A dor no período pós-cirúrgico abdominal em doentes geriátricos

A dor é uma das principais causas do sofrimento humano, comprometendo a qualidade de vida dos indivíduos, em especial o idoso que, devido aos problemas cognitivos e à elevada medicação os torna mais suscetíveis aos efeitos adversos dos medicamentos utilizados para o alívio da dor. Neste contexto, o objetivo deste estudo é avaliar a dor na pós-cirurgia abdominal em doentes geriátricos; identificar a localização e a intensidade dolorosa utilizando a Escala Numérica; analisar a dor nas dimensões sensorial, afetiva e cognitiva, utilizando o Questionário para Dor de McGill; relacionar o processo álgico com a idade, sexo, religião e tipo de abordagem cirúrgica; saber se as intervenções autónomas de enfermagem contribuem para o alívio da dor pós-operatória. Trata-se de um estudo descritivo correlacional longitudinal, com abordagem quantitativa, desenvolvido entre 14 de fevereiro e 30 de março de 2012 num Hospital no Serviço de Cirurgia Geral. A amostra constou de 30 pacientes submetidos a cirurgias abdominais. Os dados que serviram de base a este estudo foram recolhidos através da aplicação da Escala Numérica e do Questionário de Dor de McGill. Os resultados mostraram que 60% eram homens, 50% dos doentes tinham 65 e 69 anos e todos (100%), eram católicos romanos. Na primeira avaliação, 60% apresentaram dor pós-operatória moderada, 30% severa e 10% leve. Os descritores escolhidos com maior frequência foram: fisgada (90%); fina, agulhada e pontada (70%); beliscão (60%); sensível (50%); cansativa (60%) e que incomoda (50%). Nas três avaliações seguintes houve diminuição da dor severa e moderada que, aos 180 minutos era de 0% e 3% respetivamente, aumentando a percentagem de pacientes com dor leve (7%). Não encontramos relação significativa entre a variável dor pós-operatória e o sexo mas, pelo contrário, a intensidade da dor pós-operatória e a idade. O índice de dor total e sensitiva é influenciado pelo sexo. A localização da dor é influenciada pelo tipo de cirurgia, pela idade e pelo sexo. A dor pós-operatória era, principalmente, de intensidade moderada. Mesmo nos doentes a quem não foi administrado fármaco (50%), a dor foi aliviada ao longo das quatro avaliações. Desta forma, podemos inferir que as que as intervenções autónomas de enfermagem contribuem para o alívio da dor. A informação/atualização permanente dos profissionais de saúde é indispensável para que seja possível evitar ou minimizar a ocorrência de dor.

3'-UTR SIRF: A database for identifying clusters of short interspersed repeats in 3' untranslated regions

BACKGROUND:Short (~5 nucleotides) interspersed repeats regulate several aspects of post-transcriptional gene expression. Previously we developed an algorithm (REPFIND) that assigns P-values to all repeated motifs in a given nucleic acid sequence and reliably identifies clusters of short CAC-containing motifs required for mRNA localization in Xenopus oocytes.DESCRIPTION:In order to facilitate the identification of genes possessing clusters of repeats that regulate post-transcriptional aspects of gene expression in mammalian genes, we used REPFIND to create a database of all repeated motifs in the 3' untranslated regions (UTR) of genes from the Mammalian Gene Collection (MGC). The MGC database includes seven vertebrate species: human, cow, rat, mouse and three non-mammalian vertebrate species. A web-based application was developed to search this database of repeated motifs to generate species-specific lists of genes containing specific classes of repeats in their 3'-UTRs. This computational tool is called 3'-UTR SIRF (Short Interspersed Repeat Finder), and it reveals that hundreds of human genes contain an abundance of short CAC-rich and CAG-rich repeats in their 3'-UTRs that are similar to those found in mRNAs localized to the neurites of neurons. We tested four candidate mRNAs for localization in rat hippocampal neurons by in situ hybridization. Our results show that two candidate CAC-rich (Syntaxin 1B and Tubulin beta4) and two candidate CAG-rich (Sec61alpha and Syntaxin 1A) mRNAs are localized to distal neurites, whereas two control mRNAs lacking repeated motifs in their 3'-UTR remain primarily in the cell body.CONCLUSION:Computational data generated with 3'-UTR SIRF indicate that hundreds of mammalian genes have an abundance of short CA-containing motifs that may direct mRNA localization in neurons. In situ hybridization shows that four candidate mRNAs are localized to distal neurites of cultured hippocampal neurons. These data suggest that short CA-containing motifs may be part of a widely utilized genetic code that regulates mRNA localization in vertebrate cells. The use of 3'-UTR SIRF to search for new classes of motifs that regulate other aspects of gene expression should yield important information in future studies addressing cis-regulatory information located in 3'-UTRs.

