929 resultados para upper limb, neck


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HOX genes are master regulators of organ morphogenesis and cell differentiation during embryonic development, and continue to be expressed throughout post-natal life. To test the hypothesis that HOX genes are dysregulated in head and neck squamous cell carcinoma (HNSCC) we defined their expression profile, and investigated the function, transcriptional regulation and clinical relevance of a subset of highly expressed HOXD genes. Two HOXD genes, D10 and D11, showed strikingly high levels in HNSCC cell lines, patient tumor samples and publicly available datasets. Knockdown of HOXD10 in HNSCC cells caused decreased proliferation and invasion, whereas knockdown of HOXD11 reduced only invasion. POU2F1 consensus sequences were identified in the 5' DNA of HOXD10 and D11. Knockdown of POU2F1 significantly reduced expression of HOXD10 and D11 and inhibited HNSCC proliferation. Luciferase reporter constructs of the HOXD10 and D11 promoters confirmed that POU2F1 consensus binding sites are required for optimal promoter activity. Utilizing patient tumor samples a significant association was found between immunohistochemical staining of HOXD10 and both the overall and the disease-specific survival, adding further support that HOXD10 is dysregulated in head and neck cancer. Additional studies are now warranted to fully evaluate HOXD10 as a prognostic tool in head and neck cancers.

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Objective The aim of this study was to collate and compare data on the training of Specialty Registrars in Restorative Dentistry (StRs) in the management of head and neck cancer (HANC) patients across different training units within the UK and Ireland. Methods Current trainees were invited to complete an online questionnaire by the Specialty Registrars in Restorative Dentistry Group (SRRDG). Participants were asked to rate their confidence and experience of assessing and planning treatment for HANC patients, attending theatre alone and manufacturing surgical obturators, and providing implants for appropriate cases. Respondents were also asked to appraise clinical and didactic teaching at their unit, and to rate their confidence of passing a future Intercollegiate Specialty Fellowship Examination (ISFE)-station assessing knowledge of head and neck cancer. Results Responses were obtained from 21 StRs (n=21) training within all five countries of the British Isles. Most respondents were based in England (76%), with one StR in each of Scotland, Wales, Northern Ireland and the Republic of Ireland. A third (33%) were in their 5th year of training. Almost half of the StRs indicated that they were confident of independently assessing (48%) new patients with HANC, with fewer numbers reporting confidence in treatment planning (38%). The majority (52%) of respondents indicated that they were not confident of attending theatre alone and manufacturing a surgical obturator. A third (33%) rated their experience of treating HANC patients with implants as ‘poor’ or ‘very poor’, including three StRs in their 5th year of training. Less than one third (<33%) rated didactic teaching in maxillofacial prosthodontics at their unit as ‘good’ or ‘excellent’, and only 7 StRs indicated that they were confident of passing an ISFE-station focused on HANC. Conclusion Experience and training regarding patients with head and neck cancer is inconsistent for StRs across the UK and Ireland with a number of trainees reporting a lack of clinical exposure.

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bservations of the Rossiter–McLaughlin (RM) effect provide information on star–planet alignments, which can inform planetary migration and evolution theories. Here, we go beyond the classical RM modeling and explore the impact of a convective blueshift that varies across the stellar disk and non-Gaussian stellar photospheric profiles. We simulated an aligned hot Jupiter with a four-day orbit about a Sun-like star and injected center-to-limb velocity (and profile shape) variations based on radiative 3D magnetohydrodynamic simulations of solar surface convection. The residuals between our modeling and classical RM modeling were dependent on the intrinsic profile width and v sin i; the amplitude of the residuals increased with increasing v sin i and with decreasing intrinsic profile width. For slowly rotating stars the center-to-limb convective variation dominated the residuals (with amplitudes of 10 s of cm s−1 to ~1 m s−1); however, for faster rotating stars the dominant residual signature was due a non-Gaussian intrinsic profile (with amplitudes from 0.5 to 9 m s−1). When the impact factor was 0, neglecting to account for the convective center-to-limb variation led to an uncertainty in the obliquity of ~10°–20°, even though the true v sin i was known. Additionally, neglecting to properly model an asymmetric intrinsic profile had a greater impact for more rapidly rotating stars (e.g., v sin i = 6 km s−1) and caused systematic errors on the order of ~20° in the measured obliquities. Hence, neglecting the impact of stellar surface convection may bias star–planet alignment measurements and consequently theories on planetary migration and evolution.

