760 resultados para Adjustable suture


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A nearly complete skull of Parapithecus grangeri from the early Oligocene of Egypt is described. The specimen is relatively undistorted and is undoubtedly the most complete higher primate skull yet found in the African Oligocene, which also makes it the most complete Oligocene primate cranium worldwide. Belonging in superfamily Parapithecoidea, a group regarded by some as the sister group to all other Anthropoidea, this skull reveals important information about the radiation of stem anthropoideans. This cranium is about 15% larger than size estimates based on a fragmentary cranium of its contemporary and close relative Apidium phiomense. It is about the same size as that of the gray gentle lemur, Hapalemur griseus, or of platyrrhines such as the owl monkey, Aotus trivirgatus, or the titi monkey, Callicebus torquatus. Comparatively small orbits and size differences in jaws and teeth show it was both diurnal and dimorphic. This is the only specimen of the species that shows (from sockets) that there were four small upper incisors. Several mandibular specimens of the species establish that there were no permanent lower incisors and that the symphysis was fused. Like other early anthropoideans this species possessed a lower encephalization quotient and less-developed orbital frontality than later anthropoideans. There is full postorbital closure and fusion of the metopic suture, and the ectotympanic forms a rim to the auditory aperture. A probable frontal/alisphenoid contact is a potentially derived resemblance to Catarrhini. A proposed separate genus for the species P. grangeri is not sustained.

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An artificial DNA bending agent has been designed to assess helix flexibility over regions as small as a protein binding site. Bending was obtained by linking a pair of 15-base-long triple helix forming oligonucleotides (TFOs) by an adjustable polymeric linker. By design, DNA bending was introduced into the double helix within a 10-bp spacer region positioned between the two sites of 15-base triple helix formation. The existence of this bend has been confirmed by circular permutation and phase-sensitive electrophoresis, and the directionality of the bend has been determined as a compression of the minor helix groove. The magnitude of the resulting duplex bend was found to be dependent on the length of the polymeric linker in a fashion consistent with a simple geometric model. Data suggested that a 50-70 degrees bend was achieved by binding of the TFO chimera with the shortest linker span (18 rotatable bonds). Equilibrium analysis showed that, relative to a chimera which did not bend the duplex, the stability of the triple helix possessing a 50-70 degrees bend was reduced by less than 1 kcal/mol of that of the unbent complex. Based upon this similarity, it is proposed that duplex DNA may be much more flexible with respect to minor groove compression than previously assumed. It is shown that this unusual flexibility is consistent with recent quantitation of protein-induced minor groove bending.