The effect of involuntary job loss on smoking intensity and relapse.

AIMS: To assess the impact of involuntary job loss due to plant closure or layoff on relapse to smoking and smoking intensity among older workers. DESIGN, PARTICIPANTS, SAMPLE: Data come from the Health and Retirement Study, a nationally representative survey of older Americans aged 51-61 in 1991 followed every 2 years beginning in 1992. The 3052 participants who were working at the initial wave and had any history of smoking comprise the main sample. METHODS: Primary outcomes are smoking relapse at wave 2 (1994) among baseline former smokers, and smoking quantity at wave 2 among baseline current smokers. As reported at the wave 2 follow-up, 6.8% of the sample experienced an involuntary job loss between waves 1 and 2. FINDINGS: Older workers have over two times greater odds of relapse subsequent to involuntary job loss than those who did not. Further, those who were current smokers prior to displacement that did not obtain new employment were found to be smoking more cigarettes, on average, post-job loss. CONCLUSIONS: The stress of job loss, along with other significant changes associated with leaving one's job, which would tend to increase cigarette consumption, must outweigh the financial hardship which would tend to reduce consumption. This highlights job loss as an important health risk factor for older smokers.

Compressive holography of diffuse objects.

We propose an estimation-theoretic approach to the inference of an incoherent 3D scattering density from 2D scattered speckle field measurements. The object density is derived from the covariance of the speckle field. The inference is performed by a constrained optimization technique inspired by compressive sensing theory. Experimental results demonstrate and verify the performance of our estimates.

Atmospheric neutrino oscillation analysis with subleading effects in Super-Kamiokande I, II, and III

We present a search for nonzero θ13 and deviations of sin2θ23 from 0.5 in the oscillations of atmospheric neutrino data from Super-Kamiokande I, II, and III. No distortions of the neutrino flux consistent with nonzero θ13 are found and both neutrino mass hierarchy hypotheses are in agreement with the data. The data are best fit at Δm2=2.1×10-3eV2, sin2θ13=0.0, and sin2θ23=0.5. In the normal (inverted) hierarchy θ13 and Δm2 are constrained at the one-dimensional 90% C.L. to sin2θ13<0.04(0.09) and 1.9(1.7)×10 -3<Δm2<2.6(2.7)×10-3eV2. The atmospheric mixing angle is within 0.407≤sin2θ23≤0.583 at 90% C.L. © 2010 The American Physical Society.

Compressive holography.

Compressive sampling enables signal reconstruction using less than one measurement per reconstructed signal value. Compressive measurement is particularly useful in generating multidimensional images from lower dimensional data. We demonstrate single frame 3D tomography from 2D holographic data.

Indication of electron neutrino appearance from an accelerator-produced off-axis muon neutrino beam.

The T2K experiment observes indications of ν(μ) → ν(e) appearance in data accumulated with 1.43×10(20) protons on target. Six events pass all selection criteria at the far detector. In a three-flavor neutrino oscillation scenario with |Δm(23)(2)| = 2.4×10(-3)  eV(2), sin(2)2θ(23) = 1 and sin(2)2θ(13) = 0, the expected number of such events is 1.5±0.3(syst). Under this hypothesis, the probability to observe six or more candidate events is 7×10(-3), equivalent to 2.5σ significance. At 90% C.L., the data are consistent with 0.03(0.04) < sin(2)2θ(13) < 0.28(0.34) for δ(CP) = 0 and a normal (inverted) hierarchy.

Chikungunya and dengue fever among hospitalized febrile patients in northern Tanzania.

Consecutive febrile admissions were enrolled at two hospitals in Moshi, Tanzania. Confirmed acute Chikungunya virus (CHIKV), Dengue virus (DENV), and flavivirus infection were defined as a positive polymerase chain reaction (PCR) result. Presumptive acute DENV infection was defined as a positive anti-DENV immunoglobulin M (IgM) enzyme-linked immunsorbent assay (ELISA) result, and prior flavivirus exposure was defined as a positive anti-DENV IgG ELISA result. Among 870 participants, PCR testing was performed on 700 (80.5%). Of these, 55 (7.9%) had confirmed acute CHIKV infection, whereas no participants had confirmed acute DENV or flavivirus infection. Anti-DENV IgM serologic testing was performed for 747 (85.9%) participants, and of these 71 (9.5%) had presumptive acute DENV infection. Anti-DENV IgG serologic testing was performed for 751 (86.3%) participants, and of these 80 (10.7%) had prior flavivirus exposure. CHIKV infection was more common among infants and children than adults and adolescents (odds ratio [OR] 1.9, P = 0.026) and among HIV-infected patients with severe immunosuppression (OR 10.5, P = 0.007). CHIKV infection is an important but unrecognized cause of febrile illness in northern Tanzania. DENV or other closely related flaviviruses are likely also circulating.

