Cost analysis of photobiomodulation in tibia fracture in the Brazilian public health system.

Managing tibial fractures requires substantial health resources, which costs the health system. This study aimed to describe the costs of photobiomodulation (PBM) with LEDs in the healing process of soft tissue lesions associated with tibial fracture compared to a placebo. Economic analysis was performed based on a randomized controlled clinical trial, with a simulation of the cost-effectiveness and incremental cost model. Adults (n = 27) hospitalized with tibia fracture awaiting definitive surgery were randomized into two distinct groups: the PBM Group (n = 13) and the Control Group with simulated phototherapy (n = 14). To simulate the cost-effectiveness and incremental cost model, the outcome was the evolution of wound resolution by the BATES-JENSEN scale and time of wound resolution in days. The total cost of treatment for the Control group was R$21,164.56, and a difference of R$7,527.10 more was observed when compared to the treatment of the PBM group. The proposed intervention did not present incremental cost since the difference in the costs to reduce measures between the groups was smaller for the PBM group. When analyzing the ICER (Incremental cost-effectiveness ratio), it would be possible to save R$3,500.98 with PBM and decrease by 2.15 points in the daily average on the BATES-JENSEN scale. It is concluded, therefore, that PBM can be a supportive therapy of clinical and economic interest in a hospital setting.

New Measurements and Calculations on the Kinetics of an Old Reaction: OH + HO2 → H2O + O2.

Literature rate coefficients for the prototypical radical-radical reaction at 298 K vary by close to an order of magnitude; such variations challenge our understanding of fundamental reaction kinetics. We have studied the title reaction at room temperature via the use of laser flash photolysis to generate OH and HO2 radicals, monitoring OH by laser-induced fluorescence using two different approaches, looking at the direct reaction and also the perturbation of the slow OH + H2O2 reaction with radical concentration, and over a wide range of pressures. Both approaches give a consistent measurement of k1,298K ∼1 × 10-11 cm3 molecule-1 s-1, at the lowest limit of previous determinations. We observe, experimentally, for the first time, a significant enhancement in the rate coefficient in the presence of water, k1,H2O, 298K = (2.17 ± 0.09) × 10-28 cm6 molecule-2 s-1, where the error is statistical at the 1σ level. This result is consistent with previous theoretical calculations, and the effect goes some way to explaining some, but not all, of the variation in previous determinations of k1,298K. Supporting master equation calculations, using calculated potential energy surfaces at the RCCSD(T)-F12b/CBS//RCCSD/aug-cc-pVTZ and UCCSD(T)/CBS//UCCSD/aug-cc-pVTZ levels, are in agreement with our experimental observations. However, realistic variations in barrier heights and transition state frequencies give a wide range of calculated rate coefficients showing that the current precision and accuracy of calculations are insufficient to resolve the experimental discrepancies. The lower value of k1,298K is consistent with experimental observations of the rate coefficient of the related reaction, Cl + HO2 → HCl + O2. The implications of these results in atmospheric models are discussed.

Intensity matters: protocol for a randomized controlled trial exercise intervention for individuals with chronic stroke.

RATIONALE: Cardiovascular exercise is an effective method to improve cardiovascular health outcomes, but also promote neuroplasticity during stroke recovery. Moderate-intensity continuous cardiovascular training (MICT) is an integral part of stroke rehabilitation, yet it may remain a challenge to exercise at sufficiently high intensities to produce beneficial adaptations to neuroplasticity. High-intensity interval training (HIIT) could provide a viable alternative to achieve higher intensities of exercise by using shorter bouts of intense exercise interspersed with periods of recovery. METHODS AND DESIGN: This is a two-arm, parallel-group multi-site RCT conducted at the Jewish Rehabilitation Hospital (Laval, Québec, Canada) and McMaster University (Hamilton, Ontario, Canada). Eighty participants with chronic stroke will be recruited at both sites and will be randomly allocated into a HIIT or MICT individualized exercise program on a recumbent stepper, 3 days per week for 12 weeks. Outcomes will be assessed at baseline, at 12 weeks post-intervention, and at an 8-week follow-up. OUTCOMES: The primary outcome is corticospinal excitability, a neuroplasticity marker in brain motor networks, assessed with transcranial magnetic stimulation (TMS). We will also examine additional markers of neuroplasticity, measures of cardiovascular health, motor function, and psychosocial responses to training. DISCUSSION: This trial will contribute novel insights into the effectiveness of HIIT to promote neuroplasticity in individuals with chronic stroke. TRIAL REGISTRATION: ClinicalTrials.gov NCT03614585 . Registered on 3 August 2018.

Direct Measurements of Isoprene Autoxidation: Pinpointing Atmospheric Oxidation in Tropical Forests.

