Exercise Performance and Dynamic Hyperinflation in Lymphangioleiomyomatosis

Rationale: Lymphangioleiomyomatosis (LAM) is characterized by exercise performance impairment. Although airflow limitation is common, no previous studies have evaluated the prevalence and impact of dynamic hyperinflation (DH) in LAM. Objectives: To investigate the dynamic responses during maximal exercise and the prevalence, predictors, and repercussions of DH in LAM. Methods: Forty-two patients with LAM performed symptom-limited incremental cycle exercise and pulmonary functions tests (PFTs) and were compared with 10 age-matched healthy women. Dyspnea intensity, inspiratory capacity, oxygen saturation, and cardiac, metabolic, and respiratory variables were assessed during exercise. Patients with LAM also performed a 6-minute walk test (6MWT). Measurements and Main Results: Patients with LAM had higher baseline dyspnea, poorer quality of life, obstructive pattern, air trapping, and reduced diffusing capacity of carbon monoxide in PFTs. Although they had the same level of regular physical activity, their maximal exercise performance was reduced and was associated with ventilatory limitation, greater desaturation, and dyspnea. The prevalence of DH was high in LAM (55%), even in patients with mild spirometric abnormalities, and was correlated with airflow obstruction, air trapping, and diffusing capacity of carbon monoxide. Compared with the non-DH subgroup, the patients who developed DH had a ventilatory limitation contributing to exercise cessation on cycling and higher desaturation and dyspnea intensity during the 6MWT. Conclusions: Ventilatory limitation and gas exchange impairment are important causes of exercise limitation in LAM. DH is frequent in LAM, even in patients with mild spirometric abnormalities. DH was associated with the severity of disease, higher dyspnea, and lower oxygen saturation. In the 6MWT, desaturation and dyspnea were greater in patients with DH.

Frailty criteria and cognitive performance are related: data from the fibra study in Ermelino Matarazzo, São Paulo, Brazil

Objectives: To assess the relationship between the CHS frailty criteria (Fried et al., 2001) and cognitive performance. Design: Cross sectional and population-based. Setting: Ermelino Matarazzo, a poor sub district of the city of Sao Paulo, Brazil. Participants: 384 community dwelling older adults, 65 and older. Measurements: Assessment of the CHS frailty criteria, the Brief Cognitive Screening Battery (memorization of 10 black and white pictures, verbal fluency animal category, and the Clock Drawing Test) and the Mini-Mental State Examination (MMSE). Results: Frail older adults performed significantly lower than non-frail and pre frail elderly in most cognitive variables. Grip strength and age were associated to MMSE performance, age was associated to delayed memory recall, gait speed was associated to verbal fluency and CDT performance, and education was associated to CDT performance. Conclusion: Being frail may be associated with cognitive decline, thus, gerontological assessments and interventions should consider that these forms of vulnerability may occur simultaneously.

Magnetic fabrics and their relationship with the emplacement of the Piracaia pluton, SE Brazil

Magnetic fabric and rock-magnetism studies were performed on the four units of the 578 +/- 3-Ma-old Piracaia pluton (NW of Sao Paulo State, southern Brazil). This intrusion is roughly elliptical (similar to 32 km(2)), composed of (i) coarse-grained monzodiorite (MZD-c), (ii) fine-grained monzodiorite (MZD-f), which is predominant in the pluton, (iii) monzonite heterogeneous (MZN-het), and (iv) quartz syenite (Qz-Sy). Magnetic fabrics were determined by applying both anisotropy of low-field magnetic susceptibility (AMS) and anisotropy of anhysteretic remanent magnetization (AARM). The two fabrics are coaxial. The parallelism between AMS and AARM tensors excludes the presence of a single domain (SD) effect on the AMS fabric of the units. Several rock-magnetism experiments performed in one specimen from each sampled units show that for all of them, the magnetic susceptibility and magnetic fabrics are carried by magnetite grains, which was also observed in the thin sections. Foliations and lineations in the units were successfully determined by applying magnetic methods. Most of the magnetic foliations are steeply dipping or vertical in all units and are roughly parallel to the foliation measured in the field and in the country rocks. In contrast, the magnetic lineations present mostly low plunges for the whole pluton. However, for eight sites, they are steep up to vertical. Thin-section analyses show that rocks from the Piracaia pluton were affected by the regional strain during and after emplacement since magmatic foliation evolves to solid-state fabric in the north of the pluton, indicating that magnetic fabrics in this area of the pluton are related to this strain. Otherwise, the lack of solid-state deformation at outcrop scale and in thin sections precludes deformation in the SW of the pluton. This evidence allows us to interpret the observed magnetic fabrics as primary in origin (magmatic) acquired when the rocks were solidified as a result of magma flow, in which steeply plunging magnetic lineation suggests that a feeder zone could underlie this area.

