (SO2) and nitrogen dioxide (NO2)) and particulate matter less than 10 μm in aerodynamic diameter (PM10) were collected from the Beijing Municipal Environmental Monitoring Center. A time-stratified case-crossover design was conducted to evaluate the relationship between urban gaseous air pollution and EHVs for hypertension. Temperature and relative humidity were controlled for. ---------- Results: In the single air pollutant models, a 10 μg/m3 increase in SO2 and NO2 were significantly associated with EHVs for hypertension. The odds ratios (ORs) were 1.037 (95% confidence interval (CI): 1.004-1.071) for SO2 at lag 0 day, and 1.101 (95% CI: 1.038-1.168) for NO2 at lag 3 day. After controlling for PM10, the ORs associated with SO2 and NO2 were 1.025 (95% CI: 0.987-1.065) and 1.114 (95% CI: 1.037-1.195), respectively.---------- Conclusion: Elevated urban gaseous air pollution was associated with increased EHVs for hypertension in Beijing, China.