Suite from L'histoire du soldat, for clarinet, violin and piano,

Mode of access: Internet.

Also sprach Zarathustra : Tondichtung, frei nach Friedr. Nietzsche, für grosses Orchester, Op. 30 /

Originally for orchestra; arr. for 2 pianos, 4 hands.

Indian suite /

For piano, 2 hands.

La folia. [music] : variations sérieuses pour le violin /

Stamped on t.p.: Sole agents: C. F. Peters Corp., New York, N.Y.

Hungarian dances : nos. 1, 3, 10 /

Mode of access: Internet.

Validity of the geriatric depression scale and the collateral source version of the geriatric depression scale in nursing homes

Background Depression is a common psychiatric disorder in older people. The study aimed to examine the screening accuracy of the Geriatric Depression Scale (GDS) and the Collateral Source version of the Geriatric Depression Scale (CS-GDS) in the nursing home setting. Methods Eighty-eight residents from 14 nursing homes were assessed for depression using the GDS and the CS-GDS, and validated against clinician diagnosed depression using the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders (SCID) for residents without dementia and the Provisional Diagnostic Criteria for Depression in Alzheimer Disease (PDCdAD) for those with dementia. The screening performances of five versions of the GDS (30-, 15-, 10-, 8-, and 4-item) and two versions of the CS-GDS (30- and 15-item) were analyzed using receiver operating characteristic (ROC) curves. Results Among residents without dementia, both the self-rated (AUC = 0.75–0.79) and proxy-rated (AUC = 0.67) GDS variations performed significantly better than chance in screening for depression. However, neither instrument adequately identified depression among residents with dementia (AUC between 0.57 and 0.70). Among the GDS variations, the 4- and 8-item scales had the highest AUC and the optimal cut-offs were >0 and >3, respectively. Conclusions The validity of the GDS in detecting depression requires a certain level of cognitive functioning. While the CS-GDS is designed to remedy this issue by using an informant, it did not have adequate validity in detecting depression among residents with dementia. Further research is needed on informant selection and other factors that can potentially influence the validity of proxy-based measures in the nursing home setting.

Anatomical landmarks for transnasal endoscopic skull base surgery.

Resection of midline skull base lesions involve approaches needing extensive neurovascular manipulation. Transnasal endoscopic approach (TEA) is minimally invasive and ideal for certain selected lesions of the anterior skull base. A thorough knowledge of endonasal endoscopic anatomy is essential to be well versed with its surgical applications and this is possible only by dedicated cadaveric dissections. The goal in this study was to understand endoscopic anatomy of the orbital apex, petrous apex and the pterygopalatine fossa. Six cadaveric heads (3 injected and 3 non injected) and 12 sides, were dissected using a TEA outlining systematically, the steps of surgical dissection and the landmarks encountered. Dissection done by the "2 nostril, 4 hands" technique, allows better transnasal instrumentation with two surgeons working in unison with each other. The main surgical landmarks for the orbital apex are the carotid artery protuberance in the lateral sphenoid wall, optic nerve canal, lateral optico-carotid recess, optic strut and the V2 nerve. Orbital apex includes structures passing through the superior and inferior orbital fissure and the optic nerve canal. Vidian nerve canal and the V2 are important landmarks for the petrous apex. Identification of the sphenopalatine artery, V2 and foramen rotundum are important during dissection of the pterygopalatine fossa. In conclusion, the major potential advantage of TEA to the skull base is that it provides a direct anatomical route to the lesion without traversing any major neurovascular structures, as against the open transcranial approaches which involve more neurovascular manipulation and brain retraction. Obviously, these approaches require close cooperation and collaboration between otorhinolaryngologists and neurosurgeons.

