National survey of noncommunicable diseases in Seychelles 2013‐2014 (Seychelles Heart Study IV) : main findings

The 2013 survey addressed the following objectives: Primary objectives : a) Distribution of health behaviors related to NCDs, particularly tobacco use, alcohol drinking, and physical activity ; b) Distribution of the main modifiable risk factors of NCDs, particularly blood pressure, adiposity markers, diabetes and blood lipids ; c) Rates of awareness, treatment and control of hypertension, diabetes and dyslipidemia ; d) Comparison of findings in the survey 2013 with results in previous similar NCD surveys in 1989, 1994, 2004 ; e) Dietary patterns ; f) Knowledge, attitudes and practices related to NCDs and NCD risk factors. Secondary objectives : g) Assessment of indicators of quality of health (e.g. SF‐12) ; h) Assessment of psychological stress and relation with NCD ; i) Assessment of several indicators of frailty (e.g. handgrip strength test, chair strand test, functional limitations) ; j) Assessment of knowledge and level of agreement with current policies on tobacco control ; k) Use of public and private health care services, particularly for NCDs ; l) Exposure to advice on health behaviors given by health professionals at health care level ; m) Burden of chronic diseases not related to the main NCDs (e.g. musculoskeletal, mental health, etc) ; n) Screening of selected cancers ; o) Assessment of the kidney function ; p) Frequency of heart arrhythmias (one‐lead ECG) and heart murmurs (auscultation) ; q) Assessment of bone mineral density (ultrasound of calcaneus) ; r) Exposure of the population to mass media, particularly in relation to health programs, and use by the population of new communication technologies ; s) Assessment of a number of social variables and their association with the variables measured in the survey ; t) More generally, the survey provides broad information (medical, social, environment, etc) that can be useful for tailoring NCD prevention and control programs.

Ventricularisation of the left atrium: a rare cause of left ventricular dysfunction in a patient with mitral valve prolapse

Case: A 11 yo girl with Marfan syndrome was referred to cardiac MR (CMR) to measure the size of her thoracic aorta. She had a typical phenotype with arachnodactyly, abnormally long arms, and was tall and slim (156 cm, 28 kg, body mass index 11,5 kg/m2). She complained of no symptoms. Cardiac auscultation revealed a prominent mid-systolic click and an end-systolic murmur at the apex. A recent echocardiogram showed a moderately dilated left ventricle with normal function and a mitral valve prolapse with moderate mitral valve regurgitation. CMR showed a dilatation of the aortic root (38 mm, Z-score 8.9) and a severe prolapse of the mitral valve with regurgitation. The ventricular cavity was moderately dilated (116 ml/m2) and its contraction was hyperdynamic (stroke volume (SV): 97 ml; LVEF 72%, with the LV volumes measured by modified Simpson method from the apex to the mitral annulus). In this patient however, the mitral prolapse was characterized by a severe backward movement of the valve toward the left atrium (LA) in systole and the dyskinetic movement of the atrioventricular plane caused a ventricularisation of a part of the LA in systole (Figure). This resulted in a significant reduction of LVEF: more than ¼ of the apparent SV was displaced backwards into the ventricularized LA volume, reducing the effective LVEF to 51% (effective SV 69ml). Moreover, by flow measurement, the SV across the ascending aorta was 30 ml (cardiac index 2.0 l/min/m2) allowing the calculation of a regurgitant fraction across the mitral valve of 56%, which was diagnostic for a severe mitral valve insufficiency. Conclusion: This case illustrates the phenomenon of a ventricularisation of the LA where the severe prolapse gives the illusion of a higher attachement of the mitral leaflets within the atrial wall. Besides the severe mitral regurgitation, this paradoxical backwards movement of the valve causes an intraventricular unloading during systole reducing the apparent LVEF of 72% to an effective LVEF of only 51%. In addition, forward flow fraction is only 22% after accounting for the regurgitant volume, as well. This combined involvement of the mitral valve could explain the discrepancy between a low output state and an apparently hyperdynamic LV contraction. Due to its ability to precisely measure flows and volumes, CMR is particularly suited to detect this phenomenon and to quantify its impact on the LV pump function.

