Qualidade dos instrumentos de autorresposta que medem a funcionalidade do membro superior em condições músculo-esqueléticas do ombro : revisão sistemática

Contextualização: Dada a prevalência de disfunções no ombro, os registos de avaliação segundo a perspetiva do utente constituem ferramentas úteis na seleção das estratégias de intervenção. A escolha do instrumento adequado deve-se basear em grande parte na força das suas propriedades psicométricas, contudo não existem estudos que analisem sistematicamente a qualidade destas medidas. Objetivo: Análise de estudos referente às propriedades psicométricas de instrumentos de autorresposta na funcionalidade do ombro. Metodologia: Revisão da literatura em inglês/português, nas bases de dados: PubMed, PEDro, Google Académico, B-On e RCAAP. Foram analisados estudos realizados até 2015. A qualidade metodológica e as propriedades psicométricas foram avaliadas e resumidas através de dois critérios padronizados, seguindo a ideologia COSMIN. Resultados: Nesta revisão foram incluídos 6 estudos. O Disabilities of the Arm Shoulder and Hand (DASH) e o Neck and Upper Limb Index (NULI-20) demonstram boas propriedades psicométricas e uma metodologia de fraca a excelente; o Shoulder Pain And Disability Index (SPADI) e o Weelchair User’s Shoulder Pain Index (WUSPI) exibem boas propriedades psicométricas e qualidade metodológica fraca; tanto no Shoulder Rating Questionnaire (SRQ-PT) como no Upper Extremity Functional Index (UEFI) não foram avaliadas propriedades psicométricas relevantes, contudo as analisadas apresentam boas propriedades psicométricas e uma metodologia fraca. Conclusão: Devido às falhas na metodologia dos estudos incluídos, não é possível inferir qual o questionário mais apropriado à prática clínica. São necessários mais estudos de validação de instrumentos de autorresposta com melhor qualidade metodológica.

Mineralogy of sediments at DSDP Leg 67 Hole

Seven sites were drilled during Leg 67 along a transect across the Middle America Trench off Guatemala: four (Sites 494, 496, 497, and 498) on continental slope, two (Sites 499 and 500) on Trench floor, and one (Site 495) on the Cocos Plate. We studied the mineralogy of sediments from Sites 494, 495, 496, 499, and 500. Our objective was to investigate the origin and source of separate minerals and mineral assemblages, giving special attention to the influence of the alteration of basalts on the sediment mineralogy, which we expected to be particularly important in layers just above oceanic basement.

Children's Postures While Playing at Computer Workstations

There has been a significant increase in the incidence of musculoskeletal disorders (MSD) and the costs associated with these are predicted to increase as the popularity of computer use increases at home, school and work. Risk factors have been identified in the adult population but little is known about the risk factors for children and youth. Research has demonstrated that they are not immune to this risk and that they are self reporting the same pain as adults. The purpose of the study was to examine children’s postures while working at computer workstations under two conditions. One was at an ergonomically adjusted children’s workstation while the second was at an average adult workstation. A Polhemus Fastrak™ system was used to record the children’s postures and joint and segment angles were quantified. Results of the study showed that children reported more discomfort and effort at the adult workstation. Segment and joint angles showed significant differences through the upper limb at the adult workstation. Of significance was the strategy of shoulder abduction and flexion that the children used in order to place their hand on the mouse. Ulnar deviation was also greater at the adult workstation as was neck extension. All of these factors have been identified in the literature as increasing the risk for injury. A comparison of the children’s posture while playing at the children’s workstation verses the adult workstation, showed that the postural angles assumed by the children at an adult workstation exceeded the Occupational Safety and Health Association (OSHA) recommendations. Further investigation is needed to increase our knowledge of MSD in children as their potential for long term damage has yet to be determined.

