Understanding the Sharing Economy: The Role of Response to Negative Reviews in the Peer-To-Peer Accommodation Sharing Network?

Recognizing the potentially ruinous effect of negative reviews on the reputation of the hosts as well as a subjective nature of the travel experience judgements, peer-to-peer accommodation sharing plat-forms, like Airbnb, have readily embraced the “response” option, empowering hosts with the voice to challenge, deny or at least apologize for the subject of critique. However, the effects of different re-sponse strategies on trusting beliefs towards the host remain unclear. To fill this gap, this study focus-es on understanding the impact of different response strategies and review negativity on trusting be-liefs towards the host in peer-to-peer accommodation sharing setting utilizing experimental methods. Examination of two different contexts, varying in the controllability of the subject of complaint, re-veals that when the subject of complaint is controllable by a host, such strategies as confession / apol-ogy and denial can improve trusting beliefs towards the host. However, when the subject of criticism is beyond the control of the host, denial of the issue does not yield guest’s confidence in the host, where-as confession and excuse have positive influence on trusting beliefs.

Neurotized lateral gastrocnemius muscle transfer for persistent traumatic peroneal nerve palsy: Surgical technique

INTRODUCTION Persistent traumatic peroneal nerve palsy, following nerve surgery failure, is usually treated by tendon transfer or more recently by tibial nerve transfer. However, when there is destruction of the tibial anterior muscle, an isolated nerve transfer is not possible. In this article, we present the key steps and surgical tips for the Ninkovic procedure including transposition of the neurotized lateral gastrocnemius muscle with the aim of restoring active voluntary dorsiflexion. SURGICAL TECHNIQUE The transposition of the lateral head of the gastrocnemius muscle to the tendons of the anterior tibial muscle group, with simultaneous transposition of the intact proximal end of the deep peroneal nerve to the tibial nerve of the gastrocnemius muscle by microsurgical neurorrhaphy is performed in one stage. It includes 10 key steps which are described in this article. Since 1994, three clinical series have highlighted the advantages of this technique. Functional and subjective results are discussed. We review the indications and limitations of the technique. CONCLUSION Early clinical results after neurotized lateral gastrocnemius muscle transfer appear excellent; however, they still need to be compared with conventional tendon transfer procedures. Clinical studies are likely to be conducted in this area largely due to the frequency of persistant peroneal nerve palsy and the limitations of functional options in cases of longstanding peripheral nerve palsy, anterior tibial muscle atrophy or destruction.

Cayó la yuta : Basta de contrabando en la pasiva

El presente trabajo esboza una crítica con base empírica y conceptual al análisis de la construcción pasiva basado en la operación contrabando (smuggling) propuesto por Collins (2005). En primer lugar, se exponen los argumentos de tipo empírico, los cuales se basan en aspectos de la construcción pasiva española (y de otras lenguas romance de sujeto nulo) que la derivación de Collins no permite explicar. Los fenómenos más salientes que se discuten son: (i) la imposibilidad de dar cuenta de los sujetos postverbales en la pasiva de lenguas romance de sujeto nulo (e.g. fueron detenidos los asaltantes) dado el ascenso del Sintagma de Participio a la posición de especificador de Voz (contra Belletti 2009); (ii) el obligatorio tratamiento como argumento verbal del complemento agente que impide dar cuenta de su comportamiento ante islas de extracción débiles (e.g. *por el docente, no sabe Juan por qué fue desaprobada María); (iii) y la imposibilidad de explicar el arrastre de la preposición (pied-piping) ante movimiento del nominal que recibe interpretación de argumento externo a la periferia izquierda (e.g. ¿por quién fueron arrestados los asaltantes?). Los argumentos conceptuales se basan, principalmente, en la inexistencia de requerimientos gramaticales para varias de las suboperaciones y movimientos de los que depende esta derivación de la pasiva. Además, se defienden las observaciones de Gehrke y Grillo (2007) con respecto a la naturaleza ad-hoc del análisis (que, en términos técnicos, se reducen a que las computaciones propuestas por Collins requieren "ver hacia adelante" (look-ahead) en la derivación). Ante estas consideraciones, se defiende el análisis de la construcción pasiva presentado durante el auge del modelo GB (Jaeggli 1986, Baker et al. 1989), el cual, sin ser perfecto, resulta mucho más consistente con respecto al requerimiento de adecuación descriptiva de toda teoría gramatical

