Effect of a protein and energy dense n-3 fatty acid enriched oral supplement on loss of weight and lean tissue in cancer cachexia:A randomised double blind trial

Aim: N-3 fatty acids, especially eicosapentaenoic acid (EPA), may possess anticachectic properties. This trial compared a protein and energy dense supplement enriched with n-3 fatty acids and antioxidants (experimental: E) with an isocaloric isonitrogenous control supplement (C) for their effects on weight, lean body mass (LBM), dietary intake, and quality of life in cachectic patients with advanced pancreatic cancer. Methods: A total of 200 patients (95 E; 105 C) were randomised to consume two cans/day of the E or C supplement (480 ml, 620 kcal, 32 g protein ± 2.2 g EPA) for eight weeks in a multicentre, randomised, double blind trial. Results: At enrolment, patients' mean rate of weight loss was 3.3 kg/month. Intake of the supplements (E or C) was below the recommended dose (2 cans/day) and averaged 1.4 cans/day. Over eight weeks, patients in both groups stopped losing weight (Δweight E: -0.25 kg/month versus C: -0.37 kg/month; p=0.74) and LBM (ΔLBM E: +0.27 kg/month versus C: +0.12 kg/month; p=0.88) to an equal degree (change from baseline E and C, p<0.001). In view of evident non-compliance in both E and C groups, correlation analyses were undertaken to examine for potential dose-response relationships. E patients demonstrated significant correlations between their supplement intake and weight gain (r=0.50, p<0.001) and increase in LBM (r=0.33, p=0.036). Such correlations were not statistically significant in C patients. The relationship of supplement intake with change in LBM was significantly different between E and C patients (p=0.043). Increased plasma EPA levels in the E group were associated with weight and LBM gain (r=0.50, p<0.001; r=0.51, p=0.001). Weight gain was associated with improved quality of life (p<0.01) only in the E group. Conclusion: Intention to treat group comparisons indicated that at the mean dose taken, enrichment with n-3 fatty acids did not provide a therapeutic advantage and that both supplements were equally effective in arresting weight loss. Post hoc dose-response analysis suggests that if taken in sufficient quantity, only the n-3 fatty acid enriched energy and protein dense supplement results in net gain of weight, lean tissue, and improved quality of life. Further trials are required to examine the potential role of n-3 enriched supplements in the treatment of cancer cachexia.

Continuous retinal vessel diameter m easurements: the future in retinal vessel assessment?

PURPOSE. To establish an alternative method, sequential and diameter response analysis (SDRA), to determine dynamic retinal vessel responses and their time course in serial stimulation compared with the established method of averaged diameter responses and standard static assessment. METHODS. SDRA focuses on individual time and diameter responses, taking into account the fluctuation in baseline diameter, providing improved insight into reaction patterns when compared with established methods as delivered by retinal vessel analyzer (RVA) software. SDRA patterns were developed with measurements from 78 healthy nonsmokers and subsequently validated in a group of 21 otherwise healthy smokers. Fundus photography and retinal vessel responses were assessed by RVA, intraocular pressure by contact tonometry, and blood pressure by sphygmomanometry. RESULTS. Compared with the RVA software method, SDRA demonstrated a marked difference in retinal vessel responses to flickering light (P 0.05). As a validation of that finding, SDRA showed a strong relation between baseline retinal vessel diameter and subsequent dilatory response in both healthy subjects and smokers (P 0.001). The RVA software was unable to detect this difference or to find a difference in retinal vessel arteriovenous ratio between smokers and nonsmokers (P 0.243). However, SDRA revealed that smokers’ vessels showed both an increased level of arterial baseline diameter fluctuation before flicker stimulation (P 0.005) and an increased stiffness of retinal arterioles (P 0.035) compared with those in nonsmokers. These differences were unrelated to intraocular pressure or systemic blood pressure. CONCLUSIONS. SDRA shows promise as a tool for the assessment of vessel physiology. Further studies are needed to explore its application in patients with vascular diseases.