Genomic architecture of sickle cell disease clinical variation in children from West Africa : a case-control study design

Contexte : L’anémie falciforme ou drépanocytose est un problème de santé important, particulièrement pour les patients d’origine africaine. La variation phénotypique de l’anémie falciforme est problématique pour le suivi et le traitement des patients. L’architecture génomique responsable de cette variabilité est peu connue. Principe : Mieux saisir la contribution génétique de la variation clinique de cette maladie facilitera l’identification des patients à risque de développer des phénotypes sévères, ainsi que l’adaptation des soins. Objectifs : L’objectif général de cette thèse est de combler les lacunes relatives aux connaissances sur l’épidémiologie génomique de l’anémie falciforme à l’aide d’une cohorte issue au Bénin. Les objectifs spécifiques sont les suivants : 1) caractériser les profils d’expressions génomiques associés à la sévérité de l’anémie falciforme ; 2) identifier des biomarqueurs de la sévérité de l’anémie falciforme ; 3) identifier la régulation génétique des variations transcriptionelles ; 4) identifier des interactions statistiques entre le génotype et le niveau de sévérité associé à l’expression ; 5) identifier des cibles de médicaments pour améliorer l’état des patients atteints d’anémie falciforme. Méthode : Une étude cas-témoins de 250 patients et 61 frères et soeurs non-atteints a été menée au Centre de Prise en charge Médical Intégré du Nourrisson et de la Femme Enceinte atteints de Drépanocytose, au Bénin entre février et décembre 2010. Résultats : Notre analyse a montré que des profils d’expressions sont associés avec la sévérité de l’anémie falciforme. Ces profils sont enrichis de génes des voies biologiques qui contribuent à la progression de la maladie : l’activation plaquettaire, les lymphocytes B, le stress, l’inflammation et la prolifération cellulaire. Des biomarqueurs transcriptionnels ont permis de distinguer les patients ayant des niveaux de sévérité clinique différents. La régulation génétique de la variation de l’expression des gènes a été démontrée et des interactions ont été identifiées. Sur la base de ces résultats génétiques, des cibles de médicaments sont proposées. Conclusion: Ce travail de thèse permet de mieux comprendre l’impact de la génomique sur la sévérité de l’anémie falciforme et ouvre des perspectives de développement de traitements ciblés pour améliorer les soins offerts aux patients.

Características físicas, químicas, celulares e microbiológicas do leite cru obtido em tanques de expansão individuais de fornecedores de um laticínio do nordeste do Estado de São Paulo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação da distribuição das tensões em prótese do tipo “All on Four”: estudo pelo método dos elementos finitos tridimensionais

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Differential expression of a retrotransposable element, Rex6, in Colossoma macropomum fish from different Amazonian environments

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

Hispanic physicians' tobacco intervention practices: a cross-sectional survey study

Background U.S. Hispanic physicians constitute a considerable professional collective, and they may be most suited to attend to the health education needs of the growing U.S. Hispanic population. These educational needs include tobacco use prevention and smoking cessation. However, there is a lack of information on Hispanic physicians' tobacco intervention practices, their level of awareness and use of cessation protocols, and the type of programs that would best address their tobacco training needs. The purpose of this study was to assess the tobacco intervention practices and training needs of Hispanic physicians. Methods Data was collected through a validated survey instrument among a cross-sectional sample of self-reported Hispanic physicians. Data analyses included frequencies, descriptive statistics, and factorial analyses of variance. Results The response rate was 55.5%. The majority of respondents (73.3%) were middle-age males. Less than half of respondents routinely performed the most basic intervention: asking patients about smoking status (44.4%) and advising smoking patients to quit (42.2%). Twenty-five percent assisted smoking patients by talking to them about the health risks of smoking, providing education materials or referring them to cessation programs. Only 4.4% routinely arranged follow-up visits or phone calls for smoking patients. The majority of respondents (64.4%) indicated that they prescribe cessation treatments to less than 20% of smoking patients. A few (4.4%) routinely used behavioral change techniques or programs. A minority (15.6%) indicated that they routinely ask their patients about exposure to tobacco smoke, and 6.7% assisted patients exposed to secondhand smoke in understanding the health risks associated with environmental tobacco smoke (ETS). The most frequently encountered barriers preventing respondents from intervening with patients who smoke included: time, lack of training, lack of receptivity by patients, and lack of reimbursement by third party payers. There was no significant main effect of type of physician, nor was there an interaction effect (gender by type of physician), on tobacco-related practices. Conclusion The results indicate that Hispanic physicians, similarly to U.S. physicians in general, do not meet the level of intervention recommended by health care agencies. The results presented will assist in the development of tobacco training initiatives for Hispanic physicians.