Rowing Biomechanics: Technique Changes with an Increase of Power Demand

The sport of rowing has become more popular in the past decade. While it is a relatively low impact sport, injuries can occur, specifically to the ribs (Karlson K. A., 1998) and more often in female athletes (Hickey, Fricker, & McDonald , 1997). It has been proposed that as the athlete rows, applying a cyclical load to the body, the mid trapezius fatigues and is unable to resist the force produced during the drive phase (Warden S. J., Gutschlag, Wajswelner, & Crossley, 2002). Once this happens, the scapulae are then pulled anterio-laterally which increases the compression force on the ribs, increasing the risk of injury. The rowing motion of 12 female varsity and club rowers was tracked as they completed a fatiguing rowing test on a rowing ergometer. Results showed that the curvature of thoracic spine changed throughout the rowing cycle but did not change with increasing power level. The transverse shoulder angle decreased (the upper back was less straight) as power level increased (R2=-0.69±19), suggesting that the scapula moved anterio-laterally. This may be that as it tired, the mid-trapezius was unable to hold the scapulae in position. The decreasing transverse shoulder angle when the power level is increased indirectly supports the fatiguing of the retractor muscles as a mechanism of injury. It would be valuable to understand the limitations of each athlete and to be able to prescribe the optimal training zone to reduce the risk of injury.

Robotic Outcome Assessment in a Non-Human Primate Model of Middle Cerebral Artery Stroke

Stroke is a prevalent disorder with immense socioeconomic impact. A variety of chronic neurological deficits result from stroke. In particular, sensorimotor deficits are a significant barrier to achieving post-stroke independence. Unfortunately, the majority of pre-clinical studies that show improved outcomes in animal stroke models have failed in clinical trials. Pre-clinical studies using non-human primate (NHP) stroke models prior to initiating human trials are a potential step to improving translation from animal studies to clinical trials. Robotic assessment tools represent a quantitative, reliable, and reproducible means to assess reaching behaviour following stroke in both humans and NHPs. We investigated the use of robotic technology to assess sensorimotor impairments in NHPs following middle cerebral artery occlusion (MCAO). Two cynomolgus macaques underwent transient MCAO for 90 minutes. Approximately 1.5 years following the procedure these NHPs and two non-stroke control monkeys were trained in a reaching task with both arms in the KINARM exoskeleton. This robot permits elbow and shoulder movements in the horizontal plane. The task required NHPs to make reaching movements from a centrally positioned start target to 1 of 8 peripheral targets uniformly distributed around the first target. We analyzed four movement parameters: reaction time, movement time (MT), initial direction error (IDE), and number of speed maxima to characterize sensorimotor deficiencies. We hypothesized reduced performance in these attributes during a neurobehavioural task with the paretic limb of NHPs following MCAO compared to controls. Reaching movements in the non-affected limbs of control and experimental NHPs showed bell-shaped velocity profiles. In contrast, the reaching movements with the affected limbs were highly variable. We found distinctive patterns in MT, IDE, and number of speed peaks between control and experimental monkeys and between limbs of NHPs with MCAO. NHPs with MCAO demonstrated more speed peaks, longer MTs, and greater IDE in their paretic limb compared to controls. These initial results qualitatively match human stroke subjects’ performance, suggesting that robotic neurobehavioural assessment in NHPs with stroke is feasible and could have translational relevance in subsequent human studies. Further studies will be necessary to replicate and expand on these preliminary findings.

Improved Accuracy in Optical Motion Capture Measurements Leads to Increased Sensitivity to Kinematic Changes

Clinical optical motion capture allows us to obtain kinematic and kinetic outcome measures that aid clinicians in diagnosing and treating different pathologies affecting healthy gait. The long term aim for gait centres is for subject-specific analyses that can predict, prevent, or reverse the effects of pathologies through gait retraining. To track the body, anatomical segment coordinate systems are commonly created by applying markers to the surface of the skin over specific, bony anatomy that is manually palpated. The location and placement of these markers is subjective and precision errors of up to 25mm have been reported [1]. Additionally, the selection of which anatomical landmarks to use in segment models can result in large angular differences; for example angular differences in the trunk can range up to 53o for the same motion depending on marker placement [2]. These errors can result in erroneous kinematic outcomes that either diminish or increase the apparent effects of a treatment or pathology compared to healthy data. Our goal was to improve the accuracy and precision of optical motion capture outcome measures. This thesis describes two separate studies. In the first study we aimed to establish an approach that would allow us to independently quantify the error among trunk models. Using this approach we determined if there was a best model to accurately track trunk motion. In the second study we designed a device to improve precision for test, re-test protocols that would also reduce the set-up time for motion capture experiments. Our method to compare a kinematically derived centre of mass velocity to one that was derived kinetically was successful in quantifying error among trunk models. Our findings indicate that models that use lateral shoulder markers as well as limit the translational degrees of freedom of the trunk through shared pelvic markers result in the least amount of error for the tasks we studied. We also successfully reduced intra- and inter-operator anatomical marker placement errors using a marker alignment device. The improved accuracy and precision resulting from the methods established in this thesis may lead to increased sensitivity to changes in kinematics, and ultimately result in more consistent treatment outcomes.