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Introdução: A obesidade é uma afecção com alta prevalência no Brasil e no mundo. É fator de risco para comorbidades como Diabetes tipo 2 (DM2), Hipertensão Arterial Sistêmica (HAS), Dislipidemia, Apneia Obstrutiva do Sono (AOS), entre outras. Seu tratamento é complexo e a cirurgia bariátrica, executada por diferentes técnicas, tem sido uma das opções. Objetivo: Analisar os resultados publicados na literatura em relação às técnicas cirúrgicas de Banda Gástrica Ajustável (BGA), Gastrectomia Vertical (GV), Gastroplastia com derivação em Y de Roux (GDYR) e Derivação Biliopancreática (DBP) - técnica de \"Scopinaro\" e de \"Duodenal Switch\" quanto às complicações operatórias, à mortalidade, à perda do excesso de peso (PEP) e ao reganho, e a resolução das comorbidades após a operação. Método: Foram analisados 116 estudos selecionados na base de dados MEDLINE por meio da PubMed publicados na Língua Inglesa entre 2003 e 2014. Para comparar as diferentes técnicas cirúrgicas (BGA, GV, GDYR e DBP), realizou-se estudo estatístico por meio da análise de variância (ANOVA) aplicando os testes de Duncan e de Kruskal Wallis avaliando: complicações pós-operatórias (fístula, sangramento e óbito); perda e reganho do excesso de peso, e resolução das comorbidades. Resultados: A ocorrência de sangramento foi de 0,6% na média entre todos os estudos, sendo 0,44% na BGA; 1,29% na GV; 0,81% na GDYR e 2,09% na DBP. Já a ocorrência de fístulas foi de 1,3% na média entre todos os estudos, 0,68% para BGA; 1,93% para GV; 2,18% para GDYR e 5,23% para DBP. A mortalidade nos primeiros 30 dias pós-operatórios foi de 0,9% na média entre todos os estudos, 0,05% na BGA; 0,16% na GV; 0,60% na GDYR e 2,52% na DBP. A PEP após cinco anos na média entre todos os estudos foi de 63,86%, especificamente na BGA, foi de 48,35%; 52,7% na GV; 71,04% na GDYR e 77,90% na DBP. A taxa de DM2 resolvida foi de 76,9% na média entre todos os estudos, sendo 46,80% na BGA; 79,38% na GV; 79,86% na GDYR e 90,78% na DBP. A taxa de Dislipidemia resolvida após a operação foi de 74,0% na média de todo o estudo, sendo 51,28% na BGA; 58,00% na GV; 73,28% na GDYR e 90,75% na DBP. A taxa de HAS resolvida após a operação foi de 61,80% na média de todo o estudo, sendo 54,50% na BGA; 52,27% na GV; 68,11% na GDYR e 82,12% na DBP. A taxa de AOS resolvida após a operação foi de 75,0% na média de todo o estudo, sendo 56,85% na BGA; 51,43% na GV; 80,31% na GDYR e 92,50% na DBP. Conclusão: quando analisadas e comparada as quatro técnicas observa-se que nos primeiros 30 dias pós-operatório a taxa de sangramento é superior nos pacientes submetidos à DBP e taxa de fístula inferior nos pacientes da BGA. Quanto à mortalidade observou-se taxa mais pronunciada nos pacientes submetidos à DBP e menos nos submetidos à BGA. Quanto à PEP observou-se uma uniformidade entre os pacientes submetidos à GV, GDYR E DBP até o terceiro ano. Após esse período observa-se reganho de peso nos submetidos à GV até o quinto ano de seguimento. Já nos pacientes submetidos à BGA observou-se taxas de PEP menos pronunciadas em relação às demais desde o início do seguimento. Quanto à resolução das comorbidades observou-se taxas de resolução de DM2 inferiores nos pacientes submetidos à BGA, e não houve diferença entre nenhuma técnica quanto à resolução das demais comorbidades: HAS, AOS e dislipidemia

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We study the effects of finite temperature on the dynamics of non-planar vortices in the classical, two-dimensional anisotropic Heisenberg model with XY- or easy-plane symmetry. To this end, we analyze a generalized Landau-Lifshitz equation including additive white noise and Gilbert damping. Using a collective variable theory with no adjustable parameters we derive an equation of motion for the vortices with stochastic forces which are shown to represent white noise with an effective diffusion constant linearly dependent on temperature. We solve these stochastic equations of motion by means of a Green's function formalism and obtain the mean vortex trajectory and its variance. We find a non-standard time dependence for the variance of the components perpendicular to the driving force. We compare the analytical results with Langevin dynamics simulations and find a good agreement up to temperatures of the order of 25% of the Kosterlitz-Thouless transition temperature. Finally, we discuss the reasons why our approach is not appropriate for higher temperatures as well as the discreteness effects observed in the numerical simulations.

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This research studies the self-heating produced by the application of an electric current to conductive cement pastes with carbonaceous materials. The main parameters studied were: type and percentage of carbonaceous materials, effect of moisture, electrical resistance, power consumption, maximum temperature reached and its evolution and ice melting kinetics are the main parameters studied. A mathematical model is also proposed, which predicts that the degree of heating is adjustable with the applied voltage. Finally, the results have been applied to ensure that cementitious materials studied are feasible to control ice layers in transportation infrastructures.

