Comfort termico nel settore automobilistico: validazione di un modello di comfort

Questa tesi analizza un modello di comfort termico applicato all’abitacolo della Ferrari Scaglietti 612. Il comfort termico risulta un elemento fondamentale per la scelta e l'acquisto di un autoveicolo. Poiché un approccio sperimentale per la valutazione del comfort termico risulta molto costoso e difficilmente applicabile nella fase iniziale di progettazione, la Ferrari SPA ha deciso di sviluppare un'attività di ricerca sull'argomento in collaborazione con il dipartimento di Ingegneria Aerospaziale di Pisa per quantificare stato di comfort utilizzando il calcolo CFD. La presente tesi si iscrive nell'ambito di questa collaborazione. I lavori sviluppati in precedenza hanno portato alla formulazione di un modello che valuta il livello di comfort come media pesata di quattro indici di sensazione. Questa tesi analizza i dati sperimentali forniti dall’azienda Ferrari per valutare l’incidenza dei singoli indici di sensazione sulla formulazione del giudizio di comfort. E’ inoltre analizzata la correlazione fra gli indici di sensazione espressa dai cinque tester e i relativi indici calcolati con il modello teorico. Gli studi effettuati mostrano che il modello è in grado di calcolare con buona accuratezza il giudizio medio di comfort che una persona percepisce all’interno dell’abitacolo. La seconda parte della tesi è incentrata sullo studio termo fluidodinamico dell’abitacolo della Ferrari Scaglietti 612. Si analizza, con il software Ansys® FLUENT, una condizione in cui l’impianto di condizionamento raffredda l’abitacolo ed è presente un flusso di calore radiante che simula l’effetto di riscaldamento del sole. Particolare attenzione è rivolta allo studio dei modelli di trasferimento del calore radiante presenti in FLUENT

Update in laparoscopic approach to acute mesenteric ischemia

AMI is an uncommon but serious disease often associated with a bad prognosis, associated with occlusion of Superior Mesenteric Artery (SMA) for embolism or thrombosis (67.2%), mesenteric venous thrombosis (15.7%), and non-occlusive mesenteric ischemia (15.4%). Clinical markers are often aspecific and symptoms low suggestive. The gold standard for the diagnosis is multidetector CT Angiography (CTA) with sensibility of 93.3% and specificity of 95.9%. Abdominal exploration could be useful to confirm cases of AMI without signs of SMA occlusion at CTA. Few reports have been found on the diagnostic role of Exploratory Laparoscopy. To increase the sensibility of laparoscopy in the diagnosis of AMI in the last ten years, some studies had shown the possibility of using fluorescein to underline the bowel areas of interest by ischemia. The best of laparoscopy in AMI diagnosis remains the second look and bedside use (directly in ICU when possible) overall in patients with Aortic dissection type B (preferable chronic type). In a limited number of cases, it is possible to evaluate bowel perfusion laparoscopically and at the same time perform a laparoscopical bowel resection of residual ischemic segments. However, laparoscopic primary access overall in AoD is an important tool for leading therapeutic decision and timing. Finally, laparoscopy may be a feasible alternative to CTA in patients with kidney failure that contraindicates injection of iodate CT contrast medium

