Fetal kidney programming by severe food restriction: effects on structure, hormonal receptor expression and urinary sodium excretion in rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Intravenous procedural sedation: an alternative in the treatment of patients with intellectual disability

Conscious sedation has become established as an important alternative to general anesthesia (GA) in dental treatment of patients with intellectual disability (ID). Aim: to investigate dental patients undergoing sedation using a mean dose of 0.6 mg/kg intravenous midazolam and the adverse events of sedation in patients with ID. Methods: This study analyzed the records of 163 dental patients with ID aged between 2 and 76 years who had undergone conscious intravenous sedation (CIV) using a mean dose of 0.61 mg/kg of midazolam at Araçatuba Dental School, São Paulo State University, Brazil. The efficacy and complications induced by CIV were evaluated in each subject. Results: CIV was effective for dental treatment in 80% of the cases. A total of 626 dental procedures were performed. The mean treatment time was 33.9 minutes. There was statistically significant difference (p<0.05) between absence and presence of adverse reactions. Adverse reactions were observed in 21.47% of the cases. Conclusions: The results of this study showed that CIV is a useful method for dental treatment of patients with ID and these patients can need higher doses of sedative to reach an adequate level of sedation.

Perceptions of Procedural and Distributive Justice in the September 11th Victim Compensation Fund

The September l1th Victim Compensation Fund (the Fund) was created in response to the terrorist attacks of September 11, 2001. Much has been written about the Fund, both pro and con, in both popular media and scholarly literature. Perhaps the most widely used term in referring to the Fund is "unprecedented." The Fund is intriguing for many reasons, particularly for its public policy implications and its impact on the claimants themselves. The federal government has never before provided compensation to victims of terrorism through a special master who had virtually unlimited discretion in determining awards. Consequently, this formal allocation of money by a representative of the federal government to its citizens has provided an opportunity to test theories of procedural and distributive justice in a novel context. This article tests these theories by analyzing the results of a study of the Fund's claimants. Part I provides general background, summarizes existing commentary on the Fund, and discusses prior research on social justice that is relevant to the 9/11 claimants' experiences with the Fund. Part II of this article describes the methodology behind the study, in which seventy-one individuals who filed claims with the Fund completed surveys about their experiences with and perceptions of the Fund. Part III discusses the survey results. We found that participants were reasonably satisfied with the procedural aspects of the Fund, such as representatives' impartiality and respectful treatment. Participants were less satisfied, however, with the distributive aspects of the Fund, such as the unequal distribution of compensation and the reduction in compensation if claimants received compensation from other sources (e.g., life insurance). Part IV of this article addresses the implications of the study results for public policy and for theories of social justice.

Programming peculiarities in two cochlear implant users with superficial siderosis of the central nervous system

To report the audiological outcomes of cochlear implantation in two patients with severe to profound sensorineural hearing loss secondary to superficial siderosis of the CNS and discuss some programming peculiarities that were found in these cases. Retrospective review. Data concerning clinical presentation, diagnosis and audiological assessment pre- and post-implantation were collected of two patients with superficial siderosis of the CNS. Both patients showed good hearing thresholds but variable speech perception outcomes. One patient did not achieve open-set speech recognition, but the other achieved 70% speech recognition in quiet. Electrical compound action potentials could not be elicited in either patient. Map parameters showed the need for increased charge. Electrode impedances showed high longitudinal variability. The implants were fairly beneficial in restoring hearing and improving communication abilities although many reprogramming sessions have been required. The hurdle in programming was the need of frequent adjustments due to the physiologic variations in electrical discharges and neural conduction, besides the changes in the impedances. Patients diagnosed with superficial siderosis may achieve limited results in speech perception scores due to both cochlear and retrocochlear reasons. Careful counseling about the results must be given to the patients and their families before the cochlear implantation indication.