Serum α-tocopherol has a nonlinear inverse association with periodontitis among US adults

Background: Previous experimental models suggest that vitamin E may ameliorate periodontitis. However, epidemiologic studies show inconsistent evidence in supporting this plausible association. Objective: We aimed to investigate the association between serum α-tocopherol (αT) and γ-tocopherol (γT) and periodontitis in a large cross-sectional US population. Methods: This study included 4708 participants in the 1999–2001 NHANES. Serum tocopherols were measured by HPLC and values were adjusted by total cholesterol (TC). Periodontal status was assessed by mean clinical attachment loss (CAL) and probing pocket depth (PPD). Total periodontitis (TPD) was defined as the sum of mild, moderate, and severe periodontitis. All measurements were performed by NHANES. Results: Means ± SDs of serum αT:TC ratio from low to high quartiles were 4.0 ± 0.4, 4.8 ± 0.2, 5.7 ± 0.4, and 9.1 ± 2.7 μmol/mmol. In multivariate regression models, αT:TC quartiles were inversely associated with mean CAL (P-trend = 0.06), mean PPD (P-trend < 0.001), and TPD (P-trend < 0.001) overall. Adjusted mean differences (95% CIs) between the first and fourth quartile of αT:TC were 0.12 mm (0.03, 0.20; P-difference = 0.005) for mean CAL and 0.12 mm (0.06, 0.17; P < 0.001) for mean PPD, whereas corresponding OR for TPD was 1.65 (95% CI: 1.26, 2.16; P-difference = 0.001). In a dose-response analysis, a clear inverse association between αT:TC and mean CAL, mean PPD, and TPD was observed among participants with relatively low αT:TC. No differences were seen in participants with higher αT:TC ratios. Participants with γT:TC ratio in the interquartile range showed a significantly lower mean PPD than those in the highest quartile. Conclusions: A nonlinear inverse association was observed between serum αT and severity of periodontitis, which was restricted to adults with normal but relatively low αT status. These findings warrant further confirmation in longitudinal or intervention settings.

Serum α-tocopherol has a nonlinear inverse association with periodontitis among US adults

Previous experimental models suggest that vitamin E may ameliorate periodontitis. However, epidemiologic studies show inconsistent evidence in supporting this plausible association. We aimed to investigate the association between serum α-tocopherol (αT) and γ-tocopherol (γT) and periodontitis in a large cross-sectional US population. This study included 4708 participants in the 1999–2001 NHANES. Serum tocopherols were measured by HPLC and values were adjusted by total cholesterol (TC). Periodontal status was assessed by mean clinical attachment loss (CAL) and probing pocket depth (PPD). Total periodontitis (TPD) was defined as the sum of mild, moderate, and severe periodontitis. All measurements were performed by NHANES. Means ± SDs of serum αT:TC ratio from low to high quartiles were 4.0 ± 0.4, 4.8 ± 0.2, 5.7 ± 0.4, and 9.1 ± 2.7 μmol/mmol. In multivariate regression models, αT:TC quartiles were inversely associated with mean CAL (P-trend = 0.06), mean PPD (P-trend < 0.001), and TPD (P-trend < 0.001) overall. Adjusted mean differences (95% CIs) between the first and fourth quartile of αT:TC were 0.12 mm (0.03, 0.20; P-difference = 0.005) for mean CAL and 0.12 mm (0.06, 0.17; P < 0.001) for mean PPD, whereas corresponding OR for TPD was 1.65 (95% CI: 1.26, 2.16; P-difference = 0.001). In a dose-response analysis, a clear inverse association between αT:TC and mean CAL, mean PPD, and TPD was observed among participants with relatively low αT:TC. No differences were seen in participants with higher αT:TC ratios. Participants with γT:TC ratio in the interquartile range showed a significantly lower mean PPD than those in the highest quartile. A nonlinear inverse association was observed between serum αT and severity of periodontitis, which was restricted to adults with normal but relatively low αT status. These findings warrant further confirmation in longitudinal or intervention settings.

Self-tuning algorithm for dsp-based motion control in cnc applications

This thesis describes the development of an adaptive control algorithm for Computerized Numerical Control (CNC) machines implemented in a multi-axis motion control board based on the TMS320C31 DSP chip. The adaptive process involves two stages: Plant Modeling and Inverse Control Application. The first stage builds a non-recursive model of the CNC system (plant) using the Least-Mean-Square (LMS) algorithm. The second stage consists of the definition of a recursive structure (the controller) that implements an inverse model of the plant by using the coefficients of the model in an algorithm called Forward-Time Calculation (FTC). In this way, when the inverse controller is implemented in series with the plant, it will pre-compensate for the modification that the original plant introduces in the input signal. The performance of this solution was verified at three different levels: Software simulation, implementation in a set of isolated motor-encoder pairs and implementation in a real CNC machine. The use of the adaptive inverse controller effectively improved the step response of the system in all three levels. In the simulation, an ideal response was obtained. In the motor-encoder test, the rise time was reduced by as much as 80%, without overshoot, in some cases. Even with the larger mass of the actual CNC machine, decrease of the rise time and elimination of the overshoot were obtained in most cases. These results lead to the conclusion that the adaptive inverse controller is a viable approach to position control in CNC machinery.