A Restorative Theory of Criminal Justice

In this project, I defend a restorative theory of criminal justice. I argue that the response to criminal wrongdoing in a just society should take the form of an attempt to heal the damage done to the community resulting from crime. I argue that the moral responsibilities of wrongdoers as wrongdoers ought to provide the framework for how a just society should respond to crime. Following the work of R.A. Duff, I argue that wrongdoers incur second-order duties of moral recognition. Wrongdoers owe it to others to recognize their wrongdoing for what it is, i.e. wrongdoing, and to shoulder certain burdens in order to express their repentant recognition to others via a meaningful apology. In short, wrongdoers owe it to their victims and others in the community to make amends. What I will deny, however, is the now familiar claim in the restorative justice literature that restoring the normative relationships in the community damaged by criminal forms of wrongdoing requires retributive punishment. In my view, how we choose to express the judgement that wrongdoers are blameworthy should flow from an all things considered judgment that is neither reducible to the judgement that the wrongdoer is culpably responsible for wronging others, nor the judgement that the wrongdoer in some basic sense “deserves to suffer” (or “deserves punishment,” etc.).

Performance and Assessment of Rehabilitated Steel Culverts

This thesis explores the effects of rehabilitation on the structural performance of corrugated steel culverts. A full-scale laboratory experiment investigated the effects of grouted slip-liners on the performance of two buried circular corrugated steel culverts. One culvert was slip-lined and grouted using low strength grout, while the other was slip-lined and grouted using high strength grout. The performances of the culverts were measured before and after rehabilitation under service loads using single wheel pair loading at 0.45m of cover. Then, the rehabilitated culverts were loaded to their ultimate limit states. Results showed that the low and high strength grouted slip-liners provided strength well beyond requirements, with the low strength specimen failing at a load 2.4 times the fully factored service load, while the high strength specimen did not reach an ultimate limit state before bearing failure of the soil stopped testing. Results also showed that the low strength specimen behaved rigidly under service loads and flexibly under higher loads, while the high strength specimen behaved rigidly under all loads. A second full-scale experiment investigated the effect of a paved invert rehabilitation procedure on the performance of a deteriorated horizontal ellipse culvert. The performance of the culvert before and after rehabilitation was examined under service loads using tandem axle loading at 0.45m of cover. The rehabilitated culvert was then loaded up to its ultimate limit state. The culvert failed due to the formation of a plastic hinge at the West shoulder, while the paved invert cracked at the invert. Results showed that the rehabilitation increased the structural performance of the culvert, increasing the system stiffness and reducing average strains and local bending at critical locations in the culvert under service loads. A sustainability rating tool specifically for the evaluation of deteriorated culvert replacement or rehabilitation projects was also developed. A module for an existing tool, called GoldSET, was created and tested using two case studies, each comparing the replacement of a culvert using a traditional open-cut method with two trenchless rehabilitation techniques. In each case, the analyses showed that the trenchless techniques were the better alternatives in terms of sustainability.

The VLT-FLAMES Tarantula Survey XXI. Stellar spin rates of O-type spectroscopic binaries

Context: The initial distribution of spin rates of massive stars is a fingerprint of their elusive formation process. It also sets a key initial condition for stellar evolution and is thus an important ingredient in stellar population synthesis. So far, most studies have focused on single stars. Most O stars are, however, found in multiple systems. 

Aims: By establishing the spin-rate distribution of a sizeable sample of O-type spectroscopic binaries and by comparing the distributions of binary subpopulations with one another and with that of presumed-single stars in the same region, we aim to constrain the initial spin distribution of O stars in binaries, and to identify signatures of the physical mechanisms that affect the evolution of the spin rates of massive stars. 

Methods: We use ground-based optical spectroscopy obtained in the framework of the VLT-FLAMES Tarantula Survey (VFTS) to establish the projected equatorial rotational velocities (ν_esini) for components of 114 spectroscopic binaries in 30 Doradus. The ν_esini values are derived from the full width at half maximum (FWHM) of a set of spectral lines, using a FWHM vs. ν_esini calibration that we derive based on previous line analysis methods applied to single O-type stars in the VFTS sample. 

