RAWS4all project: validation of a new silicone model for robotic TAPP inguinal hernia repair.

BACKGROUND: Trans-abdominal pre-peritoneal (TAPP) hernia repair is a complex procedure that presents several challenges. Even though, due to the high prevalence of inguinal hernia, TAPP technique is increasing in frequency and robotic Abdominal Wall Surgery (rAWS) is emerging as a valuable tool in this regard. Although inguinal TAPP procedure principles have been published and simulation is needed, the availability of validated models remains scarce. METHODS: A new low-cost model was developed to simulate inguinal rTAPP repair. For validity assessment, a new TAPP-specific fidelity questionnaire and assessment scale were developed to compare the performance of novices and experts in the simulated procedure. The models used were assessed at 60 min for execution and quality score. RESULTS: Twenty-five residents and specialists from all over the country participated in this study. Execution, quality, and global performance was higher in the seniors group compared to juniors (8.91 vs 6.36, p = 0.02; 8.09 vs 5.14, p < .001; and 17 vs. 11,5, p < .001, respectively). Overall fidelity was assessed as being very high [4.41 (3.5-5.0), α = .918] as well as face [4.31 (3.0-5.0), α = .867] and content validity [4.44 (3.2-5.0), α = .803]. Participants strongly agreed that the model is adequate to be used with the DaVinci® Robot [4.52 (3.5-5.0), α = .758]. CONCLUSION: This study shows face, content, and construct validity of the model for inguinal TAPP simulation, including for robotic surgery. Therefore, the model can be a valuable tool for learning, understanding, practicing, and mastering the TAPP technique prior to participating in the operating room.

Personalized checkpoint acupuncture can reduce postoperative pain after abdominal surgery-a STRICTA-conform pilot study.

BACKGROUND: Optimal pain management is one of the core elements of Enhanced Recovery After Surgery (ERAS®) protocols and remains a challenge. Acupuncture (AC) is an effective treatment for various pain conditions. Systematic and personalized allocation of acupoints may be decisive for efficacy. METHODS: Based on the predominant pressure sensitivity of six gastrointestinal (GI) checkpoints (G1-G6), we devised a method to detect personalized patterns of pain and a corresponding set of acupoints. We performed a single AC treatment with semi-permanent needles and assessed the visual analogue scale (VAS) score, pain threshold based on pressure algometry (PA), and temperature changes on abdominal skin areas before and 5 min after AC. RESULTS: Between April and June 2021, thirty-eight patients were prospectively included in this pilot study. The mean reduction in subjective pain sensation as assessed by VAS was 86%, paralleled by an augmentation of the pain threshold as measured by PA by 64%. A small but significant increase in the skin temperature was observed above the abdominal surface. These effects were independent of the type of surgery. CONCLUSION: Checkpoint acupuncture may be a complementary tool for postoperative pain management. Further investigations are needed to explore this analgesic effect.

Reduction of Pain After Laparoscopic Bariatric Surgery by Personalized Checkpoint Acupuncture-Data of a STRICTA Conform Pilot Study.

BACKGROUND: It remains challenging in clinical practice to perform optimal pain management following bariatric surgeries. Acupuncture (AC) is an effective method of postoperative pain management, but its clinical efficacy depends on the rationale used to select AC points. METHODS: We developed a method to identify individual patterns of pain and a corresponding set of acupoints (corrAC) based on the relative pressure sensitivity of six abdominal visceral pressure points, i.e., the gastrointestinal (GI) checkpoints (G1-G6). Patients with moderate to severe pain were included and received a single AC treatment following surgery. The visual analog scale (VAS) score, pain threshold, and skin temperature were assessed before AC and at 5 min, 1 h, and 24 h following AC. AC was performed with 1-mm-deep permanent needles. RESULTS: From April 2021 to March 2022, 72 patients were included in the analysis. Fifty-nine patients received corrAC, whereas 13 received a noncorresponding AC (nonAC) as an internal control. Patients receiving corrAC showed a significant reduction (74%) in pain at 5 min after treatment (p < 0.0001) and a significant increase (37%) in the pain threshold (p < 0.0001). In this group, a significant increase in skin temperature above G1, G3, G4, and G5 was observed. Patients receiving nonAC showed neither significant pain reduction nor significant changes in pain threshold. The skin above G3 and G4 did not reveal temperature changes. CONCLUSION: Checkpoint AC may be an effective tool in postoperative pain therapy after bariatric surgery. Vegetative functional involvement might be associated with pain relief.