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To solve problems in polymer fluid dynamics, one needs the equation of continuity, motion, and energy. The last two equations contain the stress tensor and the heat-flux vector for the material. There are two ways to formulate the stress tensor: (1) one can write a continuum expression for the stress tensor in terms of kinematic tensors, or (2) one can select a molecular model that represents the polymer molecule, and then develop an expression for the stress tensor from kinetic theory. The advantage of the kinetic theory approach is that one gets information about the relation between the molecular structure of the polymers and the rheological properties. In this review, we restrict the discussion primarily to the simplest stress tensor expressions or “constitutive equations” containing from two to four adjustable parameters, although we do indicate how these formulations may be extended to give more complicated expressions. We also explore how these simplest expressions are recovered as special cases of a more general framework, the Oldroyd 8-constant model. The virtue of studying the simplest models is that we can discover some general notions as to which types of empiricisms or which types of molecular models seem to be worth investigating further. We also explore equivalences between continuum and molecular approaches. We restrict the discussion to several types of simple flows, such as shearing flows and extensional flows. These are the flows that are of greatest importance in industrial operations. Furthermore, if these simple flows cannot be well described by continuum or molecular models, then it is not necessary to lavish time and energy to apply them to more complex flow problems.

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Enquadramento – A episiotomia é uma incisão feita no períneo para aumentar o canal vaginal com o objetivo de evitar outros traumas perineais durante o parto. No entanto, esta prática, por si só, já se considera um trauma perineal pelo corte em estruturas que podem desencadear problemas futuros. A Organização Mundial de Saúde (1996) recomenda a utilização limitada da episiotomia uma vez que não existem evidências credíveis de que a utilização generalizada ou de rotina desta prática tenha um efeito benéfico. Objetivos: Demonstrar evidência científica dos determinantes da prática de episiotomia seletiva em mulheres com parto normal/eutócico; identificar a prevalência de episiotomia; analisar os fatores (variáveis sociodemográficas, variáveis relativas ao recém-nascido, variáveis contextuais da gravidez e contextuais do parto) que influenciam na ocorrência de episiotomia. Métodos: O estudo empírico I seguiu a metodologia de revisão sistemática da literatura. Efetuou-se uma pesquisa na EBSCO, PubMed, SciELO, RCAAP de estudos publicados entre janeiro de 2008 e 23 de dezembro de 2014. Os estudos encontrados foram avaliados tendo em consideração os critérios de inclusão previamente estabelecidos. Dois revisores avaliaram a qualidade dos estudos a incluir utilizando a grelha para avaliação crítica de um estudo descrevendo um ensaio clínico prospetivo, aleatorizado e controlado de Carneiro (2008). Após avaliação crítica da qualidade, foram incluídos no corpus do estudo 4 artigos nos quais se obteve um score entre 87,5% e 95%. O estudo empírico II enquadra-se num estudo quantitativo, transversal, descritivo e retrospetivo, desenvolvido no serviço de Obstetrícia do Centro Hospitalar Cova da Beira, segundo um processo de amostragem não probabilística por conveniência (n = 382). A recolha de dados efetuou-se através da consulta dos processos clínicos das mulheres com idade ≥ 18 anos que tiveram um parto vaginal com feto vivo após as 37 semanas de gestação. Resultados: Evidência de que a episiotomia não deve ser realizada de forma rotineira, cujo uso deve restringir-se a situações clínicas específicas. A episiotomia seletiva, comparada com a episiotomia de rotina, está relacionada com um menor risco de trauma do períneo posterior, a uma menor necessidade de sutura e a menos complicações na cicatrização. Amostra constituída por 382 mulheres, na faixa etária dos 18-46 anos. Apenas, não se procedeu à episiotomia em 41,7% da amostra, apontando para a presença da episiotomia seletiva. Número significativo de mulheres com parto eutócico (80,5%), com sutura (95,0%), laceração de grau I (64,9%), dor perineal (89,1%) sujeitas a episiotomia (58,3%). A maioria dos recém-nascidos nasceram com peso normal (92,3%), com um valor expressivo de mulheres sujeitas a episiotomia (91,4%). Ainda se constatou a existência de casos, apesar de reduzidos, em que o recém-nascido nasceu macrossómico (5,4%), tendo-se recorrido igualmente a esta prática. Não há uma associação direta entre a realização de episiotomia e os scores do APGAR. Conclusão: Face a estes resultados e com base na evidência científica disponível que recomenda, desde há vários anos, que se faça um uso seletivo da episiotomia, sugere-se que os profissionais de saúde estejam mais despertos para esta realidade, de modo a que se possam anular as resistências e as barreiras de mudanças por parte dos mesmos face ao uso seletivo da episiotomia. Para promover essa mudança de comportamentos é importante não só mostrar as evidências científicas, bem como transpô-las para a prática, capacitando os profissionais de saúde, sobretudo os enfermeiros, na sua atuação. Palavras-chave: Parto Normal/eutócico; Episiotomia; Episiotomia seletiva; Episiotomia de rotina.