Crassostrea patagonica (d'Orbigny, 1842) shell concentrations from the late Miocene Rio Negro province, NE Patagonia, Argentina

The Río Negro Formation (late Miocene-early Pliocene) mainly consists of continental deposits, but it contains a middle member of marine origin. It represents a transgressive-regressive sequence that can be seen at several outcrops along the N Patagonian coast. The taphonomical approach to the El Espigón marine deposits permits the identification of four main layers containing different kinds of skeletal accumulation, which mainly consist of oyster shells [Crassostrea patagonica (D'Orbigny, 1842)]. These concentrations display three different morphologies (pouches, pavements and bouquets) with a different taphonomic signature. These deposits were formed in shallow marine environments influenced by wave activity that produced valve concentrations of different entities. They contain several shell beds that represent event, composite, hiatal to lag skeletal concentrations. Traces of bioturbation in the sediment (Thalassinoides, Teichichnus) and bioerosion on the shells (Entobia, Gastrochaeonolites, Caulostrepsis), and encrusters (cirripeds, bryozoans), are also abundant in the outcrop and consititue common components of these Miocene materials. Layers 1 and 2 of the sequence were deposited in shoreface/foreshore environments at the beginning of a highstand systems tract, while layers 3 and 4 were deposited at the end, or at the beginning of a forced regression, in foreshore environments. A final erosional episode cut the top of the layer 4, which truncated the abundant bioturbaation developed there.

Uso de lodo de estação de tratamento de água centrifugado em matriz de concreto de cimento portland para reduzir o impacto ambiental

An alternative application of the humid sludge from the Passaúna WTP, located in Curitiba's metropolitan area, is proposed for concrete structures, partially replacing aggregates and cement. For the investigation, a reference concrete and four concrete mixtures with sludge were produced, and from these, two mixtures, containing 4% and 8% of sludge (m/m), were analyzed by different techniques: X ray fluorescence, X ray diffraction, thermo-gravimetric analysis, physicochemical analysis, compressive strength, etc. The properties were evaluated and the results indicate that the mixtures can be applied in different situations as cast structures for construction of concrete walls. Mixtures with more than 4% of sludge are restricted to applications where the workability of the concrete is not required, such as for residential pavements, sidewalks and stepping floors.

El diseño del suelo y la imagen de la ciudad: la calçada portuguesa

Desde el s. XVIII todas las ciudades se plantean uno de los cambios fundamentales en la estructura de su paisaje. El aumento de población y de actividad económica conlleva la desaparición de las calles térreas y su sustitución por las calles que segregan la acera, convertida en la estructura de soporte de los servicios, de la calzada como espacio de circulación rodada. En Lisboa se extiende la pavimentación de la calzad a según el 'systema Portuguez' con piedras irregulares de basalto sobre arena y ya en 1834, se configura el 'Pelouro das Calçadas' responsable de experimentar, primero, el sistema 'macadam' (c. 1839) y, posterior y paulatinamente, de introducir el asfalto. º La acera, es tratada con losas de calcáreo que, sobre todo, a partir del último tercio de siglo serán substituidas por el 'empedrado ordinario á portuguesa' en piedra calcárea. Una derivación será el 'empedrado dito de mosaico'. Experimentado por Eusebio Pinheiro Furtado en el Castillo de São Jorge (1842), va a extenderse por la ciudad, especialmente, desde la pavimentación del 'Mar Largo' en el Rossio (1848). Así, con ocasión de la ampliación de las aceras del largo de Camões, Augusto César dos Santos, Inspector da Admistração das Calçadas expresa la política de substitución del enlosado por el empedrado 'O sistema a empregar no empedramento destos passeios, deverá ser mozaico, não só pela beleza que apresenta, como por ser uma especialidade nesta cidade, beleza que se pode levar ao efeito escolhendose um padrão simples que pela sua importância não exceda os 500‐600$ o metro superficial' (Cesar dos Santos 1869). Finalmente, en 1895 la Câmara Municipal decretará el uso del 'empedrado á portuguesa' en toda nueva pavimentación y reconstrucción de las aceras. Los sitios representativos de la ciudad se cualifican artísticamente con este modo de hacer tan característico e identitario, no en vano lo podríamos entender como una de las primeras producciones de arte público en el sentido contemporáneo del término. Este sistema de pavimentación se extiende por Portugal y se internacionaliza en España, cuando Júlio César Augusto Cordeiro patenta en Madrid (1895) el 'mosaico portugués' que cristalizará en las aceras laterales del Paseo de San Juan en Barcelona (1896) -antes de la Exposición de París de 1900, de la praça de São Sebastião de Manaus, de las avenidas Rio Branco y Atlántica de Río de Janeiro- llegando a convivir con las farolas modernitas que Pere Falqués diseñó para el 'Cincd'oros' barcelonés. La calçada á portuguesa forma parte de la identidad de Lisboa y afecta a la imagen de marca de la ciudad. Sin embargo, a pesar de su valor identitario y artístico, la calçada está en peligro de muerte. El pavimento -forma entre ellos la 'calçada-forma' está en la base de algunas de las operaciones emblemáticas de construcción de la imagen de la ciudad (La Habana, 1928; Alicante, 1957; las Ramblas de Barcelona, 1969; la reforma de la Avenida Atlántica de Río por Burle Marx, 1970). Sin embargo, estas mismas operaciones demuestran que la 'forma-calçada' no responde a muchos de los requisitos de economía, seguridad o accesibilidad universal que exige la ciudad contemporánea. En el artículo planteamos analizar los motivos y razones que planean sobre la muerte anunciada de la calçada á portuguesa.

