Lesão Medular Iatrogénica - Realidade no Centro do Alcoitão

Objectivos: A etiologia da lesão medular (LM) é diversa, incluindo, para além da iatrogenia, causas traumáticas,vasculares, neoplásicas, infecciosas, degenerativas, metabólicas e congénitas. Não se conhece a verdadeiracontribuição relativa de cada grupo etiológico na incidência desta patologia no mundo. Numa investigação daliteratura existente foi encontrado apenas um estudo retrospectivo (Bacher et al.) que estudou a incidência da LMiatrogénica num Centro de Reabilitação e caracterizou essa iatrogenia. O objectivo deste trabalho foi o deestudar a incidência e caracterizar a LM iatrogénica numa população de doentes internados no Centro de Medicina de Reabilitação do Alcoitão (CMRA), assim como comparar os resultados com o trabalho atrás referido. Materiais e Métodos: Estudo longitudinal retrospectivo dos doentes com LM admitidos em primeirointernamento no Serviço de Lesões Vértebro-Medulares do CMRA, num período de 5 anos. Procedemos à colheitade elementos demográficos e clínicos do processo destes doentes. A amostra compreendeu 16 doentes. Aincidência de lesão medular iatrogénica foi determinada no período de tempo decorrido entre 1-1-2005 e 31-12-2008 (n=11). Para a caracterização da lesão medular iatrogénica aceitaram-se os doentes internados pela primeiravez entre 1-7-2004 e 30-6-2009 (n=16). Resultados: Obtivemos uma incidência de lesão iatrogénica de 2,7%. A idade média foi de 58 anos, com ligeiropredomínio do sexo feminino. O diagnóstico pré-iatrogenia mais frequente foi a espondilopatia degenerativa(53,3%). Em 50% dos casos, o acto médico iatrogénico foi a cirurgia da coluna vertebral (62,5% da colunalombar), sendo a laminectomia o procedimento mais frequente. Os quadros neuromotores de paraplegia ASIA B(31,2%) e C (37,5%) foram os mais encontrados, com nível neurológico dorsal em 56,2% dos doentes. Em 54,5%dos doentes, o quadro neurológico surgiu no pós-operatório imediato. O estudo de Bacher et al. revelou umaincidência inferior (0,69%) e um quadro neuromotor mais frequente de paraplegia ASIA A. Conclusões: A incidência da lesão medular iatrogénica é um dado epidemiológico mal estudado. A comparaçãoentre os dois estudos revela diferenças importantes de incidência, mas uma caracterização clínica relativamentesobreponível. São necessários mais estudos, nomeadamente multicêntricos, para uma melhor caracterização dalesão medular iatrogénica.

Cultura Organizacional na área de Diagnóstico por Imagem - Percepção dos Coordenadores de CHLC

Para fazer face a uma nova realidade, limitada pela crise financeira e organizacional em que se encontra o Serviço Nacional de Saúde, têm surgido várias tentativas de mudança dos modelos tradicionais de organização e de gestão nas Organizações de Saúde, a fim de se obterem organizações eficazes (Ferreira, 2011). Tendo como ponto de partida a premissa dos novos desafios impostos pelo sector da saúde, a gestão da Área de Diagnóstico Por Imagem (ADPI) do Centro Hospitalar Lisboa Central (CHLC) defronta-se com a crescente necessidade de traçar estratégias de mudança organizacional, com capacidade de adaptação à realidade vigente no sistema de saúde português. Como vários autores reiteram, o passo primordial para a introdução de mudanças organizacionais, passa pela identificação do tipo de cultura organizacional existente. Partindo desta lógica definiu-se a questão de investigação para o estudo, “Qual a percepção da Coordenação da ADPI do CHLC face à cultura organizacional vigente e à considerada desejada face à mudança organizacional para tornar a organização mais eficaz?”. Na mesma lógica, definiram-se como objectivos da investigação empírica, identificar as características da cultura organizacional da ADPI do CHLC de forma a criar estratégias de mudança organizacional, reconhecer as características da cultura que influenciam a eficácia organizacional nos diferentes polos da ADPI do CHLC e comparar as percepções do coordenador e subcoordenadores da ADPI do CHLC, face à cultura organizacional vigente e à considerada desejada em função da mudança organizacional. Trata-se de um estudo exploratório e descritivo, seguindo a estratégia de estudo de caso único com uma abordagem quantitativa. Para o efeito, recorreu-se ao questionário Organizational Culture Assessment Instrument (OCAI) desenvolvido por Cameron & Quinn (1999), o qual se aplicou à população em estudo constituída por 14 indivíduos da coordenação da ADPI do CHLC. Os resultados demonstram que a cultura organizacional vigente na ADPI do CHLC é do tipo Clã, e que é este tipo de cultura que o coordenador e subcoordenadores consideram ideal para o futuro. Havendo diferenças significativas entre hospitais que devem ser exploradas aquando do desenho de uma intervenção de desenvolvimento organizacional.

