700 research outputs found

    Comparative analysis between visual and computerized photogrammetry postural assessment

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    OBJETIVOS: Comparar a concordância interobservador da avaliação postural visual e por fotogrametria e verificar se os resultados quantitativos da fotogrametria correspondem à detecção de simetrias e assimetrias pela avaliação postural visual qualitativa. MÉTODOS: Vinte e um voluntários (24±1,9 anos) foram inicialmente avaliados visualmente por três fisioterapeutas experientes que preencheram um protocolo de avaliação postural. Em seguida tiveram fotografados a face e o corpo todo nos planos frontal anterior, posterior e sagital. As fotos foram utilizadas para traçar ângulos a partir de marcadores fixados à pele, em vários pontos anatômicos, que são referências frequentes na avaliação postural tradicional. Essas fotografias foram analisadas por três examinadores diferentes da avaliação postural visual. A concordância de cada método de avaliação postural foi avaliada pelos Coeficientes de Cramer V ou de PHI, considerando-se um nível de significância de 5%. RESULTADOS: Foi encontrada uma concordância entre os examinadores que utilizaram a fotogrametria para todos os segmentos avaliados. Não apresentaram concordância os segmentos comissura labial (p=0,00), acrômio clavicular (p=0,01), esternoclavicular (p=0,00), espinhas ilíacas anterior e posterior (p=0,00 e p=0,01) e ângulo inferior da escápula (p=0,00), que foram analizados por meio da avaliação postural visual. A comparação entre a fotogrametria e a avaliação postural visual demonstrou que o grau de concordância entre os dois métodos de avaliação foi pouco significativo para alguns segmentos do membro inferior e pelve. CONCLUSÕES: Nessas condições experimentais, os dados da fotogrametria não podem ser correlacionados com os dados da avaliação postural visual. A avaliação postural visual apresentou dados menos concordantes do que a fotogrametria, devendo ser questionada sua utilização como gold-standart.OBJECTIVES: To compare the interobserver agreement between visual and photogrammetry postural assessment and to determine whether the quantitative photogrammetry results correspond to the symmetries and asymmetries detected through qualitative visual postural assessment. METHODS: Twenty-one volunteers (mean age 24±1.9 years) were visually evaluated by three experienced physical therapists, who completed a postural assessment form. The participants' face and whole body were then photographed in the anterior and posterior frontal and sagittal planes. The photographs were used to draw angles from markers fixed to the skin at various anatomical points that are frequent references in traditional postural assessment. These photographs were analyzed by three examiners (other than the ones who performed the visual assessment). The agreement in each postural assessment method was determined using Cramer's V or the Phi coefficient, with the significance level set at 5%. RESULTS: There was agreement between the examiners who used photogrammetry, for all segments analyzed. No agreement was found for the labial commissure (p=0.00), acromioclavicular joint (p=0.01), sternoclavicular joint (p=0.00), anterior and posterior iliac spines (p=0.00 and p=0.01) or inferior angle of the scapula (p=0.00) when assessed visually. The comparison between photogrammetry and visual postural assessment showed that the agreement level between the two assessment methods was poor for some segments of the lower limb and pelvis. CONCLUSIONS: Under these experimental conditions, the photogrammetry data were not correlated with the results from the visual postural assessment. The visual postural assessment produced data that were in less agreement than the photogrammetry data, and its use as a gold standard must be questioned

    A Multicenter, Non-Interventional Study to Evaluate the Disease Activity in Multiple Sclerosis after Withdrawal of Natalizumab in Portugal

