Perfomance do transverso do abdómen : recurso à ecografia como informação de retorno extrínseca

RESUMO: Desenho do estudo: Estudo quantitativo, experimental prospectivo de factor único, desenho pré-teste, pós-teste. Objectivos: Determinar a efectividade da ecografia em tempo real, como Informação de Retorno Extrínseca Visual Ecográfica (IRE-VE) na performance do transverso do abdómen (TrA), em sujeitos saudáveis; analisar eventuais diferenças entre a IRE-VE e a Informação de Retorno Extrínseca Verbal Clínica (IRE-VC); medir a performance da musculatura abdominal, através das diferenças na espessura dos músculos TrA e oblíquo interno (OI) e deslizamento do TrA, em repouso e em contracção. Enquadramento: A maioria dos indivíduos não tem conhecimentos nem consciência do contributo de uma boa performance do TrA para a estabilidade da coluna lombar. Vários estudos recentes se têm dedicado a este assunto, tendo sido mostrado o importante contributo da ecografia como Informação de Retorno Extrínseca (IRE). Uma vez que o TrA e o OI contribuem para a estabilidade lombo pélvica, e que a aprendizagem do seu controlo motor é essencial para a recuperação da função, torna-se relevante clarificar o contributo da informação de retorno na primeira fase da aprendizagem da performance desses músculos, bem como encontrar as melhores estratégias para a sua realização. A ecografia foi o instrumento escolhido para servir esse objectivo. Métodos: Participaram no estudo 75 sujeitos, sem queixas lombares, com idades compreendidas entre os 18 e os 38 anos com um valor médio de 21,9 anos (±4,03), divididos aleatoriamente em três grupos com uma tarefa comum: a “Manobra do Transverso”, em que um grupo não recebeu IRE (GC), outro recebeu IRE verbal clínica e palpatória (GIRE-VC) e ooutro recebeu IRE visual ecográfica (GIRE-VE). Para efeitos de análise da contracção da musculatura abdominal, foram estudadas a espessura dos músculos TrA e OI e o deslizamento do TrA, visualizados em imagens ecográficas em tempo real, e congeladas para medição em diferido. Estes procedimentos foram apurados num estudo piloto de fidedignidade das medições em causa. Quanto à abordagem estatística das variáveis de performance muscular foi realizada uma análise da variância simples paramétrica para amostras independentes e um teste para a diferença de médias para amostras emparelhadas. Resultados: Observamos que no GC, a ausência de IRE cursou com uma performance idêntica nos dois momentos de avaliação e que nos dois grupos com IRE, das variáveis de performance, é significativamente diferente a contracção do TrA, para uma diferença de 1,95 mm no GIRE-VE (p=0,000) e de 0,84 mm no GIRE-VC (p=0,000). Ao comparar os grupos entre si houve diferenças no limiar da significância (p=0,056) para uma melhor contracção do TrA no GIRE-VE. As outras variáveis, contracção do OI e deslizamento do TrA, não revelaram efeito relacionado com a IRE em nenhum dos grupos. Conclusão: Dos resultados obtidos, podemos concluir que a IRE-VE, quando usada isoladamente, na Manobra do Transverso provoca um maior aumento na espessura do TrA, quando comparada com a IRE-VC . O uso da ecografia mostrou ser efectivo na facilitação da performance da Manobra do Transverso em sujeitos saudáveis.---------------------ABSTRACT: Study Design: Single Factor Experimental Design: Pre-Test Post-test Control Group Design. Objectives: To measure the contribution of different types of biofeedack on Transversus Abdominis (TrA) and Internal Oblique (IO) performance through changes in thickness and lateral slide of TrA anterior fascia during abdominal hollowing exercise (AHE). Background: Increasingly clinicians are using real-time ultrasound imaging as a form of supplementing feedback when teaching trunk stabilization exercises to patients; however, there has been no evidence of its effectiveness when used alone. Material and Methods: Seventy-five healthy subjects were divided randomly into 3 groups that received: group 1, no feedback; group 2, verbal and palpatory feedback, and group 3, realtime ultrasound feedback. The TrA and IO performance of each subject was twice assessed (before and after receiving feedback) when performing the AHE in a supine hook-lying position. Analysis of variance and T-test were used for the independent and paired samples, respectively, to determine significant changes in the performance of TrA and IO, based on intra and inter group analysis. Results: Group 1 had no differences between moments; group 2 had significant differences concerning TrA thickness (p=0,000) to a 0,84 mm thickness difference; group 3 had significant differences concerning TrA thickness (p=0,000) to a 1,94 mm difference; The ability to perform the AHE differed only among group 3 and group 1 (p=0.056), and only for changes in thickness of TrA muscle. No differences among groups were found neither for the lateral slide of TrA anterior fascia, nor for the internal oblique thickness. Conclusion: From the results of this study we conclude that real-time ultrasound feedback, when used alone during an AHE, can have a larger increase in TrA thickness when compared to verbal and palpatory feedback. The use of real time ultrasound showed to be effective as a feedback tool to facilitate the performance of the AHE in a supine hook-lying position in healthy subjects.

