Necessidades humanas básicas de pessoas em hemodiálise sob à luz da teoria de Wanda Horta / Basic human need in persons in hemodialysis in the light of Wanda Horta's theory

To know, be aware of, the Basic Human Needs of chronic renal patients on hemodialysis, according to Wanda Horta's Theory. Methods: exploratory and descriptive research of qualitative approach, conducted from interviews with 10 patients followed in a hemodialysis clinic located in a city in the interior of Bahia, Brazil. Data were categorized according to Bardin's Content Analysis technique and discussed from the perspective of Wanda Horta's Basic Human Needs Theory. Results: Three categories emerged themes that highlight the basic human needs affected in the lives of patients with chronic renal failure and on hemodialysis treatment, highlighting: Nutrition and hydration changes; Changes in sleep and rest ; and Deprivation of freedom, leisure and sociability. Final considerations: there was a predominance of psychobiological needs, namely: hydration, nutrition, locomotion, sleep, rest and body mechanics. As for psychosocial NHB, it was possible to observe those related to recreation, leisure, freedom, participation, gregarious, of self-esteem and self-realization. No NHB affections regarding the psycho-spiritual domain emerged.

Conhecer as Necessidades Humanas Básicas de pacientes renais crônicos em hemodiálise, conforme a Teoria de Wanda Horta. Métodos:pesquisa exploratória e descritiva de abordagem qualitativa, realizada a partir de entrevistas com 10 pacientes acompanhados em uma clínica de hemodiálise localizada em uma cidade do interior da Bahia, Brasil. Os dados foram categorizados de acordo com a técnica de Análise de Conteúdo de Bardin e discutidos sob a ótica da Teoria das Necessidades Humanas Básicas de Wanda Horta. Resultados: emergiram três categorias temáticas que evidenciam as necessidades humanas básicas afetadas na vida dos pacientes com insuficiência renal crônica e em tratamento com hemodiálise, destacando-se: Mudanças nutricionais e de hidratação; Alterações no sono e repouso; e Privação da liberdade, lazer e sociabilidade. Considerações finais: observou-se o predomínio das necessidades psicobiológicas, a saber: hidratação, nutrição, locomoção, sono, repouso e mecânica corporal. Quanto às NHB psicossociais, foi possível observar aquelas relacionadas à recreação, lazer, liberdade, participação, gregária, de autoestima e autorrealização. Não emergiram NHB afetas quanto ao domínio psicoespiritual.

Stochastic gene expression conditioned on large deviations.

The intrinsic stochasticity of gene expression can give rise to large fluctuations and rare events that drive phenotypic variation in a population of genetically identical cells. Characterizing the fluctuations that give rise to such rare events motivates the analysis of large deviations in stochastic models of gene expression. Recent developments in non-equilibrium statistical mechanics have led to a framework for analyzing Markovian processes conditioned on rare events and for representing such processes by conditioning-free driven Markovian processes. We use this framework, in combination with approaches based on queueing theory, to analyze a general class of stochastic models of gene expression. Modeling gene expression as a Batch Markovian Arrival Process (BMAP), we derive exact analytical results quantifying large deviations of time-integrated random variables such as promoter activity fluctuations. We find that the conditioning-free driven process can also be represented by a BMAP that has the same form as the original process, but with renormalized parameters. The results obtained can be used to quantify the likelihood of large deviations, to characterize system fluctuations conditional on rare events and to identify combinations of model parameters that can give rise to dynamical phase transitions in system dynamics.

An assessment of the ship drag penalty arising from light calcareous tubeworm fouling.