2-Methyl-1,3-butadiene (isoprene), released from biogenic sources, accounts for approximately a third of hydrocarbon emissions and is mainly removed by hydroxyl radicals, OH, the primary initiator of atmospheric oxidation. In situ measurements in clean tropical forests (high isoprene and low NO x ) have measured OH concentrations up to an order of magnitude higher than model predictions, which impacts our understanding of global oxidation. In this study, direct, laser flash photolysis, laser-induced fluorescence measurements at elevated temperatures have observed OH recycling in the presence of isoprene and oxygen under conditions where interference from secondary or heterogeneous chemistry is minimal. Our results provide the first direct, time-resolved, experimental validation of the theory-based Leuven Isoprene Mechanism (LIM1), based on isomerization of isoprene-RO2 radicals and OH regeneration, that partially accounts for model:measurement divergence in OH. While our data can be fit with only minor alterations in important LIM1 parameters, and the overall rate of product formation is similar to LIM1, there are differences with the recent experimental study by Teng et al. J. Am. Chem. Soc. 2017, 139, 5367-5377. In addition, our study indicates that the dihydroperoxide products are significantly enhanced over previous estimates. Dihydroperoxides are chemical and photochemical sources of OH, and the implications of enhanced hydroperoxide formation on the agreement between models and observations in tropical forests are examined.

OH Kinetics with a Range of Nitrogen-Containing Compounds: N-Methylformamide, t-Butylamine, and N-Methyl-propane Diamine.

Emissions of amines and amides to the atmosphere are significant from both anthropogenic and natural sources, and amides can be formed as secondary pollutants. Relatively little kinetic data exist on overall rate coefficients with OH, the most important tropospheric oxidant, and even less on site-specific data which control the product distribution. Structure-activity relationships (SARs) can be used to estimate both quantities. Rate coefficients for the reaction of OH with t-butylamine (k1), N-methyl-1,3-propanediamine (k2), and N-methylformamide (k3) have been measured using laser flash photolysis coupled with laser-induced fluorescence. Proton-transfer-reaction mass spectrometry (PTR-MS) has been used to ensure the reliable introduction of these low-vapor pressure N-containing compounds and to give qualitative information on products. Supporting ab initio calculations are presented for the t-butylamine system. The following rate coefficients have been determined: k1,298K= (1.66 ± 0.20) × 10-11 cm3 molecule-1 s-1, k(T)1 = 1.65 × 10-11 (T/300)-0.69 cm3 molecule-1 s-1, k2,293K = (7.09 ± 0.22) × 10-11 cm3 molecule-1 s-1, and k3,298K = (1.03 ± 0.23) × 10-11 cm3 molecule-1 s-1. For OH + t-butylamine, ab initio calculations predict that the fraction of N-H abstraction is 0.87. The dominance of this channel was qualitatively confirmed using end-product analysis. The reaction of OH with N-methyl-1,3-propanediamine also had a negative temperature dependence, but the reduction in the rate coefficient was complicated by reagent loss. The measured rate coefficient for reaction 3 is in good agreement with a recent relative rate study. The results of this work and the literature data are compared with the recent SAR estimates for the reaction of OH with reduced nitrogen compounds. Although the SARs reproduce the overall rate coefficients for reactions, site-specific agreement with this work and other literature studies is less strong.

As brincadeiras realizadas por crianças nas praças da cidade de Patos - PB / The games played by children in the squares of the city of Patos-PB

A brincadeira é de fundamental importância para o desenvolvimento infantil na medida em que a criança pode transformar e produzir novos significados. Esta pesquisa tem como objetivo realizar um levantamento das brincadeiras que são realizadas pelas crianças nas praças da cidade de Patos-PB, assim como verificar se elas são de caráter tradicional. É uma pesquisa de campo, tendo como objetivo compreender e explicar o problema do estudo. Durante a coleta dos dados, foram observadas as seguintes brincadeiras: o futebol (travinha, dois toques), esconde-esconde, pega-pega, toca-ajuda, bola de gude e taco, onde o futebol foi a que mais se repetiu. Crianças do sexo masculino foram as mais encontradas nas brincadeiras. Pode-se concluir que se tem realizado brincadeiras tradicionais, sendo estas catalogadas, também se percebe que elas preferem os finais de semana para brincar nas praças e no horário noturno.

Play is of fundamental importance for child development insofar as can transform and produce new meanings. This research aims to perform a survey of the games that are performed by the children in the squares of the city of Patos-PB, as well as verify if they are of a traditional character. It is a field research, because we will observe the facts and phenomena exactly as it happens in the real, based on a consistent theoretical foundation, with the objective of understanding and explaining the problem of this research. During the research, the following games were observed: football (two touches), hide and seek, pick-up, touch-aid, marbles and clubs, where soccer was the most repeated. Male children were the most found in the games. We can also conclude that children prefer the weekends to play in the squares and at night time.