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The association between oral bisphosphonate use and upper gastrointestinal cancer has been controversial. Therefore, we examined the association with esophageal and gastric cancer within the Kaiser Permanente, Northern California population. A total of 1,011 cases of esophageal (squamous cell carcinoma and adenocarcinoma) and 1,923 cases of gastric adenocarcinoma (cardia, non-cardia and other) diagnosed between 1997 and 2011 from the Kaiser Permanente, Northern California cancer registry were matched to 49,886 and 93,747 controls, respectively. Oral bisphosphonate prescription fills at least one year prior to the index date were extracted. Conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (95% CI) for the associations between prospectively evaluated oral bisphosphonate use with incident esophageal and gastric cancer diagnoses with adjustment for potential confounders. After adjustment for potential confounders, no significant associations were found for esophageal squamous cell carcinoma (OR 0.88; 95% CI: 0.51, 1.52), esophageal adenocarcinoma (OR 0.68; 95% CI: 0.37, 1.24), or gastric non-cardia adenocarcinoma (OR 0.83, 95% CI: 0.59, 1.18), but we observed an adverse association with gastric cardia adenocarcinoma (OR 1.64; 95% CI: 1.07, 2.50). In conclusion, we observed no association between oral bisphosphonate use and esophageal cancer risk within a large community-based population. A significant association was detected with gastric cardia and other adenocarcinoma risk, although this needs to be replicated.

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Neste trabalho descreve-se e interpreta-se a estratigrafia e palinologia de rochas sedimentares e metassedimentos de idade devónica e carbónica aflorantes ao longo da zona de cisalhamento Porto-Tomar, a Sul na Bacia de Santa Susana e em vários locais onde afloram os Calcários de Odivelas. Existe um registo de sedimentação descontínuo possivelmente associado a esta zona de cisalhamento desde o Devónico Superior até ao Pennsylvaniano. Desde o Devónico Superior até ao Mississippiano esta sedimentação é marinha, de carácter essencialmente turbiditico com uma tendência geral para se tornar mais proximal. A maturação térmica atingida por estas rochas (Unidade de Albergaria-a-Velha) é alta e a unidade é considerada pós-madura em termos de potencial gerador de hidrocarbonetos. O metamorfismo incipiente é acompanhado por intensa deformação. A bacia do Buçaco é inteiramente terrestre e tem a sua idade restrita ao Gjeliano (Pennsylvaniano superior). O controlo da sedimentação pela actividade da zona de cisalhamento Porto-Tomar é evidente. A sua maturação térmica é relativamente baixa (dentro da catagénese) e a deformação menos intensa, contrastando com a Unidade de Albergaria-a-Velha com a qual parece ter uma relação geométrica complexa, de origem tectónica. As relações de campo e dados da maturação térmica permitem inferir um evento térmico e de deformação à escala regional entre o Serpukoviano e o Gjeliano e outro, essencialmente de deformação, entre o Gjeliano e o Carniano (Triássico Superior). A bacia de Santa Susana tem características semelhantes à do Buçaco, visto estar enquadrada também numa zona de cisalhamento importante que neste caso separa a Zona de Ossa-Morena da Zona Sul Portuguesa. A sua idade é kasimoviana, possivelmente também moscoviana (Pennsylvaniano médio). A evolução térmica da bacia e a relação estrutural com as unidades circundantes permite inferir um evento térmico e de deformação regionalmente importante entre o Viseano e o (?)Moscoviano-Kasimoviano. O estudo detalhado de vários locais onde afloram os Calcários de Odivelas permite desenhar uma paleogeografia regional durante o intervalo Emsiano terminal-Givetiano (fim do Devónico Inferior – Devónico Médio) para o sector Oeste da Zona de Ossa-Morena: Actividade vulcânica em regime marinho (e talvez subaéreo), formando edifícios vulcânicos no topo dos quais (e possivelmente também em altos fundos estruturais) se instalaram recifes, tendo a comunidade recifal, em termos de diversidade, persistido durante todo ou grande parte deste intervalo de tempo. O evento Choteč basal é observável num destes locais.

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A family of quadratic programming problems whose optimal values are upper bounds on the independence number of a graph is introduced. Among this family, the quadratic programming problem which gives the best upper bound is identified. Also the proof that the upper bound introduced by Hoffman and Lovász for regular graphs is a particular case of this family is given. In addition, some new results characterizing the class of graphs for which the independence number attains the optimal value of the above best upper bound are given. Finally a polynomial-time algorithm for approximating the size of the maximum independent set of an arbitrary graph is described and the computational experiments carried out on 36 DIMACS clique benchmark instances are reported.