Physical and emotional causes and consequences of career termination in sports

INTRODUCTION: Elite athletes will have to face sport career termination sooner or later, and this is a crucial and inevitable process that brings about changes in the occupational, financial, social and psychological spheres of their lives, which can be followed by emotional distress. OBJECTIVE: The present study had the aim to research how former Brazilian basketball and professional soccer players have experienced retirement in sports career as well as its causes and consequences. MATERIAL AND METHODS: 79 former elite male athletes (soccer and basketball players) with mean age of 51.75 ± 8.85 years old were assessed. They have been professional athletes for 18.22 ± 4.66 years and had their career termination at about 34.36 ± 4.42 years. A semi-structured interview frame was used and the data were analyzed according to the answers frequency of occurrence for each interview item. RESULTS: It was observed that for 75.9% of these athletes the retirement from sport was their own choice. Age (49.4%) and appearance of other interests (43.0%) were the most frequent reasons related to the retirement. However, they have experienced feelings of sadness (50.6%) and resignation (36.7%) and 43% of the former athletes have experienced worsening in their physical condition after career termination. CONCLUSION: We can conclude that the hereby-assessed athletes have experienced a long sports career, but their retirement caused feelings of sadness. On the other hand, old age itself is a limitation for the practice of elite sports, and its acknowledgement has led to resignation.INTRODUÇÃO: Os atletas de alto rendimento, em determinado momento, se defrontam com o término de carreira esportiva, um processo crucial e inevitável, com exigências de ajustamentos nas esferas da vida ocupacional, financeira, social e psicológica e, que, portanto, pode ser acompanhado por distress emocional. OBJETIVO: O presente estudo teve como objetivo pesquisar como ex-atletas brasileiros de alto nível de basquetebol e futebol profissional experienciaram a aposentadoria da carreira esportiva, suas causas e conseqüências físicas e emocionais. MÉTODOS: Para tanto, foram avaliados 79 ex-atletas de alto nível, do sexo masculino, que pertenciam a duas modalidades esportivas: futebol (N = 57) e basquetebol (N = 22), com média de idade de 51,75 ± 8,85 anos. O tempo de prática como atleta profissional foi de 18,22 ± 4,66 anos e o término da carreira esportiva ocorreu em média aos 34,36 ± 4,42 anos. Utilizou-se uma entrevista semi-estruturada; os dados foram analisados pela freqüência de ocorrência de respostas para cada item da entrevista. RESULTADOS: Observou-se que, para 75,9% dos atletas, a decisão de encerrar a carreira foi espontânea. A idade (49,4%) e outros interesses emergentes (43,0%) foram as principais causas da aposentadoria. Os sentimentos vivenciados nesse momento foram de tristeza (50,6%) e de conformismo (36,7%). Para 43% dos ex-atletas a condição física piorou após o término da carreira. CONCLUSÕES: Os autores concluem que, apesar de os atletas terem experienciado uma carreira esportiva longa, o momento de se aposentar no esporte trouxe sentimentos de tristeza. Por outro lado, a idade é um limitador para a carreira esportiva e reconhecer isso levou ao conformismo.Universidade Federal de São Paulo (UNIFESP) Departamento de Reabilitação Centro de Medicina da Atividade Física e do EsporteUniversidade São Judas TadeuUNIFESP, Depto. de Reabilitação Centro de Medicina da Atividade Física e do EsporteSciEL

Divergent responses of serum testosterone and cortisol in athlete men after a marathon race

Physical exercise alters homeostasis, as it requires prompt mobilization of metabolic sources. In this study, we measured serum testosterone (T) and cortisol (C) levels and the muscle-wastage enzymes CK, CKMB and LDH in 20 healthy male athletes (ages 25 to 40 years) in response to a marathon race (42.2 km). Venous blood samples were drawn in 3 different periods: (i) in the morning, 48 h before the competition (control), (ii) at the end of the race (end), and (iii) in the next morning, 20 h after the race (recovery). At the end, T was significantly lower (from 673 to 303 ng/dl) and C higher (from 20.3 to 42.5 µg/dl) as compared to the control period. At recovery, both were virtually identical to control levels. CK, CKMB and LDH were significantly higher at the end of the competition and even higher in the recovering period (except for CKMB), characterizing muscle wastage. CK and LDH disclosed a significant negative correlation with T (-0.412 and -0.546, respectively), whereas CKMB correlated positively with C (0.4521). We conclude that the inverse correlation observed between T and C levels, and the pattern of CK, CKMB and LDH increase, allow us to confirm that a marathon race may cause a marked physical stress, resulting in a distinct hormonal imbalance and severe cellular damage.O exercício físico altera a homeostase, pois requer rápida mobilização de fontes metabólicas. Neste estudo, analisamos a resposta dos níveis séricos de testosterona (T) e cortisol (C) e das enzimas de desgaste muscular CK, CKMB e LDH, em 20 atletas masculinos sadios (25 a 40 anos), participantes de uma maratona (42,2 km). Coletas de sangue venoso foram feitas em 3 períodos: (i) pela manhã, 48 h antes da maratona (controle), (ii) logo após o término da corrida (final) e (iii) na manhã seguinte, 20 h após a realização da prova (recuperação). Ao final, T estava significantemente mais baixa (de 673 para 303 ng/dl) e C mais elevado (de 20,3 para 42,5 µg/dl) que no período controle. Na recuperação, ambos praticamente retornaram aos níveis basais. CK, CKMB e LDH estavam significantemente mais elevadas ao final da corrida e mais ainda na recuperação (exceto a CKMB), caracterizando o desgaste muscular. Enquanto CK e LDH apresentaram significante correlação negativa com a T (-0,412 e -0,546, respectivamente), CKMB correlacionou-se positivamente com o C (0,4521). Concluímos que a correlação inversa entre T e C, e o comportamento das enzimas CK, CKMB e LDH, permite comprovar que uma corrida de maratona causa intenso stress físico, provocando desequilíbrio hormonal e lesão celular severa.Universidade Federal de São Paulo (UNIFESP) Departamento de Medicina Centro de Medicina da Atividade Física e do EsporteUNIFESP, Depto. de Medicina Centro de Medicina da Atividade Física e do EsporteSciEL