A test coupon coated with light calcareous tubeworm fouling was scanned, scaled and reproduced for wind-tunnel testing to determine the equivalent sand grain roughness ks. It was found that this surface had a ks = 0.325 mm, substantially less than the previously reported values for light calcareous fouling. This result was used to predict the drag on a fouled full scale ship. To achieve this, a modified method for predicting the total drag of a spatially developing turbulent boundary layer (TBL), such as that on the hull of a ship, is presented. The method numerically integrates the skin friction over the length of the boundary layer, assuming an analytical form for the mean velocity profile of the TBL. The velocity profile contains the roughness (fouling) information, such that the prediction requires only an input of ks, the free-stream velocity (ship speed), the kinematic viscosity and the length of the boundary layer (the hull length). Using the equivalent sandgrain roughness height determined from experiments, a FFG-7 Oliver Perry class frigate is predicted to experience a 23% increase in total resistance at cruise, if its hull is coated in light calcareous tubeworm fouling. A similarly fouled very large crude carrier would experience a 34% increase in total resistance at cruise.

Dentists versus auto mechanics: are there ethical differences?

The different ethical perspectives of dentists and auto mechanics include primary concern, billing procedures, advertising, emergency care, the level of autonomy granted to their patients/ clients, the amount of disclosure given to their patients/clients, the ability to judge the work of others, and the freedom to pursue romantic relationships with their patients/clients. In analyzing these differences, one finds dentists to have much greater ethical obligations than auto mechanics. There are subtle differences between the ethical expectations of Canadian and United States dentists.

Intervención educativa sobre mecánica corporal en el personal de enfermería. 2011. Estudio aleatorizado doble ciego / Educational intervention on body mechanics in nursing personnel. 2011. Double blind randomized study

Objetivo: Valorar los efectos de un programa educativo sobre mecánica corporal en el personal de enfermería. Métodos: Es un estudio experimental, aleatorizado doble ciego. Se utilizó una muestra estratificada: grupo intervención y cargo, aplicación pre-post test, con grupo control aleatorizado. Se utilizaron 2 cuestionarios validados: el primero valida conocimientos: Alfa de Cronbach 83%, significancia 0,000; actitud utilización mecánica corporal, validado: Alfa de Cronbach 86%, significancia 0,000. El segundo evaluó la aplicación práctica, alcanzó Alfa de Cronbach 94% con significancia 0,000. Evaluación pre/post test Wilcoxon=p>0,05 La población de estudio son 301 enfermeras. La muestra fue calculada con Epi Info =109+21 personas=19% posibles pérdidas; la intervención educativa mantuvo 5 bloques, 25 personas, la intervención educativa se realizó los días lunes a viernes. Para controlar la desmotivación para la actitud de no aplicación del conocimiento/práctica se utilizó la educación interactiva teoría-práctica. Resultados: Los conocimientos mejoraron en 39,65%, p(Fisher)0,000; las actitudes 22,12% p(Fisher)0,039; y en práctica 55,86% p(Fisher)0,000; se demostró el mejoramiento significativo en conocimientos y aplicación práctica de Mecánica Corporal.

Objective: To develop educational program on body mechanics with the methodological support of the constructivist model, Infirmary Staff, José Carrasco Arteaga Hospital IESS/2011. Contribute to improving the use of body mechanics in hospital care, Infirmary Staff, José Carrasco Arteaga Hospital IESS/2011. Method and Technique: Experimental, randomized double-blind. Stratified by intervention group and in charge of Infirmary staff, pre and post test application. January/2012 randomized control group. Instruments: 2 questionnaire produced and validated by the author. The 1st validated knowledge: Cronbach's Alpha 83%, significance 0.000; attitude of body mechanics using validated: Cronbach's Alpha 86%, significance 0.000. The 2nd evaluated: its practical application Cronbach's Alpha reached 94% significance 0.000. Evaluation pre/post test Wilcoxon= p> 0,05 Universe and Sample: 301 Infirmary staff Universe. Sample calculated with Epi Info=109+21=19% of people possible losses, educational treatment remained 5 blocks, 25 people from Monday to Thursday and 30 people Friday. Results: In both groups baseline data: p(Fisher)>0.05. The results obtained after completion of the educational program was: 39.65% knowledge, p(Fisher) 0.000; 22.12% Attitudes p(Fisher) 0.039; and, 55.86% Practice p(Fisher) 0.000, were found to H1. It had showing a significant improvement in knowledge and practical application of body mechanics, as well as for controlling the attitude of discouragement for failure to apply the knowledge/practice is recommended to use the interactive education theory and practice.