The effect of a Lucia jig for 30 minutes on neuromuscular re-programming, in normal subjects

The Lucia jig is a technique that promotes neuromuscular reprogramming of the masticatory system and allows the stabilization of the mandible without the interference of dental contacts, maintaining the mandible position in harmonic condition with the musculature in normal subjects or in patients with temporomandibular dysfunction (TMD). This study aimed to electromyographically analyze the activity (RMS) of the masseter and temporal muscles in normal subjects (control group) during the use of an anterior programming device, the Lucia jig, in place for 0, 5, 10, 20 and 30 minutes to demonstrate its effect on the stomatognathic system. Forty-two healthy dentate individuals (aged 21 to 40 years) with normal occlusion and without parafunctional habits or ternporomandibular dysfunction (RDC/TMD) were evaluated on the basis of the electromyographic activity of the masseter and temporal muscles before placement of a neuromuscular re-programming device, the Lucia jig, on the upper central incisors. There were no statistically significant differences (p < 0.05) in the electromyographic activity of the masticatory muscles in the different time periods. The Lucia jig changed the electromyographic activity by promoting a neuromuscular reprogramming. In most of the time periods, it decreased the activation of the masticatory muscles, showing that this device has wide applicability in dentistry. The use of a Lucia jig over 0, 5, 10, 15, 20 and 30 minutes did not promote any statistically significant increase in muscle activity despite differences in the data, thus showing that this intra-oral device can be used in dentistry.

A systematic review with procedural assessments and meta-analysis of Low Level Laser Therapy in lateral elbow tendinopathy (tennis elbow)

Abstract Background Recent reviews have indicated that low level level laser therapy (LLLT) is ineffective in lateral elbow tendinopathy (LET) without assessing validity of treatment procedures and doses or the influence of prior steroid injections. Methods Systematic review with meta-analysis, with primary outcome measures of pain relief and/or global improvement and subgroup analyses of methodological quality, wavelengths and treatment procedures. Results 18 randomised placebo-controlled trials (RCTs) were identified with 13 RCTs (730 patients) meeting the criteria for meta-analysis. 12 RCTs satisfied half or more of the methodological criteria. Publication bias was detected by Egger's graphical test, which showed a negative direction of bias. Ten of the trials included patients with poor prognosis caused by failed steroid injections or other treatment failures, or long symptom duration or severe baseline pain. The weighted mean difference (WMD) for pain relief was 10.2 mm [95% CI: 3.0 to 17.5] and the RR for global improvement was 1.36 [1.16 to 1.60]. Trials which targeted acupuncture points reported negative results, as did trials with wavelengths 820, 830 and 1064 nm. In a subgroup of five trials with 904 nm lasers and one trial with 632 nm wavelength where the lateral elbow tendon insertions were directly irradiated, WMD for pain relief was 17.2 mm [95% CI: 8.5 to 25.9] and 14.0 mm [95% CI: 7.4 to 20.6] respectively, while RR for global pain improvement was only reported for 904 nm at 1.53 [95% CI: 1.28 to 1.83]. LLLT doses in this subgroup ranged between 0.5 and 7.2 Joules. Secondary outcome measures of painfree grip strength, pain pressure threshold, sick leave and follow-up data from 3 to 8 weeks after the end of treatment, showed consistently significant results in favour of the same LLLT subgroup (p < 0.02). No serious side-effects were reported. Conclusion LLLT administered with optimal doses of 904 nm and possibly 632 nm wavelengths directly to the lateral elbow tendon insertions, seem to offer short-term pain relief and less disability in LET, both alone and in conjunction with an exercise regimen. This finding contradicts the conclusions of previous reviews which failed to assess treatment procedures, wavelengths and optimal doses.

Modal hedges in para-pharmaceutical product instructions: some examples from English and Serbian

[EN] The paper investigates how modal hedges (Coates 1983) understood as expressions of procedural meaning , i.e. expressions which instruct the addressee/reader how to process the propositional content of an utterance/statement (Watts 2004) are used in product descriptions, advertisements and consumer instructions leaflets for a number of products belonging to the Consumer Health Care category for the purposes of complying with consumer protection laws on the one hand and serving as an implicit disclaimer of manufacturer’s responsibility on the other. The analysis is carried out contrastively for two languages, English and Serbian. The results obtained are discussed and viewed as a matter of cultural variety and difference, especially taking into consideration the fact that consumer protection laws seem to be equally strict in US, UK and Commonwealth, Europe and Serbia.