O biofeedback cinemático na realização de exercícios escápulo-torácicos

RESUMO: O Biofeedback cinemático na realização de exercícios escápulo-torácicos Patrícia Ribeiro; Ricardo Matias Desenho do estudo: Estudo quantitativo, experimental, prospetivo de fator único. Objetivos: Determinar a efetividade do biofeedback cinemático tridimensional (3D) em tempo real, como informação de retorno extrínseca, no reconhecimento da zona neutra da omoplata, em indivíduos saudáveis; medir o desempenho temporal, através do tempo que os sujeitos demoram a atingir a posição pretendida, e o desempenho no percurso, através da diferença entre o percurso efetuado e aquele que seria o percurso mais curto, sem Informação de Retorno Extrínseca (IRE), com Informação de Retorno Extrínseca clinica verbal e palpatória (IRE-VP) e com informação de retorno extrínseca visual cinemática (IRE-VC). Enquadramento: Reconhecer aquela que deve ser a posição adequada da omoplata e tomar consciência da importância dessa posição para a estabilidade e correto funcionamento da articulação gleno-umeral é uma tarefa difícil, pois a grande maioria do indivíduos não têm os conhecimentos necessários. É reconhecido o contributo que a IRE tem na reaprendizagem motora, em especial na primeira fase da aprendizagem motora – a consciencialização. Vários estudos se têm debruçado em avaliar a influencia da IRE na reabilitação de indivíduos com disfunção do ombro, tendo-se limitado ao formato electromiográfico. No sentido de encontrar novas estratégias para facilitar o processo de reaprendizagem motora nestes indivíduos, foi escolhido biofeedback cinemático tridimensional. Métodos: Participaram no estudo 60 sujeitos, sem queixas de dor no ombro, com idades compreendidas entre os 18 e os 54 anos, com um valor médio de 21,66 anos (±5.89), divididos aleatoriamente em três grupos com uma tarefa comum: o reconhecimento da zona neutra da omoplata. Um grupo não recebeu qualquer tipo de IRE - Grupo Controlo (GC), outro grupo recebeu IRE-VP e outro recebeu IRE-VC. Para efeitos de análise da performance foram consideradas duas variáveis: tempo e qualidade da execução. A abordagem estatística destas variáveis consistiu numa análise de variância simples e num teste de comparações múltiplas. Resultados: Observámos que o grupo controlo e o grupo IRE-VC efetuaram a tarefa pedida em menos tempo que o grupo IRE-VP (p<0.01) e que o grupo IRE-VC obteve melhores resultados no que respeita à qualidade da execução da tarefa do que o GC e o grupo IRE-VP (p<0.01). Conclusão: Pelos resultados obtidos, na tarefa de reconhecimento da zona neutra da omoplata, podemos concluir que o biofeedback cinemático é mais efetivo na facilitação da obtenção de melhor qualidade de execução da tarefa do que o feedback clinico ou a inexistência de feedback e igualmente efetivo à inexistência de IRE no que respeita ao tempo demorado a reconhecer essa posição. -------------- ABSTRACT:Study Design: Single factor experimental design. Objectives: To determine the effectiveness of real time cinematic biofeedback as extrinsic information in the recognition of the neutral zone of the scapula in healthy subjects; to measure the temporal performance and quality of the execution without extrinsic feedback, with clinical feedback and with cinematic feedback. Background: To recognize the proper scapula position and to be aware of the importance of this position to the stability and correct function of the gleno-umeral joint is a difficult task, because most people don’t have the necessary knowledge. It is known that extrinsic feedback is effective in motor learning, specially in the early stages. There are several studies that evaluated the influence of extrinsic feedback in rehabilitation of shoulder dysfunctions, but only in the electromyography format. Material and Methods: Sixty healthy subjects were randomly divided into 3 groups that received no feedback (group 1 – control group), verbal and palpatory feedback (group 2) and real time cinematic feedback (group 3). The performance variables considered – time and quality of execution - were statistically analyzed with ANOVA one-way and multiple comparisons test. Results: Control group and group 3 executed the task in less time that group 2 (p<0.01) and group 3 executed the task with better quality than control group and group 2 (p<0.01). Conclusions: From the results of this study we conclude that in the studied task, the cinematic feedback is more effective to facilitate a better quality of execution than no feedback or clinical feedback and, regarding to time taken to attain the requested position, equally effective to no feedback.