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    Objectives: Natalizumab (NTZ) is very effective for treatment of relapsing-remitting multiple sclerosis (RRMS), its use is mainly limited by safety issues. Discontinuation of NTZ is associated with recurrence of disease activity (reactivation and rebound). The best strategy for subsequent therapy and the predictive factors for recurrence in such patients are areas of active research. We aimed to evaluate predictors of reactivation in a multicentric study. Patients and methods: Multicentric retrospective observational study in five portuguese MS referral centers. Demographic, clinical and imagiological data were collected in the year prior, during and in the year following NTZ discontinuation. Predictors of reactivation and rebound after NTZ suspension were studied using a multivariate Cox model. Results: Sixty-nine patients were included. They were mainly non-naïve patients (97%), with a mean age of 29.1 ± 8.3 years at diagnosis, and a mean age of 37.2 ± 10.3 years at NTZ initiation. The mean annualized relapse rate (ARR) previous, during and after NTZ was 1.6 ± 1.2, 0.2 ± 0.5 and 0.6 ± 1.0, respectively. The median EDSS before, during and after NTZ was 3.5 (IQR 3.3), 3.5 (IQR 3.5) and 4.0 (IQR 3.8), respectively. The median number of infusions was 26.0 (IQR 12.5) and the main reason to NTZ discontinuation was progressive multifocal leukoencephalopathy (PML) risk (70%). After NTZ suspension, reactivation was observed in 25 (36%) patients after a median time of 20.0 (IQR 29.0) weeks. Reactivation predictors in our sample included NTZ suspension for reasons other than PML (adjusted HR = 0.228, 95% CI [0.084- 0.616], p = 0.004), ARR before NTZ (adjusted HR = 1.914 95% [CI 1.330-2.754], p < 0.001) and a longer disease duration at time of NTZ initiation (adjusted HR = 1.154, 95% CI [1.020-1.306], p = 0.023). Rebound occurred in 5 (7%) patients after a median time of 20 (IQR 34.5) weeks. Conclusion: Significant predictors of disease reactivation in our cohort were discontinuation of NTZ for reasons other than PML risk, higher disease activity before NTZ treatment, and longer disease duration. Our study provides valuable data of portuguese patients after NTZ withdrawal.info:eu-repo/semantics/publishedVersio

    Proceso de construcci?n de una cultura de paz en los ni?os de transici?n de la instituci?n educativa Armando Romero Lozano de Sevilla Valle, a trav?s de estrategias did?cticas sensibilizadoras

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    121 p. Recurso Electr?nicoEl presente proyecto de investigaci?n ?proceso de construcci?n de una cultura de paz en los ni?os de preescolar, a trav?s de estrategias did?cticas sensibilizadoras? consiste en visibilizar los alcances en la mejora de las habilidades de resoluci?n de conflictos a trav?s de actividades l?dicas y art?sticas en los ni?os de preescolar de Instituci?n Educativa Armando Romero Lozano del municipio de Sevilla valle. Todo esto se realiz? partiendo del planteamiento de los objetivos, los cuales permitir?n lograr su cometido; en primer lugar, identificar a partir de los resultados qu? problem?ticas de comportamiento tienen los ni?os, en segundo lugar, implementar un plan de intervenci?n orientado a mejorar las relaciones interpersonales de los ni?os y en tercer lugar, evaluar el impacto generado con el plan de intervenci?n propuesto para tal fin. En cuanto al marco te?rico, se busc? el soporte en los postulados de diferentes autores, los cuales resultaron pertinentes para el abordaje conceptual de este, ya que hablan del desarrollo de la capacidad creadora, principios, normas y valores que hacen un clima escolar acorde para una educaci?n para la paz y una participaci?n democr?tica, como aspectos importantes a tener en cuenta en esta investigaci?n. Respecto a la metodolog?a, se desarroll? en base a la investigaci?n la investigaci?n acci?n-participativa y cooperativa, con un enfoque etnogr?fico, dentro del paradigma cualitativo. Tras esto, el resultado que se obtendr? del proceso estudiado, que junto a referentes te?ricos ayuda a explicar los procesos de la pr?ctica escolar estudiada.This research project process of building a culture of peace in preschool children through teaching strategies visible sensitizer is the scope in improving the skills of conflict resolution through recreational and artistic activities preschoolers educational institution Armando Romero Lozano the municipality of Seville valley. All this was done based on the approach of objectives, which will allow achieve its mission; first identified from the results which problematic behavior have children, secondly, implement an intervention plan aimed at improving interpersonal relationships of children and thirdly, to assess the impact generated with the intervention plan proposed for this purpose. As for the theoretical framework, support the propositions of different authors, which were relevant to the conceptual approach to this is sought, as they speak of the development of creativity, principles, norms and values that make a chord school climate for education for peace and democratic participation, as important aspects to consider in this research. Reading methodology was developed based on the research-participatory and cooperative action with an ethnographic approach, within the qualitative research paradigm. After this, the result you get the process under study, which together with theoretical framework helps explain the processes studied school practice Keywords: skills, peace, transition, norms, values and family