Formalizing languages for service oriented computing

Service Oriented Computing is a new programming paradigm for addressing distributed system design issues. Services are autonomous computational entities which can be dynamically discovered and composed in order to form more complex systems able to achieve different kinds of task. E-government, e-business and e-science are some examples of the IT areas where Service Oriented Computing will be exploited in the next years. At present, the most credited Service Oriented Computing technology is that of Web Services, whose specifications are enriched day by day by industrial consortia without following a precise and rigorous approach. This PhD thesis aims, on the one hand, at modelling Service Oriented Computing in a formal way in order to precisely define the main concepts it is based upon and, on the other hand, at defining a new approach, called bipolar approach, for addressing system design issues by synergically exploiting choreography and orchestration languages related by means of a mathematical relation called conformance. Choreography allows us to describe systems of services from a global view point whereas orchestration supplies a means for addressing such an issue from a local perspective. In this work we present SOCK, a process algebra based language inspired by the Web Service orchestration language WS-BPEL which catches the essentials of Service Oriented Computing. From the definition of SOCK we will able to define a general model for dealing with Service Oriented Computing where services and systems of services are related to the design of finite state automata and process algebra concurrent systems, respectively. Furthermore, we introduce a formal language for dealing with choreography. Such a language is equipped with a formal semantics and it forms, together with a subset of the SOCK calculus, the bipolar framework. Finally, we present JOLIE which is a Java implentation of a subset of the SOCK calculus and it is part of the bipolar framework we intend to promote.

Designing and Programming Organizational Infrastructures for Agents situated in Artifact-based Environments

Actual trends in software development are pushing the need to face a multiplicity of diverse activities and interaction styles characterizing complex and distributed application domains, in such a way that the resulting dynamics exhibits some grade of order, i.e. in terms of evolution of the system and desired equilibrium. Autonomous agents and Multiagent Systems are argued in literature as one of the most immediate approaches for describing such a kind of challenges. Actually, agent research seems to converge towards the definition of renewed abstraction tools aimed at better capturing the new demands of open systems. Besides agents, which are assumed as autonomous entities purposing a series of design objectives, Multiagent Systems account new notions as first-class entities, aimed, above all, at modeling institutional/organizational entities, placed for normative regulation, interaction and teamwork management, as well as environmental entities, placed as resources to further support and regulate agent work. The starting point of this thesis is recognizing that both organizations and environments can be rooted in a unifying perspective. Whereas recent research in agent systems seems to account a set of diverse approaches to specifically face with at least one aspect within the above mentioned, this work aims at proposing a unifying approach where both agents and their organizations can be straightforwardly situated in properly designed working environments. In this line, this work pursues reconciliation of environments with sociality, social interaction with environment based interaction, environmental resources with organizational functionalities with the aim to smoothly integrate the various aspects of complex and situated organizations in a coherent programming approach. Rooted in Agents and Artifacts (A&A) meta-model, which has been recently introduced both in the context of agent oriented software engineering and programming, the thesis promotes the notion of Embodied Organizations, characterized by computational infrastructures attaining a seamless integration between agents, organizations and environmental entities.

Costrutti ed Applicazioni di Programmazione Generica in Linguaggi Object-Oriented

