How to progress from discourse to practice? a new agenda for change in medical schools into the next decade

In the context of medical school instruction, the segmented approach of a focus on specialties and excessive use of technology seem to hamper the development of the professional-patient relationship and an understanding of the ethics of this relationship. The real world presents complexities that require multiple approaches. Engagement in the community where health competence is developed allows extending the usefulness of what is learned. Health services are spaces where the relationship between theory and practice in health care are real and where the social role of the university can be revealed. Yet some competencies are still lacking and may require an explicit agenda to enact. Ten topics are presented for focus here: environmental awareness, involvement of students in medical school, social networks, interprofessional learning, new technologies for the management of care, virtual reality, working with errors, training in management for results, concept of leadership, and internationalization of schools. Potential barriers to this agenda are an underinvestment in ambulatory care infrastructure and community-based health care facilities, as well as in information technology offered at these facilities; an inflexible departmental culture; and an environment centered on a discipline-based medical curriculum.

Um processo para utilizar a tecnologia de impressão 3D na construção de instrumentos didáticos para o ensino de Ciências

Pós-graduação em Educação para a Ciência - FC

Ações educativas sobre prevenção de acidentes infantis com professoras de educação infantil

Pós-graduação em Educação - FFC

Smart histogram analysis applied to the skull-stripping problem in T1-weighted MRI

In this paper we address the "skull-stripping" problem in 3D MR images. We propose a new method that employs an efficient and unique histogram analysis. A fundamental component of this analysis is an algorithm for partitioning a histogram based on the position of the maximum deviation from a Gaussian fit. In our experiments we use a comprehensive image database, including both synthetic and real MRI. and compare our method with other two well-known methods, namely BSE and BET. For all datasets we achieved superior results. Our method is also highly independent of parameter tuning and very robust across considerable variations of noise ratio.

TOPOLOGY OF SINPLE SINGULARITIES OF RULED SURFACES IN R-p

In this work we compare the simple singularities of germs from R-2 to R-p with multiplicity 2 or 3 with the singularities appearing in the set of 2-ruled surfaces. We also study the topological type of all finitely determined singularities by studying generic projections of these singularities in R-3. (C) 2011 Elsevier B.V. All rights reserved.

Effect of Nintendo Wii (TM)-based motor and cognitive training on activities of daily living in patients with Parkinson's disease: A randomised clinical trial

Objectives To investigate the effect of Nintendo Wii (TM)-based motor cognitive training versus balance exercise therapy on activities of daily living in patients with Parkinson's disease. Design Parallel, prospective, single-blind, randomised clinical trial. Setting Brazilian Parkinson Association. Participants Thirty-two patients with Parkinson's disease (Hoehn and Yahr stages 1 and 2). Interventions Fourteen training sessions consisting of 30 minutes of stretching, strengthening and axial mobility exercises, plus 30 minutes of balance training. The control group performed balance exercises without feedback or cognitive stimulation, and the experimental group performed 10 Wii Fit (TM) games. Main outcome measure Section II of the Unified Parkinson's Disease Rating Scale (UPDRS-II). Randomisation Participants were randomised into a control group (n = 16) and an experimental group (n = 16) through blinded drawing of names. Statistical analysis Repeated-measures analysis of variance (RM-ANOVA). Results Both groups showed improvement in the UPDRS-II with assessment effect (RM-ANOVA P < 0.001, observed power = 0.999). There was no difference between the control group and the experimental group before training {8.9 [standard deviation (SD) 2.9] vs 10.1 (SD 3.8)}, after training [7.6 (SD 2.9) vs 8.1 (SD 3.5)] or 60 days after training [8.1 (SD 3.2) vs 8.3 (SD 3.6)]. The mean difference of the whole group between before training and after training was -0.9 (SD 2.3, 95% confidence interval -1.7 to -0.6). Conclusion Patients with Parkinson's disease showed improved performance in activities of daily living after 14 sessions of balance training, with no additional advantages associated with the Wii-based motor and cognitive training. Registered on http://www.clinicaltrials.gov (identifier: NCT01580787). (C) 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