Mobilização de competências na atividade informal do vendedor ambulante em praia de Natal (RN)

The central issue of this dissertation is to investigate the labor activity of beach hawker, in order to identify the main professional competencies mobilized in this activity, traversed by both the precariousness of the means of labor exercise, as for complex and structured routines. In the town of Natal (RN) the beaches serve as workplace for thousands of informal workers, who use various professional skills, translated into the ability to mobilize and articulate knowledge, skills and behaviors to solve problems in concrete work situations. This research therefore had as main objective to investigate the work of beach hawkers, trying to identify the core competencies mobilized for facing demands and obstacles in such a context. The beach of Ponta Negra (Natal-RN) was chosen as field of observation, in which a group of hawkers took part as voluntary subjects. Methodologically, quantitative and qualitative methods of production and analysis of data were combined in three stages. In the quantitative phase an occupational questionnaire was applied to a sample of 60 subjects, generating a set of data analyzed with quantitative univariate and multidimensional descriptive statistical tools, complemented by inferential statistical analysis. The results of this phase indicate a predominance of men sellers with salary varying in a range from one to two minimum wage Brazilian salary, age and education quite heterogeneous, extended working hours and the choice of only this activity and this beach throughout the year. Concurrently with this step of analysis, unsystematic observations of the activity of vendors were held and then driven to the technique of Instruction Impersonator with four chosen subjects. This phase had a clinicalinterpretive analysis, rooted in historical-cultural Vygotskian psychological perspective and in the french approach of skills and abilities. The main results point to several strategies for overcoming obstacles, use of technics anchored in everyday work experience and practical knowledge, building rules of conduct and collective mobilization of diverse professional skills similar to those found in formal work, such as business and time management, use of communicative tools, flexibility in problem solving, creativity and teamwork competence. We conclude that informality investigated in context can not be seen exclusively as a synonym of precariousness. It also covers skills and knowledge in a complex culture that situates informal labor in a complementary way with respect to formal work. This conclusion, therefore, contributes to overcome the notion of antinomy between formal and informal labor activity, since they both can be considered as a way to achieve job satisfaction, and even a personal representation of well done job, which is an important psychological generator of identity and social place.

Acompanhamento do crescimento e desenvolvimento da criança: a participação das mães da área rural

The accompaniment of growth and development is the central thrust of child care in primary health care in order to contribute to the reduction of infant morbidity and mortality and promote healthy development. Despite its importance, the family health unit located in rural Parazinhocounty experiences the problem of frequent absences of children to follow-up consultations. Thus, this study aims to analyze the participation of mothers in the accompaniment of growth and development of children in the Family Health Strategy. This is an exploratory, descriptive study with a qualitative approach with the method action research, developed with mothers who are part of the monitoring of the growth and development of children in the rural area of the municipality of Parazinho/RN from May to October 2014. Data collection was performed using the focus group techniques, participant observation and individual interviews. Data were analyzed using thematic analysis of categorization. The study was approved by the Research Ethics Committee, under the opinion embodied 617,559 and CAAE 28598014.7.0000.5537. In step situation analysis, were conducted two focus groups, attended by a total of 14 mothers of different rural locations. From the speeches, one realizes that they have a satisfactory understanding of the monitoring of the growth and development of the childwas a learning moment. The nurse was mentioned as key professional that actionof accompaniment. The main reason that mothers to abandon consultations is access to health services, due to the distance from their homes to the basic unit, the shortage of public transport for the movement of users and delay between the service and the back home. As a strategy to try to tackle these problems, at the suggestion of their mothers was created Monitoring of Growth and Development Itinerant, where the FHS team moved to rural locations, performing activities related to children's health. Mothers who participated in the action approved the initiative as improving access and care of health needs, despite indicate dissatisfaction as the poor infrastructure and little privacy in consultations. Therefore, it is concluded that, despite the difficulties encountered often for lack of management support and involvement of some professionals, the monitoring of growth and development itinerant proved to be an important tool in solving the problem of access to services oriented to the health of child, in addition to functioning as a space for the realization of health education, becoming, since then, an activity inherent in family health team schedule.