Israelitisches Erholungsheim Nürnberg in Büg bei Forth (Mfr.)

Freudenthal

QUANTITATIVE OH PLANAR LASER INDUCED FLUORESCENCE DIAGNOSTICS OF SYNGAS AND METHANE COMBUSTION IN A CAVITY COMBUSTOR

The current work reports quantitative OH species concentration in the cavity of a trapped vortex combustor (TVC) in the context of mixing and flame stabilization studies using both syngas and methane fuels. Planar laser induced fluorescence (PLIF) measurements of OH radical obtained using a Nd: YAG pumped dye laser are quantified using a flat flame McKenna burner. The momentum flux ratio (MFR), defined as the ratio of the cavity fuel jet momentum to that of the guide vane air stream, is observed to be a key governing parameter. At high MFRs similar to 4.5, the flame front is observed to form at the interface of the fuel jet and the air jet stream. This is substantiated by velocity vector field measurements. For syngas, as the MFR is lowered to similar to 0.3, the fuel-air mixing increases and a flame front is formed at the bottom and downstream edge of the cavity where a stratified charge is present. This trend is observed for different velocities at similar equivalence ratios. In case of methane combustion in the cavity, where the MFRs employed are extremely low at similar to 0.01, a different mechanism is observed. A fuel-rich mixture is now observed at the center of the cavity and this mixture undergoes combustion. On further increase of the cavity equivalence ratio, the rich mixture exceeds the flammability limit and forms a thin reaction zone at the interface with air stream. As a consequence, a shear layer flame at the top of the cavity interface with the mainstream is also observed. The equivalence ratio in the cavity also determines the combustion characteristics in the case of fuel-air mixtures that are formed as a result of the mixing. Overall, flame stabilization mechanisms have been proposed, which account for the wide range of MFRs and premixing in the mainstream as well.

Designing marine fishery reserves using passive acoustic telemetry

Marine Fishery Reserves (MFRs) are being adopted, in part, as a strategy to replenish depleted fish stocks and serve as a source for recruits to adjacent fisheries. By necessity, their design must consider the biological parameters of the species under consideration to ensure that the spawning stock is conserved while simultaneously providing propagules for dispersal. We describe how acoustic telemetry can be employed to design effective MFRs by elucidating important life-history parameters of the species under consideration, including home range, and ecological preferences, including habitat utilization. We then designed a reserve based on these parameters using data from two acoustic telemetry studies that examined two closely-linked subpopulations of queen conch (Strombus gigas) at Conch Reef in the Florida Keys. The union of the home ranges of the individual conch (aggregation home range: AgHR) within each subpopulation was used to construct a shape delineating the area within which a conch would be located with a high probability. Together with habitat utilization information acquired during both the spawning and non-spawning seasons, as well as landscape features (i.e., corridors), we designed a 66.5 ha MFR to conserve the conch population. Consideration was also given for further expansion of the population into suitable habitats.