Analysis and visualization of energy use for university campus

The reduction of greenhouse gas emissions is one of the big global challenges for the next decades due to its severe impact on the atmosphere that leads to a change in the climate and other environmental factors. One of the main sources of greenhouse gas is energy consumption, therefore a number of initiatives and calls for awareness and sustainability in energy use are issued among different types of institutional and organizations. The European Council adopted in 2007 energy and climate change objectives for 20% improvement until 2020. All European countries are required to use energy with more efficiency. Several steps could be conducted for energy reduction: understanding the buildings behavior through time, revealing the factors that influence the consumption, applying the right measurement for reduction and sustainability, visualizing the hidden connection between our daily habits impacts on the natural world and promoting to more sustainable life. Researchers have suggested that feedback visualization can effectively encourage conservation with energy reduction rate of 18%. Furthermore, researchers have contributed to the identification process of a set of factors which are very likely to influence consumption. Such as occupancy level, occupants behavior, environmental conditions, building thermal envelope, climate zones, etc. Nowadays, the amount of energy consumption at the university campuses are huge and it needs great effort to meet the reduction requested by European Council as well as the cost reduction. Thus, the present study was performed on the university buildings as a use case to: a. Investigate the most dynamic influence factors on energy consumption in campus; b. Implement prediction model for electricity consumption using different techniques, such as the traditional regression way and the alternative machine learning techniques; and c. Assist energy management by providing a real time energy feedback and visualization in campus for more awareness and better decision making. This methodology is implemented to the use case of University Jaume I (UJI), located in Castellon, Spain.

Cortisol salival como indicador de estrés fisiológico en niños y adultos; revisión sistemática.

Salivary cortisol is a steroid hormone that is produced in the hypothalamic-pituitary-adrenal axis and secreted into saliva when persons are under stress. High levels of cortisol in saliva can be produced by many different factors, including obesity and certain psychological disorders. The articles selected for inclusion in this review were identified using Google Scholar and Medline, and this search obtained a total of 57 items. The validity of these studies was established according to the degree of evidence presented, by citations and by their applicability to the healthcare context in Spain. Specifically, this review takes into consideration studies of salivary cortisol and stress in children and adults, and those examining the relation between high levels of salivary cortisol and other disorders such as anxiety, attention-deficit/hyperactivity disorder, social phobia or emotional deprivation. These studies show that salivary cortisol is a clear indicator of stress in both children and adults. High levels of this hormone in saliva are associated with the following main consequences: reduced immune function, affecting healing and thus prolonging recovery time; delayed growth in children; increased blood pressure and heart rate in both children and adults.

Speed of reaction-transport processes

We present an approach to determining the speed of wave-front solutions to reaction-transport processes. This method is more accurate than previous ones. This is explicitly shown for several cases of practical interest: (i) the anomalous diffusion reaction, (ii) reaction diffusion in an advective field, and (iii) time-delayed reaction diffusion. There is good agreement with the results of numerical simulations

Speed of wave-front solutions to hyperbolic reaction-diffusion equations

The asymptotic speed problem of front solutions to hyperbolic reaction-diffusion (HRD) equations is studied in detail. We perform linear and variational analyses to obtain bounds for the speed. In contrast to what has been done in previous work, here we derive upper bounds in addition to lower ones in such a way that we can obtain improved bounds. For some functions it is possible to determine the speed without any uncertainty. This is also achieved for some systems of HRD (i.e., time-delayed Lotka-Volterra) equations that take into account the interaction among different species. An analytical analysis is performed for several systems of biological interest, and we find good agreement with the results of numerical simulations as well as with available observations for a system discussed recently

Approximate solution to the speed of spreading viruses

Recently, it has been shown that the speed of virus infections can be explained by time-delayed reactiondiffusion [J. Fort and V. Me´ndez, Phys. Rev. Lett. 89, 178101 (2002)], but no analytical solutions were found. Here we derive formulas for the front speed, valid in appropriate limits. We also integrate numerically the evolution equations of the system. There is good agreement with both numerical and experimental speeds

Speed of travelling fronts: Two-dimensional and ballistic dispersal probability distributions

The speed of traveling fronts for a two-dimensional model of a delayed reactiondispersal process is derived analytically and from simulations of molecular dynamics. We show that the one-dimensional (1D) and two-dimensional (2D) versions of a given kernel do not yield always the same speed. It is also shown that the speeds of time-delayed fronts may be higher than those predicted by the corresponding non-delayed models. This result is shown for systems with peaked dispersal kernels which lead to ballistic transport

Analysis and Design of an Adaptive Polynomial Predistorter with the Loop Delay Estimator