Projeto de absorvedores de micro-ondas integrados com superfícies seletivas em frequência

Considering the fact that, the use of wireless communication systems has grown too fast, investigations concerning absorbers of electromagnetic waves has called closer attention of researchers. It is applicable from indoor systems to military applications. Paralleling with this growth, some extremely relevant investigations through Frequency Selective Surfaces (FSS) allows its filter property to be applicable in several systems, for example: reflector antennas, band-pass radomes, and absorbers, which are the main objective of this work. Therefore, the main goal of this work concerns to design micro-waves absorbers through FSS. Thus, the methodology consists basically in two steps: the first step concerns a theoretical and numerical analysis of the structures involved in the process of absorption, the second step, the analysis of the cascaded structures. In order to carry out the analysis, the Equivalent Circuit Method will be used. This method provides characteristics of transmission from the structure, for a plane wave incidence and it requires an extremely limited computing resource in relation if compared to full wave analyses method. Hence, it is useful to allow fast predictions of the development of the structures. Furthermore, a spreading matrix will be used in order to cascade the conductive FSS and the resistive FSS achieving absorption characteristics in the designed band. The experimental results used for the analysis are found in the literature due to the difficulty of building soon, given that it is not a simple construction technique. To conclude, a mathematical development through the Equivalent Circuit Method of a FSS modeling with cross-dipole geometry and a resistive FSS will be presented, as well as the cascading involving the two structures. The same setting is used with a square loop geometry. Besides it, the next steps will be discussed in the conclusion.

Pass-through of International food prices to domestic ination during and after the great recession: evidence from a set of Latin American economies

We examined how international food price shocks have impacted local ination processes in Brazil, Chile, Colombia, Mexico, and Peru in the past decade -- Using impulse-response analysis coming from cointegrated VARs, we wind that international food ination shocks take from one to six quarters to pass through to domestic head-line ination, depending on the country -- In addition, by calculating the elasticity of local prices to an international food price shock, we found that this pass-through is not complete -- We also take a closer look at how this type of shock affects local food and core prices separately, and asses the possibility second round effects over core ination stemming from the shock -- We wind that a transmission to headline prices does occur, and that part of the transmission is associated with rising core prices both directly and through possible second round effects, which implies a role for monetary policy when such a shock takes place -- This is especially relevant given that international food prices have recently been on an upward trend after falling considerably during the Great Recession

Multi-Scale Dynamic Study of Secondary Impact During Drop Testing of Surface Mount Packages

This dissertation focuses on design challenges caused by secondary impacts to printed wiring assemblies (PWAs) within hand-held electronics due to accidental drop or impact loading. The continuing increase of functionality, miniaturization and affordability has resulted in a decrease in the size and weight of handheld electronic products. As a result, PWAs have become thinner and the clearances between surrounding structures have decreased. The resulting increase in flexibility of the PWAs in combination with the reduced clearances requires new design rules to minimize and survive possible internal collisions impacts between PWAs and surrounding structures. Such collisions are being termed ‘secondary impact’ in this study. The effect of secondary impact on board-level drop reliability of printed wiring boards (PWBs) assembled with MEMS microphone components, is investigated using a combination of testing, response and stress analysis, and damage modeling. The response analysis is conducted using a combination of numerical finite element modeling and simplified analytic models for additional parametric sensitivity studies.

Wildlife as a Priority in Park Development: A Study of Illinois Park Professionals

The purpose of this thesis is to consider the factors that impact decision making in city park settings, with specific emphasis given to wildlife. Additionally, professional bias was considered as a possible response determinant. Studies connecting perceptions of wildlife and Illinois park managers have been rare or nonexistent, but offer the potential for the improvement of management strategies and recreational opportunities. Data was collected using mixed methods. City recreation practitioners statewide were invited to complete a self-administered questionnaire considering wildlife as a decision-making factor in land acquisition or restoration decisions. A small follow-up sample of park managers was interviewed via telephone for further explanation of their response. Analysis of responses from questionnaires and interviews suggested that wildlife habitat is a factor in land use decision making, but is not considered one of the highest importance. Respondents identified that nuisance wildlife, access to wildlife, and public value of wildlife were also factors in decision making. Factors associated with a high-ranking of the importance of wildlife were agencies with a high number of natural area acres, a high number of overall park acreage, personnel devoted to natural area management, the presence of hiking trails, and cities with a large population. Professional bias of recreation managers was suggested via anecdotal interview data, but could not be empirically connected with wildlife-related decision-making processes, as no managers identified themselves as having completed formal wildlife-related training. As a result, management implications include separate training for both practitioners and public. This study broadens the understanding of wildlife management in city park settings, and reaffirms that further understanding of public and pracitioner values of wildlife will lead to improved land use decisions and recreationally valuable experiences.