Holistic fisheries management: combining macroecology, ecology, and evolutionary biology

Ecosystem-based management is one of many indispensable components of objective, holistic management of human impacts on nonhuman systems. By itself, however, ecosystem-based management carries the same risks we face with other forms of current management; holism requires more. Combining single-species and ecosystem approaches represents progress. However, it is now recognized that management also needs to be evosystem-based. In other words, management needs to account for all coevolutionary and evolutionary interactions among all species; otherwise we fall far short of holism. Fully holistic practices are quite distinct from the approaches to the management of fisheries that are applied today. In this paper, we show how macroecological patterns can guide management consistently, objectively, and holistically. We present one particular macroecological pattern with two applications. The first application is a case study of fisheries from the Baltic Sea involving historical data for two species; the second involves a sample of 44 species of primarily marine fish worldwide. In both cases we evaluate historical fishing rates and determine holistic/systemic sustainable single-species fishing rates to illustrate that conventional fisheries management leads to much more extensive and pervasive overfishing than currently realized; harvests are, on average, over twenty-fold too large to be fully sustainable. In general, our approach involves not only the sustainability of fisheries and related resources but also the sustainability of the ecosystems and evosystems in which they occur. Using macroecological patterns accomplishes four important goals: 1) Macroecology becomes one of the interdisciplinary components of management. 2) Sustainability becomes an option for harvests from populations of individual species, species groups, ecosystems, and the entire marine environment. 3) Policies and goals are reality-based, holistic, or fully systemic; they account for ecological as well as evolutionary factors and dynamics (including management itself). 4) Numerous management questions can be addressed.

Sea turtles in Florida's Atlantic waters

Management of marine turtles presents various challenges due to their highly migratory nature, which includes major ontogenetic habitat shifts, seasonal movements between feeding grounds, and migrations to and from breeding grounds. Further, sea turtle spatial distributions often differ in species-specific ways during similar temporal periods. Various approaches combine to give valuable insights into spatial and temporal distributions of sea turtles and provide critical knowledge for understanding and protecting these imperiled species. Here we summarize and synthesize available data that document sea turtle occurrences in waters from the Florida Straits (lat. 24°28´N) north to the latitude of Jacksonville, Fla. (lat. 30°20´ N), including waters up to 150 km offshore, termed Florida’s Atlantic waters for this review. We summarize 951 satellite tracked sea turtles, 288 of which crossed into Florida’s Atlantic waters. All species of sea turtles inhabiting the Atlantic Ocean were found to use Florida Atlantic waters. Sea turtles use Florida’s Atlantic waters year-round, yet distributions of individual species vary seasonally. We provide a current synthesis describing the spatial and temporal distributions of the five sea turtles species using Florida’s Atlantic waters and suggest areas where further study may be warranted.

Gear modifications for fishing octopus, Octopus vulgaris, on live-bottom and adjacent flat bottom habitats in coastal waters off North Carolina

The Common Octopus, Octopus vulgaris, is an r-selected mollusk found off the coast of North Carolina that interests commercial fishermen because of its market value and the cost-effectiveness of unbaited pots that can catch it. This study sought to: 1) determine those gear and environmental factors that influenced catch rates of octopi, and 2) evaluate the feasibility of small-scale commercial operations for this species. Pots were fished from August 2010 through September 2011 set in strings over hard and sandy bottom in waters from 18 to 30 m deep in Onslow Bay, N.C. Three pot types were fished in each string; octopus pots with- and without lids, and conch pots. Proportional catch was modeled as a function of gear design and environmental factors (location, soak time, bottom type, and sea surface water temperature) using binomially distributed generalized linear models (GLM’s); parsimony of each GLM was assessed with Akaike Information Criteria (AIC). A total of 229 octopi were caught throughout the study. Pots with lids, pots without lids, and conch pots caught an average of 0.15, 0.17, and 0.11 octopi, respectively, with high variability in catch rates for each pot type. The GLM that best fit the data described proportional catch as a function of sea surface temperature, soak time, and station; greatest proportional catches occurred over short soak times, warmest temperatures, and less well known reef areas. Due to operating expenses (fuel, crew time, and maintenance), low catch rates of octopi, and high gear loss, a directed fishery for this species is not economically feasible at the catch rates found in this study. The model fitting to determine factors most influential on catch rates should help fishermen determine seasons and gear soak times that are likely to maximize catch rates. Potting for octopi may be commercially practical as a supplemental activity when targeting demersal fish species that are found in similar habitats and depth ranges in coastal waters off North Carolina.