Unimolecular decomposition kinetics of the stabilised Criegee intermediates CH2OO and CD2OO.

Decomposition kinetics of stabilised CH2OO and CD2OO Criegee intermediates have been investigated as a function of temperature (450-650 K) and pressure (2-350 Torr) using flash photolysis coupled with time-resolved cavity-enhanced broadband UV absorption spectroscopy. Decomposition of CD2OO was observed to be faster than CH2OO under equivalent conditions. Production of OH radicals following CH2OO decomposition was also monitored using flash photolysis with laser-induced fluorescence (LIF), with results indicating direct production of OH in the v = 0 and v = 1 states in low yields. Master equation calculations performed using the Master Equation Solver for Multi-Energy well Reactions (MESMER) enabled fitting of the barriers for the decomposition of CH2OO and CD2OO to the experimental data. Parameterisations of the decomposition rate coefficients, calculated by MESMER, are provided for use in atmospheric models and implications of the results are discussed. For CH2OO, the MESMER fits require an increase in the calculated barrier height from 78.2 kJ mol-1 to 81.8 kJ mol-1 using a temperature-dependent exponential down model for collisional energy transfer with ΔEdown = 32.6(T/298 K)1.7 cm-1 in He. The low- and high-pressure limit rate coefficients are k1,0 = 3.2 × 10-4(T/298)-5.81exp(-12 770/T) cm3 s-1 and k1,∞ = 1.4 × 1013(T/298)0.06exp(-10 010/T) s-1, with median uncertainty of ∼12% over the range of experimental conditions used here. Extrapolation to atmospheric conditions yields k1(298 K, 760 Torr) = 1.1+1.5-1.1 × 10-3 s-1. For CD2OO, MESMER calculations result in ΔEdown = 39.6(T/298 K)1.3 cm-1 in He and a small decrease in the calculated barrier to decomposition from 81.0 kJ mol-1 to 80.1 kJ mol-1. The fitted rate coefficients for CD2OO are k2,0 = 5.2 × 10-5(T/298)-5.28exp(-11 610/T) cm3 s-1 and k2,∞ = 1.2 × 1013(T/298)0.06exp(-9800/T) s-1, with overall error of ∼6% over the present range of temperature and pressure. The extrapolated k2(298 K, 760 Torr) = 5.5+9.2-5.5 × 10-3 s-1. The master equation calculations for CH2OO indicate decomposition yields of 63.7% for H2 + CO2, 36.0% for H2O + CO and 0.3% for OH + HCO with no significant dependence on temperature between 400 and 1200 K or pressure between 1 and 3000 Torr.

The effects of aging on cortico-spinal excitability and motor memory consolidation.

We investigated whether cortico-spinal excitability (CSE), a marker of synaptic plasticity, is associated with age-related differences in the consolidation of motor memory. Young and older participants practiced a visuomotor tracking task. Skill retention was assessed 8 and 24 hours after motor practice. Transcranial magnetic stimulation applied over the primary motor cortex at rest and during an isometric muscle contraction was used to assess absolute and normalized to baseline CSE at different points after practice. When skill performance was normalized to baseline level, both groups showed similar gains in acquisition, but the young group showed better retention 24 hours after practice. The young group also showed greater absolute CSE assessed during the isometric muscle contraction. Although young participants with greater absolute CSE showed better skill retention, it was the capacity to increase CSE after motor practice, and not absolute CSE, what was associated with skill retention in older participants. Older adults who have the capacity to increase CSE during motor memory consolidation show a better capacity to retain motor skills.

Experimentally Determined Site-Specific Reactivity of the Gas-Phase OH and Cl + i-Butanol Reactions Between 251 and 340 K.

Product branching ratios for the gas-phase reactions of i-butanol, (CH3)2CHCH2OH, with OH radicals (251, 294, and 340 K) and Cl atoms (294 K) were quantified in an environmental chamber study and used to interpret i-butanol site-specific reactivity. i-Butyraldehyde, acetone, acetaldehyde, and formaldehyde were observed as major stable end products in both reaction systems with carbon mass balance indistinguishable from unity. Product branching ratios for OH oxidation were found to be temperature-dependent with the α, ß, and γ channels changing from 34 ± 6 to 47 ± 1%, from 58 ± 6 to 37 ± 9%, and from 8 ± 1 to 16 ± 4%, respectively, between 251 and 340 K. Recommended temperature-dependent site-specific modified Arrhenius expressions for the OH reaction rate coefficient are (cm3 molecule-1 s-1): kα(T) = 8.64 × 10-18 × T1.91exp(666/T); kß(T) = 5.15 × 10-19 × T2.04exp(1304/T); kγ(T) = 3.20 × 10-17 × T1.78exp(107/T); kOH(T) = 2.10 × 10-18 × T2exp(-23/T), where kTotal(T) = kα(T) + kß(T) + kγ(T) + kOH(T). The expressions were constrained using the product branching ratios measured in this study and previous total phenomenological rate coefficient measurements. The site-specific expressions compare reasonably well with recent theoretical work. It is shown that use of i-butanol would result in acetone as the dominant degradation product under most atmospheric conditions.

