Surgical interventions for treating pectus excavatum

Background: Pectus excavatum is characterized by a depression of the anterior chest wall (sternum and lower costal cartilages) and is the most frequently occurring chest wall deformity. The prevalence ranges from 6.28 to 12 cases per 1000 around the world. Generally pectus excavatum is present at birth or is identified after a few weeks or months; however, sometimes it becomes evident only at puberty. The consequence of the condition on a individual's life is variable, some live a normal life and others have physical and psychological symptoms such as: precordial pain after exercises; impairments of pulmonary and cardiac function; shyness and social isolation. For many years, sub-perichondrial resection of the costal cartilages, with or without transverse cuneiform osteotomy of the sternum and placement of a substernal support, called conventional surgery, was the most accepted option for surgical repair of these patients. From 1997 a new surgical repair called, minimally invasive surgery, became available. This less invasive surgical option consists of the retrosternal placement of a curved metal bar, without resections of the costal cartilages or sternum osteotomy, and is performed by videothoracoscopy. However, many aspects that relate to the benefits and harms of both techniques have not been defined. Objectives: To evaluate the effectiveness and safety of the conventional surgery compared with minimally invasive surgery for treating people with pectus excavatum. Search methods: With the aim of increasing the sensitivity of the search strategy we used only terms related to the individual's condition (pectus excavatum); terms related to the interventions, outcomes and types of studies were not included. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, LILACS, and ICTPR. Additionally we searched yet reference lists of articles and conference proceedings. All searches were done without language restriction. Date of the most recent searches: 14 January 2014. Selection criteria: We considered randomized or quasi-randomized controlled trials that compared traditional surgery with minimally invasive surgery for treating pectus excavatum. Data collection and analysis: Two review authors independently assessed the eligibility of the trials identified and agreed trial eligibility after a consensus meeting. The authors also assessed the risk of bias of the eligible trials. Main results: Initially we located 4111 trials from the electronic searches and two further trials from other resources. All trials were added into reference management software and the duplicates were excluded, leaving 2517 studies. The titles and abstracts of these 2517 studies were independently analyzed by two authors and finally eight trials were selected for full text analysis, after which they were all excluded, as they did not fulfil the inclusion criteria. Authors' conclusions: There is no evidence from randomized controlled trials to conclude what is the best surgical option to treat people with pectus excavatum.

Movimento da luta antimanicomial: trajetória, avanços e desafios

This article aims to address the trajectory of anti-asylum fight movement, presenting some of their actions developed to change social imagery about madness. Its initiatives aim to bring awareness of the population to the disrespectful situations undergone by patients with mental disorders, whether in society or in mental health care. It should be noted, however, the fact that this movement has not yet been institunalized. Thus, among among its hardest challenges are the need of mental health professionals to rediscover their history and respect its trajectory as well as users recognizing the importance of partnership and the need for the presence of mental health professionals as mediators of the ongoing process. Thus, the text analysis the fact that users, family and workers should be protagonists of a new form of care in mental health.

Cuidados paliativos para pacientes em estado terminal em Unidades de Terapia Intensiva: revisão sistemática e metanálise

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Comunicação e linguagem: diálogos, trânsitos e interditos

Este trabalho indica alguns referenciais teóricos que podem colaborar na discussão acerca dos vínculos entre comunicação e linguagem. Para tanto, remete a autores que fixaram categorias, sobretudo no âmbito verbal – das quais são exemplos multicentralidade, diálogo, interação, jogo, contrato, ação –, com potencial para permitir análises mais proficientes dos textos comunicacionais mediados tecnologicamente.