Determinants of small-scale fishermen's income on Oman's Batinah Coast

The small-scale fishing industry of Oman is responsible for almost 90 percent of the total marine fishery production. It is also the main supplier of fish for Omani households. This study analyzes the factors that determine small-scale fishermen’s income on Oman’s Batinah Coast, which has almost 30 percent of Oman’s population and more than one-third of the small-scale fishermen. We find that fishermen’s income here can be explained broadly under four major blocks of variables: geographical region, fishing inputs and catch, socioeconomic and demographic characteristics, and the nature of the relationship with fisheries extension services. In general, the Wilayat (local administrative units) failed to make any significant impact on fishermen’s income. The variable “Fishing inputs and catch,” such as increases in engine power, boat length, weekly catch, and number of weekly trips, positively impacted fishermen’s income while increases in weekly fishing costs, number of crew members, and difficulty in getting ice had a significantly negative effect on the income. Furthermore, socioeconomic and demographic characteristics also contributed significantly in determining the fishermen’s income level. The other important findings were related to extension services. The variables “Fishermen’s exchange of information and cooperation with the ministry” and “Fishermen’s involvement in the extension activities” were found to have positive effects on fishermen’s income levels. Capitalizing on these findings could improve fishermen’s incomes and their lives across the region, as well as nationally.

Historical knowledge of sharks: ancient science, earliest American encounters, and American science, fisheries, and utilization

In western civilization, the knowledge of the elasmobranch or selachian fishes (sharks and rays) begins with Aristotle (384–322 B.C.). Two of his extant works, the “Historia Animalium” and the “Generation of Animals,” both written about 330 B.C., demonstrate knowledge of elasmobranch fishes acquired by observation. Roman writers of works on natural history, such as Aelian and Pliny, who followed Aristotle, were compilers of available information. Their contribution was that they prevented the Greek knowledge from being lost, but they added few original observations. The fall of Rome, around 476 A.D., brought a period of economic regression and political chaos. These in turn brought intellectual thought to a standstill for nearly one thousand years, the period known as the Dark Ages. It would not be until the middle of the sixteenth century, well into the Renaissance, that knowledge of elasmobranchs would advance again. The works of Belon, Salviani, Rondelet, and Steno mark the beginnings of ichthyology, including the study of sharks and rays. The knowledge of sharks and rays increased slowly during and after the Renaissance, and the introduction of the Linnaean System of Nomenclature in 1735 marks the beginning of modern ichthyology. However, the first major work on sharks would not appear until the early nineteenth century. Knowledge acquired about sea animals usually follows their economic importance and exploitation, and this was also true with sharks. The first to learn about sharks in North America were the native fishermen who learned how, when, and where to catch them for food or for their oils. The early naturalists in America studied the land animals and plants; they had little interest in sharks. When faunistic works on fishes started to appear, naturalists just enumerated the species of sharks that they could discern. Throughout the U.S. colonial period, sharks were seldom utilized for food, although their liver oil or skins were often utilized. Throughout the nineteenth century, the Spiny Dogfish, Squalus acanthias, was the only shark species utilized in a large scale on both coasts. It was fished for its liver oil, which was used as a lubricant, and for lighting and tanning, and for its skin which was used as an abrasive. During the early part of the twentieth century, the Ocean Leather Company was started to process sea animals (primarily sharks) into leather, oil, fertilizer, fins, etc. The Ocean Leather Company enjoyed a monopoly on the shark leather industry for several decades. In 1937, the liver of the Soupfin Shark, Galeorhinus galeus, was found to be a rich source of vitamin A, and because the outbreak of World War II in 1938 interrupted the shipping of vitamin A from European sources, an intensive shark fishery soon developed along the U.S. West Coast. By 1939 the American shark leather fishery had transformed into the shark liver oil fishery of the early 1940’s, encompassing both coasts. By the late 1940’s, these fisheries were depleted because of overfishing and fishing in the nursery areas. Synthetic vitamin A appeared on the market in 1950, causing the fishery to be discontinued. During World War II, shark attacks on the survivors of sunken ships and downed aviators engendered the search for a shark repellent. This led to research aimed at understanding shark behavior and the sensory biology of sharks. From the late 1950’s to the 1980’s, funding from the Office of Naval Research was responsible for most of what was learned about the sensory biology of sharks.