Théorie des jeux expérimentale & action motrice

How do sportspeople succeed in a non-collaborative game? An illustration of a perverse side effect of altruism Are team sports specialists predisposed to collaboration? The scientific literature on this topic is divided. The present article attempts to end this debate by applying experimental game theory. We constituted three groups of volunteers (all students aged around 20): 25 team sports specialists; 23 individual sports specialists (gymnasts, track & field athletes and swimmers) and a control group of 24 non-sportspeople. Each subgroup was divided into 3 teams that played against each other in turn (and not against teams from other subgroups). The teams played a game based on the well-known Prisoner's Dilemma (Tucker, 1950) - the paradoxical "Bluegill Sunbass Game" (Binmore, 1999) with three Nash equilibria (two suboptimal equilibria with a pure strategy and an optimal equilibrium with a mixed, egotistical strategy (p= 1/2)). This game also features a Harsanyi equilibrium (based on constant compliance with a moral code and altruism by empathy: "do not unto others that which you would not have them do unto you"). How, then, was the game played? Two teams of 8 competed on a handball court. Each team wore a distinctive jersey. The game lasted 15 minutes and the players were allowed to touch the handball ball with their feet or hands. After each goal, each team had to return to its own half of the court. Players were allowed to score in either goal and thus cooperate with their teammates or not, as they saw fit. A goal against the nominally opposing team (a "guardian" strategy, by analogy with the Bluegill Sunbass Game) earned a point for everyone in the team. For an own goal (a "sneaker" strategy), only the scorer earned a point - hence the paradox. If all the members of a team work together to score a goal, everyone is happy (the Harsanyi solution). However, the situation was not balanced in the Nashian sense: each player had a reason to be disloyal to his/her team at the merest opportunity. But if everyone adopts a "sneaker" strategy, the game becomes a free-for-all and the chances of scoring become much slimmer. In a context in which doubt reigns as to the honesty of team members and "legal betrayals", what type of sportsperson will score the most goals? By analogy with the Bluegill Sunbass Game, we recorded direct motor interactions (passes and shots) based on either a "guardian" tactic (i.e. collaboration within the team) or a "sneaker" tactic (shots and passes against the player's designated team). So, was the group of team sports specialist more collaborative than the other two groups? The answer was no. A statistical analysis (difference from chance in a logistic regression) enabled us to draw three conclusions: ?For the team sports specialists, the Nash equilibrium (1950) was stronger than the Harsanyi equilibrium (1977). ?The sporting principles of equilibrium and exclusivity are not appropriate in the Bluegill Sunbass Game and are quickly abandoned by the team sports specialists. The latter are opportunists who focus solely on winning and do well out of it. ?The most altruistic players are the main losers in the Bluegill Sunbass Game: they keep the game alive but contribute to their own defeat. In our experiment, the most altruistic players tended to be the females and the individual sports specialists

Cayó la yuta : Basta de contrabando en la pasiva

El presente trabajo esboza una crítica con base empírica y conceptual al análisis de la construcción pasiva basado en la operación contrabando (smuggling) propuesto por Collins (2005). En primer lugar, se exponen los argumentos de tipo empírico, los cuales se basan en aspectos de la construcción pasiva española (y de otras lenguas romance de sujeto nulo) que la derivación de Collins no permite explicar. Los fenómenos más salientes que se discuten son: (i) la imposibilidad de dar cuenta de los sujetos postverbales en la pasiva de lenguas romance de sujeto nulo (e.g. fueron detenidos los asaltantes) dado el ascenso del Sintagma de Participio a la posición de especificador de Voz (contra Belletti 2009); (ii) el obligatorio tratamiento como argumento verbal del complemento agente que impide dar cuenta de su comportamiento ante islas de extracción débiles (e.g. *por el docente, no sabe Juan por qué fue desaprobada María); (iii) y la imposibilidad de explicar el arrastre de la preposición (pied-piping) ante movimiento del nominal que recibe interpretación de argumento externo a la periferia izquierda (e.g. ¿por quién fueron arrestados los asaltantes?). Los argumentos conceptuales se basan, principalmente, en la inexistencia de requerimientos gramaticales para varias de las suboperaciones y movimientos de los que depende esta derivación de la pasiva. Además, se defienden las observaciones de Gehrke y Grillo (2007) con respecto a la naturaleza ad-hoc del análisis (que, en términos técnicos, se reducen a que las computaciones propuestas por Collins requieren "ver hacia adelante" (look-ahead) en la derivación). Ante estas consideraciones, se defiende el análisis de la construcción pasiva presentado durante el auge del modelo GB (Jaeggli 1986, Baker et al. 1989), el cual, sin ser perfecto, resulta mucho más consistente con respecto al requerimiento de adecuación descriptiva de toda teoría gramatical

