Pressure sores among malnourished necropsied adults - preliminary data

Pressure sores are common among bedridden, elderly, or malnourished patients, and may occur in terminal ill patients because of impaired mobility, fecal or urinary incontinence, and decreased healing capacity. The aim of this study was to compare frequency of pressure sores between malnourished and non-malnourished necropsied adults. METHOD: All (n = 201) adults (age ³ 18 years) autopsied between 1986 and 1996 at the Teaching Hospital of Triangulo Mineiro Medical School (Uberaba) were eligible for the study. Gender, race, weight, height and main diagnoses were recorded. Ninety-six cases were excluded because of probable body water retention (congestive heart failure, hepatic insufficiency, nephrotic syndrome) or pressure sores secondary to peripheral vascular ischemia. Body mass index (BMI) was used to define malnourished (BMI < 18.5 kg/m²) and non-malnourished (BMI > 18.5kg/m²) groups. RESULTS: Except for weight (42.5kg; range: 28-57 vs. 60; 36-134.5kg) and BMI (16.9; range: 12.4-18.5 vs. 22.7; range: 18.5-54.6kg/m²), respectively, there were no statistical differences among 43 malnourished and 62 non-malnourished cases in relation to age (54.9 ± 20.4 vs. 52.9 ± 17.9 years), percentage of white persons (74.4 vs. 64.5%), male gender (76.7 vs. 69.3%) and main diagnoses. Five malnourished (11.6%) and 7 (11.5%) non-malnourished cases had pressure sores (p=0.89). CONCLUSION: Pressure sores were equally common findings in necropsied persons with protein-energy malnutrition, as assessed by body mass index.

Work ethic and the legacies of political regimes

This article studies the cross-country differences in work ethic and claims that different political regimes transmitted different work ethics that still persist today. Using the World Values Survey and starting our political regime analysis in 1900, we find that Democratic regimes promote more effectively work relevance and competitiveness than Autocratic and Anocratic regimes, and that the political regime history of the country is more important than the present level of democracy. Moreover, we prove that this differences were transmitted through generations by parents, who optimally choose what work ethic to transmit taking into account their own values.

Low coronary perfusion pressure is associated with endocardial fibrosis in a rat model of volume overload cardiac hypertrophy

Left ventricular hypertrophy following volume overload is regarded as an example of cardiac remodeling without increased fibrosis accumulation. However, infarction is associated with increased fibrosis within the noninfarcted, hypertrophied myocardium, particularly in the subendocardial regions. It is conceivable to suppose that, as also occurs postinfarction, low coronary driving pressure may also interfere with accumulation of myocardial fibrosis following aortocaval fistula. PURPOSE: To investigate the role of acute hemodynamic changes in subsequent deposition of cardiac fibrosis in response to aortocaval fistula. METHOD: Aortocaval fistula were created in 4 groups of Wistar rats that were followed over 4 and 8 weeks: aortocaval fistula 4 and aortocaval fistula 8 (10 rats each) and their respective controls (sham-operated controls - Sh), Sh4 and Sh8 (8 rats each). Hemodynamic measurements were performed 1 week after surgery. Hypertrophy and fibrosis were quantified by myocyte diameter and collagen volume fraction at the end of follow up. RESULT: Compared with Sh4 and Sh8, pulse pressure, left ventricular end-diastolic pressure, and +dP/dt were higher in aortocaval fistula 4 and aortocaval fistula 8, but -dP/dt was similar. Coronary driving pressure (mm Hg), used as an estimate of perfusion pressure, was lower in aortocaval fistula 8 (52.6 ± 4.1) than in Sh8 (100.8 ± 1.3), but comparable between aortocaval fistula 4 (50.0 ± 8.9) and Sh4 (84.8 ± 2.3). Myocyte diameter was greater in aortocaval fistula 8, whereas interstitial and subendocardial fibrosis were greater in aortocaval fistula 4 and aortocaval fistula 8. Coronary driving pressure correlated inversely and independently with subendocardial fibrosis (r² = .86, P <.001), whereas left ventricular systolic pressure (r² = 0.73, P = .004) and end-diastolic pressure (r² = 0.55, P = 012) correlated positively and independently with interstitial fibrosis. CONCLUSION: Coronary driving pressure falls and ventricular pressures increase early after aortocaval fistula and are associated with subsequent myocardial fibrosis deposition.