Effect of enzymatic treatment on the cross-flow microfiltration of acai pulp: Analysis of the fouling and recovery of phytochemicals

This study aimed to investigate the effects of pectinase enzyme treatment of acai pulp on cross-flow microfiltration (CFMF) performance and on phytochemical and functional characteristics of their compounds. Analyses of fouling mechanisms were carried out through resistance in series and blocking in law models. The enzymatic treatment was conducted using Ultrazym(R) AFPL (Novozymes A/S) at 500 mg kg(-1) of acai pulp for 30 min at 35 degrees C. Before microfiltrations, untreated and enzyme-treated acai pulps were previously diluted in distilled water (1:3; w/v). CFMFs were conducted using commercial alpha-alumina (alpha-Al2O3) ceramic membranes (Andritz AG, Austria) of 0.2 mu m and 0.8 mu m pore sizes, and 0.0047 m(2) of filtration area. The microfiltration unit was operated in batch mode for 120 min at 25 degrees C and the fluid-dynamic conditions were transmembrane pressure of Delta P = 100 kPa and cross-flow velocity of 3 m s(-1) in turbulent flow. The highest values of permeate flux and accumulated permeate volume were obtained using enzyme-treated pulp and 0.2 mu m pore size membranes with steady flux values exceeding 100 L h(-1) m(-2). For the 0.8 mu m pore size membrane, the estimated total resistance after the microfiltration of enzyme-treated acai pulp was 21% lower than the untreated pulp, and for the 0.2 mu m pore size membrane, it was 18%. Cake filtration was the dominant mechanism in the early stages of most of the CFMF processes. After approximately 20 min, however, intermediate pore blocking and complete pore blocking contributed to the overall fouling mechanisms. The reduction of the antioxidant capacity of the permeates obtained after microfiltration of the enzyme-treated pulp was higher (p < 0.01) than that obtained using untreated pulp. For total polyphenols, on the contrary, the permeates obtained after microfiltration of the enzyme-treated pulp showed a lower mean reduction (p < 0.01) than those from the untreated pulp. The results show that the enzymatic treatment had a positive effect on the CFMF process of acai pulp. (C) 2012 Elsevier Ltd. All rights reserved.

Quantitative coronary arterial stenosis assessment by multidetector CT and invasive coronary angiography for identifying patients with myocardial perfusion abnormalities

