Kanamari from Juruá (Katukina language family) : phonological and morphosyntactic aspects

Orientador: Angel Humberto Corbera MoriTese (doutorado) - Universidade Estadual de Campinas, Instituto de Estudos da LinguagemResumo: Este trabalho apresenta, a partir de uma abordagem tipológico-funcional, descrição e análise de dados da língua falada pelo povo Kanamari localizado na região do Rio Juruá, no sudoeste do estado do Amazonas, Brasil. O objetivo principal desta pequisa foi descrever especificamente esse dialeto e, para tal, foram analisados, primordialmente, mitos, relatos e textos informativos. Inicialmente, são apresentados informações sobre o povo Kanamari, como localização, modo de vida e cultura, bem como a classificação linguística de sua língua. Há também uma descrição dos principais aspectos fonológicos, como quadro de sons, alofonias, processos, estrutura silábica e acento. Com base na análise dos textos, foram descritas as classes de palavras, suas divisões e particularidades. Em seguida, apresenta-se a estrutura da oração, a partir do estudo da estrutura dos sintagmas nominais e posposicionais, das categorias funcionais do verbo, como os tipos de tempo, aspecto e modalidade, e da marcação de caso. Os tipos de orações são, então, detalhados através da análise das orações transitivas, intransitivas, copulares e não-verbais. Além disso, são examinadas as orações formadas por verbos derivados, como as antipassivas, as causativas, as aplicativas, as intransitivadas, as reflexivas e as recíprocas. Descreve-se, também, algumas outras construções complexas, como as sentenças imperativas e interrogativas, a coordenação, as orações subordinadas, divididas em completivas, relativas e adverbiais, e as construções similativas e comparativas. Ao final desse trabalho, pode-se consultar, nos apêndices, a ortografia utilizada nessa pesquisa, listas de termos lexicais relacionados a flora e fauna, termos de parentesco e termos de partes do corpo. Há também uma lista de verbos transitivos e intransitivos, com exemplos retirados de dados textuais, e, por fim, cinco textos analisadosAbstract: This work presents a functional-typological analysis of data from the language spoken by the Kanamari people, who live along the Juruá River, in the southwestern region of the Amazonas State in Brazil. The main purpose of this research was to describe this specific dialect, therefore, data analysis were primarily on myths, stories and informative texts from speakers of this region. Initially, information about the Kanamari people is presented, such as their location, way of life and culture. Also, the language family of Kanamari is described. The main phonological aspects of Kanamari are presented, namely the sound charts, allophony, phonological processes, syllable structure and accent. From the analyzed texts, the word classes were described, including their subdivisions and some of their particularities. Subsequently, the phrasal structure is introduced, with description and analysis of the noun and postpositional phrases, the functional categories of verbs, as the time, aspect and modality categories and the case markers. Then, clause types are detailed with the explanation of the transitive, intransitive, copula and non-verbal clauses. Furthermore, the clauses formed by verbal derivations are delineated, these are the antipassive, the causative, the applicative and the intransitivization process that results in reflexive and reciprocal constructions. Some complex constructions are described as well, for instance, the imperative and interrogative sentences, the coordination, the subordinate clauses, which can be divided in complement, relative and adverbial clauses, and the comparative and similative constructions. In the Appendices, some lexical lists are provided, these are related to flora and fauna, family relationships and parts of the body. In addition, there is a list of transitive and intransitive verbs, represented with original examples taken from textual data. Finally, five analyzed texts are documentedDoutoradoLinguisticaDoutora em Linguístic

Traqueostomia convencional a beira do leito: procedimento de rotina para pacientes em ventilação mecânica prolongada