Influence of the Main Cereal and Feed Form of the Diet on Performance and Digestive Tract Traits of Brown-Egg Laying Pullets.

The influence of the main cereal and feed form of the diet on performance and digestive tract traits was studied in 576 brown-egg laying pullets from 1 to 120 d of age. From 1 to 45 d of age, 4 diets arranged factorially with 2 cereals (corn vs. wheat) and 2 feed forms (mash vs. pellets) were used. Each treatment was replicated 6 times (24 pullets per replicate). From 46 to 120 d of age, all diets were offered in mash form and the only difference among diets was the cereal used. Cumulatively, pullets fed the corn diets had higher BW gain (P < 0.05) but similar feed conversion ratio as pullets fed the wheat diets. From 1 to 45 d of age, pullets fed pellets consumed more feed (P < 0.001) and had higher BW gain (P < 0.001) than those fed mash. Most of the beneficial effects of pelleting on productive performance were still evident at 120 d of age. At 45 d of age, gizzard weight (g/kg of BW) was higher (P < 0.01) in pullets fed corn than in pullets fed wheat diets. Feeding pellets reduced the relative weight of the digestive tract and the gizzard (P < 0.001) as well as the length (cm/kg of BW) of the small intestine (P < 0.01) at both ages. The pH of gizzard contents at 120 d of age was not affected by cereal but was lower in pullets that were fed mash from 1 to 45 d of age (P < 0.01). We conclude that wheat can be used in substitution of corn in pullet diets with only a slight reduction in BW gain and that feeding pellets from 1 to 45 d of age increased BW gain and pH of the gizzard and reduced the relative weight of the gizzard and the length of the gastrointestinal tract at 120 d of age.

Factores nutricionales que influyen sobre las variables productivas y el desarrollo del tracto gastrointestinal en pollitas comerciales rubias = Nutritional factors affecting productive performance and gastrointestinal tract traits in commercial brown-egg laying pullets