Semi-quantitative stenosis assessment by coronary CT angiography only modestly predicts stress-induced myocardial perfusion abnormalities. The performance of quantitative CT angiography (QCTA) for identifying patients with myocardial perfusion defects remains unclear. CorE-64 is a multicenter, international study to assess the accuracy of 64-slice QCTA for detecting a parts per thousand yen50% coronary arterial stenoses by quantitative coronary angiography (QCA). Patients referred for cardiac catheterization with suspected or known coronary artery disease were enrolled. Area under the receiver-operating-characteristic curve (AUC) was used to evaluate the diagnostic accuracy of the most severe coronary artery stenosis in a subset of 63 patients assessed by QCTA and QCA for detecting myocardial perfusion abnormalities on exercise or pharmacologic stress SPECT. Diagnostic accuracy of QCTA for identifying patients with myocardial perfusion abnormalities by SPECT revealed an AUC of 0.71, compared to 0.72 by QCA (P = .75). AUC did not improve after excluding studies with fixed myocardial perfusion abnormalities and total coronary arterial occlusions. Optimal stenosis threshold for QCTA was 43% yielding a sensitivity of 0.81 and specificity of 0.50, respectively, compared to 0.75 and 0.69 by QCA at a threshold of 59%. Sensitivity and specificity of QCTA to identify patients with both obstructive lesions and myocardial perfusion defects were 0.94 and 0.77, respectively. Coronary artery stenosis assessment by QCTA or QCA only modestly predicts the presence and the absence of myocardial perfusion abnormalities by SPECT. Confounding variables affecting the relationship between coronary anatomy and myocardial perfusion likely account for some of the observed discrepancies between coronary angiography and SPECT results.

Flow Boiling Characteristics for R1234ze(E) in 1.0 and 2.2 mm Circular Channels

Experimental flow boiling heat transfer results are presented for horizontal 1.0 and 2.2 mm I. D. (internal diameter) stainless steel tubes for tests with R1234ze(E), a new refrigerant developed as a substitute for R134a with a much lower global warming potential (GWP). The experiments were performed for these two tube diameters in order to investigate a possible transition between macro and microscale flow boiling behavior. The experimental campaign includes mass velocities ranging from 50 to 1500 kg/m(2) s, heat fluxes from 10 to 300 kW/m(2), exit saturation temperatures of 25, 31 and 35 degrees C, vapor qualities from 0.05 to 0.99 and heated lengths of 180 mm and 361 mm. Flow pattern characterization was performed using high speed videos. Heat transfer coefficient, critical heat flux and flow pattern data were obtained. R1234ze(E) demonstrated similar thermal performance to R134a data when running at similar conditions. [DOI: 10.1115/1.4004933]

Relationship of aerobic and neuromuscular indexes with specific actions in judo

Objective. - The aim of this study was to verify the relationship of aerobic and neuromuscular indexes with specific situations in judo. Method. - Eighteen male judokas took part in the study. The following assessments were performed: vertical jump (CMJ) on a force platform; Special Judo Fitness Test (SJFT) to obtain the number of throws and percentage of the maximal heart rate (%HRmax) one minute after the test; match simulation to obtain the peak blood lactate (LACmax) and the percentage of the blood lactate removal (BLR); incremental test to obtain the velocity at the anaerobic threshold (vAT) and peak velocity (PV) reached in the test. Results. - A significant correlation was observed between the number of throws in the SJFT, the vAT (r = 0.60; P < 0.01), PV (r = 0.70; P < 0.01) and CMJ (r = 0.74; P < 0.01). A significant inverse correlation was found between the LACmax and vAT (r = -0.59; P = 0.01). Conclusions. - It can be concluded that the performance in the SJFT was determined by the aerobic capacity and power and the muscle power. Athletes with greater aerobic ability (vAT) presented lower blood lactate accumulation after the match. (c) 2011 Elsevier Masson SAS. All rights reserved.

A continuously differentiable upwinding scheme for the simulation of fluid flow problems

This paper deals with the numerical solution of complex fluid dynamics problems using a new bounded high resolution upwind scheme (called SDPUS-C1 henceforth), for convection term discretization. The scheme is based on TVD and CBC stability criteria and is implemented in the context of the finite volume/difference methodologies, either into the CLAWPACK software package for compressible flows or in the Freeflow simulation system for incompressible viscous flows. The performance of the proposed upwind non-oscillatory scheme is demonstrated by solving two-dimensional compressible flow problems, such as shock wave propagation and two-dimensional/axisymmetric incompressible moving free surface flows. The numerical results demonstrate that this new cell-interface reconstruction technique works very well in several practical applications. (C) 2012 Elsevier Inc. All rights reserved.