BACKGROUND: Tracheostomy is electively performed in critically ill patients requiring prolonged respiratory support. The risk of transporting, the increasing associated cost and operative room schedule are some of the obstacles for wider acceptance of this procedure. The use of rigid selection criteria exclude many patients who would benefit of this approach. OBJECTIVE: To determine the safety of open bedside tracheostomy (OBT) as a routine intensive care units (ICU) procedure without any selection criteria, considering its peri and postoperative complications. METHOD: Retrospective medical chart review of all patients that underwent elective tracheostomy between April 1999 and December 2005 at ICU of three private hospitals. RESULTS: The study group comprised 552 patients with a mean age of 69.6 ± 15.8 years. The incidence of significant complications (until 30 days after the procedure) was 4.34% (24 cases): 9 minor bleeding, 9 major bleeding, 2 subcutaneous emphysema, 4 stomal infections. Late complications were: laryngotracheal stenosis in 2 and tracheoinomminate fistula in 1 patient. CONCLUSIONS: OBT seems to be a safe and simple procedure, when performed by a team of experienced physicians under controlled circumstances, and should be considered as an option for ICU patients.INTRODUÇÃO: A traqueostomia é um procedimento eletivo realizado em pacientes de unidades de terapia intensiva sob ventilação mecânica prolongada. O risco associado ao transporte, custos e dificuldades de agendamento cirúrgico são alguns obstáculos para uma maior aceitação da traqueostomia. O uso de rígidos critérios de seleção para a realização deste procedimento a beira do leito exclui muitos pacientes que se beneficiariam deste método. OBJETIVO: Determinar à segurança da traqueostomia convencional a beira do leito como procedimento de rotina (sem a utilização dos critérios de seleção) em unidades de terapia intensiva, considerando as complicações intra e pós-operatórias. MÉTODO: Revisão retrospectiva de prontuários de pacientes submetidos à traqueostomia eletiva nas unidades de terapia intensiva de três hospitais privados no período de abril de 1999 a dezembro de 2005. RESULTADOS: Foram incluídos 552 pacientes com idade media de 69.6 ± 15.8 anos. A incidência de complicações pós-operatórias (até o 30º pós-operatório) foi 4.34% (24 casos): 9 sangramentos leves, 9 sangramentos importantes, 2 enfisemas subcutâneos, 4 infecções do estoma. As complicações tardias observadas foram: estenose laringotraqueal em 2 pacientes e fistula traqueo-inominada em 1 paciente. CONCLUSÃO: A traqueostomia convencional a beira do leito parece ser um procedimento simples e seguro quando realizado por equipe experiente em condições controladas, deve, portanto ser considerada como uma opção para pacientes em terapia intensiva sob ventilação prolongada

Open bedside tracheostomy: routine procedure for patients under prolonged mechanical ventilation

BACKGROUND: Tracheostomy is electively performed in critically ill patients requiring prolonged respiratory support. The risk of transporting, the increasing associated cost and operative room schedule are some of the obstacles for wider acceptance of this procedure. The use of rigid selection criteria exclude many patients who would benefit of this approach. OBJECTIVE: To determine the safety of open bedside tracheostomy (OBT) as a routine intensive care units (ICU) procedure without any selection criteria, considering its peri and postoperative complications. METHOD: Retrospective medical chart review of all patients that underwent elective tracheostomy between April 1999 and December 2005 at ICU of three private hospitals. RESULTS: The study group comprised 552 patients with a mean age of 69.6 ± 15.8 years. The incidence of significant complications (until 30 days after the procedure) was 4.34% (24 cases): 9 minor bleeding, 9 major bleeding, 2 subcutaneous emphysema, 4 stomal infections. Late complications were: laryngotracheal stenosis in 2 and tracheoinomminate fistula in 1 patient. CONCLUSIONS: OBT seems to be a safe and simple procedure, when performed by a team of experienced physicians under controlled circumstances, and should be considered as an option for ICU patients.INTRODUÇÃO: A traqueostomia é um procedimento eletivo realizado em pacientes de unidades de terapia intensiva sob ventilação mecânica prolongada. O risco associado ao transporte, custos e dificuldades de agendamento cirúrgico são alguns obstáculos para uma maior aceitação da traqueostomia. O uso de rígidos critérios de seleção para a realização deste procedimento a beira do leito exclui muitos pacientes que se beneficiariam deste método. OBJETIVO: Determinar à segurança da traqueostomia convencional a beira do leito como procedimento de rotina (sem a utilização dos critérios de seleção) em unidades de terapia intensiva, considerando as complicações intra e pós-operatórias. MÉTODO: Revisão retrospectiva de prontuários de pacientes submetidos à traqueostomia eletiva nas unidades de terapia intensiva de três hospitais privados no período de abril de 1999 a dezembro de 2005. RESULTADOS: Foram incluídos 552 pacientes com idade media de 69.6 ± 15.8 anos. A incidência de complicações pós-operatórias (até o 30º pós-operatório) foi 4.34% (24 casos): 9 sangramentos leves, 9 sangramentos importantes, 2 enfisemas subcutâneos, 4 infecções do estoma. As complicações tardias observadas foram: estenose laringotraqueal em 2 pacientes e fistula traqueo-inominada em 1 paciente. CONCLUSÃO: A traqueostomia convencional a beira do leito parece ser um procedimento simples e seguro quando realizado por equipe experiente em condições controladas, deve, portanto ser considerada como uma opção para pacientes em terapia intensiva sob ventilação prolongada