Théorie des jeux expérimentale & action motrice

How do sportspeople succeed in a non-collaborative game? An illustration of a perverse side effect of altruism Are team sports specialists predisposed to collaboration? The scientific literature on this topic is divided. The present article attempts to end this debate by applying experimental game theory. We constituted three groups of volunteers (all students aged around 20): 25 team sports specialists; 23 individual sports specialists (gymnasts, track & field athletes and swimmers) and a control group of 24 non-sportspeople. Each subgroup was divided into 3 teams that played against each other in turn (and not against teams from other subgroups). The teams played a game based on the well-known Prisoner's Dilemma (Tucker, 1950) - the paradoxical "Bluegill Sunbass Game" (Binmore, 1999) with three Nash equilibria (two suboptimal equilibria with a pure strategy and an optimal equilibrium with a mixed, egotistical strategy (p= 1/2)). This game also features a Harsanyi equilibrium (based on constant compliance with a moral code and altruism by empathy: "do not unto others that which you would not have them do unto you"). How, then, was the game played? Two teams of 8 competed on a handball court. Each team wore a distinctive jersey. The game lasted 15 minutes and the players were allowed to touch the handball ball with their feet or hands. After each goal, each team had to return to its own half of the court. Players were allowed to score in either goal and thus cooperate with their teammates or not, as they saw fit. A goal against the nominally opposing team (a "guardian" strategy, by analogy with the Bluegill Sunbass Game) earned a point for everyone in the team. For an own goal (a "sneaker" strategy), only the scorer earned a point - hence the paradox. If all the members of a team work together to score a goal, everyone is happy (the Harsanyi solution). However, the situation was not balanced in the Nashian sense: each player had a reason to be disloyal to his/her team at the merest opportunity. But if everyone adopts a "sneaker" strategy, the game becomes a free-for-all and the chances of scoring become much slimmer. In a context in which doubt reigns as to the honesty of team members and "legal betrayals", what type of sportsperson will score the most goals? By analogy with the Bluegill Sunbass Game, we recorded direct motor interactions (passes and shots) based on either a "guardian" tactic (i.e. collaboration within the team) or a "sneaker" tactic (shots and passes against the player's designated team). So, was the group of team sports specialist more collaborative than the other two groups? The answer was no. A statistical analysis (difference from chance in a logistic regression) enabled us to draw three conclusions: ?For the team sports specialists, the Nash equilibrium (1950) was stronger than the Harsanyi equilibrium (1977). ?The sporting principles of equilibrium and exclusivity are not appropriate in the Bluegill Sunbass Game and are quickly abandoned by the team sports specialists. The latter are opportunists who focus solely on winning and do well out of it. ?The most altruistic players are the main losers in the Bluegill Sunbass Game: they keep the game alive but contribute to their own defeat. In our experiment, the most altruistic players tended to be the females and the individual sports specialists