NEGLECTED CELLO REPERTOIRE OF TWENTIETH CENTURY ENGLISH COMPOSERS

In the Twentieth Century, the proliferation of cellists and the exceptional development of cello techniques, combined with composers' acceptance of the challenges by these developments, led many British composers to contribute to the enrichment of the cello concert repertoire. A great number of compositions written for the cello in the Twentieth Century England have been long neglected. In comparison with their other works in the genres of concerto, symphony, and opera, works for cello by prominent Twentieth Century English composers Elgar, Walton, and Britten are relatively unknown, except for Elgar's cello concerto. There are also many lesser-known composers like Delius, Bax, Bridge, and Clarke, who flourished in the fmt half of the century, but eventually became disregarded. Some reasons for this neglect may be as follows: the reluctant attitude toward new trends in the English musical establishment around the turn of the century; a lack of readily available editions of these composers' compositions; an over-abundance of fine composers at one time; and lastly, an overly individualistic approach to the music restricting a general public appreciation and recognition. Encountering a recording of the Walton cello concerto prompted me to further study the neglected Twentieth Century English cello repertoire. Many works of the above-mentioned composers still have not been fully valued in the cello repertoire. For this reason, the purpose of this project was to inspire cellists to learn and broaden as well as to appreciate the beauty of the Twentieth Century cello literature. As part of the doctoral performance project, three recitals featuring the works by six English composers were performed. My collaborator in all three recitals was pianist Eunae KO. The fmt recital included the Sonata for cello and piano by Frank Bridge and the Concerto by William Walton. The second recital was comprised of relatively unknown cello works: Sonatina in D major by Arnold Bax, Romance by Frederick Delius, and the Sonata Op. 40 by Rebecca Clarke. The third recital consisted of Folk-Tale by Arnold Bax and the Symphony for Cello and Orchestra Op. 68 by Benjamin Britten.

Emergency Department Efficiency in an Academic Hospital: A Simulation Study

Gemstone Team HOPE (Hospital Optimal Productivity Enterprise)

The controlled delivery of hydrogen sulfide for the preservation of heart tissue

Gemstone Team Organ Storage and Hibernation

Magnetophoretic circuits for digital control of single particles and cells.

The ability to manipulate small fluid droplets, colloidal particles and single cells with the precision and parallelization of modern-day computer hardware has profound applications for biochemical detection, gene sequencing, chemical synthesis and highly parallel analysis of single cells. Drawing inspiration from general circuit theory and magnetic bubble technology, here we demonstrate a class of integrated circuits for executing sequential and parallel, timed operations on an ensemble of single particles and cells. The integrated circuits are constructed from lithographically defined, overlaid patterns of magnetic film and current lines. The magnetic patterns passively control particles similar to electrical conductors, diodes and capacitors. The current lines actively switch particles between different tracks similar to gated electrical transistors. When combined into arrays and driven by a rotating magnetic field clock, these integrated circuits have general multiplexing properties and enable the precise control of magnetizable objects.

INNOVATIONS IN FRENCH CHAMBER MUSIC AND MÉLODIE (1886 – 1962) – A COLLABORATIVE PIANIST’S PERSPECTIVE

French chamber music in the last quarter of the nineteenth century displayed significant advances in musical innovations and technical developments. As the Parisian public began to favor instrumental music and mélodie over opera, vocal and chamber music with piano became one of the main genres to express French composers’ creativity and individuality. The composers Franck, Debussy, Fauré, Duparc, Ravel, Chausson and Poulenc were the major contributors to this unusually creative period in French music. French mélodies of this period blend precision with lyricism, and demand the performer’s elegance and wit. They show careful settings of the French language’s rhythmic subtleties and increased expressiveness in and importance of the piano accompaniment. The chamber works of this period demanded superior pianistic and instrumental virtuosity while displaying wide ranges of sonority, multiple tone colors, and rhythmic fluidity. The three recitals which comprise this dissertation project were performed at the University of Maryland Gildenhorn Recital Hall on 27 October 2006, All Nations Mission Church (Dayton, NJ) on 5 December 2009, and the Leah M. Smith Lecture Hall of the University of Maryland on 11 May 2010. The repertoire included Poulenc’s Sonata for Oboe and Piano (1962) with oboist Yeongsu Kim, French mélodies by Fauré, Chausson, Debussy, Ravel and Duparc with soprano Jung-A Lee and baritone Hyun-Oh Shin, Poulenc’s Sextet for Piano, Flute, Oboe, Clarinet, Bassoon and Horn (1932-1939) with flutist Katrina Smith, clarinetist Jihoon Chang, bassoonist Erich Heckscher, hornist Heidi Littman and oboist Yeongsu Kim, Debussy’s Sonata for Cello and Piano (1915) with cellist Ji-Sook Shin, Poulenc’s Sonata for Violin and Piano (1942-1949) with violinist Ji-Hee Lim, Franck’s Sonata for Violin and Piano (1886) with violinist Na-Young Cho, Ravel’s Piano Trio (1915) with cellist Ji-Sook Shin and violinist Yu-Jeong Lee and Ravel’s Sonata for Violin and Piano (1927) with violinist Yu-Jeong Lee. The recitals were recorded on compact discs and are archived within the Digital Repository at the University of Maryland (DRUM).