    REALMS Study: Real-World Effectiveness and Safety of Fingolimod in Patients with Relapsing-Remitting Multiple Sclerosis in Portugal

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    Background: Fingolimod, an oral sphingosine 1-phosphate receptor modulator, is approved by EMA for relapsing-remitting multiple sclerosis (RRMS). Objectives: To assess the effectiveness and safety of fingolimod in patients with RRMS in real-world clinical practice in Portugal. Methods: Retrospective, multicentre, non-interventional study, reporting 3 years follow-up of data collected from October 2015 to July 2016. Sociodemographic data and previous treatments at baseline and data regarding disease evolution, including number of relapses, annualised relapse rates (ARR) and Expanded Disability Status Scale (EDSS), were collected. Results: Two-hundred and seventy-five participants were enrolled in the REALMS study. Results showed that the main reason to switch to fingolimod was failure of previous treatment (56.7%) and only 3.6% were naïve patients. In the total population, there was a significant decrease in ARR of 64.6% in the first year of treatment, 79.7% in the second year and 82.3% in the third year, compared with baseline. More than 67.0% of patients had no relapses during the 3 years after switching to fingolimod. EDSS remained stable throughout the study. Conclusions: Therapy with fingolimod showed a sustained effectiveness and safety over the 3 years, particularly on patients switched from first-line drugs (BRACE). No new safety issues were reported.info:eu-repo/semantics/publishedVersio

    Genomic Arrangement of Regulons in Bacterial Genomes

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    Regulons, as groups of transcriptionally co-regulated operons, are the basic units of cellular response systems in bacterial cells. While the concept has been long and widely used in bacterial studies since it was first proposed in 1964, very little is known about how its component operons are arranged in a bacterial genome. We present a computational study to elucidate of the organizational principles of regulons in a bacterial genome, based on the experimentally validated regulons of E. coli and B. subtilis. Our results indicate that (1) genomic locations of transcriptional factors (TFs) are under stronger evolutionary constraints than those of the operons they regulate so changing a TF's genomic location will have larger impact to the bacterium than changing the genomic position of any of its target operons; (2) operons of regulons are generally not uniformly distributed in the genome but tend to form a few closely located clusters, which generally consist of genes working in the same metabolic pathways; and (3) the global arrangement of the component operons of all the regulons in a genome tends to minimize a simple scoring function, indicating that the global arrangement of regulons follows simple organizational principles

    Influenza vaccination of healthcare workers in acute-care hospitals: a case-control study of its effect on hospital-acquired influenza among patients

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    <p>Abstract</p> <p>Background</p> <p>In acute-care hospitals, no evidence of a protective effect of healthcare worker (HCW) vaccination on hospital-acquired influenza (HAI) in patients has been documented. Our study objective was to ascertain the effectiveness of influenza vaccination of HCW on HAI among patients.</p> <p>Methods</p> <p>A nested case-control investigation was implemented in a prospective surveillance study of influenza-like illness (ILI) in a tertiary acute-care university hospital. Cases were patients with virologically-confirmed influenza occurring ≥ 72 h after admission, and controls were patients with ILI presenting during hospitalisation with negative influenza results after nasal swab testing. Four controls per case, matched per influenza season (2004-05, 2005-06 and 2006-07), were randomly selected. Univariate and multivariate conditional logistic regression models were fitted to assess factors associated with HAI among patients.</p> <p>Results</p> <p>In total, among 55 patients analysed, 11 (20%) had laboratory-confirmed HAI. The median HCW vaccination rate in the units was 36%. The median proportion of vaccinated HCW in these units was 11.5% for cases vs. 36.1% for the controls (<it>P </it>= 0.11); 2 (20%) cases and 21 (48%) controls were vaccinated against influenza in the current season (<it>P </it>= 0.16). The proportion of ≥ 35% vaccinated HCW in short-stay units appeared to protect against HAI among patients (odds ratio = 0.07; 95% confidence interval 0.005-0.98), independently of patient age, influenza season and potential influenza source in the units.</p> <p>Conclusions</p> <p>Our observational study indicates a shielding effect of more than 35% of vaccinated HCW on HAI among patients in acute-care units. Investigations, such as controlled clinical trials, are needed to validate the benefits of HCW vaccination on HAI incidence in patients.</p
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