Cayó la yuta : Basta de contrabando en la pasiva

El presente trabajo esboza una crítica con base empírica y conceptual al análisis de la construcción pasiva basado en la operación contrabando (smuggling) propuesto por Collins (2005). En primer lugar, se exponen los argumentos de tipo empírico, los cuales se basan en aspectos de la construcción pasiva española (y de otras lenguas romance de sujeto nulo) que la derivación de Collins no permite explicar. Los fenómenos más salientes que se discuten son: (i) la imposibilidad de dar cuenta de los sujetos postverbales en la pasiva de lenguas romance de sujeto nulo (e.g. fueron detenidos los asaltantes) dado el ascenso del Sintagma de Participio a la posición de especificador de Voz (contra Belletti 2009); (ii) el obligatorio tratamiento como argumento verbal del complemento agente que impide dar cuenta de su comportamiento ante islas de extracción débiles (e.g. *por el docente, no sabe Juan por qué fue desaprobada María); (iii) y la imposibilidad de explicar el arrastre de la preposición (pied-piping) ante movimiento del nominal que recibe interpretación de argumento externo a la periferia izquierda (e.g. ¿por quién fueron arrestados los asaltantes?). Los argumentos conceptuales se basan, principalmente, en la inexistencia de requerimientos gramaticales para varias de las suboperaciones y movimientos de los que depende esta derivación de la pasiva. Además, se defienden las observaciones de Gehrke y Grillo (2007) con respecto a la naturaleza ad-hoc del análisis (que, en términos técnicos, se reducen a que las computaciones propuestas por Collins requieren "ver hacia adelante" (look-ahead) en la derivación). Ante estas consideraciones, se defiende el análisis de la construcción pasiva presentado durante el auge del modelo GB (Jaeggli 1986, Baker et al. 1989), el cual, sin ser perfecto, resulta mucho más consistente con respecto al requerimiento de adecuación descriptiva de toda teoría gramatical

Théorie des jeux expérimentale & action motrice

How do sportspeople succeed in a non-collaborative game? An illustration of a perverse side effect of altruism Are team sports specialists predisposed to collaboration? The scientific literature on this topic is divided. The present article attempts to end this debate by applying experimental game theory. We constituted three groups of volunteers (all students aged around 20): 25 team sports specialists; 23 individual sports specialists (gymnasts, track & field athletes and swimmers) and a control group of 24 non-sportspeople. Each subgroup was divided into 3 teams that played against each other in turn (and not against teams from other subgroups). The teams played a game based on the well-known Prisoner's Dilemma (Tucker, 1950) - the paradoxical "Bluegill Sunbass Game" (Binmore, 1999) with three Nash equilibria (two suboptimal equilibria with a pure strategy and an optimal equilibrium with a mixed, egotistical strategy (p= 1/2)). This game also features a Harsanyi equilibrium (based on constant compliance with a moral code and altruism by empathy: "do not unto others that which you would not have them do unto you"). How, then, was the game played? Two teams of 8 competed on a handball court. Each team wore a distinctive jersey. The game lasted 15 minutes and the players were allowed to touch the handball ball with their feet or hands. After each goal, each team had to return to its own half of the court. Players were allowed to score in either goal and thus cooperate with their teammates or not, as they saw fit. A goal against the nominally opposing team (a "guardian" strategy, by analogy with the Bluegill Sunbass Game) earned a point for everyone in the team. For an own goal (a "sneaker" strategy), only the scorer earned a point - hence the paradox. If all the members of a team work together to score a goal, everyone is happy (the Harsanyi solution). However, the situation was not balanced in the Nashian sense: each player had a reason to be disloyal to his/her team at the merest opportunity. But if everyone adopts a "sneaker" strategy, the game becomes a free-for-all and the chances of scoring become much slimmer. In a context in which doubt reigns as to the honesty of team members and "legal betrayals", what type of sportsperson will score the most goals? By analogy with the Bluegill Sunbass Game, we recorded direct motor interactions (passes and shots) based on either a "guardian" tactic (i.e. collaboration within the team) or a "sneaker" tactic (shots and passes against the player's designated team). So, was the group of team sports specialist more collaborative than the other two groups? The answer was no. A statistical analysis (difference from chance in a logistic regression) enabled us to draw three conclusions: ?For the team sports specialists, the Nash equilibrium (1950) was stronger than the Harsanyi equilibrium (1977). ?The sporting principles of equilibrium and exclusivity are not appropriate in the Bluegill Sunbass Game and are quickly abandoned by the team sports specialists. The latter are opportunists who focus solely on winning and do well out of it. ?The most altruistic players are the main losers in the Bluegill Sunbass Game: they keep the game alive but contribute to their own defeat. In our experiment, the most altruistic players tended to be the females and the individual sports specialists