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This paper presents the development and implementation of a digital simulation model of a threephase, three-leg, three-winding power transformer. The proposed model, implemented in MATLAB environment, is based on the simultaneous analysis of both magnetic and electric lumped-parameters equivalents circuits, and it is intended to study its adequacy to incorporate, at a later stage, the influences of the occurrence of windings interturn short-circuit faults. Both simulation and laboratory tests results, obtained so far, for a three-phase, 6 kVA transformer, demonstrate the adequacy of the model under normal operating conditions.

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Este trabalho foi apresentado no âmbito de Provas de Agregação na área de Arqueologia. Estas provas académicas, constituídas por 3 fases, são de carácter público. Para cada fase existe um arguente, sendo as fases, respectivamente, a discussão do currículo do candidato, a análise de um relatório de uma disciplina do ensino universitário e uma lição-síntese, seguida de discussão. Esta última prova consiste numa apresentação de uma hora de um tema à escolha e, como parte constituinte das Provas de Agregação, pode ser pensada de duas formas essencialmente opostas: uma de entre as várias lições do programa da disciplina apresentado no relatório acima mencionado, fazendo por isso a descrição de uma qualquer parte do conteúdo desse mesmo programa; ou, pelo contrário, respeitar o título da prova e fazer-se uma verdadeira lição síntese, de carácter inédito.

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DESIGN: A randomized controlled trial.OB JECTIVE: To investigate the immediate effects on pressure pain thresholds over latent trigger points (TrPs) in the masseter and temporalis muscles and active mouth opening following atlanto-occipital joint thrust manipulation or a soft tissue manual intervention targeted to the suboccipital muscles. BACKGROUND : Previous studies have described hypoalgesic effects of neck manipulative interventions over TrPs in the cervical musculature. There is a lack of studies analyzing these mechanisms over TrPs of muscles innervated by the trigeminal nerve. METHODS: One hundred twenty-two volunteers, 31 men and 91 women, between the ages of 18 and 30 years, with latent TrPs in the masseter muscle, were randomly divided into 3 groups: a manipulative group who received an atlanto-occipital joint thrust, a soft tissue group who received an inhibition technique over the suboccipital muscles, and a control group who did not receive an intervention. Pressure pain thresholds over latent TrPs in the masseter and temporalis muscles, and active mouth opening were assessed pretreatment and 2 minutes posttreatment by a blinded assessor. Mixed-model analyses of variance (ANOVA) were used to examine the effects of interventions on each outcome, with group as the between-subjects variable and time as the within-subjects variable. The primary analysis was the group-by-time interaction. RESULTS: The 2-by-3 mixed-model ANOVA revealed a significant group-by-time interaction for changes in pressure pain thresholds over masseter (P<.01) and temporalis (P =.003) muscle latent TrPs and also for active mouth opening (P<.001) in favor of the manipulative and soft tissue groups. Between-group effect sizes were small. CONCLUSIONS: The application of an atlanto-occipital thrust manipulation or soft tissue technique targeted to the suboccipital muscles led to an immediate increase in pressure pain thresholds over latent TrPs in the masseter and temporalis muscles and an increase in maximum active mouth opening. Nevertheless, the effects of both interventions were small and future studies are required to elucidate the clinical relevance of these changes. LEVEL OF EVIDENCE : Therapy, level 1b. J Orthop Sports Phys Ther 2010;40(5):310-317. doi:10.2519/jospt.2010.3257. KEYWORDSDS: cervical manipulation, muscle trigger points, neck, TMJ, upper cervical.

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In embedded systems, the timing behaviour of the control mechanisms are sometimes of critical importance for the operational safety. These high criticality systems require strict compliance with the offline predicted task execution time. The execution of a task when subject to preemption may vary significantly in comparison to its non-preemptive execution. Hence, when preemptive scheduling is required to operate the workload, preemption delay estimation is of paramount importance. In this paper a preemption delay estimation method for floating non-preemptive scheduling policies is presented. This work builds on [1], extending the model and optimising it considerably. The preemption delay function is subject to a major tightness improvement, considering the WCET analysis context. Moreover more information is provided as well in the form of an extrinsic cache misses function, which enables the method to provide a solution in situations where the non-preemptive regions sizes are small. Finally experimental results from the implementation of the proposed solutions in Heptane are provided for real benchmarks which validate the significance of this work.

