Interaction of nitric oxide and muscle contraction in adenosine-induced muscle vasodilation in humans

Adenosine (ADO) is one of several endogenous substances known to mediate muscle vasodilation during exercise. The purpose of this study was to examine (1) the role of nitric oxide (NO) in ADO-mediated vasodilation; (2) the magnitude of muscle blood flow (MBF) responses to ADO infusion during exercise; and (3) the influence of ADO in regulating heterogeneous MBF distribution. In healthy, young participants (N=14), local MBF was measured using near-infared spectroscopy and indocyanine green (ICG) dye at two locations on the vastus lateralis (VL). Cardiac output was quantified using a dye-dilution technique with ICG dye. Participants were tested at rest and during 1-leg knee extension exercise (25W) under different conditions: control, ADO infusion (150mg·kg body mass -1 ·min -1 ) and ADO+NO blockade (L-NMMA; 1mg·kg body mass -1 ·min -1 ). At rest and exercise, we found that mean VLBF increased from control to ADO and decreased significantly from ADO to ADO+L-NMMA infusion; exercising BF values were always significantly higher than at rest. Additionally, with ADO infusion, a peak increase in oxy-hemoglobin concentration (O 2 Hb) was reached within 2 minutes of initiating infusion; however the magnitude differed between muscle regions, indirectly indicating ADO-induced metabolic heterogeneity. O 2 Hb subsequently decreased over time, reaching a stable level at 5 min. Also, we observed that when MBF is elevated through ADO infusion, usual exercise-mediated vasodilator signals are not subsequently down-regulated during contraction demonstrating a lack of autoregulation. We conclude that NO does playa role in mediating ADO-induced vasodilation and there is a lack of autoregulatory feedback when ADO is infused during exercise

The impact of physical activity and blood pressure on cardiovascular events and mortality

Hypertension is the leading risk factor for the development of cardiovascular disease (CVD). Physical activity (PA) is beneficial for preventing hypertension and decreases risk of mortality and CVD. The purpose of this thesis was to study the relationships between PA, blood pressure (BP), and how they act to impact mortality and CVD development. A systematic review examined the impact of PA on mortality in patients with high BP. Six articles evaluating over 90,000 participantswere identified. Cand all-cause mortality were shown to be inversely related to PA in all studies. Individuals with high BP who participated in any level of PA had a reduced risk of CVD mortality, and greater than two-fold increased risk of mortality was noted for inactive individuals. The second study specifically examined the main and interaction effects of different levels of PA and BP on both fatal and non-fatal CVD events, and mortality in the Scottish Health Survey. We found a significant interaction effect between PA and BP on CVDsuch that doing any level of activity for the BP groups <160 mmHg reduced risk of CVD; in those with systolic BP ≥160 mmHg, there was no change in risk. The third study evaluated the causal relationships between PA, BP, and mortality and Major Adverse Cardiovascular Events (MACE) using the Honolulu Heart Program. Advanced statistical models (i.e., Marginal structural models) were used to estimate the separate causal relationships of PA and BP on mortality/MACE, and the causal relationship of PA on BP. Being active was associated with reduced risk of mortality and MACE. BP was shown to have a dose-dependent relationship with all-cause mortality and MACE (increased BP increased risk of events). Active participants showed a reduced BP (~2.5 mmHg). Being physically active is associated with better outcomes and that BP may be a mediator of this relationship. The findings from this thesis suggest a causal relationship between greater PA and lower BP, and that high PA acts with low BP in reducing the risk of mortality and cardiovascular events. Thisoutcome supports engagement in physical activity for longevity and maintenance of healthy blood pressure

Cultural adaptation to Brazil of the questionnaire Costs of caring for children with cancer.