THE INFLUENCE OF THE BACK FUNCTIONAL LINE ON LOWER EXTREMITY FRONTAL PLANE KINEMATICS AND KINEMATIC PREDICTORS OF LOADING DURING RUNNING

Running injuries have been linked to poor lower extremity dynamic alignment, increased whole body and joint loading, and insufficient modulation of stiffness throughout stance phase. Upper body muscle activity and movement have a relationship to lower body dynamics; however, the literature has largely neglected their role during running. To date, biomechanical gait analysis has primarily focused on lower extremity mechanics and muscle activation patterns with no studies investigating the role of functional muscle synergies on stability and loading during running. Therefore, the primary objective of this project is to determine the role of the Back Functional Line (BFL), via measure of latissimus dorsi (LD), gluteus maximus (GM), and vastus lateralis (VL) muscle activity, during running and to determine their influence on lower extremity kinematics and kinematic predictors of loading that are linked to running-related injuries (RRI). We used conditions of arm swing constraint to manipulate the action of the LD and investigate the response in GM and VL muscles. Our main variables of interest include: 1) BFL muscle activity, specifically mean and peak amplitude, onset, and co-activation of the LD and GM 2) frontal plane lower extremity kinematics, and 3) kinematic predictors of kinetics, specifically foot inclination angle at initial contact and vertical COM displacement. Twenty healthy recreational runners (10 M; 10 F) participated in this study. Male runners tended to be slighter older with a higher weekly running mileage and longer running history. All participants were between the ages of 18 and 55 years old and consistently ran at least once per week. Participants ran under three arm conditions - free arm swing, unilateral arm swing constraint, and bilateral arm swing constraint. During the running trials, surface EMG and lower extremity kinematics were collected over the gait cycle. We operationally defined the primary BFL as the muscle synergy composed of the non-dominant upper extremity (i.e., constrained side during unilateral condition) LD muscle, the dominant GM muscle, and the dominant VL muscle. The secondary BFL was defined as the dominant upper extremity (i.e., unconstrained during unilateral condition) LD muscle, the non-dominant GM muscle, and the non-dominant VL muscle. Primary and secondary BFL muscle synergy activity were analyzed during two specific phases of gait - the pre-activation (PA) phase and the loading response (LR) phase. In support of the hypothesis, the primary BFL LD mean amplitude decreased during both the PA and LR phases of gait. GM and VL muscle mean amplitude demonstrated a varied response. During the PA phase, both the GM and VL muscles increased during the unilateral condition and decreased during the bilateral condition. During LR phase, GM and VL muscles increased during both arm swing constraint conditions. The highest increase in amplitude was seen during the unilateral condition. Peak amplitudes for each muscle did not change dramatically across conditions for either the PA or LR phases of gait. Secondary BFL LD and GM mean and peak amplitude increased during both the PA and LR phases of gait, with changes during the LR phase reaching significance for both muscles. Secondary BFL VL also increased in mean and peak amplitude during the bilateral constraint condition. GM and VL mean and peak muscle amplitude were significantly correlated during the LR phase, but not for the PA phase. This indicates that the lower extremity muscles of the BFL (GM and VL) may not be preparing for impact similarly but are adjusting muscle activity in a similar fashion as the lower limb is loaded. The increase in muscle amplitude for secondary BFL muscles, particularly during the LR phase of gait, may have resulted from a difference between lower limb strength or lower extremity single leg stability. Onset of muscle