Bird count in Mastbos forest (Breda, Netherlands) in the years 1950 to 1981

Notes from Henrik de Nie: The project started as a phenological study in cooperation with the (Dutch) meteorological institute (KNMI) to register the time of arrival of Fitis and Tjiftaf. During 1951 to 1969 he went every day to the wood (except 1966, in this year his wife died). Thereafter he went no more daily, but because he knew the wood very well and he was free to choice the day on which he did a survey, therefore he choose days with relatively good weather. He did not observe very common bird species, maybe because they are dependent on nest boxes and he did not want to be dependent on the management of the nest box-people (in fact I forgot precisely his arguments, and now I cannot ask him this): Common Starling; Eurasian Tree Sparrow (not common); Great Tit; Eurasian Blue Tit Pieter mentioned 14 species that scored many zero values or only one observation: Stock Dove; Common Cuckoo; Lesser Spotted Woodpecker; Eurasian Golden Oriole; Eurasian Nuthatch; Short-toed Treecreeper; Common Nightingale; Marsh Warbler; Lesser Whitethroat; Goldcrest; Common Firecrest (after 1970 he had difficulties in hearing these two species); Spotted Flycatcher; Eurasian Bullfinch; Black Woodpecker He also mentioned species that he found much fewer as: European Greenfinch; European Pied Flycatcher; Long-eared Owl; Red Crossbill; Sedge Warbler; Icterine Warbler; Eurasian Woodcock; Eurasian Siskin; European Green Woodpecker; Great Spotted Woodpecker; Eurasian Hobby; Western Barn Owl; Woodlark; Common Wood Pigeon; Little Owl; European Crested Tit; Hawfinch. But for these species I think that observations are strongly dependent on the number of visits to the wood. Also here, many zeros and few 1 x during the whole series of visits.

Landfast sea-ice and platelet-layer thickness and conductivity of Atka Bay, Antarctica, December 2012

Ice shelves strongly impact coastal Antarctic sea-ice and the associated ecosystem through the formation of a sub-sea-ice platelet layer. Although progress has been made in determining and understanding its spatio-temporal variability based on point measurements, an investigation of this phenomenon on a larger scale remains a challenge due to logistical constraints and a lack of suitable methodology. In this study, we applied a laterally-constrained Marquardt-Levenberg inversion to a unique multi-frequency electromagnetic (EM) induction sounding dataset obtained on the landfast sea ice of Atka Bay, eastern Weddell Sea, in 2012. In addition to consistent fast-ice thickness and -conductivities along > 100 km transects; we present the first comprehensive, high resolution platelet-layer thickness and -conductivity dataset recorded on Antarctic sea ice. The reliability of the algorithm was confirmed by using synthetic data, and the inverted platelet-layer thicknesses agreed within the data uncertainty to drill-hole measurements. Ice-volume fractions were calculated from platelet-layer conductivities, revealing that an older and thicker platelet layer is denser and more compacted than a loosely attached, young platelet layer. The overall platelet-layer volume below Atka Bay fast ice suggests that the contribution of ocean/ice-shelf interaction to sea-ice volume in this region is even higher than previously thought. This study also implies that multi-frequency EM induction sounding is an effective approach in determining platelet layer volume on a larger scale than previously feasible. When applied to airborne multi-frequency EM, this method could provide a step towards an Antarctic-wide quantification of ocean/ice-shelf interaction.

Pollen records of profile Krumbach from southern Germany

Some years ago a fossil lake basin was found in the northeastern part of the former Rhine-pied- mont-glacier, situated between the endmoraine system ofthe elassical Riß- andWürm glacia- tions, respectively. The lacustrine sediments contain the pollenflora ofthe Eemian interglacial. They are intensively thrusted. These sediments are eovered by a loam-layer, rieh in elasts. The thickness of this loam-layer varies between at least 170 and 400 cm. It consists in its major part of loess-loam and solifluction material. Yet just on top of the lake sediments mentioned an in- tensively compressed loam, characterized by quarzgrains with all features of glacially pressed material, together with striated elasts is met with. It strongly resembles atil!. Ifthis is true, the stratigraphie division ofthe last glaciation strongly deviates from the hitherto accepted scheme, incorporating an early glacier advance, long before the elassical young-endmoraine systems of the Würm glaciation were formed.