RegCM3 nested in HadAM3 scenarios A2 and B2: projected changes in extratropical cyclogenesis, temperature and precipitation over the South Atlantic Ocean

The RegCM3 (Regional Climate Model-version 3) was nested in HadAM3 model to simulate present (1975-1989, referred hereafter as RegHad) and two future climate scenarios (A2 and B2 from 2071 to 2085, referred as RegA2 and RegB2) over the South America (SA) and South Atlantic Ocean (SAO). Projected changes in the air temperature, precipitation, low level circulation and cyclogenesis climatology were investigated. The cyclogenesis were identified using an automatic scheme for tracking based on the minimum of relative vorticity (zeta) from 10-m height wind. During summer, a general decrease (increase) in the precipitation is projected by RegA2 and RegB2 over the northeastern SA (center-west and south Brazil, north Argentina and Uruguay). For winter, an anomalous low level anticyclonic circulation is associated with the reduction in the rainfall over the central part of southern Brazil in RegA2 and RegB2 scenarios. Similar to HadAM3, RegCM3 projects larger warming in A2 scenario. For the present climate, when compared to HadAM3, RegHad defines better both the location of the main cyclogenetic areas and its annual cycle near southwestern SAO. The projections indicate a reduction in the total number of cyclones of -7.2% and -4.7% for RegA2 and RegB2, respectively, while HadAM3 reduction is -4.5% for both scenarios. The decrease is larger for initially intense cyclones (zeta <=-<= 2.5 x 10(-5) s-(1)): -20.9% (RegA2) and -11.3% (RegB2). For the lifetime, distance traveled and mean velocity of the cyclones, the A2 and B2 scenarios present mean values close to the present climate ( 3 days, 1900 km, and 9 m s(-1), respectively). Regarding the initial mean vorticity of the systems, RegB2 simulates values similar to the present climate, but they are initially weaker in RegA2. In general, RegA2 and RegB2 show a large decrease in the number of cyclones over the southern SAO due to an anticyclonic anomaly covering SAO between 30-55A degrees S. The reduction is larger in the scenario with higher concentrations of greenhouse gases (RegA2).

Modeling the gluon propagator in Landau gauge: Lattice estimates of pole masses and dimension-two condensates

We present an analytic description of numerical results for the Landau-gauge SU(2) gluon propagator D(p(2)), obtained from lattice simulations (in the scaling region) for the largest lattice sizes to date, in d = 2, 3 and 4 space-time dimensions. Fits to the gluon data in 3d and in 4d show very good agreement with the tree-level prediction of the refined Gribov-Zwanziger (RGZ) framework, supporting a massive behavior for D(p(2)) in the infrared limit. In particular, we investigate the propagator's pole structure and provide estimates of the dynamical mass scales that can be associated with dimension-two condensates in the theory. In the 2d case, fitting the data requires a noninteger power of the momentum p in the numerator of the expression for D(p(2)). In this case, an infinite-volume-limit extrapolation gives D(0) = 0. Our analysis suggests that this result is related to a particular symmetry in the complex-pole structure of the propagator and not to purely imaginary poles, as would be expected in the original Gribov-Zwanziger scenario.

Silicon location through backscattered electron imaging and X-ray microanalysis in leaves of Cyperus ligularis L. and Rhynchospora aberrans C. B. Clarke (Cyperaceae)

(Silicon location through backscattered electron imaging and X-ray microanalysis in leaves of Cyperus ligularis L. and Rhynchospora aberrans C. B. Clarke (Cyperaceae)). The Cyperaceae show the ability to incorporate silicon by depositing colloidal silica, which is recorded by the occurrence of projections in the form of cones, in inner tangential walls of some epidermal cells or "silica cells". Leaves of C. ligularis and R. aberrans were analyzed through the technique of electron backscatter. Cyperus ligularis accumulates silica, in addition to "silica cells", in some stomata, trichomes and the cell walls that surround the cavities of the aerenchyma. The silica in the latter occurs in various forms; however, the cells located near the vascular bundles have conical projections, similar to those of the epidermis. Rhynchospora aberrans presents "silica cells" whose projections have tapered "satellites". In this species, silica also occurs in stomata and certain epidermal cells adjacent to them. It appears that the silicon deposition occurs in combination with the wall (with no apparent structural changes), and structures of secretion, or projections of the wall. These structural changes in the species, and location, are probably related to functional and environmental factors, especially the soil, in addition to relation with taxonomic groups.