Nuevo método de identificación usando la respuesta escalón para sistemas de fase no mínima de segundo orden

Este artículo presenta un nuevo método de identificación para sistemas de fase no mínima basado en la respuesta escalón. El enfoque propuesto provee un modelo aproximado de segundo orden evitando diseños experimentales complejos. El método propuesto es un algoritmo de identificación cerrado basado en puntos característicos de la respuesta escalón de sistemas de fase no mínima de segundo orden. Él es validado usando diferentes modelos lineales. Ellos tienen respuesta inversa entre 3,5% y 38% de la respuesta en régimen permanente. En simulaciones, ha sido demostrado que resultados satisfactorios pueden ser obtenidos usando el procedimiento de identificación propuesto, donde los parámetros identificados presentan errores relativos medios, menores que los obtenidos mediante el método de Balaguer.

Recessive Mutations in RTN4IP1 Cause Isolated and Syndromic Optic Neuropathies

International audience

Team performance according to ball possession characteristics : a social networks approach

Over the last few years, football entered in a period of accelerated access to large amount of match analysis data. Social networks have been adopted to reveal the structure and organization of the web of interactions, such as the players passing distribution tendencies. In this study we investigated the influence of ball possession characteristics in the competitive success of Spanish La Liga teams. The sample was composed by OPTA passing distribution raw data (n=269,055 passes) obtained from 380 matches involving all the 20 teams of the 2012/2013 season. Then, we generated 760 adjacency matrixes and their corresponding social networks using Node XL software. For each network we calculated three team performance measures to evaluate ball possession tendencies: graph density, average clustering and passing intensity. Three levels of competitive success were determined using two-step cluster analysis based on two input variables: the total points scored by each team and the scored per conceded goals ratio. Our analyses revealed significant differences between competitive performances on all the three team performance measures (p < .001). Bottom-ranked teams had less number of connected players (graph density) and triangulations (average clustering) than intermediate and top-ranked teams. However, all the three clusters diverged in terms of passing intensity, with top-ranked teams having higher number of passes per possession time, than intermediate and bottom-ranked teams. Finally, similarities and dissimilarities in team signatures of play between the 20 teams were displayed using Cohen’s effect size. In sum, findings suggest the competitive performance was influenced by the density and connectivity of the teams, mainly due to the way teams use their possession time to give intensity to their game.

Evidencia sobre la eficacia de cannabinoides en el dolor neuropático oncológico

Contexto: La eficacia de los cannabinoides en el dolor neuropático es desconocida. El control del dolor es determinante en los pacientes ya que genera un impacto negativo en la calidad de vida de los pacientes. Objetivo: El presente trabajo pretende demostrar la evidencia sobre la eficacia de los medicamentos cannabinoides en el control del dolor neuropático oncológico, mediante la evaluación de la literatura disponible. Metodología: Se realizó una revisión sistemática de literatura incluyendo estudios experimentales, observacionales y revisiones sistemáticas en un periodo de 15 años. Se incluyeron todos los estudios desde el años 2000 con evidencia IB según la escala de evidencia de Oxford. Resultados: Cuatro estudios cumplieron criterios para su inclusión, sin embargo la evidencia es baja y no permite recomendar o descartar los cannabinoides como terapia coadyuvante en control del dolor neuropático oncológico. La combinación de THC/CDB (Sativex®) parece ser un medicamento seguro pues no se reportaron muertes asociadas a su uso, sin embargo la presentación de eventos adversos a nivel gastrointestinal y neurológico podría aumentar el riesgo de interacciones medicamentosas y tener un impacto negativo en la calidad de vida de los pacientes oncológicos. Conclusiones: No hay suficiente literatura y la evidencia no es suficiente para recomendar o descartar el uso de los cannabinoides en dolor neuropático oncológico. Futuros estudios deben realizarse para analizar el beneficio de estos medicamentos. Aunque ética y socialmente hay resistencia para el uso de los cannabinoides, actualmente hay una gran discusión política en el mundo y en Colombia para su aceptación como terapia en el control del dolor.