Objectiveto present the cultural adaptation of the questionnaire Costs of caring for children with cancer, offering a valid and reliable tool to assess the economic repercussions of childhood cancer for Brazilian families.Methodit is a methodological research with a cross-sectional design. The methodological framework to validate the questionnaire was a combined process that included seven steps: translation to Portuguese; first translated consensus version; evaluation by Expert Committee; consensus on the Expert Committee version; back-translation; consensus of back-translated versions; semantic validation. The study was conducted in two phases: phase one was the translation and back-translations process, with five expert committee members. Phase two was the semantic validation, with 24 participants, who answered an instrument about their impressions of the questionnaire and suggested modifications.Resultsin phase one, items were included, excluded, and replaced to make the content equivalent and valid for use with Brazilian context. In phase two, the majority of the participants were mothers, who made suggestions about the relevance and clarity of the items in the questionnaire.Conclusionsthe authors discussed these recommendations and made adaptations, turning the questionnaire into a valid and reliable tool for application

Titanium and Ruthenium Phthalocyanines for NO2 Sensors: A Mini-Review

This review presents studies devoted to the description and comprehension of phenomena connected with the sensing behaviour towards NO2 of films of two phthalocyanines, titanium bis-phthalocyanine and ruthenium phthalocyanine. Spectroscopic, conductometric, and morphological features recorded during exposure to the gas are explained and the mechanisms of gas-molecule interaction are also elucidated. The review also shows how X-ray reflectivity can be a useful tool for monitoring morphological parameters such as thickness and roughness that are demonstrated to be sensitive variables for monitoring the exposure of thin films of sensor materials to NO2 gas

Análise dos processos de otimização no projeto de um navio Roll-on/Roll-off

TCC (graduação) - Universidade Federal de Santa Catarina. Campus Joinville. Engenharia Naval.A busca por projetos ‘adequados’ de engenharia tornou-se um dos grandes paradigmas do mundo moderno. No campo da engenharia naval, cada embarcação pode ser considerada um elemento único, projetada para função específica e necessitando atender às necessidades e desejos do armador. Trata-se de um conjunto amplo e difuso de atributos, cuja relação custo de construção versus capacidade de carga tem grande importância. Um dos maiores problemas dentro da engenharia naval é como trabalhar com os diversos requisitos de projeto simultaneamente aos objetivos do armador, uma vez que quanto maior a capacidade de carga, maior o custo de construção do navio, o que torna vital a utilização de uma metodologia estruturada e eficiente para o projeto de navios. Uma possível solução consiste na aplicação de técnicas de otimização ao problema de projetos navais visando o aperfeiçoamento dos mesmos em busca dos melhores resultados. O presente Trabalho de Conclusão de Curso apresenta os resultados de análise comparativa entre abordagens mono e multiobjetivo, associadas à aplicação de técnicas de otimização com algoritmo NSGA2, a um projeto de um navio do tipo RoRo, para transporte de 1000 a 2000 carros, entre Brasil, México, Peru e Chile. Comparam-se os resultados otimizados com aqueles provenientes de um projeto conceitual não-otimizado (abordagem clássica). A partir de pesquisa experimental, com população de 20 elementos, a otimização considera dois objetivos: maximizar o retorno financeiro anual e maximizar a segurança (minimizar o fator de risco). Os projetos otimizados apresentaram resultados melhores que o projeto pela abordagem clássica, como ganho de 20% em relação ao retorno financeiro anual, de forma a concluir que vale a pena aplicar a otimização na fase conceitual de projeto.The search for ‘adequate’ engineering solutions has become one of the biggest paradigms of the modern world. In the naval architecture/engineering field, each vessel can be considered a unique element, designed for a specific function and meeting the shipowner’s requirements and desires. It is a joint of diverse attributes, in which the relation between shipbuilding cost versus cargo capacity has a huge importance. One of the biggest issues in naval architecture/engineering is how to work the shipowner’s diverse requirements simultaneously, since that the higher the cargo capacity, the higher the construction cost, which makes it vital to apply a structured and efficient methodology for ship design. A possible solution is by applying optimization techniques in the design process, looking to improve its results. This graduation project presents mono and multiobjective optimizations, using the genetic algorithm NSGA2, and compares the results to a classical ship design approach. The ship design is for a RoRo type vessel, with a cargo capacity of 1000 to 2000 cars, sailing between Brazil, Mexico, Peru and Chile. Using an experimental research technique, with an initial population of 20 elements, the optimization process considers two objectives: maximize the annual revenue, and maximize the security (minimize risk factor). The optimized designs present better results than the one done by the classical methodology, for example an increase of 20% in the financial revenue, therefore, it is worth using optimization techniques in the initial phases of ship design