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Contention on the memory bus in COTS based multicore systems is becoming a major determining factor of the execution time of a task. Analyzing this extra execution time is non-trivial because (i) bus arbitration protocols in such systems are often undocumented and (ii) the times when the memory bus is requested to be used are not explicitly controlled by the operating system scheduler; they are instead a result of cache misses. We present a method for finding an upper bound on the extra execution time of a task due to contention on the memory bus in COTS based multicore systems. This method makes no assumptions on the bus arbitration protocol (other than assuming that it is work-conserving).

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RESUMO - As lesões musculoesqueléticas ligadas ao trabalho (LMELT) são frequentes em contexto hospitalar e particularmente entre os enfermeiros (Estryn-Béhar, 1991; NIOSH, 1997). Em meio ocupacional o diagnóstico destas patologias é, com frequência, realizado com recurso a questionários de sintomas. A aplicação de questionários de auto-referência de sintomas de LMELT tem permitido recolher informação sobre a prevalência europeia destas lesões, registando-se valores que oscilam entre os 17 e os 44% (Buckle, 1999) e entre nós, designadamente numa indústria de componentes automóveis, os valores apresentam dimensão semelhante ou superior (Serranheira et al., 2003). O presente estudo pretendeu identificar a sintomatologia musculoesquelética auto-referida pelos enfermeiros em meio hospitalar, procurando relações com a actividade de enfermagem. Utilizou-se um instrumento de recolha de informação construído a partir de uma adaptação do questionário nórdico musculoesquelético (QNM) (Kuorinka et al., 1987) que se aplicou a 899 enfermeiros de diferentes serviços em cinco hospitais da região do grande Porto, no ano de 2004 (responderam 507 enfermeiros). Os resultados evidenciam uma prevalência elevada de sintomas musculoesqueléticos em diferentes zonas anatómicas nos últimos 12 meses (84%), particularmente atingindo a região lombar (65%), cervical (55%), dorsal (37%), ombros (34%) e punhos/mãos (30%). Não se encontram associações significativas entre algumas actividades que os enfermeiros realizam e a presença de níveis de desconforto, incómodo ou dor com origem no sistema musculoesquelético, eventualmente devido ao elevado número de subactividades desempenhadas pelos enfermeiros. Apesar disso, existem algumas relações: (1) com a tipologia de actividades realizadas (por exemplo levantamento e transporte de cargas) nos diferentes serviços (destaca-se a Medicina e a Neonatologia), (2) com o aumento do número de horas de trabalho semanais. Desse modo, observa-se que a prevalência de sintomas de LMELT neste grupo profissional é elevada o que pode condicionar a actividade dos enfermeiros e, por consequência, o bem-estar dos utentes. Sugere-se que a actividade de enfermagem e a organização do trabalho deste grupo profissional sejam objecto de uma análise mais detalhada no sentido da identificação dos elementos determinantes da sintomatologia musculoesquelética e sua consequente prevenção.

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BACKGROUND: This study describes the prevalence, associated anomalies, and demographic characteristics of cases of multiple congenital anomalies (MCA) in 19 population-based European registries (EUROCAT) covering 959,446 births in 2004 and 2010. METHODS: EUROCAT implemented a computer algorithm for classification of congenital anomaly cases followed by manual review of potential MCA cases by geneticists. MCA cases are defined as cases with two or more major anomalies of different organ systems, excluding sequences, chromosomal and monogenic syndromes. RESULTS: The combination of an epidemiological and clinical approach for classification of cases has improved the quality and accuracy of the MCA data. Total prevalence of MCA cases was 15.8 per 10,000 births. Fetal deaths and termination of pregnancy were significantly more frequent in MCA cases compared with isolated cases (p < 0.001) and MCA cases were more frequently prenatally diagnosed (p < 0.001). Live born infants with MCA were more often born preterm (p < 0.01) and with birth weight < 2500 grams (p < 0.01). Respiratory and ear, face, and neck anomalies were the most likely to occur with other anomalies (34% and 32%) and congenital heart defects and limb anomalies were the least likely to occur with other anomalies (13%) (p < 0.01). However, due to their high prevalence, congenital heart defects were present in half of all MCA cases. Among males with MCA, the frequency of genital anomalies was significantly greater than the frequency of genital anomalies among females with MCA (p < 0.001). CONCLUSION: Although rare, MCA cases are an important public health issue, because of their severity. The EUROCAT database of MCA cases will allow future investigation on the epidemiology of these conditions and related clinical and diagnostic problems.