El objetivo general de esta Tesis doctoral fue estudiar la influencia de diversos factores nutricionales sobre los parámetros productivos y el desarrollo del tracto digestivo de pollitas rubias destinadas a la producción de huevos comerciales. Para alcanzar este objetivo se realizaron tres experimentos donde se estudió el cereal principal, el tamaño de partícula del cereal y el nivel de energía y la presentación de los piensos. En el experimento 1 se estudió la influencia del cereal (piensos con enzimas) y la presentación del pienso sobre los parámetros productivos y las características del tracto digestivo en 576 pollitas rubias de 1 a 120 d de edad. De 1 a 45 d de la edad, se utilizaron 4 piensos experimentales organizados de forma factorial con 2 cereales al 50% de inclusión (maíz vs. trigo) y 2 presentaciones del pienso (harina vs. gránulo de 2- mm de diámetro). Cada tratamiento se replicó 6 veces (24 pollitas por réplica). De 46 a 120 d de edad todas las dietas (maíz o trigo) se ofrecieron en harina y por tanto, la única diferencia entre tratamientos fue el cereal utilizado. De 1 a 120 d de edad, las pollitas que recibieron los piensos basados en maíz tuvieron una ganancia de peso vivo (PV) superior (P < 0,05) que las que recibieron los piensos basados en trigo, pero el índice de conversión (IC) fue similar para ambos grupos. De 1 a 45 d de edad, las pollitas alimentadas con gránulo consumieron más pienso (P < 0,001) y tuvieron una ganancia de peso superior (P < 0,001) que las pollitas alimentadas con harina. Gran parte de los efectos beneficiosos de la granulación sobre los parámetros productivos se mantuvieron al final de la prueba (120 d de edad). A los 45 d de edad, el peso relativo de la molleja (PR; g/kg PV) fue superior (P < 0,01) en pollitas alimentadas con maíz que en pollitas alimentadas con trigo. La alimentación en gránulo redujo el PR del tracto gastro intestinal (TGI) y de la molleja (P < 0,001), así como la longitud relativa (LR; cm/kg PV) del intestino delgado (P< 0.01) a ambas edades (45 y 120 d de edad). El tipo de cereal utilizado no afectó al pH del contenido de la molleja a 120 d de edad pero fué inferior (P < 0,01) en las pollitas que recibieron el pienso en harina de 1 a 45 d de la edad que en las que recibieron el pienso en gránulo. Se concluye que el trigo puede substituir al maíz en piensos para pollitas si se acepta una ligera reducción en la ganancia de peso. Asímismo, la alimentación en gránulo de 1 a 45 d de edad aumentó la ganancia de peso a esta edad y al final de la prueba, así como el pH de la molleja a 120 d de edad. La presentación del pienso en gránulo redujo el PR de la molleja y la LR del TGI a 120 d de edad. En el experimento 2 se utilizaron un total de 864 pollitas rubias Hy-Line de 1 d de edad para estudiar la influencia del cereal de la dieta (500 g de maíz o trigo/kg) y el tamaño de partícula del mismo (molienda con molino de martillos con un diámetro de criba de 6, 8, o 10-mm) sobre los parámetros productivos y las características del TGI de 1 a 120 d de edad. Cada uno de los 6 tratamientos se replicó 6 veces (24 pollitas por réplica). De 1 a 45 d de edad, la ganancia de PV aumentó (P< 0,001) y el IC se mejoró (P < 0,05) al reducir el tamaño de partícula del cereal, pero no se observaron diferencias en el periodo crecimiento de 45 a 120 d de edad. A los 45 d de vida, las pollitas alimentadas con maíz tendieron (P < 0,10) a tener un mayor PR del TGI y del proventrículo y una mayor LR del intestino delgado que las pollitas alimentadas con trigo. Asímismo, el PR del TGI a esta edad, aumentó (P < 0,05) a medida que aumentaba el tamaño de partícula del cereal utilizado. A los 120 d de edad, el tratamiento no afectó el PR de ninguno de los órganos del TGI ni al pH de la molleja. Sin embargo, la LR del intestino delgado fue superior (P < 0,05) para las pollitas alimentadas con trigo que para las pollitas alimentadas con maíz. La LR del TGI se redujó (P < 0,05) al aumentar el tamaño de partícula del cereal. Se concluye que el trigo puede incluirse 500 g/kg en piensos de pollitas de 1 a 120 días de edad y que el tamaño de partícula de los cereales afecta el crecimiento de las pollitas durante los primeros 45 d de vida, pero no después. Por lo tanto, se recomienda moler el cereal utilizado al inicio del período de recría (1 a 45 d de edad) con una criba de diámetro igual o inferior a 8 mm. En el experimento 3 se utilizaron un total de 1.152 pollitas rubias Hy-Line de 1 d de edad para estudiar la influencia del nivel de energía de la dieta y la presentación del pienso sobre la