Le sport dans l'Espagne franquiste

Jusqu'à sa mort, en novembre 1975, le Général Franco fut, tel que le proclamaient ses pièces de monnaie, le « Caudillo d'Espagne par la grâce de Dieu » et, selon ses apologistes, il était responsable uniquement devant Dieu et l'Histoire. Bien que durant les dernières années de sa vie, sa participation directe dans les décisions politiques courantes fut assez réduite, il est pourtant certain qu'aucune décision importante ne pouvait être prise sans son consentement. Jusqu'au tout dernier moment, il conserva, grâce à la dénommée « Constitution franquiste », le pouvoir de nommer et de destituer les ministres, pouvoir qu'il utilisa toujours à sa guise. De telles prémisses conduisent à considérer logique l'utilisation du sport au service d'une idée politique. On assista alors à une tentative de mise sur pied du modèle de l'Allemagne nazie, mais il fallait tenir compte du fait que Franco n'avait jamais été disposé à construire un état totalitaire ayant un seul et unique parti, à l'image du modèle italien ou allemand. Après l'échec des puissances de l'Axe, Franco vit très clairement la nécessité d'abandonner le côté fasciste de son régime. Et, en ce qui concerne tout particulièrement le sport, Franco ne fut jamais disposé à dépenser la moindre somme d'argent dans ce domaine, comme l'avaient pourtant fait Hitler ou Mussolini.

Maternal effort mediates the prevalence of trypanosomes in the offspring of a passerine bird.

The relationships between parental effort, offspring growth, and offspring blood parasitemias are poorly known. We examined the effect of parental effort on offspring size and prevalence of trypanosomes in peripheral blood of nestling Pied Flycatchers Ficedula hypoleuca aged 13 days. Trypanosome infections were likely to be shared by siblings, indicating the role of a common environment and/or shared genes in the susceptibility to infection. Broods infected by trypanosomes had reduced growth, but this was due to decreased parental, especially maternal, energy expenditure in broods with nestlings infected by trypanosomes. There was no association between parental infection with trypanosomes and both their energy expenditure and the infection of their broods. Under stressful conditions caused by low maternal energy expenditure, the immune response of nestlings during growth was probably impaired, in a way analogous to the relapses of blood parasitemias with reproductive effort in breeding animals.

Instabilidades MHD no Tokamak TCABR

Este trabalho descreve o estudo das instabilidades magneto-hidro-dinâmicas (MHD) comumente observadas nas descargas elétricas de plasma no tokamak TCABR, do Instituto de Física da USP. Dois diagnósticos principais foram empregados para observar essas instabilidades: um conjunto poloidal de 24 bobinas magnéticas (bobinas de Mirnov) colocadas próximas à borda do plasma e um medidor de emissões na faixa do Ultra Violeta e de raios X moles com 20 canais (sistema SXR), cujo circuito de condicionamento de sinais foi aprimorado como parte deste trabalho. Esses diagnósticos foram escolhidos porque fornecem informações complementares, uma vez que o sistema SXR observa a parte central da coluna de plasma, enquanto as bobinas de Mirnov detectam as instabilidades MHD na região mais externa da coluna. As informações coletadas por esses diagnósticos foram submetidas à análise espectral com resolução temporal e espacial, possibilitando determinar a evolução das características espectrais e espaciais das instabilidades MHD observadas. Essas análises revelaram que durante a etapa inicial da formação do plasma (quando a corrente de plasma ainda está aumentando) ilhas magnéticas com números de onda decrescente, identificadas como sendo modos kink de borda, são detectadas nas bobinas de Mirnov. Após a formação do plasma, quando os parâmetros de equilíbrio estão relativamente estáveis (platô), oscilações são detectadas tanto nas bobinas de Mirnov quanto no sistema de SXR, indicando a presença de instabilidades MHD em toda a coluna de plasma. Em geral as oscilações medidas nas bobinas de Mirnov tem baixa amplitude e correspondem a pequenas ilhas magnéticas que foram identificadas como sendo modos de ruptura (modos tearing). Por outro lado, as instabilidades na região central foram identificadas como dentes de serra, que correspondem a relaxações periódicas da região interna à superfície magnética com fator de segurança q=1 e que são acompanhadas de oscilações precursoras, cuja amplitude depende da fase do ciclo de relaxação. Devido à essa modulação de amplitude, aparecem picos de frequência satélite nos espectrogramas dos sinais do SXR. Além disso, devido ao fato dos ciclos de relaxação não serem sinusoidais, os harmônicos da frequência de relaxação também aparecem nesses espectrogramas. No entanto, em muitas descargas do TCABR, a intensidade das oscilações medidas nas bobinas de Mirnov aumentam significativamente durante o platô, com efeitos sobre a frequência de todas as instabilidades MHD, até mesmo sobre os dentes de serra localizados na região central da coluna. Em todos os casos, observou-se que durante o platô a frequência das ilhas magnéticas coincide com a frequência das oscilações precursoras do dente de serra, apesar de serem duas instabilidades distintas, localizadas em posições radiais muito diferentes. Essa coincidência de frequências possibilitou descrever a evolução em frequência de todas as oscilações detectadas em diversos diagnósticos com base em apenas duas frequências básicas: a dos ciclos de relaxação dente de serra e a das ilhas magnéticas.