A systematic review of the survival and complication rates of resin-bonded bridges after an observation period of at least 5 years

OBJECTIVES: The objectives of this systematic review were to assess the 5-year survival of resin-bonded bridges (RBBs) and to describe the incidence of technical and biological complications. METHODS: An electronic Medline search complemented by manual searching was conducted to identify prospective and retrospective cohort studies on RBBs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data extraction were performed independently by two reviewers. Failure and complication rates were analyzed using random-effects Poissons regression models to obtain summary estimates of 5-year proportions. RESULTS: The search provided 6110 titles and 214 abstracts. Full-text analysis was performed for 93 articles, resulting in 17 studies that met the inclusion criteria. Meta-analysis of these studies indicated an estimated survival of RBBs of 87.7% (95% confidence interval (CI): 81.6-91.9%) after 5 years. The most frequent complication was debonding (loss of retention), which occurred in 19.2% (95% CI: 13.8-26.3%) of RBBs over an observation period of 5 years. The annual debonding rate for RBBs placed on posterior teeth (5.03%) tended to be higher than that for anterior-placed RBBs (3.05%). This difference, however, did not reach statistical significance (P=0.157). Biological complications, like caries on abutments and RBBs lost due to periodontitis, occurred in 1.5% of abutments and 2.1% of RBBs, respectively. CONCLUSION: Despite the high survival rate of RBBs, technical complications like debonding are frequent. This in turn means that a substantial amount of extra chair time may be needed following the incorporation of RBBs. There is thus an urgent need for studies with a follow-up time of 10 years or more, to evaluate the long-term outcomes.

A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. Part II: transalveolar technique

OBJECTIVES: The objectives of this systematic review were to assess the survival rate of implants placed in sites with transalveolar sinus floor elevation. MATERIAL AND METHODS: An electronic search was conducted to identify prospective and retrospective cohort studies on transalveolar sinus floor elevation, with a mean follow-up time of at least 1 year after functional loading. Failure and complication rates were analyzed using random-effects Poisson regression models to obtain summary estimates/ year proportions. RESULTS: The search provided 849 titles. Full-text analysis was performed for 176 articles, resulting in 19 studies that met the inclusion criteria. Meta-analysis of these studies indicated an estimated annual failure rate of 2.48% (95% confidence interval (95% CI): 1.37-4.49%) translating to an estimated survival rate of 92.8% (95% CI): 87.4-96.0%) for implants placed in transalveolarly augmented sinuses, after 3 years in function. Furthermore, subject-based analysis revealed an estimated annual failure of 3.71% (95% CI: 1.21-11.38%), translating to 10.5% (95% CI: 3.6-28.9%) of the subjects experiencing implant loss over 3 years. CONCLUSION: Survival rates of implants placed in transalveolar sinus floor augmentation sites are comparable to those in non-augmented sites. This technique is predictable with a low incidence of complications during and post-operatively.

A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation

OBJECTIVES: The objectives of this systematic review were to assess the survival rate of grafts and implants placed with sinus floor elevation. MATERIAL AND METHODS: An electronic search was conducted to identify studies on sinus floor elevation, with a mean follow-up time of at least 1 year after functional loading. RESULTS: The search provided 839 titles. Full-text analysis was performed for 175 articles resulting in 48 studies that met the inclusion criteria, reporting on 12,020 implants. Meta-analysis indicated an estimated annual failure rate of 3.48% [95% confidence interval (CI): 2.48%-4.88%] translating into a 3-year implant survival of 90.1% (95% CI: 86.4%-92.8%). However, when failure rates was analyzed on the subject level, the estimated annual failure was 6.04% (95% CI: 3.87%-9.43%) translating into 16.6% (95% CI: 10.9%-24.6%) of the subjects experiencing implant loss over 3 years. CONCLUSION: The insertion of dental implants in combination with maxillary sinus floor elevation is a predictable treatment method showing high implant survival rates and low incidences of surgical complications. The best results (98.3% implant survival after 3 years) were obtained using rough surface implants with membrane coverage of the lateral window.