Teleodontologia síncrona como ferramenta para avaliação de pacientes portadores de disfunções temporomandibulares

Orientador: Prof. Dr. Cassius Carvalho Torres-PereiraCoorientadores: Profa. Dra. Priscila Brenner Hilgenberg Sydney e Prof. Dr. Daniel BonottoDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Odontologia. Defesa : Curitiba, 01/08/2022Inclui referênciasResumo: O rápido desenvolvimento de tecnologias em comunicação permitiu uma melhora substancial da acurácia e viabilidade do uso dessas ferramentas para o diagnóstico remoto. O objetivo desse estudo foi avaliar a viabilidade e concordância diagnóstica da teleconsulta síncrona em comparação ao exame clínico presencial na especialidade de Disfunção Temporomandibular e Dor Orofacial. Sessenta e um pacientes (50 mulheres; 11 homens) com idade média de 46,07 anos encaminhados para o Serviço Ambulatorial de Dor Orofacial (SAMDOF – UFPR) foram inicialmente avaliados remotamente através de uma videochamada em um aplicativo de smartphone - WhatsApp seguindo um roteiro adaptado do Critério Diagnóstico para Disfunções Temporomandibulares (DC/TMD). Em seguida, os pacientes foram examinados por um avaliador presencial, cego para a primeira avaliação, considerado padrão de referência para diagnóstico dessas condições. O diagnóstico para ambas as avaliações foi obtido de forma padronizada a partir dos construtos disponíveis na Árvore de Decisão Diagnóstica Interativa do aplicativo NeuroUp. Além disso, dados sobre a experiência e satisfação com o modelo remoto foram coletados. Para cada tipo e subtipo de DTM, valores de concordância diagnóstica, sensibilidade, especificidade, valores preditivos positivos e valores preditivos negativos, foram calculados com intervalo de confiança de 95%. Foi encontrada concordância "quase perfeita" para Mialgia (k=0.915; S 98%; E 94%; VPP 98%; VPN 94%), Artralgia (k=0.863; S 100%; E 85%; VPP 90%; VPN 100%), Deslocamento de Disco sem Redução sem limitação de abertura (k=0.955; S 100%; E 98%; VPP 93%; VPN 100%) e Sem DTM – Controle (k=1.00; S 100%; E 100%; VPP 100%; VPN 100%). Concordância "substancial" para os subtipos Cefaleia atribuída a DTM (k=0.761; S 73%; E 98%; VPP 89%; VPN 94%), Deslocamento de disco sem redução com limitação de abertura (k=0.659; S 50%; E 100%; VPP 100%; VPN 98%) e Subluxação (k=7.82; S 80%; E 98%; VPP 80%; VPN 98%). Os diagnósticos de Mialgia local (k=0.573; S 79%; E 78%; VPP 77%; VPN 81%), Dor Miofascial com referência (k=0.524; S 62%; E 89%; VPP 67%; VPN 87%) e Deslocamento de disco com redução (k=0.563; S 93%; E 60%; VPP 83%; VPN 80%) obtiveram concordância "moderada". Doença articular degenerativa (k=0.170; S 33%; E 84%; VPP 33%; VPN 84%) e Deslocamento de disco com redução com travamento intermitente (k=0.000; S 0; E 98%; VPP 0; VPN 100%) obtiveram concordância "fraca" e "sem concordância", respectivamente. Dos 61 participantes, 90% (n=55) aceitariam participar de nova teleconsulta e 92% (n=56) relataram que não houve desconforto durante a avaliação remota. Evitar deslocamentos (47,5%) foi a principal vantagem relatada, seguida por ser tratado mais rápido (29,5%) e menos faltas no trabalho (16,4%). Sobre o nível de satisfação, 38% (n=23) e 57% (n23) relataram estar muito satisfeitos e satisfeitos, respectivamente. A teleconsulta síncrona mostrou ser viável e com concordância diagnóstica adequada para o diagnóstico