productividad y las características del TGI. De 1 a 45 d de edad se utilizaron 6 piensos organizados de forma factorial con 3 concentraciones energéticas (baja: 11,44 MJ; media: 12,05 MJ y alta: 12,66 MJ/kg) y 2 presentaciones del pienso (harina vs. gránulo). De 45 a 120 d todos los piensos experimentales se suministraron en forma de harina y por tanto, la única diferencia entre tratamientos fue el nivel de EMAn utilizado. Cada uno de los 6 tratamientos se replicó 8 veces y la unidad experimental fue la jaula con 24 pollitas. De 1 a 120 d de edad, la ganancia de PV y el IC mejoraron a medida que aumentó la EMAn del pienso (P < 0,001). Las pollitas alimentadas con gránulo de 1 a 45 d de edad comieron mas y tuvieron una ganancia de peso superior (P < 0,001) que las alimentadas con harina. En el global de la prueba, la ganancia de PV fue mayor (P < 0,01) para las pollitas alimentadas con piensos en gránulo. A los 45 d de edad, el PR de todos los segmentos del TGI estudiados fue inferior para las pollitas alimentadas con piensos de alta energía que para las pollitas alimentadas con piensos de media o baja energía. A 120 d de edad, el PR de la molleja fue superior (P < 0,01) para las pollitas alimentadas con piensos de baja energía que con los otros piensos. Sin embargo, la LR del TGI no se vió afectada por el nivel de energía de los piensos. A los 45 d de edad, la alimentación con gránulo redujo el PR del proventrículo (P < 0,05), de la molleja (P < 0,001) y del TGI (P < 0.001), así como la LR del intestino delgado (P < 0,05) y de los ciegos (P < 0,001). A pesar de que las pollitas solo recibieron los piensos en gránulo durante los primeros 45 d de vida, la alimentación con gránulos redujo el PR de la molleja y del proventrículo a 120 d de edad. Se concluye que la alimentación con gránulos durante los primeros 45 d de vida mejora el consumo de pienso y el PV de las pollitas a 120 d de edad. Un aumento del nivel de energía de la dieta de 12,0 a 12,7 MJ/kg mejora los parámetros productivos de 1 a 120 d de edad pero reduce el tamaño del proventrículo y de la molleja. En base de estos resultados concluimos que maíz y trigo con enzimas pueden utilizarse indistintamente en piensos para pollitas de 1 a 120 d de edad con sólo una ligera disminución del PV final con trigo. La granulación y la reducción del tamaño de partícula del cereal del pienso de primera edad (1 a 45 d de vida) y el uso de piensos de alta densidad energética, mejoran los PV a 120 d de edad. Por lo tanto, es recomendable moler los cereales con cribas de no más de 8-mm de diámetro. También, la granulación del pienso y el uso de piensos de alta energía (pobres en fibra bruta) pueden reducir el desarrollo del TGI especialmente de la molleja, lo que puede perjudicar el consumo posterior de pienso durante el inicio del ciclo de puesta. ABSTRACT The general objective of this Thesis was to study the effect of different nutritional factors on productive performance and the development of the gastrointestinal tract (GIT) of commercial brown egg-laying pullets from 1 to 120 d of age. In this respect, the influence of type and particle size of the cereal, and feed form, and energy content of the die,t were studied in 3 experiments. In experiment 1, the influence of the main cereal and feed form of the diet on performance and GIT traits was studied in 576 brown-egg laying pullets from 1 to 120 d of age. From 1 to 45 d of age, 4 diets arranged factorially with 2 cereals (maize vs. wheat) and 2 feed forms (mash vs. pellets) were used. Each treatment was replicated 6 times (24 pullets per replicate). From 46 to 120 d of age, all diets were offered in mash form and therefore, the only difference among diets was the cereal used. Cumulatively, pullets fed the maize diets had higher body weight (BW) gain (P< 0.05) but similar feed conversion ratio (FCR) than pullets fed the wheat diets. From 1 to 45 d of age, pullets fed pellets consumed more feed (P < 0.001) and had higher BW gain (P < 0.001) than pullets fed mash. Most of the beneficial effects of pelleting on productive performance of the birds were still evident at 120 d of age. At 45 d of age, gizzard relative weight (RW; g/kg BW) was higher (P < 0.01) in pullets fed maize than in pullets fed wheat. Feeding pellets reduced the RW of the GIT and the gizzard (P < 0.001) as well as the relative length (RL; cm/kg BW) of the small intestine (SI, P < 0.01) at both ages. The pH of the gizzard contents at 120 d of age was not affected by the main cereal of the diet, but was lower in pullets fed mash from 1 to 45 d of age (P < 0.01) than in