Una identidad en reconstrucción. La calçada a portuguesa

La calçada á portuguesa forma parte de la identidad de Lisboa y afecta a la imagen de marca de la ciudad. Sin embargo, a pesar de su valor identitario y artístico, la calçada está en peligro de muerte. El tratamiento particularizado del pavimento está en la base de algunas de las operaciones emblemáticas de construcción de la imagen de la ciudad. Desgraciadamente, en el caso de la calçada, estas mismas operaciones demuestran que no responde a muchos de los requisitos de economía, seguridad o accesibilidad universal que exige la ciudad contemporánea. En ese trabajo analizamos los motivos y razones que planean sobre la muerte anunciada de la calçada á portuguesa. Este tipo de pavimento ya ha sido ampliamente estudiado (Paes 1883; Bairrada 1985; Cabrera y Nunes 1990; Matos 2004; Sisti 2006), pero nuestra investigación sitúa a Barcelona como la primera ciudad donde se utiliza este sistema de pavimentación fuera del territorio portugués (Esparza, 2013) lo que nos permite establecer algunos paralelismos entre el sistema de pavimentación de Lisboa y Barcelona que puedan dar luz al debate existente sobre la sobrevivencia o no de este sistema de pavimentación en Lisboa.

Auscultatory and electrocardiographic characteristics of Crioulo horses

In order to determine auscultatory and electrocardiographic characteristics of Crioulo horses, one hundred animals ranging between one and twenty-six years of age (21 stallions, nine geldings, 27 pregnant mares e 43 not pregnant mares) were evaluated. The cardiac auscultation was performed during the clinical examination of the cardiovascular system, evaluating frequency, rate, normal and abnormal heart sounds (heart murmurs). The electrocardiographic examination followed the bipolar base-apex derivative system with animals at rest, by using an ECG-PC TEB equipment. The cardiac frequency, heart rate, morphology, duration, wave and complex amplitudes and interval durations were determined. The results were submitted to ANOVA and Tukey tests with an error probability of 5%. The cardiac auscultation revealed presence of functional systolic and diastolic murmur (10.00%) and systolic murmur compatible with tricuspid regurgitation besides normal heart sounds S1 (100.0%), S2 (100.0%), S3 (19.0%) and S4 (34.0%). The cardiac frequency obtained the average of 43.64 bpm, observing significative differences in relation to sexual and age factors and training level. The sinus rhythm was the most frequent (57.00%), followed by sinus tachycardia (38.00%) and sinus arrhythmia (5.00%), being observed rhythm disturbances in 16% of tracings. The P and T waves were observed more frequently in their forms P bifida positive (95.00%) and biphasic T (91.00%), being variable at tracing. There were also observed Q waves in 12.00% of the tracings. Thus, it was concluded that the auscultatory characteristics of Crioulo horses are according to the described in the literature for the species and the sexual factor, category, age factor and training level can influence some electrocardiographic parameters.