Results: The overall ν_esini distribution of the primary stars resembles that of single O-type stars in the VFTS, featuring a low-velocity peak (at ν_esini<200 kms^-1) and a shoulder at intermediate velocities (200 <ν_esini<300 kms^-1). The distributions of binaries and single stars, however, differ in two ways. First, the main peak at ν_esini ~ 100kms^-1 is broader and slightly shifted towards higher spin rates in the binary distribution than that of the presumed-single stars. This shift is mostly due to short-period binaries (P_orb~<10 d). Second, the ν_esini distribution of primaries lacks a significant population of stars spinning faster than 300 kms^-1, while such a population is clearly present in the single-star sample. The ν_esini distribution of binaries with amplitudes of radial velocity variation in the range of 20 to 200 kms^-1 (mostly binaries with P_orb ~ 10-1000 d and/or with q<0.5) is similar to that of single O stars below ν_esini_~<170kms^-1. 

Conclusions: Our results are compatible with the assumption that binary components formed with the same spin distribution as single stars, and that this distribution contains few or no fast-spinning stars. The higher average spin rate of stars in short-period binaries may either be explained by spin-up through tides in such tight binary systems, or by spin-down of a fraction of the presumed-single stars and long-period binaries through magnetic braking (or by a combination of both mechanisms). Most primaries and secondaries of SB2 systems with P_orb~<10 d appear to have similar rotational velocities. This is in agreement with tidal locking in close binaries where the components have similar radii. The lack of very rapidly spinning stars among binary systems supports the idea that most stars with ν_esini_~> 300kms^-1 in the single-star sample are actually spun-up post-binary interaction products. Finally, the overall similarities (low-velocity peak and intermediate-velocity shoulder) of the spin distribution of binary and single stars argue for a massive star formation process in which the initial spin is set independently of whether stars are formed as single stars or as components of a binary system.

Budowa, asymetria i dymorfizm płciowy stawu ramiennego w populacji średniowiecznej i współczesnej

Wydział Biologii: Instytut Antropologii

Sternoclavicular Septic Arthritis Caused by Acupuncture over the Posterior Neck

Acupuncture has been used therapeutically for thousands of years and is considered a relatively safe procedure. Sternoclavicular joint (SCJ) arthritis is a rare joint infection and has never been reported as an adverse event of acupuncture. We report the case of a 50-year-old woman who presented with progressive left neck, shoulder and upper chest pain after acupuncture. A computerized tomography (CT) scan revealed septic arthritis over the left sternoclavicular joint (SCJ) and methicillin-sensitive Staphylococcus aureus bacteraemia was noted. The patient was discharged uneventfully after intravenous antibiotic treatment. SCJ septic arthritis should be considered if unilateral neck and upper chest pain occurs after acupuncture.

INJURIES RELATED TO COMPETITIVE AND NONCOMPETITIVE SPORTS IN ELDERLY MEN

Objective: To verify the sociodemographic profile and the frequency of musculoskeletal injuries in elderly people who practice competitive and noncompetitive sports activities in the city of Pelotas, RS. Methods: Descriptive study, including 29 male subjects, aged 65 years or older, who practiced sports modalities in a competitive and noncompetitive way, in the city of Pelotas, in 2015. Data collection was performed through the application of a questionnaire with questions addressing economic, sociodemographic, nutritional and behavioral issues, and injuries sustained in sports activities. Statistical analysis was performed by calculating measures of central tendency for continuous variables and proportions for categorical variables. Results: The current practice of competitive sports was described by 58.6% (n=17) of the subjects, and the most practiced sports were 7-a-side football (53.0%, n=9), tennis (23.5%, n=4) and swimming (23.5%, n=4). Noncompetitive sports were practiced by 44.8% (n=13), and tennis was the most popular sport played (92.3%, n=12). The frequency of injuries among individuals practicing competitive and noncompetitive sports was, respectively, 35.3% (n=6), and 38.5% (n=5). The most frequent injuries were epicondylitis (50.0%, n=3) and meniscus injuries (60.0%, n=3), and the most affected body regions were knee (27.3%, n=3), elbow (27.3%, n=3), and shoulder (18.2%, n=2). The injuries occurred during the sports activities, and the dominant side was the one affected in 63.6% (n=7). Conclusion: This study verified that the occurrence of injuries in elderly individuals who practice sports is relevant, even among those who practice them noncompetitively, with epicondylitis as the most frequent among them, whereas meniscus injuries are the most frequent among those who practice competitive sports.

