Pelvic-Floor Rehabilitation, Part 2 : Pelvic-Floor Reeducation With Interferential Currents and Exercise in the Treatment of Genuine Stress Incontinence in Postpartum Women : A Cohort Study

Background and Purpose. This descriptive cohort study investigated a physical therapy program of pelvic-floor neuromuscular electrostimulation (NMES) combined with exercises, with the aim of developing a simple, inexpensive, and conservative treatment for postpartum genuine stress incontinence (GSI). Subjects. Eight female subjects with urodynamically established GSI persisting more than 3 months after delivery participated in the study. The subjects ranged in age from 24 to 37 years (X̅=32, SD=4.2). Methods. This was a descriptive multiple-subject cohort study. Each subject received a total of nine treatment sessions during 3 consecutive weeks, consisting of two 15-minute sessions of NMES followed by a 15-minute pelvic-floor muscle exercise program. Patients also practiced daily pelvic-floor exercises during the 3-week treatment period. The treatment intervention was measured using three separate variables. Maximum muscle contractions (pretraining, during training, and posttraining) were measured indirectly as pressure, using perineometry. Urine loss pretraining and posttraining was measured by means of a Pad test. Self-reported frequency of incontinence was recorded daily throughout the period of the study, using a diary. Data were analyzed using a one-way repeated measures analysis of variance (ANOVA), a Wilcoxon signed-ranks test, and a Friedman two-way ANOVA by ranks. Results. The results indicated that maximum pressure generated by pelvic-floor contractions was greater and both the quantity of urine loss and the frequency of incontinence were lower following the implementation of the physical therapy program. Five subjects became continent, and three others improved. A follow-up survey 1 year later confirmed the consistency of these results. Conclusion and Discussion. The results suggest that the proposed physical therapy program may influence postpartum GSI. Further studies are needed to validate this simple, inexpensive, and conservative physical therapy protocol.

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.

Large Eddy Simulations applied to wind loading and pollutant dispersion

The application of Computational Fluid Dynamics based on the Reynolds-Averaged Navier-Stokes equations to the simulation of bluff body aerodynamics has been thoroughly investigated in the past. Although a satisfactory accuracy can be obtained for some urban physics problems their predictive capability is limited to the mean flow properties, while the ability to accurately predict turbulent fluctuations is recognized to be of fundamental importance when dealing with wind loading and pollution dispersion problems. The need to correctly take into account the flow dynamics when such problems are faced has led researchers to move towards scale-resolving turbulence models such as Large Eddy Simulations (LES). The development and assessment of LES as a tool for the analysis of these problems is nowadays an active research field and represents a demanding engineering challenge. This research work has two objectives. The first one is focused on wind loads assessment and aims to study the capabilities of LES in reproducing wind load effects in terms of internal forces on structural members. This differs from the majority of the existing research, where performance of LES is evaluated only in terms of surface pressures, and is done with a view of adopting LES as a complementary design tools alongside wind tunnel tests. The second objective is the study of LES capabilities in calculating pollutant dispersion in the built environment. The validation of LES in this field is considered to be of the utmost importance in order to conceive healthier and more sustainable cities. In order to validate the numerical setup adopted, a systematic comparison between numerical and experimental data is performed. The obtained results are intended to be used in the drafting of best practice guidelines for the application of LES in the urban physics field with a particular attention to wind load assessment and pollution dispersion problems.

“Study of Electro-thermal Effects on PLA Materials Fed with AC Currents”

Given the rise in the emergence of new composite materials, their multifunctional properties, and possible applications in simple and complex structural components, there has been a need to unravel the characterization of these materials. The possibility of printing these conductive composite materials has opened a new area in the design of structural components which can conduct, transmit, and modulate electric signals with no limitation from complex geometry. Although several works have researched the behaviour of polymeric composites due to the immediate growth, however, the electrothermal behaviour of the material when subjected to varying AC applied voltage (Joule’s effect) has not been thoroughly researched. This study presents the characterization of the electrothermal behaviour of conductive composites of a polylactic acid matrix reinforced with conductive carbon black particles (CB-PLA). An understanding of this behaviour would contribute to the improved work in additive manufacturing of functional electro-mechanical conductive materials with potential application in energy systems, bioelectronics, etc. In this study, the electrothermal interplay is monitored under applied AC voltage, varying lengths, and filament printing orientations (longitudinal, oblique, and transverse). Each sample was printed using the fused deposition modeling technique such that each specimen has three different lengths (1L, 2L, 2.75L). To this end, deductions were made on properties that affect composite’s efficiency and life expectancy. The result of this study shows a great influence of printing orientation on material properties of 3D printed conductive composites of CB-PLA. The result also identifies the contribution of AC applied voltage to composites' stabilization time. This knowledge is important to provide experimental background for components' electrothermal interplay, estimate possible degradation and operating limits of composite structures when used in applications.