Transvenous lead extractions: comparison of laser vs. mechanical approach.

AIMS: In this retrospective study we compared different lead extraction techniques. METHODS AND RESULTS: Between January 2009 and December 2012 we performed transvenous lead extraction procedures on 206 leads in 122 patients. Mean implant duration (MID) was 69.6 months (1-384 months). Leads with lead implant duration ≥ 12 months were assigned to groups according to the extraction technique: Group A: no extraction tool; Group B: laser approach; and Group C: mechanical approach. Overall clinical success was 93.3%. Group A showed a significantly lower MID [38.1 (19-122) months] compared with Groups B and C [83.1 (13-168) months; P < 0.0001 vs. 95.4 (12-384) months; P < 0.0001]. Mean implant duration between Groups B and C did not differ significantly (P = 0.28). Clinical and complete procedural success was 100% in Group A. Clinical success rate was higher in Group C than in Group B (97.0 vs. 76.9%, P = 0.018). Complete procedural success did not differ significantly between Groups B and C (88.9 vs. 76.9%; P = 0.132). In Groups B and C, absence of complete procedural success occurred in long implanted leads (MID 107.8 ± 36.4 and 137.6 ± 89.2 months). Relative costs per extracted lead were 49% higher in Group B than in Group C. CONCLUSION: In case of long implanted leads a laser and a mechanical approach are comparable in complete procedural success and safety. Clinical success and cost effectiveness analysis favours the mechanical approach. Regardless of the extraction technique efficacy and safety optimization has to focus on long implanted leads.

Assessment of acetabular cup positioning from a lateral radiographic projection after total hip replacement.

OBJECTIVE: To demonstrate first that a ventrodorsal radiographic (VDR) projection is inadequate for obtaining accurate acetabular cup position (ACP) measurements after total hip replacement (THR), and second to validate use of the lateral radiographic (LR) projection to measure ACP. STUDY DESIGN: In vitro study. METHODS: Eleven VDRs were obtained after insertion of a cup into the acetabulum of a Sawbones pelvis fixed at an approximated angle. For each VDR, the pelvis was placed in varying degrees of craniocaudal pelvic tilt (CCPT). Fifteen LRs were obtained of a Sawbones pelvis with varying ACPs. Five blinded observers made previously described measurements of ACP on each VDR and angle of lateral opening (ALO) and coronal retroversion (CR) on each LR. RESULTS: An almost perfect level of agreement was observed between 5 observers for the repeatability of both VDR and LR measurements. When varying degrees of CCPT were introduced, there was no agreement in the measurements of ACP from VDRs. In all cases, and at all ACPs, measurements taken from LRs were in agreement. CONCLUSION: Undetectable CCPT causes significant variability in ACP measurements on VDRs predisposing postoperative radiographic measurements to inaccuracy. Measurements obtained from an LR of CR and ALO are accurate and consistent between observers and it should be used to measure ACP. The VDR should be performed to assess bone and implant integrity but not to obtain measurements of ACP because of CCPT causing measurements to be unreliable. Measurements of ACP obtained from an LR in conjunction with femoral anteversion may allow for investigation of the influence of ACP on coxofemoral joint luxation after THR.

Analysis of the injection force of solostar® compared with other disposable insulin pen devices at constant volume flow rates.