Advergaming e In-game advertising: Attori e contesti di una forma emergente di Internet marketing

Due nuove mode che si stanno propagando sempre più tra gli innumerevoli tentativi di realizzare nuovi formati di pubblicità on-line sono la pubblicità che diventa videogame gratuito, giocabile on-line o scaricabile, chiamata advergame, e la collocazione di pubblicità, oramai nella stragrande maggioranza dinamiche, nei videogames sopratutto di grandi software house, chiamata in-game advertising. Infatti nella società odierna i pubblicitari devono camuffare i consigli per gli acquisti per fare in modo che non vengano rifiutati. L'advergame in passato è stato lodato per il suo metodo innovativo di fare pubblicità. La sua caratteristica è la capacità di divertire e intrattenere l'utente ottenendo una connotazione non intrusiva e un effetto fidelizzante, peculiarità che fa di questo mezzo uno strumento potenzialmente molto valido. Si tratta, in parole povere, di videogames spesso multiplayer, nei quali gli scenari, gli oggetti e i personaggi evocano determinati brand o prodotti. Per quello che invece riguarda l'in-game advertising, si tratta di una forma particolarmente efficace di pubblicità che permette di ottenere dei tassi di ricordo rilevanti e che consente un elevato coinvolgimento emotivo. E' a livello della creazione degli spazi pubblicitari che si scatena la fantasia degli sviluppatori: se nei giochi sportivi basta trasporre in 3D gli spazi pubblicitari presenti solitamente nella realtà, in altre tipologie di gioco è necessario sfruttare parti dell'ambientazione o creare degli intermezzi atti allo scopo. Esempio tipico è quello di manifesti pubblicitari inseriti in spazi di gioco come le locande, soprattutto nei giochi di ruolo e nelle avventure grafiche. Gli investimenti in queste particolari forme di comunicazione, crescono a tassi elevatissimi e il business è molto allettante, non a caso le principali agenzie specializzate in materia sono state acquisite da grandi colossi: AdScape Media da Google e Massive Inc. da Microsoft. L'advergame e l'in-game advertising possono essere usati per lanciare un nuovo prodotto sul mercato, per rafforzare l'immagine del brand e per ottenere un database di utenti disposti ad essere sollecitati per ottenere in modo facile e non dispendioso riscontri su future attività di marketing. Perciò mi sono proposto di analizzare la situazione odierna del marketing, in particolare la parte che riguarda la pubblicità, i vantaggi ottenuti da questa scienza dallo sviluppo tecnologico, fattore che ha determinato la nascita dei due formati pubblicitari in esame e analizzati in seguito. Inoltre effettuerò l'analisi del fenomeno che vede i grandi colossi dell'IT tentare l'inserimento come agenzie intermediarie fra le software house da una parte e le grandi multinazionali dall'altra, queste ultime alla ricerca di nuovi canali più profittevoli dove sponsorizzare le proprie attività. Cercherò infine di capire le scelte di tutti gli attori che girano attorno a questi formati pubblicitari e i benefici che ne traggono per ipotizzare quale sarà il contesto che si andrà a delineare.