activity during loading response did not significantly differ across conditions for the LD, GM, or VL muscles, however, analysis of co-activation demonstrated that LD and GM were in-phase throughout the gait cycle. This suggests that this portion of the BFL may be acting together to stabilize the lumbopelvic-hip complex (LPHC) during running. LD and GM appeared to be co-activated throughout the gait cycle regardless of arm swing variation. Instability, either from asymmetrical movement patterns or poor single leg stability may contribute to the activation of the BFL muscle synergy. GM increased during the unilateral arm swing constraint during both phase and for both BFL synergies, indicating that asymmetrical movement patterns may induce a potential instability or an unstable state requiring the need for greater stability around the LPHC. Knee frontal plane kinematics changed significantly across conditions. Knee abduction angle showed the greatest increase during the unilateral arm swing constraint condition suggesting that asymmetrical movement patterns effect lower extremity mechanics more so than symmetrical patterns (i.e., bilateral arm swing restriction or free arm swing). Hip adduction and contralateral pelvic drop angles did not differ significantly across conditions. Our study did not find a significant relationship between BFL muscle activity and knee abduction angles. Participants demonstrated larger knee abduction angles on their non-dominant limb at midstance. The corresponding (secondary) BFL LD and GM demonstrated a significant increase during the LR phase. This may indicate that BFL muscle activity is engaged when the need for lower limb stability is greater, either due to poor single leg dynamic control or abnormal frontal plane mechanics. Kinematic predictors of joint and whole-body loading differed across conditions. Vertical COM displacement was significantly decreased during the bilateral arm swing constraint condition. Foot inclination angle at initial contact did not significantly change with arm swing constraint. Differences were found between right and left lower extremity foot strikes (i.e., foot inclination angle) across all conditions; the non-dominant limb demonstrated greater plantarflexion during initial contact. Knee flexion angle at initial contact and peak knee flexion during stance did not demonstrate a significant change. Muscle activity was not significantly correlated to kinematic predictors. Spatiotemporal measures altered with arm swing suppression. Stride length decreased and step rate increased significantly. Taken together, these results suggest that runners alter spatiotemporal measures more so than sagittal plane kinematics when adjusting to arm swing suppression. The role of the BFL muscle synergy during running remains unclear. Asymmetrical movement patterns and arm swing restriction appear to influence BFL muscle activity and lower extremity kinematics. Single leg stability, particularly during the LR phase, may alter BFL muscle activity due to the need for increased stabilization of the loaded limb and the LPHC. Future research is needed to determine how these variables impact BFL muscle activation and whether injured runners respond differently to arm swing constraint during running.Physical Therap

Development and delivery of a medical informatics educational workshop for family medicine faculty

A four-hour faculty development workshop on Medical Informatics curriculum design, development, and delivery was given to twenty-five Family Medicine Faculty members as a pre-conference offering for the 2008 Society of Teachers of Family Medicine Annual Predoctoral Education Conference by a group of Family Medicine and Informatics faculty experts. The workshop included instructional lectures, specific curricular examples from other institutions, a hands-on guided practice session with Medical Informatics websites and tools, an interactive faculty-facilitated curricular design exercise, and a feedback and sharing session