Insulin pen devices have greatly enhanced the portability and accessibility to insulin therapy for millions of people with diabetes. Comparison research data should be reviewed thoroughly. In this issue of Journal of Diabetes Science and Technology, the study presented by Thomas van der Burg is balanced in number of samples tested, same tensile meter, and identical units per second delivery rate into an open beaker. Mean plateau force of SoloSTAR® and KwikPen™ were significantly lower. KwikPen and SoloSTAR utilized 5-mm length 31-gauge (G) needles vs 6-mm 31G needles for FlexPen® and Next Generation FlexPen®, perhaps skewing results in favor of shorter needles instead of device design. Individual understanding of correct insulin use, appropriate self-monitoring of blood glucose, vision and dexterity capability, and affordability of therapy must be considered first. SoloSTAR holds one unique market advantage, delivery of up to 80 units of insulin per injection.

An extension of fracture mechanics/technology to larger and smaller cracks/defects.

Fracture mechanics/technology is a key science and technology for the design and integrity assessment of the engineering structures. However, the conventional fracture mechanics has mostly targeted a limited size of cracks/defects, say of from several hundred microns to several tens of centimeters. The author and his group has tried to extend that limited size and establish a new version of fracture technology for very large cracks used in geothermal energy extraction and for very small cracks/defects or damage often appearing in the combination of mechanical and electronic components of engineering structures. Those new versions are reviewed in this paper.

Unicompartmental knee prostheses: in vitro wear assessment of the menisci tibial insert after two different fixation methods.

Knee osteoarthritis is a complex clinical scenario where many biological and mechanical factors influence the severity of articular degenerative changes. Minimally invasive knee prosthetic surgery, with only a compartment replacement (unicompartmental knee replacement), might be a good compromise between osteotomy and total knee prosthesis. The focus of this study was to develop and validate a protocol to assess the fixation method of the femoral components in mechanical simulation, for pre-clinical validation; the wear behaviour of two different fixation frames was quantified and compared. In particular, two different wear tests were conducted using the same knee simulator, the same load profiles and the same kinematics; two different fixation methods were applied to the femoral sleds (synthetic femur and metal block). Surface characterization on both articulating bearings was performed by a roughness measuring machine and coordinate measuring machine. The wear produced by the tibial inserts using the synthetic femur was considerably higher than the wear registered by the metal-block holder. Roughness measurements on femoral sleds showed a limited number of scratches with high R(t) values for the metal-block set-up; the damaged surface broadened in the case of femoral condyles and tibial inserts mounted on composite bone, but lower R(t) and linear penetration values were measured. The two holding frames showed different wear activities as a consequence of dissimilar dynamic performance. Further observations should be made in vivo to prove the actual importance of synthetic bone simulations and specific material behaviour.

Triggering vacuum capillaries for pneumatic pumping and metering liquids in point-of-care immunoassays.

An innovative vacuum capillary pneumatic actuation concept that can be used for point-of-care testing has been investigated. The vacuum glass capillaries are encapsulated within a laminated pouch and incorporated into the fluidic card. Vacuum glass capillaries broken by external force such as finger pressure, generate the pneumatic forces to induce liquid flow in the fluidic system. The sizes of vacuum capillary play a vital role in the pumping and metering functions of the system. The luteinizing hormone (LH) chromatographic immunoassay performances in the fluidic cards show consistency comparable to that obtained by manual micropipetting. The vacuum capillary pneumatic actuation will be applied in other complex handling step bioassays and lab-on-a-chip devices.

Monte Carlo simulations of phase transitions and adsorption isotherm discontinuities on surface compression.