Comparing autonomous underwater vehicle (AUV) and vessel-based tracking performance for locating acoustically tagged fish

Autonomous underwater vehicles (AUV’s) are increasingly used to collect physical, chemical, and biological information in the marine environment. Recent efforts include merging AUV technology with acoustic telemetry to provide information on the distribution and movements of marine fish. We compared surface vessel and AUV tracking capabilities under rigorous conditions in coastal waters near Juneau, Alaska. Tracking surveys were conducted with a REMUS 100 AUV equipped with an integrated acoustic receiver and hydrophone. The AUV was programmed to navigate along predetermined routes to detect both reference transmitters at 20–500 m depths and tagged fish and crabs in situ. Comparable boat surveys were also conducted. Transmitter depth had a major impact on tracking performance. The AUV was equally effective or better than the boat at detecting reference transmitters in shallow water, and significantly better for transmitters at deeper depths. Similar results were observed for tagged animals. Red king crab, Paralithodes camtschaticus, at moderate depths were recorded by both tracking methods, while only the AUV detected Sablefish, Anoplopoma fimbria, at depths exceeding 500 m. Strong currents and deep depths caused problems with AUV navigation, position estimation, and operational performance, but reflect problems encountered by other AUV applications that will likely diminish with future advances, enhanced methods, and increased use.

Three decades of U.S. Gulf of Mexico white shrimp, Litopenaeus setiferus, commercial catch statistics

Gulf of Mexico, white shrimp, Litopenaeus setiferus, catch statistics have been collected by NOAA’s National Marine Fisheries Service for over 50 years. Recent occurrences such as natural and manmade disasters have raised awareness for the need to publish these types of data. Here we report shrimp data collected from 1984 to 2011. These 28 years of catch history are the time series used in the most recent Gulf of Mexico white shrimp stock assessment. Fishing effort for this stock has fluctuated over the period reported, ranging from 54,675 to 162,952 days fished. Catch averaged 55.7 million pounds per year, increasing significantly over the times series. In addition, catch rates have been increasing in recent years, with CPUE levels ranging from 315 lb/day fished in 2002, to 1,175 lb/ day fished in 2008. The high CPUE’s we have measured is one indication that the stock was not in decline during this time period. Consequently, we believe the decline in effort levels is due purely to economic factors. Current stock assessments are now using these baseline data to provide managers with further insights into the Gulf L. setiferus stocks.

Cryopreservation of sperm of common carp, Cyprinus carpio and silver barb, Barbonymus gonionotus for genetically improved seed production