Desfechos tardios de sobreviventes de ensaio clínico randomizado controlado (protocolo ARDSnet vs. Open Lung Approach para o manejo ventilatório da síndrome do desconforto respiratório agudo moderado-grave)

Apesar da utilização da ventilação mecânica protetora como estratégia para o tratamento da síndrome do desconforto respiratório agudo, ao menos um quarto dos pacientes com essa síndrome ainda apresentam redução na função pulmonar após 6 meses de seguimento. Não se sabe se esta redução está relacionada com a gravidade da síndrome ou associada com a forma de ventilar o paciente. Nosso objetivo neste trabalho foi avaliar a associação entre alterações funcionais e estruturais do pulmão com parâmetros de gravidade clínica e de ventilação mecânica. Foi realizada uma análise secundária dos dados obtidos em estudo randomizado e controlado que incluiu pacientes com síndrome do desconforto respiratório agudo moderada/grave, internados em seis unidades de terapia intensiva em um hospital terciário da cidade de São Paulo. Foram analisados dados de pacientes que tinham ao menos um teste de função pulmonar no seguimento. O teste funcional incluiu a medida da capacidade vital forçada, volumes pulmonares e a capacidade de difusão do monóxido de carbono após 1, 2 e 6 meses de seguimento. Foram considerados variáveis independentes o volume corrente, a pressão de distensão e a pressão positiva ao final da expiração (todos medidos após 24 horas da randomização) e um sistema de classificação de prognóstico (APACHE II), a relação PaO2/FIO2 e a complacência respiratória estática (todos medidos antes da randomização). Também foi realizada tomografia de alta resolução do tórax juntamente com os testes de função pulmonar, e posterior análise quantitativa das imagens. Na avaliação de 6 meses também foi realizado teste de caminhada de 6 minutos e um questionário de qualidade de vida (SF-36). Um total de 21 pacientes realizaram o teste de função pulmonar após 1 mês e 15 pacientes realizaram após 2 e 6 meses de seguimento. A capacidade vital forçada foi relacionada inversamente com a pressão de distensão na avaliação de 1, 2 e 6 meses (p < 0,01). A capacidade de difusão do monóxido de carbono relacionou-se inversamente com a pressão de distensão e com o APACHE II (ambos p < 0,01) na avaliação de 1 e 2 meses. Após 6 meses de seguimento, houve correlação inversa entre a pressão de distensão e a capacidade vital forçada independente do volume corrente, da pressão de platô e da complacência estática respiratória após ajustes (R2 = 0,51, p = 0,02). A pressão de distensão também se relacionou com o volume pulmonar total, a densidade pulmonar media e a porcentagem de volume pulmonar não aerado ou pobremente aerado medidos através da análise quantitativa da tomografia computadorizada de tórax realizada na avaliação de 6 meses. Também foi observada relação entre a qualidade de vida após 6 meses de seguimento e a pressão de distensão considerando o domínio estado geral de saúde. Nós concluímos que mesmo em pacientes ventilados com reduzido volume corrente e pressão de platô limitada, maiores valores de pressão de distensão relacionaram-se com menores valores de função pulmonar no seguimento de longo prazo