Hypertension in employees of a University General Hospital

PURPOSE: To find out the prevalence of hypertension in employees of the Hospital and relate it to social demographic variables. METHODS: Blood pressure measurement was performed with a mercury sphygmomanometer, using an appropriate cuff size for arm circumference, weight, and height in a population sample of 864 individuals out of the 9,905 employees of a University General Hospital stratified by gender, age, and job position. RESULTS: Hypertension prevalence was 26% (62% of these reported being aware of their hypertension and 38% were unaware but had systolic/diastolic blood pressures of >140 and/or >90 mm Hg at the moment of the measurement). Of those who were aware of having hypertension, 51% were found to be hypertensive at the moment of the measurement. The prevalence was found to be 17%, 23%, and 29% (P <.05) in physicians, nursing staff, and "others", respectively. The univariate analysis showed a significant odds ratio for the male gender, age >50 years, work unit being the Institute of Radiology and the Administration Building, educational level work >10 years, and body mass index >30 kg/m². The multivariate logistic regression model revealed a statistically significant association of hypertension with the following variables: gender, age, skin color, family income, and body mass index. CONCLUSIONS: Hypertension prevalence was high, mainly in those who were not physicians or members of the nursing staff. High-risk groups (obese, non-white, men, low family income) should be better advised of prevention and early diagnosis of hypertension by means of special programs.

NSP work project investment styles

This paper analyzes the Nova Student Portfolio (NSP) with the objective to understand performances of the fund. Each investment style has been analyzed (growth, value and momentum) in order to highlight what style allocation contributed positively and which had a negative impact. The results show that the team mainly invested in value stocks, which contributed positively but that its growth investments had a negative impact on the stock picking performance. The stock selection shows a major influence of the value investment style. A statistical approach shows that the market factor was the one explaining the most the NSP returns.

Biotransformation/separation routes to obtain pure enantiomers

The objective of the work presented in this thesis was the development of an innovative approach for the separation of enantiomers of secondary alcohols, combining the use of an ionic liquid (IL) - both as solvent for conducting enzymatic kinetic resolution and as acylating agent - with the use of carbon dioxide (CO2) as solvent for extraction. Menthol was selected for testing this reaction/separation approach due to the increasing demand for this substance, which is widely used in the pharmaceutical, cosmetics and food industries. With a view to using an ionic ester as acylating agent, whose conversion led to the release of ethanol, and due to the need to remove this alcohol so as to drive reaction equilibrium forward, a phase equilibrium study was conducted for the ehtanol/(±)-menthol/CO2 system, at pressures between 8 and 10 MPa and temperatures between 40 and 50 oC. It was found that CO2 is more selective towards ethanol, especially at the lowest pressure and highest temperature tested, leading to separation factors in the range 1.6-7.6. The pressure-temperature-composition data obtained were correlated with the Peng-Robinson equation of state and the Mathias-Klotz-Prausnitz mixing rule. The model fit the experimental results well, with an average absolute deviation (AAD) of 3.7 %. The resolution of racemic menthol was studied using two lipases, namely lipase from Candida rugosa (CRL) and immobilized lipase B from Candida antarctica (CALB), and two ionic acylating esters. No reaction was detected in either case. (R,S)-1-phenylethanol was used next, and it was found that with CRL low, nonselective, conversion of the alcohol took place, whereas CALB led to an enantiomeric excess (ee) of the substrate of 95%, at 30% conversion. Other acylating agents were tested for the resolution of (±)-menthol, namely vinyl esters and acid anhydrides, using several lipases and varying other parameters that affect conversion and enantioselectivity, such as substrate concentration, solvent and temperature. One such acylating agent was propionic anhydride. It was thus performed a phase equilibrium study on the propionic anhydride/CO2 system, at temperatures between 35 and 50 oC. This study revealed that, at 35 oC and pressures from 7 MPa, the system is monophasic for all compositions. The enzymatic catalysis studies carried out with propionic anhydride revealed that the extent of noncatalyzed reaction was high, with a negative effect on enantioselectivity. These studies showed also that it was possible to reduce considerably the impact of the noncatalyzed reaction relative to the reaction catalyzed by CRL by lowering temperature to 4 oC. Vinyl decanoate was shown to lead to the best results at conditions amenable to a process combining the use of supercritical CO2 as agent for post-reaction separation. The use of vinyl decanoate in a number of IL solvents, namely [bmim][PF6], [bmim][BF4], [hmim][PF6], [omim][PF6], and [bmim][Tf2N], led to an enantiomeric excess of product (eep) values of over 96%, at about 50% conversion, using CRL. In n-hexane and supercritical CO2, reaction progressed more slowly.(...)