THE INFLUENCE OF USING SNAKES AND LADDERS GAME TOWARD STUDENTS’ SIMPLE PAST TENSE MASTERY AT THE SECOND SEMESTER OF THE EIGHTH GRADE OF SMPN 3 PALAS SOUTH OF LAMPUNG IN ACADEMIC YEAR 2017/2018

Based on classroom teaching and learning activities, it was found that some learners experienced difficulties in learning simple past tense. They were low-motivated in tense especially simple past tense. They were also confused how to change the regular and irregular verb in simple past tense. In addition, the technique used by the teacher was monotonous, which made the learners bored to join English lesson especially simple past tense. It was proven by the learners’ simple past tense score in which 68% of the learners got <72. For that reason, snakes and ladders game is the best answer to support success in teaching learning process to improve the learners’ simple past tense. The objective of this research is to find out whether there is significant influence of using snakes and ladders game towards students’ simple past tense. Two classes were chosen as 1st and 2nd experimental class by using Cluster Random Sampling. 1st experimental class was treated by using snakes and ladders game 2nd experimental class was treated by using Lecturing Technique. The test had been tried out to find out the validity, reliability, before it was used to gather the data. The formula was used to analyze the data was t-test. It was used to determine whether there was a significance difference both experimental class and control class or not. After collecting the data, were analyzed by using independent sample t-test, it was found that the result of Sig. (2-tailed) of the equal variance was 0.02, and α = 0.05. Ha is accepted if Sig. (ρvalue) ≤ α = 0.05 and Ho is accepted. Based on the computation, it can be concluded that there was influence of using snake and ladder game toward students’ simple past tense mastery at the second semester of the eighth grade. Keywords:Snake and Ladder Game, Simple Past Tense Mastery

impact of frequency and severity of rhinitis on lung function in children and adolescents without asthma