Quantitative assessment of the intensity of palmar and plantar sweating in patients with primary palmoplantar hyperhidrosis

Objective: To compare individuals with and without hyperhidrosis in terms of the intensity of palmar and plantar sweating. Methods: We selected 50 patients clinically diagnosed with palmoplantar hyperhidrosis and 25 normal individuals as controls. We quantified sweating using a portable noninvasive electronic device that has relative humidity and temperature sensors to measure transepidermal water loss. All of the individuals had a body mass index of 20-25 kg/cm(2). Subjects remained at rest for 20-30 min before the measurements in order to reduce external interference. The measurements were carried out in a climate-controlled environment (21-24 degrees C). Measurements were carried out on the hypothenar region on both hands and on the medial plantar region on both feet. Results: In the palmoplantar hyperhidrosis group, the mean transepidermal water loss on the hands and feet was 133.6 +/- 51.0 g/m(2)/h and 71.8 +/- 40.3 g/m(2)/h, respectively, compared with 37.9 +/- 18.4 g/m(2)/h and 27.6 +/- 14.3 g/m(2)/h, respectively, in the control group. The differences between the groups were statistically significant (p < 0.001 for hands and feet). Conclusions: This method proved to be an accurate and reliable tool to quantify palmar and plantar sweating when performed by a trained and qualified professional

Interventions for hyperhidrosis in secondary care : a systematic review and value-of-information analysis