Survival and failure rates of orthodontic temporary anchorage devices: a systematic review

AIM: The purpose of this study was to systematically review the literature on the survival rates of palatal implants, Onplants((R)), miniplates and mini screws. MATERIAL AND METHODS: An electronic MEDLINE search supplemented by manual searching was conducted to identify randomized clinical trials, prospective and retrospective cohort studies on palatal implants, Onplants((R)), miniplates and miniscrews with a mean follow-up time of at least 12 weeks and of at least 10 units per modality having been examined clinically at a follow-up visit. Assessment of studies and data abstraction was performed independently by two reviewers. Reported failures of used devices were analyzed using random-effects Poisson regression models to obtain summary estimates and 95% confidence intervals (CI) of failure and survival proportions. RESULTS: The search up to January 2009 provided 390 titles and 71 abstracts with full-text analysis of 34 articles, yielding 27 studies that met the inclusion criteria. In meta-analysis, the failure rate for Onplants((R)) was 17.2% (95% CI: 5.9-35.8%), 10.5% for palatal implants (95% CI: 6.1-18.1%), 16.4% for miniscrews (95% CI: 13.4-20.1%) and 7.3% for miniplates (95% CI: 5.4-9.9%). Miniplates and palatal implants, representing torque-resisting temporary anchorage devices (TADs), when grouped together, showed a 1.92-fold (95% CI: 1.06-2.78) lower clinical failure rate than miniscrews. CONCLUSION: Based on the available evidence in the literature, palatal implants and miniplates showed comparable survival rates of >or=90% over a period of at least 12 weeks, and yielded superior survival than miniscrews. Palatal implants and miniplates for temporary anchorage provide reliable absolute orthodontic anchorage. If the intended orthodontic treatment would require multiple miniscrew placement to provide adequate anchorage, the reliability of such systems is questionable. For patients who are undergoing extensive orthodontic treatment, force vectors may need to be varied or the roots of the teeth to be moved may need to slide past the anchors. In this context, palatal implants or miniplates should be the TADs of choice.

Mechanical and technical risks in implant therapy

PURPOSE: To systematically appraise the impact of mechanical/technical risk factors on implant-supported reconstructions. MATERIAL AND METHODS: A MEDLINE (PubMed) database search from 1966 to April 2008 was conducted. The search strategy was a combination of MeSH terms and the key words: design, dental implant(s), risk, prosthodontics, fixed prosthodontics, fixed partial denture(s), fixed dental prosthesis (FDP), fixed reconstruction(s), oral rehabilitation, bridge(s), removable partial denture(s), overdenture(s). Randomized controlled trials, controlled trials, and prospective and retrospective cohort studies with a mean follow-up of at least 4 years were included. The material evaluated in each study had to include cases with/without exposure to the risk factor. RESULTS: From 3,568 articles, 111 were selected for full text analysis. Of the 111 articles, 33 were included for data extraction after grouping the outcomes into 10 risk factors: type of retentive elements supporting overdentures, presence of cantilever extension(s), cemented versus screw-retained FDPs, angled/angulated abutments, bruxism, crown/implant ratio, length of the suprastructure, prosthetic materials, number of implants supporting an FDP, and history of mechanical/technical complications. CONCLUSIONS: The absence of a metal framework in overdentures, the presence of cantilever extension(s) > 15 mm and of bruxism, the length of the reconstruction, and a history of repeated complications were associated with increased mechanical/technical complications. The type of retention, the presence of angled abutments, the crown-implant ratio, and the number of implants supporting an FDP were not associated with increased mechanical/technical complications. None of the mechanical/technical risk factors had an impact on implant survival and success rates.

Job Intelligence-Services für Hochschulen

Internetbasierte Jobportale liefern in Form von Stellenanzeigen eine interessante Datengrundlage, um Qualifikationsanforderungen von nachfragenden Unternehmen an potenzielle Hochschulabsolventen transparent zu machen. Hochschulen können durch Analyse dieser Qualifikationsanforderungen das eigene Aus- und Weiterbildungsangebot arbeitsmarktorientiert weiterentwickeln und sich somit in der Hochschullandschaft profilieren. Hierfür ist es indes erforderlich, die Stellenanzeigen aus Jobportalen zu extrahieren und mithilfe adäquater analytischer Informationssysteme weiter zu verarbeiten. In diesem Beitrag zum CampusSource White Paper Award wird ein Konzept für Job Intelligence-Services vorgestellt, die die systematische Analyse von Qualifikationsanforderungen auf Grundlage von Stellenanzeigen aus Jobportalen gestatten.

