Avaliação da Estereopsia em Crianças sob Terapêutica Oclusiva por Ambliopia e Relação desta com a Acuidade Visual

Introdução: A ambliopia é a principal causa de diminuição da acuidade visual em crianças. O diagnóstico e tratamento precoces são fundamentais para o sucesso terapêutico. A oclusão continua a ser o tratamento mais utilizado nesta patologia. Objectivos: Este estudo teve como objectivo a avaliação da estereopsia em crianças com ambliopia sob terapêutica oclusiva e a sua relação com a acuidade visual. Material e Métodos: Estudo prospectivo que incluiu 35 crianças com ambliopia, por anisometropia, estrabismo ou ambos, a fazer terapêutica oclusiva. Em cada consulta foi avaliada a melhor acuidade visual corrigida (MAVC) e a estereopsia para perto. Resultados: A idade média no início do estudo era de 6,17 anos (intervalo 3-9 anos) e o seguimento médio foi de 17 meses (intervalo 6-24 meses). Após tratamento com oclusão houve uma melhoria da MAVC média de 0,5 para 0,84 (p<0,001) e da estereopsia para perto de 1148 para 415 segundos de arco (p<0,001). Observou-se uma correlação linear significativa entre a melhoria da AV e da estereopsia (0,001<p<0,01). Conclusão: Podemos dizer que, em crianças com ambliopia, após tratamento com oclusão, a melhoria da acuidade visual está relacionada com uma melhoria da estereopsia

Functional impairment in people with interstitial lung diseases: is one measure enough?

Introduction: Interstitial lung diseases (ILD) comprehend a large group of lung diseases that include disease settings associated with sustained progression and leading to respiratory failure, decreased functional status and premature death. Functional status can be defined as an individual’s ability to perform normal daily activities required to meet basic needs, fulfill usual roles and maintain health and well-being. It includes functional capacity, i.e., an individual’s maximum capacity to perform daily life activities in a standardized environment; and functional performance, i.e., the activities people actually do during the course of their daily life. Decreased functional status is the most frequent reported impact by people with ILD and is associated with increased dependence on others, exacerbations and hospital admissions. Yet, little is known how functional status is impaired in people with ILD. Objectives: To explore functional impairments in people with ILD. Methods: A cross-sectional study was conducted with people with ILD. Age, sex, body mass index (BMI) and lung function were collected. Functional capacity was assessed with the 1-minute sit-tostand test (1-minSTS), the 6-minute walk test (6MWT) and quadriceps maximum voluntary contraction (QMVC). Functional performance was assessed with the London Chest Activities of Daily Living (LCADL). Participants’ functional capacity was classified as impaired if the 1-minSTS, 6MWT and/or QMVC values were below 70% of predicted. Participants’ functional performance was considered impaired if above the cut-off point of 28% of the LCADL. Descriptive statistics were performed. Results: In total, 156 people with ILD (65 ± 13 years; 51.9% female; BMI 28.7 ± 6.1 kg/m2 ; FVC 79.2 ± 20.1%predicted; DLCO 55.4 ± 21.2%predicted) participated. ILD diagnosis included fibrosis hypersensitivity pneumonitis (43%), idiopathic pulmonary fibrosis (24%), connective tissue disease-associated ILD (14%), dust-related (1%) and others (17%). Functional capacity was impaired in 55.3%, 23.8% and 41.8% of the sample assessed with the 1-minSTS, 6MWT and QMVC, respectively. Functional performance was impaired in 48.5% of people with ILD. Conclusions: A large proportion of people with ILD show impairments in functional status, i.e., in capacity, in performance or in both. Lack of impairment in one measure does not rule out functional status impairment. Patient-centered and comprehensive assessment of functional status seems vital to guide individually tailored interventions and improve this meaningful domain for the daily life of ILD patients.publishe

Probing the interference between non-linear, axionic and space-time-anisotropy effects in the QED vacuum