‘Wooden Man’? : Masculinities in the Work of J. M. Coetzee (Boyhood, Youth and Summertime)

In seeking to advance the possibility of justice, gender and postcolonial studies have argued for the importance of the study of masculinities, through the acknowledgment that a richer understanding of such gendered formations may provide the basis for recognition of the Other and that, left uncriticised, such formations may be continuously delineated by the reproduction of systems of domination. The current study finds as its object the representations of masculinities in J. M. Coetzee’s Boyhood (1997), Youth (2002) and Summertime (2009). As works of transition in terms of Coetzee’s oeuvre - post-apartheid and post-Disgrace - the trilogy provides an account of the development of a man through several stages of life. While portraying the tensions of different geographical and cultural locations, such as apartheid South Africa and the London of the Sixties, the trilogy articulates the various norms that impact in the formation of gender, particularly of masculinities, through a complex system of power relations. The adherence to such norms is never linear, as the trilogy provides imaginative accounts of the contradictions that assist in the formulation of gender, depicting both the allure and the terror that constitute hegemonic masculinity. Located in the intersection of gender and postcolonial studies, the present study is based on the works by Raewyn Connell on masculinities. Animated by such a critical framework, the main research question of the present study is whether the trilogy advances a notion of masculinity that differs from the traditional rigid model, that is, whether there is resistance to hegemonic masculinity and what the spaces inhabited by the subaltern are. It is suggested that the trilogy presents the reader with instances of resistance to normative formulations of masculinity, by contrasting domination with the possibility of justice, and advancing an understanding of the often fatal consequences of gender norms to one’s sense of being in the world.

Should my company use Bitcoin?

This work project analyses the possibility for a company to trade their goods and services for bitcoins, by joining the Bitcoin network. It analyses the technological and business requirements to join the Bitcoin Network by looking at Bitcoin’s potential to act as a mean of exchange for trade, unit of account and store of value. The analysis points to the motives, benefits and risks for investors to use the Bitcoin as a traditional currency and recommends on strategies for addressing those risks and maximizing benefits. Other than companies this report, to a lesser extent, will also analyse the Bitcoin from an investor’s point of view, this is, should an investor buy bitcoins for trade and make savings on a regular and everyday basis? A major finding in this work project is that companies could start using the Bitcoin system as a legit form of payment since the benefits of using this technology outweigh the costs and risks, given the right approach. This form of payment will contribute for the upgrade of a company’s business’ image, attract a new pool of consumers and businesses that already trade in bitcoins and pressure existing financial institutions and electronic payment vendors to upgrade their service levels.

Masonry infill walls under blast loading using confined underwater blast wave generators (WBWG)

The vulnerability of the masonry envelop under blast loading is considered critical due to the risk of loss of lives. The behaviour of masonry infill walls subjected to dynamic out-of-plane loading was experimentally investigated in this work. Using confined underwater blast wave generators (WBWG), applying the extremely high rate conversion of the explosive detonation energy into the kinetic energy of a thick water confinement, allowed a surface area distribution avoiding also the generation of high velocity fragments and reducing atmospheric sound wave. In the present study, water plastic containers, having in its centre a detonator inside a cylindrical explosive charge, were used in unreinforced masonry infills panels with 1.7m by 3.5m. Besides the usage of pressure and displacement transducers, pictures with high-speed video cameras were recorded to enable processing of the deflections and identification of failure modes. Additional numerical studies were performed in both unreinforced and reinforced walls. Bed joint reinforcement and grid reinforcement were used to strengthen the infill walls, and the results are presented and compared, allowing to obtain pressure-impulse diagrams for design of masonry infill walls.