A modified Primal-Dual Logarithmic-Barrier Method for solving the Optimal Power Flow problem with discrete and continuous control variables

The aim of solving the Optimal Power Flow problem is to determine the optimal state of an electric power transmission system, that is, the voltage magnitude and phase angles and the tap ratios of the transformers that optimize the performance of a given system, while satisfying its physical and operating constraints. The Optimal Power Flow problem is modeled as a large-scale mixed-discrete nonlinear programming problem. This paper proposes a method for handling the discrete variables of the Optimal Power Flow problem. A penalty function is presented. Due to the inclusion of the penalty function into the objective function, a sequence of nonlinear programming problems with only continuous variables is obtained and the solutions of these problems converge to a solution of the mixed problem. The obtained nonlinear programming problems are solved by a Primal-Dual Logarithmic-Barrier Method. Numerical tests using the IEEE 14, 30, 118 and 300-Bus test systems indicate that the method is efficient. (C) 2012 Elsevier B.V. All rights reserved.

Analysis of a new cross flow heat exchanger flow arrangement - Extension to several rows

The present paper presents a theoretical analysis of a cross flow heat exchanger with a new flow arrangement comprehending several tube rows. The thermal performance of the proposed flow arrangement is compared with the thermal performance of a typical counter cross flow arrangement that is used in chemical, refrigeration, automotive and air conditioning industries. The thermal performance comparison has been performed in terms of the following parameters: heat exchanger effectiveness and efficiency, dimensionless entropy generation, entransy dissipation number, and dimensionless local temperature differences. It is also shown that the uniformity of the temperature difference field leads to a higher thermal performance of the heat exchanger. In the present case this is accomplished thorough a different organization of the in-tube fluid circuits in the heat exchanger. The relation between the recently introduced "entransy dissipation number" and the conventional thermal effectiveness has been obtained in terms of the "number of transfer units". A case study has been solved to quantitatively to obtain the temperature difference distribution over two rows units involving the proposed arrangement and the counter cross flow one. It has been shown that the proposed arrangement presents better thermal performance regardless the comparison parameter. (C) 2012 Elsevier Masson SAS. All rights reserved.

Knowledge management and strategic orientation: leveraging innovativeness and performance

Purpose - The aim of this study is to investigate whether knowledge management (KM) contributes to the development of strategic orientation and to enhance innovativeness, and whether these three factors contribute to improve business performance. Design/methodology/approach - A sample of 241 Brazilian companies was surveyed, using Web-based questionnaires with 54 questions, using ten-point scales to measure the degree of agreement on each item of each construct. Structural equation modeling techniques were applied for model assessment and analysis of the relationships among constructs. Exploratory factor analysis, confirmatory factor analysis, and path analysis using the technique of structural equation modeling were applied to the data. Findings - Effective KM contributes positively to strategic orientation. Although there is no significant direct effect of KM on innovativeness, the relationship is significant when mediated by strategic orientation. Similarly effective KM has no direct effect on business performance, but this relationship becomes statistically significant when mediated by strategic orientation and innovativeness. Research limitations/implications - The findings indicate that KM permeates all relationships among the constructs, corroborating the argument that knowledge is an essential organizational resource that leverages all value-creating activities. The results indicate that both KM and innovativeness produce significant impacts on performance when they are aligned with a strategic orientation that enables the organization to anticipate and respond to changing market conditions. Originality/value - There is a substantial body of research on several types of relationships involving KM, strategic orientation, innovativeness and performance. This study offers an original contribution by analyzing all of those constructs simultaneously using established scales so that comparative studies are possible.

A new evolutionary clustering search for a no-wait flow shop problem with set-up times

This paper addresses the m-machine no-wait flow shop problem where the set-up time of a job is separated from its processing time. The performance measure considered is the total flowtime. A new hybrid metaheuristic Genetic Algorithm-Cluster Search is proposed to solve the scheduling problem. The performance of the proposed method is evaluated and the results are compared with the best method reported in the literature. Experimental tests show superiority of the new method for the test problems set, regarding the solution quality. (c) 2012 Elsevier Ltd. All rights reserved.