Desenvolvimento de equipamento para estimular a propriocepção utilizando ímãs permanentes

This study developed the Magnetic Proprioceptive Stimulator – MPS at the Technological Federal University of Parana - UTFPR to stimulate, record and quantify the proprioceptive activity of the shoulder joint, using permanent magnets. A pilot study was conducted to investigate the proprioceptive stimulation generated by MPS. The results of this study show that the magnetic and mechanical forces generated by permanent magnets can change the static and dynamic stability of the shoulder joint. The angular changes of the shoulder joint during the stimulation of proprioception were photographed, videotaped and analyzed by vector editing program. The joint movements caused by the action of the magnets were recorded by an optical sensor installed in the MPS and displayed in a graphical interface for analyzing the proprioceptive dynamics. The study concluded that the Magnetic Proprioceptive Stimulator is safe, effective to stimulate proprioception and features high economic viability.

Características quantitativas da carcaça de bubalinos de três grupos genéticos terminados em confinamento e abatidos em diferentes estádios de maturidade

Objetivou-se estudar as características quantitativas da carcaça de 36 bubalinos (12 Murrah 12 Jafarabadi e 12 Mediterrâneo), com idade média de 18 meses e peso vivo inicial de 330 kg, terminados em confinamento. Os 12 animais de cada grupo genético foram divididos aleatoriamente em três subgrupos de quatro animais e submetidos aos seguintes tratamentos: Maturidade 1: 400 kg PV ao abate; Maturidade 2: 450 kg PV ao abate; Maturidade 3: 500 kg PV ao abate. Durante o experimento, uma ração única, em que 50% da MS foi composta por volumoso, foi fornecida, ad libitum, para todos os animais. Após os abates pré-fixados, determinou-se o peso corporal vazio (PCVZ) dos animais pelo somatório das partes integrantes do corpo. Não houve diferença entre grupos genéticos e maturidades, em relação à porcentagem dos cortes dianteiro, paleta, traseiro total e alcatra completa. O rendimento de traseiro especial foi maior nos animais abatidos aos 400 kg PV e menor naqueles com 500 kg PV, enquanto o dos animais com 450 kg PV não diferiu dos demais. O rendimento de ponta-de-agulha, por sua vez, foi maior nos animais com 500 kg PV e menor nos com 400 kg PV. Os valores observados nesses dois pesos de abate não diferiram do obtido nos animais com 450 kg. A produção de carne a partir das raças Murrah, Jafarabadi e Mediterrâneo criadas no Brasil não difere quanto aos rendimentos de carcaça, traseiro, dianteiro e dos principais cortes básicos de interesse comercial.

Inverse kinematics for upper limb compound movement estimation in exoskeleton-assisted rehabilitation

Robot-Assisted Rehabilitation (RAR) is relevant for treating patients affected by nervous system injuries (e.g., stroke and spinal cord injury) -- The accurate estimation of the joint angles of the patient limbs in RAR is critical to assess the patient improvement -- The economical prevalent method to estimate the patient posture in Exoskeleton-based RAR is to approximate the limb joint angles with the ones of the Exoskeleton -- This approximation is rough since their kinematic structures differ -- Motion capture systems (MOCAPs) can improve the estimations, at the expenses of a considerable overload of the therapy setup -- Alternatively, the Extended Inverse Kinematics Posture Estimation (EIKPE) computational method models the limb and Exoskeleton as differing parallel kinematic chains -- EIKPE has been tested with single DOFmovements of the wrist and elbow joints -- This paper presents the assessment of EIKPEwith elbow-shoulder compoundmovements (i.e., object prehension) -- Ground-truth for estimation assessment is obtained from an optical MOCAP (not intended for the treatment stage) -- The assessment shows EIKPE rendering a good numerical approximation of the actual posture during the compoundmovement execution, especially for the shoulder joint angles -- This work opens the horizon for clinical studies with patient groups, Exoskeleton models, and movements types --