Retrospective study of pre-anesthetic electrocardiogram examination of 700 dogs conducted at the Veterinary Hospital of UFMG (2013-2014)

Abstract: Pre-operative electrocardiograms performed in 700 dogs were analyzed in order to establish correlation between sex, age, indication for surgery, body condition score, breed and weight. Initially a clinical questionnaire was filled out from each owner, including age, breed, sex, weight, clinical history and surgical indication. Dogs above 6 years of age or those showing any kind of cardiac auscultation disturbances were referred to electrocardiogram (ECG) evaluation. All ECG were performed and analyzed by the same veterinary specialist. Abnormalities at ECG were founnd in 364 of 700 (52%) evaluated dogs, and the most frequent variation was sinus arrhythmia, observed in 293 dogs (25.4%). No significant correlation was found between the electrocardiographic alterations with weight, sex and age of the animals. Therefore ECG should be conducted routinely regardless of age, sex, breed or surgical indication, highlighting its value for determining a safe anesthetic protocol that promotes minimal cardiopulmonary depression and allows rapid post-surgical recovery.

Clinical signs of pneumonia in children: association with and prediction of diagnosis by fuzzy sets theory

The present study compares the performance of stochastic and fuzzy models for the analysis of the relationship between clinical signs and diagnosis. Data obtained for 153 children concerning diagnosis (pneumonia, other non-pneumonia diseases, absence of disease) and seven clinical signs were divided into two samples, one for analysis and other for validation. The former was used to derive relations by multi-discriminant analysis (MDA) and by fuzzy max-min compositions (fuzzy), and the latter was used to assess the predictions drawn from each type of relation. MDA and fuzzy were closely similar in terms of prediction, with correct allocation of 75.7 to 78.3% of patients in the validation sample, and displaying only a single instance of disagreement: a patient with low level of toxemia was mistaken as not diseased by MDA and correctly taken as somehow ill by fuzzy. Concerning relations, each method provided different information, each revealing different aspects of the relations between clinical signs and diagnoses. Both methods agreed on pointing X-ray, dyspnea, and auscultation as better related with pneumonia, but only fuzzy was able to detect relations of heart rate, body temperature, toxemia and respiratory rate with pneumonia. Moreover, only fuzzy was able to detect a relationship between heart rate and absence of disease, which allowed the detection of six malnourished children whose diagnoses as healthy are, indeed, disputable. The conclusion is that even though fuzzy sets theory might not improve prediction, it certainly does enhance clinical knowledge since it detects relationships not visible to stochastic models.

Canadian Willite advertisement, ca. 1920.

Consists of an advertising broadsheet (circa 1920) for Canadian Willite, a permanent asphaltic pavement. This product was used on River Road in Niagara Falls, Canada. The broadsheet features a segment titled "The Road Fit for a Prince" about the Prince of Wales visit to Niagrara Falls on October 20, 1919.

Influence of additives on the charactaristics of stone matrix asphalt

The increase in traffic growth and maintenance expenditures demands the urgent need for building better, long-lasting, and more efficient roads preventing or minimizing bituminous pavement distresses. Many of the principal distresses in pavements initiate or increase in severity due to the presence of water. In Kerala highways, where traditional dense graded mixtures are used for the surface courses, major distress is due to moisture induced damages. The Stone Matrix Asphalt (SMA) mixtures provide a durable surface course. Proven field performance of test track at Delhi recommends Stone Matrix Asphalt as a right choice to sustain severe climatic and heavy traffic conditions. But the concept of SMA in India is not so popularized and its application is very limited mainly due to the lack of proper specifications. This research is an attempt to study the influence of additives on the characteristics of SMA mixtures and to propose an ideal surface course for the pavements. The additives used for this investigation are coir, sisal, banana fibres (natural fibres), waste plastics (waste material) and polypropylene (polymer). A preliminary investigation is conducted to characterize the materials used in this study. Marshall test is conducted for optimizing the SMA mixtures (Control mixture-without additives and Stabilized mixtures with additives). Indirect tensile strength tests, compression strength tests, triaxial strength tests and drain down sensitivity tests are conducted to study the engineering properties of stabilized mixtures. The comparison of the performance of all stabilized mixtures with the control mixture and among themselves are carried out. A statistical analysis (SPSS package Ver.16) is performed to establish the findings of this study

Utilidad de los signos físicos en el diagnóstico de neumonía. ¿es necesaria la placa de tórax?