Experiments were conducted to develop and standardize the protocols for cryopreservation of sperm of common carp, Cyprinus carpio and also for using the cryopreserved sperm for fertilization of eggs. Nine extender solutions as Alsever's solution, kurokura-1, kurokura-2, urea egg-yolk, egg-yolk citrate, 0.6% glucose, 0.9% NaCl, Ma and Mb, and five cryoprotectants namely ethanol, methanol, dimethylsulfoxide (DMSO), dimethylamine (DMA) and glycerol were tested. The cryoprotectants were mixed at 10% concentration of the extenders (v/v) to make the cryodiluents. Milt and cryodiluents were mixed at a ratio of 1:9 for Alsever's solution, kurokura-1, kurokura-2, 0.6% glucose and 0.9% NaCl, 1:4 for urea egg-yolk, egg-yolk citrate, Ma and Mb. Among the cryodiluents Alsever's solution mixed with either ethanol or methanol was found to be suitable and it produced more than 90% and 80% spermatozoan motility at equilibrium and post-thaw periods, respectively. Kurokura-1 and kurokura-2 when mixed with the same cryoprotectants showed good spermatozoan motility at equilibrium period (80-90%) but the motility was reduced (30-55%) at post-thaw state. Other extenders did not produce acceptable sperm-motility and in some cases the frozen milt became clotted. Different dilution ratios (1:1, 1:2, 1:4, 1:5, 1:7, 1:9, 1:12, 1:15, 1:20) were formulated for obtaining a suitable milt dilution, the dilution ratio of 1: 9 (milt : cryodiluent) demonstrated the highest post-thaw spermatozoan motility (80%) in Alserver's solution. The optimum concentration of cryoprotectants in the cryodiluents was determined, 10% concentration level was found to be effective to produce the highest number of spermatozoan motility in comparison to the other concentrations (5%, 15%, 20% 30%). Sperm preserved with the cryodiluent Alsever's solution along with either methanol or ethanol was found to be effective to fertilize eggs and produce hatchlings. The hatching rates ranged between 1.48% and 14.76%, compare to control. The fish produced through use of cryopreserved sperm and normal sperm were found to grow well and no significant (P<0.05) growth difference was observed between them. In case of silver barb, Barbonymus gonionotus, sperm tested against six extenders such as egg-yolk citrate, urea-egg-yolk, kurokura-1, kurokura-2, 0.9% NaCl and modified fish ringer (MFR) solution. Cryoprotectants used were the same as those of C. carpio. Milt was diluted with the cryodiluent at a ratio of 1:4 for egg-yolk citrate and urea-egg-yolk, 1:5 for kurokura-1 and 1:9 for 0.9% NaCl, MFR and kurokura-2. The cryoprotectant concentration was maintained at 10% of the extender (v/v) in all the cases. Among the extenders, egg-yolk citrate and urea-egg-yolk mixed with 10% DMSO, methanol and ethanol produced 50% post-thaw spermatozoan motility, whereas DMA and glycerol provided only 10% motility. Trials on milt dilution ratio and cryoprotectant concentration are being conducted. Fertilization trials are also underway.

Characterization of High Melt Strength Polypropylene Synthesized via Silane Grafting Initiated by In Situ Heat Induction Reaction

High melt strength polypropylene (HMSPP) was synthesized by in situ heat induction reaction, in which pure polypropylene (PP) powders without any additives were used as a basic resin and vinyl trimethoxysilane (VTMS) as a grafting and crosslinking agent. The grafting reaction of VTMS with PP was confirmed by FTIR. The structure and properties of HMSPP were characterized by means of various measurements. The content of grafted silane played a key role on the melt strength and melt flow rate (MFR) of HMSPP. With increasing the content of grafted silane, the melt strength of HMSPP increased, and the MFR reduced. In addition, due to the existence of cross-linking structure, the thermal stability and tensile strength of HMSPP were improved compared with PP.

Neodymium oxide co-catalyzed melt free radical grafting of maleic anhydride onto co-polypropylene by reactive extrusion

Rare earth oxide, neodymium oxide (Nd2O3), CO-catalyzed melt grafting of maleic anhydride (MAH) onto co-polypropylene (co-PP) in the presence of dicumyl peroxide (DCP) was carried out by reactive extrusion. The experimental results reveal that the addition of Nd2O3 as a coagent leads to an enhancement in both MFR and the grafting degree of MAH, along with a simultaneous decrease in the gel content. When the Nd2O3 concentration is 6.0 mmol%, the increment of the grafting degree of MAH maximally is up to about 20% compared with the related system without adding Nd2O3, and the gel content decreases simultaneously to a very low level of about 3%. Attenuated total reflection FTIR (ATR-FTIR) indicates that the gel in the graft copolymers mainly arise from the cross-linking reaction between ethylene units of co-PP. A reasonable reaction mechanism has been put forward on the basis of our experimental results and other mechanisms reported in the literature. We also tentatively explain above results by means of synergistic effect between DCP and Nd2O3, which causes a higher concentration of the macroradical, in particular the tertiary macroradical.