Background: Hyperhidrosis is uncontrollable excessive sweating that occurs at rest, regardless of temperature. The symptoms of hyperhidrosis can significantly affect quality of life. The management of hyperhidrosis is uncertain and variable. Objective: To establish the expected value of undertaking additional research to determine the most effective interventions for the management of refractory primary hyperhidrosis in secondary care. Methods: A systematic review and economic model, including a value-of-information (VOI) analysis. Treatments to be prescribed by dermatologists and minor surgical treatments for hyperhidrosis of the hands, feet and axillae were reviewed; as endoscopic thoracic sympathectomy (ETS) is incontestably an end-of-line treatment, it was not reviewed further. Fifteen databases (e.g. CENTRAL, PubMed and PsycINFO), conference proceedings and trial registers were searched from inception to July 2016. Systematic review methods were followed. Pairwise meta-analyses were conducted for comparisons between botulinum toxin (BTX) injections and placebo for axillary hyperhidrosis, but otherwise, owing to evidence limitations, data were synthesised narratively. A decision-analytic model assessed the cost-effectiveness and VOI of five treatments (iontophoresis, medication, BTX, curettage, ETS) in 64 different sequences for axillary hyperhidrosis only. Results and conclusions: Fifty studies were included in the effectiveness review: 32 randomised controlled trials (RCTs), 17 non-RCTs and one large prospective case series. Most studies were small, rated as having a high risk of bias and poorly reported. The interventions assessed in the review were iontophoresis, BTX, anticholinergic medications, curettage and newer energy-based technologies that damage the sweat gland (e.g. laser, microwave). There is moderate-quality evidence of a large statistically significant effect of BTX on axillary hyperhidrosis symptoms, compared with placebo. There was weak but consistent evidence for iontophoresis for palmar hyperhidrosis. Evidence for other interventions was of low or very low quality. For axillary hyperhidrosis cost-effectiveness results indicated that iontophoresis, BTX, medication, curettage and ETS was the most cost-effective sequence (probability 0.8), with an incremental cost-effectiveness ratio of £9304 per quality-adjusted life-year. Uncertainty associated with study bias was not reflected in the economic results. Patients and clinicians attending an end-of-project workshop were satisfied with the sequence of treatments for axillary hyperhidrosis identified as being cost-effective. All patient advisors considered that the Hyperhidrosis Quality of Life Index was superior to other tools commonly used in hyperhidrosis research for assessing quality of life. Limitations: The evidence for the clinical effectiveness and safety of second-line treatments for primary hyperhidrosis is limited. This meant that there was insufficient evidence to draw conclusions for most interventions assessed and the cost-effectiveness analysis was restricted to hyperhidrosis of the axilla. Future work: Based on anecdotal evidence and inference from evidence for the axillae, participants agreed that a trial of BTX (with anaesthesia) compared with iontophoresis for palmar hyperhidrosis would be most useful. The VOI analysis indicates that further research into the effectiveness of existing medications might be worthwhile, but it is unclear that such trials are of clinical importance. Research that established a robust estimate of the annual incidence of axillary hyperhidrosis in the UK population would reduce the uncertainty in future VOI analyses

Treatment of palmoplantar hyperhidrosis by video-assisted thoracoscopic sympathectomy: third versus fourth thoracic ganglion