Objetivos : evaluar las características operativas del examen físico en el diagnóstico de neumonía y evaluar su acuerdo inter-observador. Marco de referencia : los estudios que avaluaron al examen físico como prueba diagnóstica en neumonía son metodológicamente deficientes. Diseño : estudio ciego de corte transversal para evaluación de prueba diagnóstica. Pacientes : adultos quienes consultan al servicio de urgencias y hospitalización de la FCI por síntomas respiratorios agudos o exacerbación de los mismos. Mediciones : examen físico por dos observadores independientes, toma de radiografía de tórax y lectura por radiólogo experto. Se tomaron los datos que permitieron calcular el índice de severidad de neumonía (PSI). Resultados : de 198 pacientes, 85(42%) tenían neumonía radiográficamente. Las características operativas del examinador1 fueron: Sensibilidad:63.2%, Especificidad:54,1%, LR(+)=1,36, LR(-)=0,68; para el examinador2: Sensibilidad:34,3%, Especificidad:71,7%, LR(+)=1,17, LR(-)=0,92. La correlación entre diagnóstico clínico para derrame pleural fue k=-0,052, no significativa (p=0,445); y para neumonía k=0.25 significativa (p=0.022). Al medirse la severidad de neumonía por PSI, la sensibilidad aumento estratificada a severidad (II:Sensibilidad:40%; III:Sensibilidad: 57%; IV:Sensibilidad;75%; V:Sensibilidad:80%). Conclusiones : el examen físico no es sensible ni especifico en el diagnóstico de neumonía. Existe un índice de acuerdo débil en el examen físico de tórax para el diagnóstico de derrame pleural y neumonía Es más probable el diagnóstico clínico de neumonía al aumentar la severidad por PSI.

Analysis of experimental interlocking blocks of concrete with addition of residues of process the tires retreading production

Analysis of experimental interlocking blocks of concrete with addition of residues of process the tires retreading production. With the population growth in recent years, industry in general has adjusted itself to resulting demand. the industry of tire retreading generates residues that have been discarded without any control. this adds to environmental pollution and promotes the proliferation of vectors harmful to health, aiming to find an application for this type of residues, this study presents experimental results to interlocking concrete block pavements, with addition of residues tires, interlocking blocks were built up and we determined, through laboratory tests, the need to set the mark that provide greater return regarding analyzed characteristics, there are four types of dosage of concrete with residues tires. We accomplished tests of compression strength, water absorption and resistance to impact. Through the preliminary results, we verified that are satisfactory, confirming the possibility of applying this type of interlocking block in environments with low demand, which would bring the economy of natural sources of aggregates, beyond ecological benefits through the reuse of residues from retreading of tires.

One, two or no record of late neoproterozoic glaciation in South-East Cameroon?