New Guidelines Of Cerebral Cardiopulmonary Resuscitation By The American Heart Association (2005 - 2006) [novas Diretrizes De Reanimação Cardiorrespiratória Cerebral Da Sociedade Americana De Cardiologia (2005 - 2006)]

No abstract available

Operant measurement of auditory threshold in prelingually deaf users of cochlear implants: II

Two experiments evaluated an operant procedure for establishing stimulus control using auditory and electrical stimuli as a baseline for measuring the electrical current threshold of electrodes implanted in the cochlea. Twenty-one prelingually deaf children, users of cochlear implants, learned a Go/No Go auditory discrimination task (i.e., pressing a button in the presence of the stimulus but not in its absence). When the simple discrimination baseline became stable, the electrical current was manipulated in descending and ascending series according to an adapted staircase method. Thresholds were determined for three electrodes, one in each location in the cochlea (basal, medial, and apical). Stimulus control was maintained within a certain range of decreasing electrical current but was eventually disrupted. Increasing the current recovered stimulus control, thus allowing the determination of a range of electrical currents that could be defined as the threshold. The present study demonstrated the feasibility of the operant procedure combined with a psychophysical method for threshold assessment, thus contributing to the routine fitting and maintenance of cochlear implants within the limitations of a hospital setting.

Marine influence in the Barreiras Formation, State of Alagoas, northeastern Brazil

Tidal processes were important for deposition of the Barreiras Formation located in northern Brazil, while correlatable deposits in northeastern Brazil have been traditionally related to continental environments. Facies analysis in southern Alagoas revealed that the Barreiras Formation consists of cross-stratified conglomerates and sandstones (facies Sx and Cgx), compound cross-stratified sandstones (facies Cx), and heterolithic beddings (facies H). A significant portion of these deposits occurs within channel morphologies displaying fining and thinning upward successions. An abundance of sedimentary features is comparable to those from the northern Brazilian counterpart. These include: tidal bundles; herringbone cross-stratification; heterolithic beddings with sandstone and mudstone beds in sharp contacts; and ichnofossils mostly consisting of Ophiomorpha nodosa, Skolithos and Planolites. Altogether, these features point to a marginal marine depositional setting dominated by tidal processes, which are related to an estuarine system, an interpretation also provided for the Barreiras Formation in northern Brazil. The widespread occurrence of deposits with unambiguous evidence of tidal processes in the Barreiras Formation of northern Brazil, and now in the State of Alagoas, leads to argue that the early/middle Miocene worldwide marine transgression might have left a much more widespread sedimentary record along the Brazilian coast than currently regarded.

Migração lateral da desembocadura do Rio Itapocú, SC, Brasil: evolução morfológica e condicionantes físicas

Desembocaduras são ambientes bastante dinâmicos e sujeitos à complexa interação entre fatores estabilizadores e desestabilizadores. Dependendo dessa interação, desembocaduras podem apresentar a tendência de migração ao longo de barreiras arenosas. Um dos mecanismos mais eficientes de transporte de sedimento paralelo à costa, e consequentemente migração de canais, são as correntes longitudinais geradas pelas ondas se aproximando obliquamente à costa. A motivação do presente trabalho é entender o comportamento morfodinâmico do sistema de desembocadura do rio Itapocú, localizado no centro-norte de Santa Catarina (SC), frente aos processos forçantes que atuam na sua migração ao longo da linha de costa. A morfologia dos pontais arenosos foi obtida a partir de levantamentos morfológicos com o uso de DGPS. Para analisar a refração de ondas foi utilizado o modelo numérico MIKE 21 SW, sendo considerados como condições de contorno os dados de ondas referentes ao ano de 2002 e os dados de ondas previstos referentes ao período de coleta. Os dados de saída do modelo foram utilizados para estimar a deriva litorânea potencial na região. Os resultados morfológicos obtidos demonstraram uma migração da desembocadura para o norte durante o período analisado, sendo mais intenso durante o inverno e o verão. Ondas incidentes do quadrante sul sofreram mais o fenômeno da refração e as ondas de leste apresentaram menor variação angular ao se aproximarem à costa. A deriva litorânea potencial anual para os dados de ondas de 2002 apresentou sentido norte-sul, com inversão de sentido durante o outono. Utilizando os dados de ondas previstas para o período dos levantamentos, a deriva litorânea potencial estimada apresentou sentido sul-norte, concordando com a migração observada. Na região próxima a desembocadura, nos pontais arenosos, a deriva potencial apresentou direção para o norte durante todas as estações. Os dados de descarga fluvial não apresentaram influência na migração do canal, porém apresentaram uma relação com a largura do mesmo sazonalmente.Os dados de morfologia juntamente com os dados de deriva litorânea referentes às ondas de 2004/2005 mostraram claramente a migração do canal para o norte sendo a deriva a principal contribuinte para a migração da desembocadura.