Low temperature, Grand Canonical Monte Carlo simulations were used to study the adsorption of fluid layers on cubic, hexagonal, and atomically smooth substrates to determine the effects of registry and surface compression on the system. The size of the fluid molecules was fixed to be 20% larger than the substrate molecules in order to observe the transition from an expanded to commensurate and finally to an incommensurate monolayer. For relatively weak fluid-substrate interactions, the cubic system underwent a first-order phase transition. As the strength of the fluid-substrate interactions increased, the molecules became fixed at commensurate locations and the transition from low density to commensurate packing became continuous. The strong fluid-substrate interactions lead to the development of a kink in the adsorption isotherm that showed the increased stability of the commensurate phase. This kink became more pronounced as the system temperature was decreased. The hexagonal system showed less dramatic results due to a decrease in the substrate well depth of the relative to the cubic system. The system did experience a first-order phase transition for a weak fluid-substrate interactions and the transition became much more gradual as the fluid-substrate interaction increased. The molecules became fixed to commensurate substrate locations, but the surface was not corrugated sufficiently to have a stable commensurate phase. The atomically smooth substrate showed the first-order phase transition expected of a low temperature system with no effects of registry.

Impact of sludge thickening on energy recovery from anaerobic digestion.

This paper presents energy balances for various digestion systems, which include single mesophilic digestion, single thermophilic digestion, two-stage thermophilic-mesophilic digestion system and systems at elevated solids content in sludge. On the basis of a sludge flow containing 30 tons TS/day (equivalent to a 100 ML/d WWTP plant) it was shown that a two-stage thermophilic-mesophilic digestion system generated more available energy than single mesophilic digestion and single thermophilic digestion systems. Sludge thickening offered the greatest amount of available energy; however that energy surplus was offset by the cost of thickening. After the cost of thickening was converted into equivalent energy units it was shown that the price of energy is important in calculation of equivalent energy units related to operation of the thickening plant. Sludge thickening may be beneficial from energy view point compared to conventional mesophilic digestion when price of energy exceeds dollars 0.08 CAN kW-hr.

[About machines and instruments (I): the body of the automaton in the work of E.T.A. Hoffmann]. / Sobre máquinas e instrumentos (I): el cuerpo del autómata en la obra de E.T.A. Hoffmann.

Immediately after becoming interested in animal magnetism, and undoubtedly as a result of this interest, E.T.A. Hoffmann used automata as the central characters in some of his most notable works. This paper aims to show how this interest reveals the author's critical attitude towards a conception of the human being which, developing in parallel to anatomy-based medicine, had led in the eighteenth century to a doctrine whose most complete expression is to be found in "L'homme machine," by J.O. De La Mettrie. Nowadays we can see these tales, like those dedicated to animal magnetism, as a cry of alarm against one of the consequences of such a mechanical conception of a human being: the growth of "biopower," or of "biopolitics," terms coined by Foucault in his last works; but also against the risks entailed by the Promethean drive of modernity.

Experimental free energy surface reconstruction from single-molecule force spectroscopy using Jarzynski's equality.

We used the atomic force microscope to manipulate and unfold individual molecules of the titin I27 domain and reconstructed its free energy surface using Jarzynski's equality. The free energy surface for both stretching and unfolding was reconstructed using an exact formula that relates the nonequilibrium work fluctuations to the molecular free energy. In addition, the unfolding free energy barrier, i.e., the activation energy, was directly obtained from experimental data for the first time. This Letter demonstrates that Jarzynski's equality can be used to analyze nonequilibrium single-molecule experiments, and to obtain the free energy surfaces for molecular systems, including interactions for which only nonequilibrium work can be measured.

Accurate assessment of work done and power during a Wingate anaerobic test.

A Monark cycle ergometer is used in physiological studies to measure work done and power. In this paper, the accuracy of a Monark rope-braked cycle ergometer was examined for a Wingate anaerobic test (WAnT). The traditional method of determining brake torque fails to take into account rope-brake theory and, as the brake torque is used to determine the moment of inertia of the flywheel, a second error is introduced into the calculation to determine the work done or power. In this study, the rope tensions were measured to determine the actual brake torque. A deceleration test was carried out to determine the moment of inertia of the system. The work done by subjects of different masses was calculated for various accelerations and it was found that the traditional calculations overestimate work done and power by between 12% and 14.7%.