Fluidodinamica biomedica computazionale del flusso sanguigno in presenza di affezioni strumentali e/o patologiche

La tesi di Dottorato studia il flusso sanguigno tramite un codice agli elementi finiti (COMSOL Multiphysics). Nell’arteria è presente un catetere Doppler (in posizione concentrica o decentrata rispetto all’asse di simmetria) o di stenosi di varia forma ed estensione. Le arterie sono solidi cilindrici rigidi, elastici o iperelastici. Le arterie hanno diametri di 6 mm, 5 mm, 4 mm e 2 mm. Il flusso ematico è in regime laminare stazionario e transitorio, ed il sangue è un fluido non-Newtoniano di Casson, modificato secondo la formulazione di Gonzales & Moraga. Le analisi numeriche sono realizzate in domini tridimensionali e bidimensionali, in quest’ultimo caso analizzando l’interazione fluido-strutturale. Nei casi tridimensionali, le arterie (simulazioni fluidodinamiche) sono infinitamente rigide: ricavato il campo di pressione si procede quindi all’analisi strutturale, per determinare le variazioni di sezione e la permanenza del disturbo sul flusso. La portata sanguigna è determinata nei casi tridimensionali con catetere individuando tre valori (massimo, minimo e medio); mentre per i casi 2D e tridimensionali con arterie stenotiche la legge di pressione riproduce l’impulso ematico. La mesh è triangolare (2D) o tetraedrica (3D), infittita alla parete ed a valle dell’ostacolo, per catturare le ricircolazioni. Alla tesi sono allegate due appendici, che studiano con codici CFD la trasmissione del calore in microcanali e l’ evaporazione di gocce d’acqua in sistemi non confinati. La fluidodinamica nei microcanali è analoga all’emodinamica nei capillari. Il metodo Euleriano-Lagrangiano (simulazioni dell’evaporazione) schematizza la natura mista del sangue. La parte inerente ai microcanali analizza il transitorio a seguito dell’applicazione di un flusso termico variabile nel tempo, variando velocità in ingresso e dimensioni del microcanale. L’indagine sull’evaporazione di gocce è un’analisi parametrica in 3D, che esamina il peso del singolo parametro (temperatura esterna, diametro iniziale, umidità relativa, velocità iniziale, coefficiente di diffusione) per individuare quello che influenza maggiormente il fenomeno.

Coding of reaching in 3-D space

Many psychophysical studies suggest that target depth and direction during reaches are processed independently, but the neurophysiological support to this view is so far limited. Here, we investigated the representation of reach depth and direction by single neurons in an area of the medial posterior parietal cortex (V6A). Single-unit activity was recorded from V6A in two Macaca fascicularis monkeys performing a fixation-to-reach task to targets at different depths and directions. We found that in a substantial percentage of V6A neurons depth and direction signals jointly influenced fixation, planning and arm movement-related activity in 3D space. While target depth and direction were equally encoded during fixation, depth tuning became stronger during arm movement planning, execution and target holding. The spatial tuning of fixation activity was often maintained across epochs, and this occurred more frequently in depth. These findings support for the first time the existence of a common neural substrate for the encoding of target depth and direction during reaching movements in the posterior parietal cortex. Present results also highlight the presence in V6A of several types of cells that process independently or jointly eye position and arm movement planning and execution signals in order to control reaches in 3D space. It is possible that depth and direction influence also the metrics of the reach action and that this effect on the reach kinematic variables can account for the spatial tuning we found in V6A neural activity. For this reason, we recorded and analyzed behavioral data when one monkey performed reaching movements in 3-D space. We evaluated how the target spatial position, in particular target depth and target direction, affected the kinematic parameters and trajectories describing the motor action properties.

Effect of training systems and pruning methods on fruit quality in apple

The introduction of dwarfed rootstocks in apple crop has led to a new concept of intensive planting systems with the aim of producing early high yield and with returns of the initial high investment. Although yield is an important aspect to the grower, the consumer has become demanding regards fruit quality and is generally attracted by appearance. To fulfil the consumer’s expectations the grower may need to choose a proper training system along with an ideal pruning technique, which ensure a good light distribution in different parts of the canopy and a marketable fruit quality in terms of size and skin colour. Although these aspects are important, these fruits might not reach the proper ripening stage within the canopy because they are often heterogeneous. To describe the variability present in a tree, a software (PlantToon®), was used to recreate the tree architecture in 3D in the two training systems. The ripening stage of each of the fruits was determined using a non-destructive device (DA-Meter), thus allowing to estimate the fruit ripening variability. This study deals with some of the main parameters that can influence fruit quality and ripening stage within the canopy and orchard management techniques that can ameliorate a ripening fruit homogeneity. Significant differences in fruit quality were found within the canopies due to their position, flowering time and bud wood age. Bi-axis appeared to be suitable for high density planting, even though the fruit quality traits resulted often similar to those obtained with a Slender Spindle, suggesting similar fruit light availability within the canopies. Crop load confirmed to be an important factor that influenced fruit quality as much as the interesting innovative pruning method “Click”, in intensive planting systems.