Circulation and suspended particulate matter transport in a tidally dominated estuary: caravelas estuary, Bahia, Brazil

The circulation and transport of suspended particulate matter in the Caravelas Estuary are assessed. Nearly-synoptic hourly hydrographic, current (ADCP velocity and volume transport) and suspended particulate matter data were collected during a full semidiurnal spring tide, on the two transects Boca do Tomba and Barra Velha and on longitudinal sections at low and high tide. On the first transect the peak ebb currents (-1.5 ms-1) were almost twice as strong as those of the wider and shallow Barra Velha inlet (-0.80 ms-1) and the peak flood currents were 0.75 and 0.60 ms-1, respectively. Due to the strong tidal currents both inlets had weak vertical salinity stratification and were classified with the Stratification-circulation Diagram as Type 2a (partially mixed-weakly stratified) and Type 1a (well mixed). Volume transports were very close, ranging from -3,500 to 3,100 m³s-1 at the ebb and flood, respectively, with a residual -630 m³s-1. The concentration of the suspended particulate matter was closely related to the tidal variation and decreased landwards from 50 mg.L-1 at the estuary mouth, to 10 mg.L-1 at distances of 9 and 16 km for the low and high tide experiments, respectively. The total residual SPM transport was out of the estuary at rates of -18 tons per tidal cycle.

Hydrodynamics and suspended sediment transport in the Camboriú estuary - Brazil: pre jetty conditions

Estuarine hydrodynamics is a key factor in the definition of the filtering capacity of an estuary and results from the interaction of the processes that control the inlet morphodynamics and those that are acting in the mixing of the water in the estuary. The hydrodynamics and suspended sediment transport in the Camboriú estuary were assessed by two field campaigns conducted in 1998 that covered both neap and spring tide conditions. The period measured represents the estuarine hydrodynamics and sediment transport prior to the construction of the jetty in 2003 and provides important background information for the Camboriú estuary. Each field campaign covered two complete tidal cycles with hourly measurements of currents, salinity, suspended sediment concentration and water level. Results show that the Camboriú estuary is partially mixed with the vertical structure varying as a function of the tidal range and tidal phase. The dynamic estuarine structure can be balanced between the stabilizing effects generated by the vertical density gradient, which produces buoyancy and stratification flows, and the turbulent effects generated by the vertical velocity gradient that generates vertical mixing. The main sediment source for the water column are the bottom sediments, periodically resuspended by the tidal currents. The advective salt and suspended sediment transport was different between neap and spring tides, being more complex at spring tide. The river discharge term was important under both tidal conditions. The tidal correlation term was also important, being dominant in the suspended sediment transport during the spring tide. The gravitational circulation and Stokes drift played a secondary role in the estuarine transport processes.

Hidrodinâmica e transporte de material particulado em suspensão sazonal em um estuário dominado por maré: Estuário de Caravelas (BA)

O objetivo do presente estudo é caracterizar a hidrodinâmica e o transporte de material particulado em suspensão (MPS) no estuário de Caravelas sob diferentes condições de maré e vazão fluvial. Foram realizadas quatro campanhas hidrográficas durante ciclos completos de maré, sendo em condições de maré de sizígia e quadratura, e durante os períodos seco e chuvoso. Dados de nível de água, velocidade e direção de correntes, salinidade, temperatura e turbidez foram obtidos em uma estação fixa próxima da desembocadura do estuário. A partir destes dados foram obtidos os transportes residuais de MPS e calculado os mecanismos de transporte. As maiores concentrações médias de material particulado em suspensão ocorreram em condições de sizígia. Em condições de maré de quadraturao transporte resultante de MPS foi com sentido estuário acima, porém de pequena intensidade. Em condições de sizígia o estuário é caracterizado por correntes mais intensas e assimétricas, com dominância de vazante. Durante a condição de sizígia o estuário pode atuar como importador ou exportador de MPS. O estuário do rio Caravelas foi classificado como bem misturado e fracamente estratificado. A hidrografia e o balanço sedimentar são principalmente modulados pela altura da marée o aporte de água doce é irrelevante.