Introdução: Atualmente, a simpatectomia torácica videoassistida tornou-se o tratamento de escolha para hiperidrose palmar. O principal efeito colateral após operação é a hiperidrose compensatória (HC), sendo considerada a maior causa de insatisfação pelos pacientes. Objetivo: Comparar os resultados obtidos com a simpatectomia torácica videotoracoscópica realizada em dois níveis ganglionares distintos (terceiro versus quarto gânglio torácico) no tratamento da hiperidrose palmo-plantar, por meio de um ensaio clínico randomizado e cego. Método: Foram selecionados 40 pacientes entre fevereiro de 2007 e maio de 2009. Os participantes foram aleatorizados em dois grupos de 20 pacientes (G3 e G4) e submetidos à operação com seguimento de 12 meses (1ª semana, 1° mês, 6° mês e 12° mês). Utilizamos um método objetivo para mensuração do suor, aferindo a TEWL (transepidermal water loss) pelo VapoMeter, além da avaliação da qualidade de vida antes e após a operação. Também foram estudados: resolução da hiperidrose palmar, incidência e intensidade da HC. Resultados: Todos os pacientes apresentaram resolução da hiperidrose palmar após a operação, com diferença estatística em relação ao fator tempo, quando comparados os valores da TEWL palmar no pré-operatório com os seus respectivos valores na 1ª semana, 1° mês, 6° mês e 12° mês. O principal efeito colateral observado foi a hiperidrose compensatória, incidindo com maior frequência no grupo G3 após 12 meses de seguimento; apesar disto, não houve diferença estatística em relação à intensidade (gravidade) da HC nos grupos estudados. Verificou-se melhora da qualidade de vida desde a primeira avaliação do pós-operatório, sem diferença entre os grupos, que assim se manteve até o fim do estudo. As regiões mais acometidas pela HC foram dorso, tórax, abdome e coxas; no entanto, não houve diferença estatística da TEWL mensurada nessas regiões após 12 meses de acompanhamento. Conclusão: Ambas as técnicas foram efetivas no tratamento da hiperidrose palmar, gerando redução objetiva da TEWL independente do gânglio operado. A simpatectomia no nível de G3 apresentou maior incidência de HC; apesar disso, a melhora da qualidade de vida foi similar em ambos os grupos, não existindo diferença significativa da TEWL quantificada no dorso, abdome, coxas e pés após 12 mesesIntroduction: Currently, video-assisted thoracic sympathectomy has become the preferred treatment for palmar hyperhidrosis. The main side effect after surgery remains compensatory hyperhidrosis (CH), considered the major cause of dissatisfaction for patients. Objective: To compare the results obtained of video-assisted sympathectomy performed on two distinct ganglion levels (third versus fourth thoracic ganglion) in the treatment of palmo-plantar hyperhidrosis, through a blind randomized clinical trial. Method: We selected 40 patients from February 2007 to May 2009. All participants were randomized into two groups of 20 patients (G3 and G4) and underwent the operation, being followed for 12 months (1 week, 1 month, 6 months and 12th month). We used an objective method for measuring sweat, checking the \"TEWL (transepidermal water loss) measured by the\"VapoMeter\", and evaluated the quality of life before and after the operation. Also studied were: palmar hyperhidrosis, incidence and intensity of the CH. Results: All patients ceased suffering from palmar hyperhidrosis after surgery, with statistical difference regarding the time factor when we compared the values of \"TEWL\" palmar preoperatively with their respective values at 1 week, 1 month, 6 months and 12th month. The main side effect observed was compensatory sweating, most frequent in G3 after 12 months of follow-up; despite this, there was no statistical difference regarding the intensity (severity) of CH in both groups. There was an improvement in quality of life since the first evaluation of the postoperative period, with no difference between groups, and so it remained until the end of follow-up. The areas most affected by CH were back, chest, abdomen and thighs; however, there was no statistical difference in the \"TEWL\" measured in these areas after 12 months of follow-up. Conclusion: Both techniques were effective in the treatment of palmar hyperhidrosis, generating objective reduction of \"TEWL\" regardless of the ganglion operated. Sympathectomy G3 had a higher incidence of CH, yet the improvement in quality of life was similar in both groups without significant differences of \"TEWL\" quantified on the back, abdomen, thighs and legs after 12 months of follow u

A phonological analysis of the Kanamari language (Katukina).

Orientador: Angel Humberto Corbera MoriDissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Estudos da LinguagemResumo: O resumo poderá ser visualizado no texto completo da tese digitalAbstract: The abstract is available with the full electronic documentMestradoLinguisticaMestra em Linguístic

Projection onto a Capped Rotated Second-Order Cone with Applications to Sparse Regression Relaxations

This paper establishes a closed-form expression for projecting onto a capped rotated second-order cone. This special object is a convex set that arises as a part of the feasible region of the perspective relaxation of mixed-integer nonlinear programs (MINLP) with binary indicator variables. The rapid computation of the projection onto this convex set enables the development of effective methods for solving the continuous relaxation of MINLPs whose feasible region may involve a Cartesian product of a large number of such sets. As a proof of concept for the applicability of our projection method, we develop a projected gradient method and specialize a general form of FISTA to use our projection technique in order to effectively solve the continuous perspective relaxation of a sparse regression problem with $L_0$ and $L_2$ penalties. We also generalize the basic sparse regression formulation and solution method to support group sparsity. In experiments we first demonstrate that the projection problem is solved faster and more accurately with our closed-form than with an interior-point solver, and also when solving sparse regression problems our methods that applies our projection formula can outperform a state-of-the-art interior point solver while nearly matching its solution accuracy