Introducción. Se han observado alteraciones espirométricas en pacientes con rinitis, sin asma, proporcionales al grado clínico de la rinitis establecido por la guía Allergic Rhinitis and its Impact on Asthma (ARIA). Recientemente se ha validado una nueva clasificación de la rinitis como ARIA modificada (ARIAm), que disocia la forma moderada de la grave. Se desconoce el impacto de la rinitis sobre la función pulmonar considerando su frecuencia y gravedad por separado. Objetivos. Determinar las posibles alteraciones de la función pulmonar y su potencial reversibilidad al broncodilatador en niños y adolescentes con rinitis alérgica y no alérgica sin asma, de acuerdo a su frecuencia (intermitente y persistente) y gravedad (leve, moderada y grave) establecida según ARIAm. Población y métodos. Estudio observacional, analítico de corte transversal, que incluyó pacientes de ambos sexos, entre 5 y 18 años, con rinitis alérgica y no alérgica, sin asma. Se realizó espirometría por curva flujo-volumen y se analizó la existencia de anormalidades en la función pulmonar y la respuesta broncodilatadora en relación con el grado de rinitis por ARIAm ajustando un modelo logístico. Se consideró un valor de p<0,05 para establecer significación estadística. Resultados. Se incluyeron 189 pacientes. En 42 (22,2%) se observó al menos un parámetro alterado en la función pulmonar. Los pacientes con rinitis persistente exhibieron mayor afectación de la función pulmonar que los de grado intermitente (p=0,0257). El defecto funcional fue más frecuente en las formas grave y moderada que en el grado leve (p=0,0052) y fue independiente de la condición de atopia (p=0,1574 para frecuencia y p =0,5378 para gravedad). No se encontró diferencia en la reversibilidad al broncodilatador entre los grupos (p=0,1859 y p=0,0575, respectivamente). Conclusiones. La alteración de la función pulmonar se asoció con rinitis persistente. Fue más prevalente en las formas moderada y grave pero no existieron diferencias significativas entre ambas. El defecto funcional se demostró tanto en rinitis alérgica como no alérgica.Background: Subclinical spirometric abnormalities have been observed in patients with rhinitis without asthma, proportional to the clinical grade established by Allergic Rhinitis and Its Impact on Asthma (ARIA) guideline. Recently has been validated a new criteria of rhinitis classification designed as ARIA modified (ARIAm), which allow to discrimination moderate to severe grades. Rhinitis impact on lung function according to frequency and severity considering separately is unknown. Objectives: To investigate possible subclinical alterations in lung function and bronchodilator reversibility in children and adolescents with allergic and non-allergic rhinitis without asthma, according to the frequency and severity criteria of rhinitis classified by ARIAm. Methods: In an observational cross sectional study we included children and adolescents aged 5 to 18 years with symptoms of allergic and non-allergic rhinitis without asthma. Spirometry was performed by flow-volume curve and we analyzed the abnormalities in respiratory function and bronchodilator response in relation to clinical grade of rhinitis by ARIAm using an adjusted logistic model. A p value Results: We studied 189 patients; 42 (22.2%) had some spirometric abnormalities. Patients with persistent rhinitis had greater impairment of lung function compared to intermittently grade (p = 0.0257). The functional defect was more frequent in rhinitis severe and moderate than mild grade (p = 0.0052) and was independent of atopy status both frequency (p = 0.1574) and severity (p=0.5378). There was no difference in bronchodilator reversibility between groups (p = 0.1859 and p = 0.0575 respectively). Conclusion: Impaired lung function was associated with persistent rhinitis. It was more prevalent in moderate and severe rhinitis, but there wasn’t a significant difference between them. The functional defect was demonstrated in both allergic and nonallergic rhinitis.Fil: Saranz, Ricardo J.. Universidad Católica de Córdoba. Facultad de Medicina. Clínica Universitaria Reina Fabiola; ArgentinaFil: Lozano, Alejandro. Universidad Católica de Córdoba. Facultad de Medicina. Clínica Universitaria Reina Fabiola; ArgentinaFil: Lozano, Natalia A.. Universidad Católica de Córdoba. Facultad de Medicina. Clínica Universitaria Reina Fabiola; ArgentinaFil: Bovina Martijena, María del Pilar. Universidad Católica de Córdoba. Facultad de Medicina. Clínica Universitaria Reina Fabiola; ArgentinaFil: Sasia, Laura V.. Universidad Católica de Córdoba. Facultad de Medicina. Clínica Universitaria Reina Fabiola; ArgentinaFil: Berardi, Yanina V.. Universidad Católica de Córdoba. Facultad de Medicina. Clínica Universitaria Reina Fabiola; ArgentinaFil: Agresta, María Fernanda. Universidad Católica de Córdoba. Facultad de Medicina; ArgentinaFil: Ianiero, Luciano. Universidad Católica de Córdoba. Facultad de Medicina; ArgentinaFil: Ponzio, Marina Flavia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; Argentina. Universidad Nacional de Córdoba. Facultad de Medicina. Departamento de Fisiología Humana y Física Biomédica. Cátedra de Fisiología Humana; Argentin

Surgical site infection after caesarean section. Space for post-discharge surveillance improvements and reliable comparisons

Surgical site infections (SSI) after caesarean section (CS) represent a substantial health system concern. Surveying SSI has been associated with a reduction in SSI incidence. We report the findings of three (2008, 2011 and 2013) regional active SSI surveillances after CS in community hospital of the Latium region determining the incidence of SSI. Each CS was surveyed for SSI occurrence by trained staff up to 30 post-operative days, and association of SSI with relevant characteristics was assessed using binomial logistic regression. A total of 3,685 CS were included in the study. A complete 30 day post-operation follow-up was achieved in over 94% of procedures. Overall 145 SSI were observed (3.9% cumulative incidence) of which 131 (90.3%) were superficial and 14 (9.7%) complex (deep or organ/space) SSI; overall 129 SSI (of which 89.9% superficial) were diagnosed post-discharge. Only higher NNIS score was significantly associated with SSI occurrence in the regression analysis. Our work provides the first regional data on CS-associated SSI incidence, highlighting the need for a post-discharge surveillance which should assure 30 days post-operation to not miss data on complex SSI, as well as being less labour intensive