An evolutionary multi-objective optimization system for earthworks

Earthworks involve the levelling or shaping of a target area through the moving or processing of the ground surface. Most construction projects require earthworks, which are heavily dependent on mechanical equipment (e.g., excavators, trucks and compactors). Often, earthworks are the most costly and time-consuming component of infrastructure constructions (e.g., road, railway and airports) and current pressure for higher productivity and safety highlights the need to optimize earthworks, which is a nontrivial task. Most previous attempts at tackling this problem focus on single-objective optimization of partial processes or aspects of earthworks, overlooking the advantages of a multi-objective and global optimization. This work describes a novel optimization system based on an evolutionary multi-objective approach, capable of globally optimizing several objectives simultaneously and dynamically. The proposed system views an earthwork construction as a production line, where the goal is to optimize resources under two crucial criteria (costs and duration) and focus the evolutionary search (non-dominated sorting genetic algorithm-II) on compaction allocation, using linear programming to distribute the remaining equipment (e.g., excavators). Several experiments were held using real-world data from a Portuguese construction site, showing that the proposed system is quite competitive when compared with current manual earthwork equipment allocation.

Para cá e para lá dos muros: relações familiares na interface entre o interior e o exterior da prisão

Tese de Doutoramento em Sociologia

Ergonomics, anthropometrics, and kinetic evaluation of gait: A case study

This study aimed to develop appropriate changes in a pair of shoes in order to improve the gait of an individual selected for this case study. This analysis took into account ergonomic aspects, namely those relating to the individual’s anthropometrics. Gait analysis was done with the adapted footwear both before and after intervention.A conventional X-ray was performed, which revealed a 29-mm left lower limb shortening and possible foot adduction. The anthropometric assessment confirmed a 27-mm asymmetry between the left knee and foot.Corrective changes were implemented in the left boot, with a 20-mm increase in the plantar aspect and approximately 30-mm in the calcaneus area.The pressure-mapping system WalkinSense was used for the kinetic gait analysis. Results showed some improvement in plantar pressure distribution after corrective changes in footwear. Peak pressure in the left foot decreased from 2.8kg/cm2 to 1.6kg/cm2. The second peak also showed a marked decrease. The right foot presented with a reduction in peak plantar pressure from 2.7kg/cm2 to 2.3kg/cm2.After identifying asymmetries, the associated pathologies and modifyingthe footwear, a kinetic analysis of gait before and after altering the footwear was undertaken, which showed improvements in the gait. According to the obtained results, it was possible to demonstrate that the initially proposed objectives were achieved, i.e., the changes in footwear resulted in an improvement of the analyzed individual.

Analytical and numerical study of the electro-osmotic annular flow of viscoelastic fluids

In this work we present semi-analytical solutions for the electro-osmotic annular flow of viscoelastic fluids modeled by the Linear and Exponential PTT models. The viscoelastic fluid flows in the axial direction between two concentric cylinders under the combined influences of electrokinetic and pressure forcings. The analysis invokes the Debye-Hückel approximation and includes the limit case of pure electro-osmotic flow. The solution is valid for both no slip and slip velocity at the walls and the chosen slip boundary condition is the linear Navier slip velocity model. The combined effects of fluid rheology, electro-osmotic and pressure gradient forcings on the fluid velocity distribution are also discussed.

Annular flow of viscoelastic fluids: Analytical and numerical solutions

This work provides analytical and numerical solutions for the linear, quadratic and exponential Phan–Thien–Tanner (PTT) viscoelastic models, for axial and helical annular fully-developed flows under no slip and slip boundary conditions, the latter given by the linear and nonlinear Navier slip laws. The rheology of the three PTT model functions is discussed together with the influence of the slip velocity upon the flow velocity and stress fields. For the linear PTT model, full analytical solutions for the inverse problem (unknown velocity) are devised for the linear Navier slip law and two different slip exponents. For the linear PTT model with other values of the slip exponent and for the quadratic PTT model, the polynomial equation for the radial location (β) of the null shear stress must be solved numerically. For both models, the solution of the direct problem is given by an iterative procedure involving three nonlinear equations, one for β, other for the pressure gradient and another for the torque per unit length. For the exponential PTT model we devise a numerical procedure that can easily compute the numerical solution of the pure axial flow problem

High strain rate constitutive modeling forhistorical structures subjected to blast loading

Doctoral Thesis Civil Engineering