Most adaptive linearization circuits for the nonlinear amplifier have a feedback loop that returns the output signal oj'tne eunplifier to the lineurizer. The loop delay of the linearizer most be controlled precisely so that the convergence of the linearizer should be assured lot this Letter a delay control circuit is presented. It is a delay lock loop (ULL) with it modified early-lute gate and can he easily applied to a DSP implementation. The proposed DLL circuit is applied to an adaptive linearizer with the use of a polynomial predistorter, and the simulalion for a 16-QAM signal is performed. The simulation results show that the proposed DLL eliminates the delay between the reference input signal and the delayed feedback signal of the linearizing circuit perfectly, so that the predistorter polynomial coefficients converge into the optimum value and a high degree of linearization is achieved

Femtosecond wavepacket interferometry using the rotational dynamics of a trapped cold molecular ion

A Ramsey-type interferometer is suggested, employing a cold trapped ion and two time-delayed offresonant femtosecond laser pulses. The laser light couples to the molecular polarization anisotropy, inducing rotational wavepacket dynamics. An interferogram is obtained from the delay dependent populations of the final field-free rotational states. Current experimental capabilities for cooling and preparation of the initial state are found to yield an interferogram visibility of more than 80%. The interferograms can be used to determine the polarizability anisotropy with an accuracy of about ±2%, respectively ±5%, provided the uncertainty in the initial populations and measurement errors are confined to within the same limits.

Front spreading in population dynamic models. Theory and application to the Neolithic transition

This thesis presents population dynamics models that can be applied to predict the rate of spread of the Neolithic transition (change from hunter-gathering to farming economics) across the European continent, which took place about 9000 to 5000 years ago. The first models in this thesis provide predictions at a continental scale. We develop population dynamics models with explicit kernels and apply realistic data. We also derive a new time-delayed reaction-diffusion equation which yields speeds about a 10% slower than previous models. We also deal with a regional variability: the slowdown of the Neolithic front when reaching the North of Europe. We develop simple reaction-diffusion models that can predict the measured speeds in terms of the non-homogeneous distribution of pre-Neolithic (Mesolithic) population in Europe, which were present in higher densities at the North of the continent. Such models can explain the observed speeds.

Global exponential periodicity of a class of neural networks with recent-history distributed delays

In this paper, we propose to study a class of neural networks with recent-history distributed delays. A sufficient condition is derived for the global exponential periodicity of the proposed neural networks, which has the advantage that it assumes neither the differentiability nor monotonicity of the activation function of each neuron nor the symmetry of the feedback matrix or delayed feedback matrix. Our criterion is shown to be valid by applying it to an illustrative system. (c) 2005 Elsevier Ltd. All rights reserved.

A model for self-directed problem-based learning for renal therapeutics

Objective To introduce a new approach to problem-based learning (PBL) for self-directed learning in renal therapeutics. Design This 5-week course, designed for large student cohorts using minimal teaching resources, was based on a series of case studies and subsequent pharmaceutical care plans, followed by intensive and regular feedback from the instructor. Assessment Assessment of achievement of the learning outcomes was based on weekly-graded care plans and peer review assessment, allowing each student to judge the contributions of each group member and their own, along with a written case-study based examination. The pharmaceutical care plan template, designed using a “tick-box” system, significantly reduced staff time for feedback and scoring. Conclusion The proposed instructional model achieved the desired learning outcomes with appropriate student feedback, while promoting skills that are essential for the students' future careers as health care professionals.

Projeto de controladores baseados em LMIs: realimentação derivativa e sistemas chaveados utilizando estrutura variável

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Evaluating the legacy of landscape history: extinction debt and species credit in bird and small mammal assemblages in the Brazilian Atlantic Forest

There is now an extensive literature on extinction debt following deforestation. However, the potential for species credit in landscapes that have experienced a change from decreasing to expanding forest cover has received little attention. Both delayed responses should depend on current landscape forest cover and on species life-history traits, such as longevity, as short-lived species are likely to respond faster than long-lived species. We evaluated the effects of historical and present-day local forest cover on two vertebrate groups with different longevities understorey birds and non-flying small mammals - in forest patches at three Atlantic Forest landscapes. Our work investigated how the probability of extinction debt and species credit varies (i) amongst landscapes with different proportions of forest cover and distinct trajectories of forest cover change, and (ii) between taxa with different life spans. Our results suggest that the existence of extinction debt and species credit, as well as the potential for their future payment and/or receipt, is not only related to forest cover trajectory but also to the amount of remaining forest cover at the landscape scale. Moreover, differences in bird and small mammal life spans seem to be insufficient to affect differently their probability of showing time-delayed responses to landscape change. Synthesis and applications. Our work highlights the need for considering not only the trajectory of deforestation/regeneration but also the amount of forest cover at landscape scale when investigating time-delayed responses to landscape change. As many landscapes are experiencing a change from decreasing to expanding forest cover, understanding the association of extinction and immigration processes, as well as their interactions with the landscape dynamic, is a key factor to plan conservation and restoration actions in human-altered landscapes.