Handbook of Intermediality

This handbook offers students and researchers compact orientation in their study of intermedial phenomena in Anglophone literary texts and cultures by introducing them to current academic debates, theoretical concepts and methodologies. By combining theory with text analysis and contextual anchoring, it introduces students and scholars alike to a vast field of research which encompasses concepts such as intermediality, multi- and plurimediality, intermedial reference, transmediality, ekphrasis, as well as related concepts such as visual culture, remediation, adaptation, and multimodality, which are all discussed in connection with literary examples. Hence each of the 30 contributions spans both a theoretical approach and concrete analysis of literary texts from different centuries and different Anglophone cultures.

El mundo lúdico en la literatura de Rabelais: la obra Gargantua y el repertorio de juegos del capítulo XXII de la edición 1542

En el presente estudio de tesis doctoral analizamos un texto literario francés del siglo XVI en el que aparecen 217 juegos. Como valor añadido se trata de parte de un texto reconocido mundialmente por la Literatura Universal como es el Gargantua de François Rabelais. A tenor de la conocida y famosa definición de Gimnasia establecida por Francisco de Amorós y Ondeano allá por 1830 en su Manuel d'éducation physique, gymnastique et morale, uno de los objetos de estudio en nuestra ciencia es la relación de nuestros movimientos con nuestras costumbres. Para ello indudablemente debemos recurrir a todo tipo de fuentes, escritas, orales o de otro tipo, para analizarlas. “La gimnasia es la ciencia razonada de nuestros movimientos, de sus relaciones con nuestros sentidos, nuestra inteligencia, nuestros sentimientos, nuestras costumbres y el desarrollo de todas nuestras facultades...” Costumbres, tradición e historia, en definitiva, que se contrasta con los medios utilizados en su análisis, herramientas TIC como son librerías digitales, buscadores de textos y palabras. A través del análisis de textos de diversa índole hemos ido obteniendo datos sobre los juegos. Estas fuentes han sido novelas, diccionarios, enciclopedias y ensayos desde el siglo XIV hasta obras contemporáneas. Se ha realizado un análisis estadístico de estas fuentes lo que ha dado a este estudio otro valor añadido desde un punto de vista metodológico. El resultado del estudio se ha plasmado en una colección de fichas creadas a partir de un estudio comparativo de diferentes fichas de juegos de autores de relevancia. ABSTRACT Gymnastics is the reasoned science of our movements, of its relations with our senses, our intelligence, our feelings, our customs and the development of all our faculties… In accordance with the all known famous definition of Gymnastics that established Don Francisco de Amorós and Ondeano in 1830 in his Manuel d'éducation physique, gymnastique et morale, one of the objects of study in our science is the relation of our movements with our customs. For it doubtlessly we must resort to all type of sources, written, oral or of another type, to analyze them. In the present doctoral thesis study we analyzed a French literary text of the XVI th century in which they appear 217 games. As added value treats world-wide from a recognized text by Universal Literature as it is the Gargantua of François Rabelais. Customs, tradition and history, really, that are resisted with means used in its analysis, TIC tools as they are digital libraries and tools to seek texts and words. Through text analysis of diverse nature we have been collecting data on the games. These sources have been novels, dictionaries, encyclopedias and tests from century XIV to contemporary works. A statistical analysis of these sources has been made which has given to this study another value added from a methodological point of view. The result of the study has been resumed in index cards created from a comparative cards study from different relevant authors.