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Wormian bones (WB) are irregular small cranial ossicles found along suture lines and fontanels. In Brazil, gunshot wounds to the skull are quite common in young individuals. Nevertheless, as far as we know, this is the first report of a WB giving an erroneous aspect of gunshot entrance due to its displacement position. The present manuscript describes the case of a Brazilian young man who died due to ballistic trauma, where a gaping bony defect on the right side of the skull was thought to be the exit wound of an injury related to the destruction found on the left side, highly suggestive of firearm injury. Thus, this case study has brought to light similarities between a traumatic lesion and an orifice of a WB, with emphasis on differential diagnosis during routine anthropological examinations.

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Triassic turbidites of the Nanpanjiang basin of south China represent the most expansive and voluminous siliciclastic turbidite accumulation in south China. The Nanpanjiang basin occurs at a critical junction between the southern margin of the south China plate and the Indochina, Siamo and Sibumasu plates to the south and southwest. The Triassic Yangtze carbonate shelf and isolated carbonated platforms in the basin have been extensively studied, but silicilastic turbidites in the basin have received relatively little attention. Deciphering the facies, paleocurrent indicators and provenance of the Triassic turbidites is important for several reasons: it promises to help resolve the timing of plate collisions along suture zones bordering the basin to the south and southwest, it will enable evaluation of which suture zones and Precambrian massifs were source areas, and it will allow an evaluation of the impact of the siliciclastic flux on carbonate platform evolution within the basin. Turbidites in the basin include the Early Triassic Shipao Formation and the Middle-Late Triassic Baifeng, Xinyuan, Lanmu Bianyang and Laishike formations. Each ranges upward of 700 m and the thickest is nearly 3 km. The turbidites contain very-fine sand in the northern part of the basin whereas the central and southern parts of the basin also commonly contain fine and rarely medium sand size. Coarser sand sizes occur where paleocurrents are from the south, and in this area some turbidites exhibit complete bouma sequences with graded A divisions. Successions contain numerous alternations between mud-rich and sand-rich intervals with thickness trends corresponding to proximal/ distal fan components. Spectacularly preserved sedimentary structures enable robust evaluation of turbidite systems and paleocurrent analyses. Analysis of paleocurrent measurements indicates two major directions of sediment fill. The northern part of the basin was sourced primarily by the Jiangnan massif in the northeast, and the central and southern parts of the basin were sourced primarily from suture zones and the Yunkai massif to the south and southeast respectively. Sandstones of the Lower Triassic Shipao Fm. have volcaniclastic composition including embayed quartz and glass shards. Middle Triassic sandstones are moderately mature, matrix-rich, lithic wackes. The average QFL ratio from all point count samples is 54.1/18.1/27.8% and the QmFLt ratio is 37.8/ 18.1/ 44.1%. Lithic fragments are dominantly claystone and siltstone clasts and metasedimentary clasts such as quartz mica tectonite. Volcanic lithics are rare. Most samples fall in the recycled orogen field of QmFLt plots, indicating a relatively quartz and lithic rich composition consistent with derivation from Precambrian massifs such as the Jiangnan, and Yunkai. A few samples from the southwest part of the basin fall into the dissected arc field, indicating a somewhat more lithic and feldspar-rich composition consistent with derivation from a suture zone Analysis of detrial zircon populations from 17 samples collected across the basin indicate: (1) Several samples contain zircons with concordant ages greater than 3000 Ma, (2) there are widespread peaks across the basin at 1800 Ma and 2500, (3) a widespread 900 Ma population, (3) a widespread population of zircons at 440 Ma, and (5) a larger population of younger zircons about 250 Ma in the southwestern part which is replaced to the north and northwest by a somewhat older population around 260-290 Ma. The 900 Ma provenance fits derivation from the Jiangnan Massif, the 2500, 1800, and 440 Ma provenance fits the Yunkai massif, and the 250 Ma is consistent with convergence and arc development in suture zones bordering the basin on the south or southwest. Early siliciclastic turbidite flux, proximal to source areas impacted carbonate platform evolution by infilling the basin, reducing accommodation space, stabilizing carbonate platform margins and promoting margin progradation. Late arrival, in areas far from source areas caused margin aggradation over a starved basin, development of high relief aggradational escarpments and unstable scalloped margins.