pullets fed pellets. We conclude that wheat supplemented with enzymes can be used in substitution of maize in pullet diets with only a slight reduction in BW gain at 120 d of age. Also, feeding pellets from 1 to 45 d of age increased BW gain and pH of the gizzard, and reduced the RW of the gizzard and the RL of the GIT at 120 d of age. In experiment 2, a total of 864 brown-egg laying pullets was used to study the effects of the main cereal of the diet (500 g maize or wheat/kg) and particle size of the cereal (hammer milled to pass through a 6, 8, and 10-mm screen) on growth performance and GIT traits from 1 to 120 d of age. Each of the 6 treatments was replicated 6 times (24 pullets per replicate). Type of cereal did not affect pullet performance at any age. From 1 to 45 d of age, BW gain was increased (P < 0.001) and FCR was improved (P < 0.05) as the particle size of the cereal was reduced, but no effects were observed after this age. At 45 d of age, pullets fed maize tended (P < 0.10) to have a heavier RW of the GIT and proventriculus and a higher relative length (RL, cm/kg BW) of the SI than pullets fed wheat. Also at this age, the RW of the GIT increased (P < 0.05) with increases in particle size of the cereal. At 120 d of age, dietary treatment did not affect the RW of any of the organs studied or gizzard pH, but the RL of the SI was higher (P < 0.05) for pullets fed wheat than for pullets fed maize. Also, the RL of the SI was reduced (P < 0.05) as the particle size of the cereal increased. We conclude that 500 g wheat/kg can be included in pullet feeds from 1 to 120 d of age, and that particle size of the cereal affects pullet performance during the first 45 d of life but not thereafter. Therefore, it is recommended to grind the cereal used in this period with a screen size of no more than 8-mm. In experiment 3, a total of 1,152 one-day-old Hy-Line Brown egg laying pullets were used to study the influence of the energy content of the diet and feed form on productive performance and on several GIT traits. From 1 to 45 d of age, there were 6 diets arranged factorially with 3 concentrations of AMEn (low: 11.66 MJ/kg, medium: 12.05 MJ/kg and high: 12.66 MJ/kg) of the diet and 2 feed forms (mash vs. pellets). From 45 to 120 d all diets were fed in mash form and therefore, the only difference among treatments in this period was the energy content of the diets. Each of the 6 treatments was replicated 8 times and the experimental unit was formed by 24 pullets. Cumulatively, BW gain and FCR improved as the AMEn of the diet increased (P < 0.001). Also, pullets fed pellets from 1 to 45 d of age had higher feed intake and BW gain (P < 0.001) in this period and higher cumulative BW gain (P < 0.01) than pullets fed mash. At 45 d of age, the RWof all the segments of the GIT was lower for pullets fed the high- than for pullets fed the medium- or low- energy diets. At 120 d of age, the RW of the gizzard was higher (P < 0.01) for pullets fed the low energy diets than for pullets fed the other diets. However, the RL of the GIT was not affected by the energy content of the diet. Feeding pellets reduced the RW of the proventriculus (P < 0.05), gizzard (P < 0.001), and GIT (P < 0.001), as well as the RL of the small intestine (P < 0.05) and the ceaca (P < 0.001) at 45 d of age. The effects of feeding pellets on RW of gizzard and proventriculus were still evident at 120 d of age. We concluded that feeding pellets from 1 to 45 d of age improved feed intake and BW of pullets at 120 d of age and that an increase in the energy content of the diet increased pullet performance at all ages but reduced the RW of the proventriculus and gizzard. We conclude that maize and wheat can be used indistinctly in diets for egg laying pullets from 1 to 120 d of age, with only a slight reduction in final BW when wheat is used. Also, particle size of the cereal affects pullet performance during the first 45 d of life but not thereafter. Pelleting of the feeds, and grinding the cereal with a screen size of no more than 8-mm from 1 to 45 d of age, and the use of high density energy diets are recommended in order to achieve adequate target BW at 120 d of age. However, pelleting of the feed, very fine grinding, and the use of high AMEn diets might hinder the development of the GIT, especially that of the gizzard, which might affect feed intake of laying hens especially at the beginning of the production cycle.

Suite from L'histoire du soldat = The soldier's tale /

Marche du soldat -- Le violon du soldat -- Petit concert -- Tango-valse-rag -- La danse du diable.