das principais DTMs dolorosas, especialmente para os diagnósticos de mialgia e artralgia, além de apresentar boa aceitação entre os pacientes.Abstract: The recent development of communication technologies has allowed a substantial improvement in the accuracy and feasibility of the use of these tools for remote diagnosis in dentistry. The aim of this study was to evaluate the feasibility and diagnostic agreement of synchronous teleconsultation compared to physical standard examination for temporomandibular disorders and orofacial pain. Sixty-one patients (50 women; 11 men) with a mean age of 46.07 years referred to the Orofacial Pain Ambulatory Service (SAMDOF - UFPR) were initially evaluated remotely through a video call on a smartphone application – WhatsApp – following a script adapted from the Diagnostic Criteria for Temporomandibular Disorderss (DC/TMD). Then, the patients were examined by an evaluator in person, blinded for the first evaluation, considered a reference standard for the diagnosis of these conditions. The diagnosis for both assessments was obtained in a standardized way from the constructs available in the Interactive Diagnostic Decision Tree of the NeuroUp application. In addition, data on experience and satisfaction with the remote model were also collected. For each type and subtype of TMD, diagnostic agreement values, sensitivity, specificity, positive predictive values and negative predictive values were calculated with a 95% confidence interval. "Almost perfect" agreement was found for Myalgia (k=0.915; S 98%; E 94%; PPV 98%; NPV 94%), Arthralgia (k=0.863; S 100%; E 85%; PPV 90%; NPV 100%), Disc displacement without reduction without limited opening (k=0.955; S 100%; E 98%; PPV 93%; NPV 100%) and No TMD - Control (k=1.00; S 100%; E 100%; PPV 100%; NPV 100%; NPV 100%). "Substantial" agreement for the subtypes Headache attributed to TMD (k=0.761; S 73%; E 98%; PPV 89%; VPN 94%), Disc displacement without reduction with limited opening (k=0.659; S 50%; E 100%; PPV 100%; VPN 98%) and Subluxation (k=7.82; S 80%; E 98%; PPV 80%; VPN 98%). The diagnoses of Local myalgia (k=0.573; S 79%; E 78%; PPV 77%; VPN 81%), Myofascial pain with referral (k=0.524; S 62%; E 89%; PPV 67%; VPN 87%) and Disc displacement with reduction (k=0.563; S 93%; E 60%; PPV 83%; VPN 80%) obtained "moderate" agreement. Degenerative joint disease (k=0.170; S 33%; E 84%; PPV 33%; NPV 84%) and Disc displacement with reduction with intermittent locking (k=0.000; S 0; E 98%; PPV 0; NPV 100%) obtained "weak" and "no agreement", respectively. Of the 61 participants, 90% (n=55) would agree to participate in another teleconsultation and 92% (n=56) reported that there was no discomfort during the remote assessment. Avoiding travel (47.5%) was the main advantage reported, followed by being treated faster (29.5%) and fewer absences from work (16.4%). Regarding the level of satisfaction, 38% (n=23) and 57% (n23) reported being very satisfied and satisfied, respectively. Synchronous tele-consultation proved to be feasible and with adequate diagnostic agreement for the diagnosis of the main painful TMDs, especially for the diagnoses of myalgia and arthralgia, and showed good acceptance among patients

Metal-Poor Stars Observed with the Magellan Telescope I. Constraints on Progenitor Mass and Metallicity of AGB Stars Undergoing s-Process Nucleosynthesis