Radiocarbon geochronology of the sediments of the São Paulo Bight (southern Brazilian upper margin)

The aim of this work was to generate an inventory of the data on radiocarbon datings obtained from sediments of the São Paulo Bight (southern Brazilian upper margin) and to analyze the data in terms of Late Quaternary sedimentary processes and sedimentation rates. A total of 238 radiocarbon datings from materials collected using differents ampling procedures was considered for this work. The sedimentation rates varied from less than 2 to 68 cm.kyr-1. The highest sedimentation rate values were found in a low-energy (ría type) coastal system as well as in the upwelling zones of Santa Catarina and Cabo Frio. The lowest rates were found on the outer shelf and upper slopes. Our results confirm the strong dependency of the shelf currents, with an emphasis to the terrigenous input from the Río de La Plata outflow which is transported via the Brazilian Coastal Current, as well as of the coupled Brazil Current - Intermediate Western Boundary Current (BC-IWBC) dynamics on the sedimentary processes. At least three indicators ofthe paleo sea level were found at 12200 yr BP (conventional radiocarbon age) (103 meters below sea level - mbsl),8300-8800 cal yr BP (13 mbsl) and 7700-8100 cal yr BP (6 mbsl).

Hydrodynamics of the Itapocu river and the Barra Velha lagoon estuarine system, SC, Brazil

A hydrodynamic characterization of the Itapocu river and Barra Velha lagoon estuarine system was carried out with the objective of evaluating how the current regime in this area is affected by astronomical and meteorological tides and the river discharge. Meteorological, water level and current velocity and direction data were gathered hourly during a twenty-day period, from 22-July until 10-August, 2004. Current meters were positioned at the inlet, at the entrance of the north and south lagoons and at the lower estuary of the river along with a tide gauge. The estuarine system showed distinct current behavior among the different sectors within the estuary, responding to the different forcings. The strongest currents were observed at the inlet while the weakest values were observed at the northern lagoon, a location that showed little dynamic. The general flow was ebb-dominated flux, in response to fluvial discharge, even during local wind water set-up event.

A descriptive analysis of the seasonal variation of physical oceanographic characteristics in the northern region of the Todos os Santos Bay (Bahia, Brazil)

The results obtained in the August and December 2003, August 2004 and January 2005 oceanographic campaigns in the northern region of the Todos os Santos Bay (lat. 12º44.5'S; long. 038º35.00'W) between the Madre de Deus and Maré islands are analyzed. Instruments of continuous and discrete samplings were used to measure hydrographic properties currents and tides. The water mass of the northern region of the bay is forced by semidiurnal and mesotides of form number 0.08 and the lunar component M2 height was estimated at 91cm. The time series of the surface currents indicated movements in the N/S direction, forced by the tide with maximum magnitudes of 0.73 m.s-1 on the December 2003 campaign. However, in August 2004 the currents were dominated by the wind stress forcing, with a maximum speed of 1.85 m.s-1 and SE direction. Near the bottom, the influence of the tide is not as evident, with a decrease in intensity due to internal and bottom friction, with a maximum velocity of 0.17 m.s-1. The thermal and haline structures were weakly horizontally, as well as vertically stratified, with extreme values varying in the intervals 23ºC (August, 2004) to 28ºC (December, 2003) and 31.0 psu (August, 2003) to 36.0 psu (December, 2003), respectively. Some conclusions may be drawn from these results: i) The signs of the dilution of the fresh water discharges of the Caípe, Mataripe and São Paulo rivers in the region under the influence of the RLAM were observed only during the winter periods, but in the summer the region was flooded by waters of oceanic origin and the salinities above 36.0 indicated TW mass intrusion; ii) The N-S circulation near the RLAM is strongly dominated by the tide, and the importance of the M2 component was unequivocal, however, the E-W component presented some tidal modulation away from abrupt bottom topographical changes, and iii) The residual series, calculated as the difference between the original and modeled, is about ¼ of the original and confirmed its semidiurnal character.

A simple procedure for reliability assessment of thin composite plates against buckling

In some circumstances ice floes may be modeled as beams. In general this modeling supposes constant thickness, which contradicts field observations. Action of currents, wind and the sequence of contacts, causes thickness to vary. Here this effect is taken into consideration on the modeling of the behavior of ice hitting inclined walls of offshore platforms. For this purpose, the boundary value problem is first equated. The set of equations so obtained is then transformed into a system of equations, that is then solved numerically. For this sake an implicit solution is developed, using a shooting method, with the accompanying Jacobian. In-plane coupling and the dependency of the boundary terms on deformation, make the problem non-linear and the development particular. Deformation and internal resultants are then computed for harmonic forms of beam profile. Forms of giving some additional generality to the problem are discussed.