Magnetic resonance-compatible robotic and mechatronics systems for image-guided interventions and rehabilitation: a review study.

The continuous technological progress of magnetic resonance imaging (MRI), as well as its widespread clinical use as a highly sensitive tool in diagnostics and advanced brain research, has brought a high demand for the development of magnetic resonance (MR)-compatible robotic/mechatronic systems. Revolutionary robots guided by real-time three-dimensional (3-D)-MRI allow reliable and precise minimally invasive interventions with relatively short recovery times. Dedicated robotic interfaces used in conjunction with fMRI allow neuroscientists to investigate the brain mechanisms of manipulation and motor learning, as well as to improve rehabilitation therapies. This paper gives an overview of the motivation, advantages, technical challenges, and existing prototypes for MR-compatible robotic/mechatronic devices.

Performance of a low cost MBT prior to landfilling: study of the biological treatment of size reduced MSW without mechanical sorting.

In France, the interest in Mechanical Biological Treatment (MBT) prior to landfilling is actually growing. In the absence of acceptance criteria for the waste to be landfilled, an alternative to the intensive, high-technology MBT can only find its place in the French context if it shows substantial benefits from an environmental, economic or operational point of view. This paper presents an experiment of low-cost MBT of size reduced MSW without material splitting. The performance of an experimental, pilot-scale mechanical and biological treatment process has been studied on 37.5 Mg of raw municipal solid waste. The mechanical process has been kept simple with only coarse shredding and no material recovery. The biological treatment, which was a low-cost forced aeration process, was monitored for 25 weeks. The biogas production potential of the waste was reduced by 90% to 19 NL kgDM(-1). The initial AT4 index of 82.9 mg O2 gDM(-1) decreased to 16.0 mg O2 gDM(-1). After 25 weeks of aerobic treatment, the dry mass loss reached 37%, while the mass of waste going to landfill was reduced by 28%. The average performances of the process were explained by the biological process itself, which was not optimal, and also by the characteristics of the input waste. The high particle size of the treated waste and the high content of slowly biodegradable matter (such as paper and cardboard) may both be significant drawbacks for the biological stabilisation of waste.

Mechanical design of walking machines.

The performance of existing actuators, such as electric motors, is very limited, be it power-weight ratio or energy efficiency. In this paper, we discuss the method to design a practical walking machine under this severe constraint with focus on two concepts, the gravitationally decoupled actuation (GDA) and the coupled drive. The GDA decouples the driving system against the gravitational field to suppress generation of negative power and improve energy efficiency. On the other hand, the coupled drive couples the driving system to distribute the output power equally among actuators and maximize the utilization of installed actuator power. First, we depict the GDA and coupled drive in detail. Then, we present actual machines, TITAN-III and VIII, quadruped walking machines designed on the basis of the GDA, and NINJA-I and II, quadruped wall walking machines designed on the basis of the coupled drive. Finally, we discuss walking machines that travel on three-dimensional terrain (3D terrain), which includes the ground, walls and ceiling. Then, we demonstrate with computer simulation that we can selectively leverage GDA and coupled drive by walking posture control.

Intelligence by mechanics.

Research on the biomechanics of animal and human locomotion provides insight into basic principles of locomotion and respective implications for construction and control. Nearly elastic operation of the leg is necessary to reproduce the basic dynamics in walking and running. Elastic leg operation can be modelled with a spring-mass model. This model can be used as a template with respect to both gaits in the construction and control of legged machines. With respect to the segmented leg, the humanoid arrangement saves energy and ensures structural stability. With the quasi-elastic operation the leg inherits the property of self-stability, i.e. the ability to stabilize a system in the presence of disturbances without sensing the disturbance or its direct effects. Self-stability can be conserved in the presence of musculature with its crucial damping property. To ensure secure foothold visco-elastic suspended muscles serve as shock absorbers. Experiments with technically implemented leg models, which explore some of these principles, are promising.