Inter-annual variability of precipitation constrains the production response of boreal Pinus sylvestris to nitrogen fertilization

© 2015 Published by Elsevier B.V.Tree growth resources and the efficiency of resource-use for biomass production determine the productivity of forest ecosystems. In nutrient-limited forests, nitrogen (N)-fertilization increases foliage [N], which may increase photosynthetic rates, leaf area index (L), and thus light interception (IC). The product of such changes is a higher gross primary production and higher net primary production (NPP). However, fertilization may also alter carbohydrate partitioning from below- to aboveground, increasing aboveground NPP (ANPP). We analyzed effects of long-term N-fertilization on NPP, and that of long-term carbon storing organs (NPPS) in a Pinus sylvestris forest on sandy soil, a wide-ranging forest type in the boreal region. We based our analyses on a combination of destructive harvesting, consecutive mensuration, and optical measurements of canopy openness. After eight-year fertilization with a total of 70gNm^-2, ANPP was 27±7% higher in the fertilized (F) relative to the reference (R) stand, but although L increased relative to its pre-fertilization values, IC was not greater than in R. On the seventh year after the treatment initiation, the increase of ANPP was matched by the decrease of belowground NPP (78 vs. 92gCm^-2yr^-1; ~17% of NPP) and, given the similarity of IC, suggests that the main effect of N-fertilization was changed carbon partitioning rather than increased canopy photosynthesis. Annual NPPS increased linearly with growing season temperature (T) in both treatments, with an upward shift of 70.2gCm^-2yr^-1 by fertilization, which also caused greater amount of unexplained variation (r²=0.53 in R, 0.21 in F). Residuals of the NPPS-T relationship of F were related to growing season precipitation (P, r²=0.48), indicating that T constrains productivity at this site regardless of fertility, while P is important in determining productivity where N-limitation is alleviated. We estimated that, in a growing season average T (11.5±1.0°C; 33-year-mean), NPPS response to N-fertilization will be nullified with P 31mm less than the mean (325±85mm), and would double with P 109mm greater than the mean. These results suggest that inter-annual variation in climate, particularly in P, may help explaining the reported large variability in growth responses to fertilization of pine stands on sandy soils. Furthermore, forest management of long-rotation systems, such as those of boreal and northern temperate forests, must consider the efficiency of fertilization in terms of wood production in the context of changes in climate predicted for the region.

Interactive Effects of Plant Species and Organic Carbon on Nitrate Removal in Chesapeake Bay Treatment Wetlands

Nitrate from agricultural runoff are a significant cause of algal blooms in estuarine ecosystems such as the Chesapeake Bay. These blooms block sunlight vital to submerged aquatic vegetation, leading to hypoxic areas. Natural and constructed wetlands have been shown to reduce the amount of nitrate flowing into adjacent bodies of water. We tested three wetland plant species native to Maryland, Typha latifolia (cattail), Panicum virgatum (switchgrass), and Schoenoplectus validus (soft-stem bulrush), in wetland microcosms to determine the effect of species combination and organic amendment on nitrate removal. In the first phase of our study, we found that microcosms containing sawdust exhibited significantly greater nitrate removal than microcosms amended with glucose or hay at a low nitrate loading rate. In the second phase of our study, we confirmed that combining these plants removed nitrate, although no one combination was significantly better. Furthermore, the above-ground biomass of microcosms containing switchgrass had a significantly greater percentage of carbon than microcosms without switchgrass, which can be studied for potential biofuel use. Based on our data, future environmental groups can make a more informed decision when choosing biofuel-capable plant species for artificial wetlands native to the Chesapeake Bay Watershed.