We present a comprehensive abundance analysis of two newly-discovered carbon-enhanced metal-poor (CEMP) stars. HE2138-3336 is a s-process-rich star with [Fe/H] = -2.79, and has the highest [Pb/Fe] abundance ratio measured thus far, if NLTE corrections are included ([Pb/Fe] = +3.84). HE2258-6358, with [Fe/H] = -2.67, exhibits enrichments in both s- and r-process elements. These stars were selected from a sample of candidate metal-poor stars from the Hamburg/ESO objective-prism survey, and followed up with medium-resolution (R ~ 2,000) spectroscopy with GEMINI/GMOS. We report here on derived abundances (or limits) for a total of 34 elements in each star, based on high-resolution (R ~ 30,000) spectroscopy obtained with Magellan-Clay/MIKE. Our results are compared to predictions from new theoretical AGB nucleosynthesis models of 1.3 Mo with [Fe/H] = -2.5 and -2.8, as well as to a set of AGB models of 1.0 to 6.0 Mo at [Fe/H] = -2.3. The agreement with the model predictions suggests that the neutron-capture material in HE2138-3336 originated from mass transfer from a binary companion star that previously went through the AGB phase, whereas for HE2258-6358, an additional process has to be taken into account to explain its abundance pattern. We find that a narrow range of progenitor masses (1.0 < M(Mo) < 1.3) and metallicities (-2.8 < [Fe/H] < -2.5) yield the best agreement with our observed elemental abundance patterns.Comment: Accepted for publication in Ap

Controle da intensidade de dor em pacientes com síndrome dolorosa miofascial em músculo masséter, após administração tópica de capsaicina 8%

Orientador : Daniel Bonotto.Monografia (especialização) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Curso de Especialização em Disfunção Temporomandibular e Dor Orofacial.Inclui referênciasResumo : A síndrome dolorosa miofascial (SDM) é um dos quadros mais frequentes dentre as dores crônicas orofaciais. Os músculos afetados possuem pontos de gatilho e encontram-se em estado de contração com aumento da rigidez, fadiga e tensão, promovendo a sensação de fraqueza muscular, restrição na amplitude de movimento, dor irradiada e, ocasionalmente, espasmos musculares. O tratamento considerado padrão ouro é o agulhamento (seco ou com anestésico) dos pontos de gatilho e tem o objetivo de promover sua inativação. Outras opções de tratamento, através do uso de medicações tópicas, têm sido propostas e uma substância de destaque dentre as utilizadas para a analgesia tópica é a capsaicina. Essa substância, em alta concentração, promove depleção da substância P, um neuropeptídeo presente em fibras nervosas sensitivas do tipo C, causando uma dessensibilização farmacológica e funcional o que gera resultados no controle da dor. Sendo assim, o objetivo deste estudo foi avaliar a efetividade da aplicação de um creme de capsaicina 8%, em sessão única, no controle da dor de pacientes diagnosticados com SDM no músculo masséter

A graphical perspective of marginal structural models : an application for the estimation of the effect of physical activity on blood pressure

Estimating causal effects requires important prior subject-matter knowledge and, sometimes, sophisticated statistical tools. The latter is especially true when targeting the causal effect of a time-varying exposure in a longitudinal study. Marginal structural models (MSMs) are a relatively new class of causal models which effectively deal with the estimation of the effects of time-varying exposures. MSMs have traditionally been embedded in the counterfactual framework to causal inference. In this paper, we use the causal graph framework to enhance the implementation of MSMs. We illustrate our approach using data from a prospective cohort study, the Honolulu Heart Program. These data consist of 8006 men at baseline. To illustrate our approach, we focused on the estimation of the causal effect of physical activity on blood pressure, which were measured at three time-points. First, a causal graph is built to encompass prior knowledge. This graph is then validated and improved utilizing structural equation models. We estimated the aforementioned causal effect using MSMs for repeated measures and guided the implementation of the models with the causal graph. Employing the causal graph framework, we also show the validity of fitting conditional MSMs for repeated measures in the context implied by our data