We pursue the investigation of a generic non-linear extension of axionic electrodynamics (ED) in a Carroll-Field-Jackiw (CFJ) scenario that implements Lorentz-symmetry violation (LSV). The model consists of an arbitrary non-linear ED action coupled to the axion field in presence of an anisotropy four-vector that realizes the breaking of Lorentz symmetry under the particle point of view. The non-linear electromagnetic field is expanded around a constant and uniform magnetic background up to second order in the propagating photon field. Our attention is the study of the material properties of the vacuum in the particular case of a space-like CFJ $4$-vector. The dispersion relations associated to the plane wave solutions are explicitly worked out in two situations: the magnetic background perpendicular and parallel to the wave direction. We extend these results to consider the analysis of the birefringence phenomenon in presence of non-linearity, the axion and the LSV manifested through the spatial anisotropy. Three specific proposals of non-linear ED are contemplated: Euler-Heisenberg, Born-Infeld and the Modified Maxwell ED. Throughout the paper, we shall justify why we follow the unusual path of connecting, in a single Lagrangian density, three pieces of physics beyond the Standard Model, namely, non-linearity, axions and LSV. We anticipate that we shall not be claiming that the simultaneous introduction of these three topics beyond the Standard Model will bring new insights or clues for the efforts to detect axions or to constrain parameters associate to both non-linear ED and LSV physics . Our true goal is to actually inspect and describe how axionic, non-linear and LSV effects interfere with one another whenever physical entities like refraction indices and birefringence are computed in presence of an external constant and homogeneous magnetic background.Comment: 27 pages, no figure

The axion-photon mixing in non-linear electrodynamic scenarios

In this contribution, we re-assess some aspects of axionic electrodynamics by coupling non-linear electromagnetic effects to axion physics. We present a number of motivations to justify the coupling of the axion to the photon in terms of a general non-linear extension of the electromagnetic sector. Our emphasis in the paper relies on the investigation of the constitutive permittivity and permeability tensors, for which the axion contributes by introducing dependence on the frequency and wave vector of the propagating radiation. Also, we point out how the axion mass and the axion-photon-photon coupling constant contribute to a dispersive behavior of the electromagnetic waves, in contrast to what happens in the case of non-linear extensions, when effective refractive indices appear which depend only on the direction of the propagation with respect to the external fields. The axion changes this picture by yielding refractive indices with dependence on the wavelength. We apply our results to the special case of the Born-Infeld Electrodynamics and we show that it becomes birefringent whenever the axion is coupled. The paper is supplemented by an Appendix, where we approach the recent discussion on the controversy in defining the Poynting vector of axionic electrodynamics. We present our path to tackle the question and give the expressions we work out for both the Poynting vector and the momentum density transported by the waves.Comment: 30 pages, no figure

Crystallographic and magnetic properties of UFe5.8Al6.2 single crystals

Single crystals of UFe5.8Al6.2 were characterised by X-ray and neutron diffraction, 57Fe Mössbauer spectroscopy and magnetisation. The structure refinement by X-ray and neutron diffraction shows a ThMn12-type structure, the Fe atoms fully occupying the 8f and partially occupying the 8j positions. Mössbauer spectra confirm these occupations and further indicate a magnetic ordering below 293 K. Magnetisation measurements show a ferromagnetic behaviour below 300 K, with a and b as easy directions and a spontaneous magnetisation of 10.4 [mu]B/f.u. at 5 K, due to the Fe occupation of 8j position. These single crystal results significantly differ from those previously obtained in UFe6Al6 polycrystalline samples obtained by melting and annealing.http://www.sciencedirect.com/science/article/B6TJJ-3V7WTYX-N/1/f7893080a7f27a628198f02aeb40fe2

Desilication of MOR zeolite: Conventional versus microwave assisted heating

MOR zeolites were modified via desilication treatments with NaOH, under conventional and microwave heating. The samples were characterized by powder X-ray diffraction, (27)Al and (29)Si NMR spectroscopy. TEM and N(2) adsorption at -196 degrees C. The acidity of the samples and the space available inside the pores were evaluated through a catalytic model reaction, the isomerization of m-xylene, for which the profiles of the coke thermal decomposition were also analyzed. Powder X-ray diffraction and (29)Si and (27)Al MNR results show that in comparison with conventional heating, microwave irradiation (a less time consuming process) leads to identical amount of Si extraction from the zeolite framework. With this treatment. in addition to the customary mesopores development promoted by conventional heating, a partial conversion of the zeolite microporosity into larger micropores, is observed. The microwave irradiated and conventionally heated samples show different catalytic behavior in the m-xylene isomerization model reaction. It was observed that, by controlling the experimental conditions, it is possible to obtain samples with catalytic properties closer to the parent material, which is also confirmed by the respective coke analysis. (C) 2011 Elsevier B.V. All rights reserved