Diseño de una herramienta para la aplicación de técnicas de minería de textos

El objetivo del presente trabajo es el estudio, diseño e implementación de una herramienta software, con interfaz gráfica de usuario, que permita aplicar diversas técnicas de análisis de textos de forma simple. Las técnicas de análisis, que serán implementadas en la herramienta, extraerán información de textos escritos en un lenguaje humano, es decir un lenguaje no artificial, y se le presentará al usuario. La herramienta permite la obtención de tres tipos de información: categorías a las que pertenece un texto, dentro de un conjunto de categorías predeterminadas; grupos de textos que son similares entre sí; y la polaridad de opinión expresada en un texto hacia el tema u objeto del que trata, que puede ser neutra, positiva o negativa.---ABSTRACT---The aim of this work is to study, design and implement a software tool, with graphical user interface, which will enable a user to easily apply various text analysis techniques. The techniques implemented in the tool will extract information from texts written in natural language, i.e. a non artificial language, and will present it to the user. The tool will extract three different types of information about a given set of texts: their categories (from a predefined set of categories), groups of similar texts, the polarity of the attitude expressed in the texts towards their topic.

BALAÃO – O QUE OUVE AS PALAVRAS DE EL, TEM O CONHECIMENTO DE ELYON E VÊ A VISÃO DE SHADDAI: UM ESTUDO DE NÚMEROS 22-24

A presente pesquisa busca avaliar exegeticamente o texto que se encontra na Bíblia, especificamente no livro de Números capítulos 22-24 que relata sobre um personagem conhecido como Balaão. A pesquisa tem também como objeto o estudo sobre o panteão de divindades relatado no mesmo texto, assim como também o estudo dos textos descobertos em Deir Alla, na Jordânia, que apresentam um personagem designado como Balaão, possivelmente o mesmo personagem de Nm 22-24. A motivação que levou ao desenvolvimento dessa pesquisa foi o fato de se ter deparado com os conceitos dos diversos nomes divinos exibidos no texto, além da questão do profetismo fora de Israel, assim como as possibilidades hermenêuticas que se abrem para a leitura desse texto bíblico. O conceito geral sempre foi o de que Israel era a única nação onde existiam “verdadeiros” profetas e uma adoração a um único Deus, o “monoteísmo”. O que despertou interesse foi perceber, especialmente por meio da leitura dos livros bíblicos, que o profetismo não se restringiu somente a Israel. Ele antecede à formação do antigo Israel e já existia no âmbito das terras do antigo Oriente Médio, e que Israel ainda demorou muito tempo para ser monoteísta. Quem é esse Balaão, filho de Beor? Estudaremos sobre sua pessoa e sua missão. Examinaremos os textos de Deir Alla sobre Balaão e sua natureza de personagem mediador entre o divino e o humano. Esse personagem é apresentado como um grande profeta e que era famoso como intérprete de presságios divinos. Analisaremos a importante questão sobre o panteão de deuses que são apresentados na narrativa de Balaão nomeados como: El, Elyon Elohim e Shaddai, além de Yahweh. Entendemos, a princípio, que o texto possui uma conexão com a sociedade na qual foi criado e usando da metodologia exegética, faremos uma análise da narrativa em questão, buscando compreender o sentido do texto, dentro de seu cenário histórico e social. Cenário este, que nos apresentou esse profeta, não israelita, que profere bênçãos dos deuses sobre Israel e que, além disso, pronuncia maldições sobre os inimigos desse mesmo Israel. Percebemos que, parte do texto pesquisado é apresentado sob a ótica de Israel sobre as outras nações. A pesquisa defende, portanto, que o texto de Nm 22-24, além de nos apresentar um profeta fora de Israel igual aos profetas da Bíblia, defende que, o panteão de divindades também era adorado por Israel e que tais nomes são epítetos de uma mesma divindade, no caso YHWH. Defende, também, um delineamento de um projeto de domínio político e militar de Israel sobre as nações circunvizinhas.

Computer speech synthesis: its status and prospects.

Computer speech synthesis has reached a high level of performance, with increasingly sophisticated models of linguistic structure, low error rates in text analysis, and high intelligibility in synthesis from phonemic input. Mass market applications are beginning to appear. However, the results are still not good enough for the ubiquitous application that such technology will eventually have. A number of alternative directions of current research aim at the ultimate goal of fully natural synthetic speech. One especially promising trend is the systematic optimization of large synthesis systems with respect to formal criteria of evaluation. Speech recognition has progressed rapidly in the past decade through such approaches, and it seems likely that their application in synthesis will produce similar improvements.