Generic programming is likely to become a new challenge for a critical mass of developers. Therefore, it is crucial to refine the support for generic programming in mainstream Object-Oriented languages — both at the design and at the implementation level — as well as to suggest novel ways to exploit the additional degree of expressiveness made available by genericity. This study is meant to provide a contribution towards bringing Java genericity to a more mature stage with respect to mainstream programming practice, by increasing the effectiveness of its implementation, and by revealing its full expressive power in real world scenario. With respect to the current research setting, the main contribution of the thesis is twofold. First, we propose a revised implementation for Java generics that greatly increases the expressiveness of the Java platform by adding reification support for generic types. Secondly, we show how Java genericity can be leveraged in a real world case-study in the context of the multi-paradigm language integration. Several approaches have been proposed in order to overcome the lack of reification of generic types in the Java programming language. Existing approaches tackle the problem of reification of generic types by defining new translation techniques which would allow for a runtime representation of generics and wildcards. Unfortunately most approaches suffer from several problems: heterogeneous translations are known to be problematic when considering reification of generic methods and wildcards. On the other hand, more sophisticated techniques requiring changes in the Java runtime, supports reified generics through a true language extension (where clauses) so that backward compatibility is compromised. In this thesis we develop a sophisticated type-passing technique for addressing the problem of reification of generic types in the Java programming language; this approach — first pioneered by the so called EGO translator — is here turned into a full-blown solution which reifies generic types inside the Java Virtual Machine (JVM) itself, thus overcoming both performance penalties and compatibility issues of the original EGO translator. Java-Prolog integration Integrating Object-Oriented and declarative programming has been the subject of several researches and corresponding technologies. Such proposals come in two flavours, either attempting at joining the two paradigms, or simply providing an interface library for accessing Prolog declarative features from a mainstream Object-Oriented languages such as Java. Both solutions have however drawbacks: in the case of hybrid languages featuring both Object-Oriented and logic traits, such resulting language is typically too complex, thus making mainstream application development an harder task; in the case of library-based integration approaches there is no true language integration, and some “boilerplate code” has to be implemented to fix the paradigm mismatch. In this thesis we develop a framework called PatJ which promotes seamless exploitation of Prolog programming in Java. A sophisticated usage of generics/wildcards allows to define a precise mapping between Object-Oriented and declarative features. PatJ defines a hierarchy of classes where the bidirectional semantics of Prolog terms is modelled directly at the level of the Java generic type-system.

Procedural and dosimetric aspects in peripheral angiography using CO2 as contrast medium

Lo scopo di questa tesi è lo studio degli aspetti procedurali e dosimetrici in angiografie periferiche che utilizzano la CO2 come mezzo di contrasto. La tecnica angiografica consiste nell’imaging radiologico di vasi sanguigni tramite l’iniezione di un mezzo di contrasto, e il suo uso è in costante incremento a causa dell’aumento di pazienti con malattie vascolari. I mezzi di contrasto iodati sono i più comunemente utilizzati e permettono di ottenere immagini di ottima qualità, ma presentano il limite di una elevata nefrotossicità. La CO2 è considerata un’interessante alternativa al mezzo iodato, per la sua acclarata biocompatibilità, soprattutto per pazienti con elevati fattori di rischio (diabete e/o insufficienza renale). Il suo utilizzo presenta comunque alcuni aspetti problematici, dovuti allo stato gassoso e al basso contrasto intrinseco rispetto alla soluzione iodata. Per quest’ultimo motivo si ritiene generalmente che l’utilizzo della CO2 comporti un aumento di dose rispetto ai mezzi di contrasto tradizionali. Il nostro studio, effettuato su diversi apparati radiologici, ha dimostrato che i parametri di emissione radiologica sono gli stessi per i protocolli di angiografia tradizionale, con iodio, e quelli che utilizzano CO2. Questa evidenza suggerisce che i protocolli CO2 operino solo sul trattamento delle immagini ottenute e non sulla modalità di acquisizione, e dal punto di vista dosimetrico l’angiografia con CO2 è riconducibile all’angiografia tradizionale. L’unico fattore che potrebbe portare a un effettivo incremento di dose al paziente è un allungamento dei tempi di scopia e di procedura, che andrebbe verificato con una campagna di misure in ambito clinico. Sulla base della stessa evidenza, si ritiene che la visualizzazione della CO2 possa essere ulteriormente migliorata attraverso l’ottimizzazione dei parametri di emissione radiologica (kVp, frame rate e durata degli impulsi) attualmente predisposti per l’uso di mezzi di contrasto iodati.