Enhancing spiral-wound ultrafiltration performance for direct drinking water treatment through operational procedures improvement: A feasible option for the Sao Paulo Metropolitan Region

This work aimed to evaluate the influence of specific operational conditions on the performance of a spiral-wound ultrafiltration pilot plant for direct drinking water treatment, installed at the Guarapiranga's reservoir, in the Sao Paulo Metropolitan Region. Results from operational tests showed that the volume of permeate produced in the combination of periodic relaxation with flushing and chlorine dosage procedures was 49% higher than the volume obtained when these procedures were not used. Two years of continuous operation demonstrated that the ultrafiltration pilot plant performed better during fall and winter seasons, higher permeate flow production and reduced chemical cleanings frequency. Observed behavior seems to be associated with the algae bloom events in the reservoir, which are more frequent during spring and summer seasons, confirmed by chlorophyll-a analysis results. Concentrate clarification using ferric chloride was quite effective in removing NOM and turbidity, allowing its recirculation to the ultrafiltration feed tank. This procedure made it possible to reach almost 99% water recovery considering a single 54-hour recirculation cycle. Water quality monitoring demonstrated that the ultrafiltration pilot plant was quite efficient, and that potential pathogenic organisms, Escherichia coil and total coliforms, turbidity and apparent color removals were 100%, 95.1%, and 91.5%, respectively. (C) 2012 Elsevier B.V. All rights reserved.

Mini-Mental State Examination performance in frail, pre-frail, and non-frail community dwelling older adults in Ermelino Matarazzo, Sao Paulo, Brazil

Background: Frailty in older adults is a multifactorial syndrome defined by low metabolic reserve, less resistance to stressors, and difficulty in maintaining organic homeostasis due to cumulative decline of multiple physiological systems. The relationship between frailty and cognition remains unclear and studies about Mini-Mental State Examination (MMSE) performance and frailty are scarce. The objective was to examine the association between frailty and cognitive functioning as assessed by the MMSE and its subdomains. Methods: A cross-sectional population-based study (FIBRA) was carried out in Ermelino Matarazzo, a poor subdistrict of the city of Sao Paulo, Brazil. Participants were 384 community dwelling older adults, 65 years and older who completed the MMSE and a protocol to assess frailty criteria as described in the Cardiovascular Health Study (CHS). Results: Frail older adults had significantly worse performance on the MMSE (p < 0.001 for total score). Linear regression analyses showed that the MMSE total score was influenced by age (p < 0.001), education (p < 0.001), family income (p < 0.001), and frailty status (p < 0.036). Being frail was associated more significantly with worse scores in Time Orientation (p < 0.004) and Immediate Memory (p < 0.001). Conclusions: Our data suggest that being frail is associated with worse cognitive performance, as assessed by the MMSE. It is recommended that the assessment of frail older adults should include the investigation of their cognitive status.

Performance of fixed-pressure valve with antisiphon device SPHERA (R) in hydrocephalus treatment and overdrainage prevention

Patients with hydrocephalus and risk factors for overdrainage may be submitted to ventricular shunt (VS) implant with antisiphon device. The objective of this study was to prospectively evaluate for two years the clinical and tomographic results of the implant of fixed-pressure valves with antisiphon device SPHERA (R) in 35 adult patients, with hydrocephalus and risk factors for overdrainage. Of these, 3 had congenital hydrocephalus in adult patients with very dilated ventricles (Evans index >50%), 3 had symptomatic overdrainage after previous VS implant (subdural hematoma, hygroma or slit ventricle syndrome), 1 had previous chronic subdural hematoma, 15 had normal pressure hydrocephalus with final lumbar pressure <5 cm H2O after tap test (40 mL), 6 had pseudotumor cerebri, and 7 had hydrocephalus due to other causes. Clinical improvement was observed and sustained in 94.3% of the patients during the two-year period with no computed tomography (CT) evidence of hypo or overdrainage, and no immediate early or late significant complications.