Triple-q octupolar ordering in NpO_2

We report the results of resonant X-ray scattering experiments performed at the Np M_4,5 edges in NpO_2. Below T_0 = 25 K, the development of long-range order of Np electric quadrupoles is revealed by the growth of superlattice Bragg peaks. The electronic transition is not accompanied by any measurable crystallographic distortion, either internal or external, so the symmetry of the system remains cubic. The polarization and azimuthal dependence of the intensity of the resonant peaks is well reproduced assuming Templeton scattering from a triple-q longitudinal antiferroquadrupolar structure. Electric quadrupole order in NpO_2 could be driven by the ordering at T_0 of magnetic octupoles of Gamma_5 symmetry, splitting the Np ground state quartet and leading to a singlet ground state with zero dipole magnetic moment.Comment: 4 Pages, 3 Figures, submitted to Phys. Rev. Lett. v2: resubmitted after referee report

Pulmonary rehabilitation in primary health care: an effective intervention even with minimal resources

No abstract available.publishe

Bringing pulmonary rehabilitation closer to the community and keeping its effectiveness

Background: Pulmonary Rehabilitation (PR) is a key evidence-based intervention in the management of chronic respiratory diseases. Nevertheless, it is still highly inaccessible and underutilised by patients, as most PR programmes are directed to patients with advanced disease and/or held on a hospital-basis. There is an urgent need to increase access to PR and therefore, new intervention models that can be more inclusive and closer to patients' homes have been recommended. Purpose: To evaluate the effects of a community-based PR programme in patients with chronic respiratory diseases. Methods: A quasi-experimental study was conducted. Patients were recruited from primary health care centres. Patients enrolled in a 12- week community-based PR programme of exercise training, twice a week, and education and psychosocial support, once every other week. Outcome measures used to assess effectiveness of the programme were collected pre/post PR. Dyspnoea during activities was collected with the modified medical research council-dyspnoea scale (mMRC); anxiety and depression symptoms with the Hospital Anxiety and Depression Scale (HADS); health-related quality of life with the Saint George's Respiratory Questionnaire (SGRQ); quadriceps muscle strength (QMS) with a handheld dynamometer; functionality with the 1-minute sit-to-stand (1-minSTS); exercise tolerance with the sixminute walk test (6MWT) and functional balance with the Brief Balance Evaluation System Test (Brief-BESTest). Differences were examined using the Student's t-test or the Wilcoxon test, according to data normality, and effect sizes (ES) were calculated. For the measures with an established minimal clinically important difference (MCID), an analysis of the number of patients that improved above that value was conducted. Results: Fifty-six patients (36 male; 67.0±10.3years; 56.8±3.2% FEV %predicted) with COPD (n=37), asthma (n=11), asthma-COPD overlap syndrome (n=2), interstitial lung disease (n=2), pneumonitis (n=2), pulmonary fibrosis (n=1), lung transplant due to COPD (n=1) and bronchiectasis (n=1) participated. After the PR programme, significant improvements were observed in the mMRC (2[0-4] vs. 1[0-3]; p≤0.001; ES=-0.49; 22 (39,3%) patients above the MCID); HADS Anxiety (6.5±3.5 vs. 5.7±3.4;p=0.042; ES=-0.23; 23 (41,1%) patients above the MCID) and HADS Depression (6.6±4.1 vs. 5.8±3.8; p=0.113; ES=-0.19; 23 (41,1%) patients above the MCID); SGRQ total score (46.5±19.0 vs. 38.4±16.5; p≤0.001; ES=-0.45; 35 (62,5%) patients above the MCID); QMS (29.3±7.5 vs. 32.9±7.6Kgf; p≤0.001; ES=0.48); 1-minSTS (26±10 vs. 30±11 repetitions; p≤0.001; ES=0.38; 26 (46,4%) patients above the MCID), 6MWT (400.8±116.9 vs. 455.8±118.5m; p≤0.001; ES=0.47; 40 (71,4%) patients above the MCID), Brief-BESTest (17.2±5.0 vs. post 20.2±3.3; p≤0.001; ES=0.70; 13 (23,2%) patients above the MCID). Conclusion(s): Community-based PR programmes are feasible and effective to conduct in patients with chronic respiratory diseases, providing similar benefits for symptoms, health-related quality of life, lower limb muscle strength, functionality, exercise tolerance and balance to those well-established for PR programmes carried out in hospital outpatient settings. Implications: Community-based PR programmes are a feasible and effective way of increasing access to a fundamental intervention for patients with chronic respiratory diseases.publishe