Statistical analysis of the error associated with the simplification of the stratigraphy in geotechnical models

The uncertainties in the determination of the stratigraphic profile of natural soils is one of the main problems in geotechnics, in particular for landslide characterization and modeling. The study deals with a new approach in geotechnical modeling which relays on a stochastic generation of different soil layers distributions, following a boolean logic – the method has been thus called BoSG (Boolean Stochastic Generation). In this way, it is possible to randomize the presence of a specific material interdigitated in a uniform matrix. In the building of a geotechnical model it is generally common to discard some stratigraphic data in order to simplify the model itself, assuming that the significance of the results of the modeling procedure would not be affected. With the proposed technique it is possible to quantify the error associated with this simplification. Moreover, it could be used to determine the most significant zones where eventual further investigations and surveys would be more effective to build the geotechnical model of the slope. The commercial software FLAC was used for the 2D and 3D geotechnical model. The distribution of the materials was randomized through a specifically coded MatLab program that automatically generates text files, each of them representing a specific soil configuration. Besides, a routine was designed to automate the computation of FLAC with the different data files in order to maximize the sample number. The methodology is applied with reference to a simplified slope in 2D, a simplified slope in 3D and an actual landslide, namely the Mortisa mudslide (Cortina d’Ampezzo, BL, Italy). However, it could be extended to numerous different cases, especially for hydrogeological analysis and landslide stability assessment, in different geological and geomorphological contexts.

Hypersonic phonon propagation in mesoscopic systems by Brillouin spectroscopy

Phononic crystals, capable to block or direct the propagation of elastic/acoustic waves, have attracted increasing interdisciplinary interest across condensed matter physics and materials science. As of today, no generalized full description of elastic wave propagation in phononic structures is available, mainly due to the large number of variables determining the band diagram. Therefore, this thesis aims for a deeper understanding of the fundamental concepts governing wave propagation in mesoscopic structures by investigation of appropriate model systems. The phononic dispersion relation at hypersonic frequencies is directly investigated by the non-destructive technique of high-resolution spontaneous Brillouin light scattering (BLS) combined with computational methods. Due to the vector nature of the elastic wave propagation, we first studied the hypersonic band structure of hybrid superlattices. These 1D phononic crystals composed of alternating layers of hard and soft materials feature large Bragg gaps. BLS spectra are sensitive probes of the moduli, photo-elastic constants and structural parameters of the constituent components. Engineering of the band structure can be realized by introduction of defects. Here, cavity layers are employed to launch additional modes that modify the dispersion of the undisturbed superlattice, with extraordinary implications to the band gap region. Density of states calculations in conjunction with the associated deformation allow for unambiguous identication of surface and cavity modes, as well as their interaction with adjacent defects. Next, the role of local resonances in phononic systems is explored in 3D structures based on colloidal particles. In turbid media BLS records the particle vibration spectrum comprising resonant modes due to the spatial confinement of elastic energy. Here, the frequency and lineshapes of the particle eigenmodes are discussed as function of increased interaction and departure from spherical symmetry. The latter is realized by uniaxial stretching of polystyrene spheres, that can be aligned in an alternating electric field. The resulting spheroidal crystals clearly exhibit anisotropic phononic properties. Establishing reliable predictions of acoustic wave propagation, necessary to advance, e.g., optomechanics and phononic devices is the ultimate aim of this thesis.