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Mode of access: Internet.

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National Highway Traffic Safety Administration, Washington, D.C.

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Mode of access: Internet.

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Remarks presented to the United States Chamber of Commerce Banking, Monetary and Fiscal Affairs Committee on September 29, 1976.

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Objective: The purpose of this study was to grow artificial blood vessels for autologous transplantation as arterial interposition grafts in a large animal model (dog). Method and results: Tubing up to 250 mm long, either bare or wrapped in biodegradable polyglycolic acid (Dexon) or nonbiodegradable polypropylene (Prolene) mesh, was inserted in the peritoneal or pleural cavity of dogs, using minimally invasive techniques, and tethered at one end to the wall with a loose suture. After 3 weeks the tubes and their tissue capsules were harvested, and the inert tubing was discarded. The wall of living tissue was uniformly 1-1.5 mm thick throughout its length, and consisted of multiple layers of myofibroblasts and matrix overlaid with a single layer of mesothelium. The myofibroblasts stained for a-smooth muscle actin, vimentin, and desmin. The bursting strength of tissue tubes with no biodegradable mesh scaffolds was in excess of 2500 mm Hg, and the suture holding strength was 11.5 N, both similar to that in dog carotid and femoral arteries. Eleven tissue tubes were transplanted as interposition grafts into the femoral artery of the same dog in which they were grown, and were harvested after 3 to 6.5 months. Eight remained patent during this time. At harvest, their lumens were lined with endothelium-like cells, and wall cells stained for alpha-actin, smooth muscle myosin, desmin and smoothelin; there was also a thick adventitia containing vasa vasorum. Conclusion: Peritoneal and pleural cavities of large animals can function as bioreactors to grow myofibroblast tubes for use as autologous vascular grafts.

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Background: How a scar is managed postoperatively influences Its cosmetic outcome. After Suture removal, scars are susceptible to skin tension, which may be the trigger for hypertrophic scarring. Paper tape to support the scar may reduce multidirectional forces and prevent hypertrophic scarring. Methods: Seventy patients who had under gone cesarean section at the Royal Brisbane and Women's Hospital were randomized to treatment and control groups. Patients in the control group received no postoperative intervention. Patients in the treatment group applied paper tape to their scars for 12 weeks. Scars were assessed at 6 weeks, 12 weeks, and 6 months after surgery using Ultrasound to measure intradermal scar volume. Scars were also assessed using the International Clinical Recommendations. Results: Paper tape significantly decreased scar volume by a mean of 0.16 cm(3), (95 percent confidence Interval, 0.00 to 0.29 cm(3)) At 12 weeks after surgery, 41 percent of the control group developed hypertrophic scars compared with none in the treatment group (exact test, p = 0.003). In the treatment group, one patient developed a hypertrophic scar and four developed stretched scars only after the tape was removed. The odds of developing a hypertrophic scar were 13.6 times greater in the control than in the treatment group (95 percent confidence interval, 3.6 to 66.9). Of the 70 patients randomized, 39 completed the study. Four patients in the treatment group developed a localized red rash beneath the tape. These reactions were minor and transient and resolved without medical intervention. Conclusions: The development of hypertrophic and stretched scars in the treatment group only after the tape was removed suggests that tension acting on a scar is die trigger for hypertrophic scarring. Paper tape is likely to be an effective modality for the prevention of hypertrophic scarring through its ability to eliminate scar tension.