Severe climate changes culminating in at least three major glacial events have been recognized in the Neoproterozoic sedimentary record from many parts of the world Supportive to the global nature of these climatic shifts a considerable amount of data have been acquired from deposits exposed in Pan-African orogenic belts in southwestern and western Africa By comparison published data from the Pan-African belts in Central Africa are scarce We report here evidence of possibly two glacial events recorded in the Mintom Formation that is located on the margin of the Pan-African orogenic Yaounde belt in South-East Cameroon In the absence of reliable radiometric data only maximum and minimum age limits of 640 and 580 Ma respectively can at present be applied to the Mintom Formation The formation consists of two lithostratigraphic ensembles each subdivided in two members (i e in ascending stratigraphic order the Kol Metou Momibole and Atog Adjap Members) The basal ensemble exhibits a typical glacial to post-glacial succession It includes diamictites comprising cobbles and boulders in a massive argillaceous siltstone matrix and laminated siltstones followed by in sharp contact a 2 m-thick massive dolostone that yielded negative delta(13)C values (<-3 parts per thousand. V-PDB) similar to those reported for Marinoan cap carbonates elsewhere However uncertainty remains regarding the glacial influence on the siliciclastic facies because the diamictite is better explained as a mass-flow deposit and diagnostic features such as dropstones have not been seen in the overlying siltstones The Mintom Formation may thus provide an example of an unusual succession of non-glacial diamictite overlain by a truly glacial melt-related cap-carbonate We also report the recent discovery of ice-striated pavements on the structural surface cut in the Mintom Formation suggesting that glaciers developed after the latter had been deposited and deformed during the Pan-African orogeny Striations which consistently exhibit two principal orientations (N60 and N110) were identified in two different localities in the west of the study area on siltstones of the Kol Member and in the east on limestones of the Atog Adjap Member respectively N60-oriented striae indicate ice flow towards the WSW Assigning an age to these features remains problematical because they were not found associated with glaciogenic deposits Two hypotheses can equally be envisaged e either the striated surfaces are correlated (1) to the Gaskiers (or Neoproterozoic post-Gaskiers) glaciation and represent the youngest Ediacaran glacial event documented in the southern Yaounde belt or (2) to the Late Ordovician Hirnantian (Saharan) glaciation thereby providing new data about Hirnantian ice flows in Central Africa (C) 2010 Elsevier Ltd All rights reserved

Efeitos da variação da carga por eixo, pressão de inflação e tipo de pneu na resposta elástica de um pavimento

O presente trabalho é uma análise experimental que procura investigar os efeitos dos fatores carga por eixo, pressão de inflação e tipo de pneu sobre o desempenho de pavimentos. Os dados e informações existentes sobre o quadro de cargas por eixo praticada pela frota de veículos pesados é razoável. A ação conjunta dos referidos fatores é ainda uma questão pouco explorada. Assim, para compensar a escassez de dados sobre pressão de inflação e tipo de construção de pneus utilizados na frota de carga, programou-se uma pesquisa de campo na rodovia estadual RS/240. As informações oriundas da pesquisa demonstram que há um acréscimo generalizado no valor da pressão dos pneus e um aumento de uso dos pneus de fabricação radial em relação aos pneus convencionais. Os dados de campo subsidiaram a programação de um experimento fatorial cruzado executado na Área de Pesquisas e Testes de Pavimentos da UFRGS/DAER. A variação dos níveis dos fatores deu-se através de um simulador linear de tráfego atuando sobre uma pista experimental com 20 m de comprimento por 3,5 m de largura. Tendo como resposta estrutural do pavimento a máxima deflexão superficial recuperável medida com uma viga Benkelmam, determinou-se como significantes os efeitos dos fatores carga por eixo e pressão de enchimento dos pneus. Os cálculos estatísticos indicam também que não há diferenças significativas entre os pneus tipo 9.00R20 e 9.00x20 e que todas interações não exercem efeitos significativos sobre a variável de resposta. Em seqüência, determinaram-se as áreas de contato do rodado duplo do simulador de tráfego com a superfície do pavimento ensaiado para as combinações dos níveis dos fatores. Pode-se, então, comparar área de contato medida com área circular calculada, considerada em muitos modelos de dimensionamento de pavimentos. Relacionou-se a variação da pressão de contato com a deflexão recuperável e procedeu-se uma comparação da mesma com a pressão de inflação nominal dos pneus. Apresenta-se um modelo de análise do desempenho do pavimento em função da carga por eixo e da pressão de inflação, nos limites do experimento. Os dados decorrentes do experimento viabilizaram a determinação dos Fatores de Equivalência de Cargas para os níveis dos fatores, considerando-se o pavimento ensaiado. Avaliou-se, via evolução das deflexões e dos Fatores de Equivalência de Cargas, a redução da vida do pavimento, obtendo-se, para a combinação de níveis mais críticos de carregamento, resultados significativos de até 88 % de redução. Propõe-se, por último, uma formulação para o Fator de Equivalência de Cargas que considere também a ação da pressão de inflação.