An instrument to measure fast gas phase radical kinetics at high temperatures and pressures.

Fast radical reactions are central to the chemistry of planetary atmospheres and combustion systems. Laser-induced fluorescence is a highly sensitive and selective technique that can be used to monitor a number of radical species in kinetics experiments, but is typically limited to low pressure systems owing to quenching of fluorescent states at higher pressures. The design and characterisation of an instrument are reported using laser-induced fluorescence detection to monitor fast radical kinetics (up to 25 000 s(-1)) at high temperatures and pressures by sampling from a high pressure reaction region to a low pressure detection region. Kinetics have been characterised at temperatures reaching 740 K and pressures up to 2 atm, with expected maximum operational conditions of up to ∼900 K and ∼5 atm. The distance between the point of sampling from the high pressure region and the point of probing within the low pressure region is critical to the measurement of fast kinetics. The instrumentation described in this work can be applied to the measurement of kinetics relevant to atmospheric and combustion chemistry.

Evaluation of the effect of acute sibutramine in female rats in the elevated T-maze and elevated plus-maze tests.

Sibutramine is a serotonin and norepinephrine reuptake inhibitor indicated for the treatment of obesity. A pre-clinical study showed that acute administration of sibutramine promoted anxiolytic- and panicolytic-like effects in male rats. However, in clinical reports, sibutramine favoured the onset of panic attacks in women. In this study, the effect of sibutramine on experimental anxiety in females and the relevance of different oestrous cycle phases for this effect were analysed. In experiment 1, both male and female rats were submitted to acute intraperitoneal injection of sibutramine or vehicle 30 min. before testing in the elevated T-maze (ETM) and in the open-field test (OF). Females in the pro-oestrus (P), oestrus (E), early dioestrus (ED) and late dioestrus (LD) phases were tested in the ETM and OF (experiment 2) or in the elevated plus-maze (EPM) 30 min. after the injection of sibutramine. Sibutramine impaired the escape response in the ETM in both males and females. This effect was observed for P, E and ED, but not for LD females. Sibutramine altered neither the inhibitory avoidance in the ETM nor the behaviour of females in the EPM. Thus, sibutramine promoted a panicolytic-like effect in female rats cycling at P, E and ED, but not in the LD phase and did not alter behaviours related to anxiety in both ETM and EPM. Considering that pre-clinical studies aiming the screening of anxiolytic drugs employ male rodents, data here obtained reinforce the importance of better understanding the effects of drugs in females.

New insights in the atmospheric HONO formation: new pathways for N2O4 isomerization and NO2 dimerization in the presence of water.

Isomerization of N(2)O(4) and dimerization of NO(2) in thin water films on surfaces are believed to be key steps in the hydrolysis of NO(2), which generates HONO, a significant precursor to the OH free radical in lower atmosphere and high-energy materials. Born-Oppenheimer molecular dynamics simulations using the density functional theory are carried out for NO(2)(H(2)O)(m), m ≤ 4, and N(2)O(4)(H(2)O)(n) clusters, n ≤ 7, used to mimic the surface reaction, to investigate the mechanism around room temperature. The results are (i) the NO(2) dimerization and N(2)O(4) isomerization reactions occur via two possible pathways, the non-water-assisted and water-assisted mechanisms; (ii) the NO(2) dimerization in the presence of water yields either ONONO(2)(H(2)O)(m) or NO(3)(-)NO(+)(H(2)O)(m) clusters, but it is also possible to form the HNO(3)(NO(2)(-))(H(3)O(+))(H(2)O)(m-2) transition state to form HONO and HNO(3), directly; (iii) the N(2)O(4) isomerization yields the NO(3)(-)NO(+)(H(2)O)(n) cluster, but it does not hydrolyze faster than the NO(2)(+)NO(2)(-)(H(2)O)(n) hydrolysis to directly form the HONO and HNO(3). New insights for hydrolysis of oxides of nitrogen in and on thin water films on surfaces in the atmosphere are discussed.