Can Qigong Be a Tool to Assist Students in Handling COVID-19's Resulting Academic Stress?

The recent COVID-19 pandemic has increased students' stress as they may feel under increased pressure to have a good performance and compensate for the disruption to their education. Improving attention levels and learning capacity may assist in ameliorating academic performance. Qigong is a traditional Chinese medicine technique that appears to have positive effects on the management of mental health and may provide tools for coping with stressful situations. This paper explores data obtained while conducting a previous study and includes an excess of data from a total of 44 participants who were previously divided into an experimental Qigong group and a sham Qigong control group. The improvements in specific auditory processing and reaction times may indicate benefits in attention and learning capacity. These improvements were more pronounced in the experimental Qigong group compared to the sham Qigong group. Qigong may be able to assist in improving students' academic performance and can be easily integrated into physical education classes. It could also assist students to cope with the increased academic pressure resulting from the COVID-19 pandemic context.

Perceived Health Benefits of Taijiquan and Qigong.

Background: Taijiquan and qigong are traditional Chinese therapeutic disciplines with several health benefits and the ability to improve the quality of life of their practitioners. As traditional vegetative biofeedback therapies, they can activate functional vegetative changes in the body. These neurovegetative actions have been studied in the last few years to better explain the mechanisms through which these techniques of traditional Chinese medicine work. Primary Study Objective: To support current research, it is important to further explore these neurovegetative actions according to contemporary Chinese medicine models to clarify the mechanisms of their working in light of conventional medical terms. This study aims to explore the health benefits that these practices may produce for practitioners. Methods: 345 taijiquan and qigong practitioners were recruited for this study to assess the perceived health benefits of taijiquan and qigong. We conducted a survey to assist in this purpose. Results: Taijiquan combined with qigong may be more beneficial than taijiquan alone. Additionally, these practices seem to produce notable benefits for anxiety, depression, and other emotional disturbances. They also seem to have positive results in addressing arthritis and pain in the back, shoulder, neck, and knees. In addition, taijiquan and qigong may have benefits in managing several digestive, neurological, cardiovascular, and respiratory diseases, and provide some assistance in the management of some oncologic conditions. Conclusion: Breathing exercises, slow and controlled movement, self-massage, and directed thought are the therapeutic characteristics that allow this wide range of potential, perceived health benefits. More scientific studies are needed to confirm the mechanisms through which taijiquan and qigong may benefit health. However, it is suggested that these techniques may have an impact on health mainly via the modulation of the autonomic nervous system.

Qigong for the Emotional Exhaustion in Nurses: Implications of a Prospective Randomized Controlled Trial in the COVID-19 Pandemic.

Introduction: Burnout is commonly understood as resulting from chronic stress at work. It may have several consequences for the well-being and health of the worker. As a dimension of burnout, emotional exhaustion appears to be predicted mostly by work overload, interpersonal conflicts, and the inadequate use of skills. Emotional exhaustion is considered to be the affective component of burnout and may cause depersonalization. Burnout seems to be highly prevalent among nurses and more so during the COVID-19 pandemic. To address the new demands that the pandemic has placed on health care systems, nurses must be provided specific training in stress coping techniques. Qigong is an applied psychophysiological feedback technique that can be done independently by the practitioner; it enables the user to learn how to control their bodily functions and processes. As such, the objective of this study is to understand if qigong can be used as a complementary therapy for emotional exhaustion in nurses and if it can be implemented during critical events such as the COVID-19 pandemic. Method: A total of 44 nurses aged between 27 and 54 years (90.9% female), with high levels of emotional exhaustion, were randomized into intervention and control groups. The "white ball" system of qigong, led by a traditional Chinese medicine specialist, was taught to participants in the intervention group for 4 weeks. After this period, participants had 4 weeks for self-practice. The Maslach Burnout Inventory was used to capture the nurses' level of emotional exhaustion at the beginning and end of the experimental period, as well as after the 4-week self-practice period. Results: The results showed that 70% of the participants in the intervention group had significantly decreased emotional exhaustion levels, which reduced from high to either moderate (55%) or low (15%) after the experimental phase. Moreover, these benefits were maintained after the 4 weeks of self practice. Conclusion: The results of this study suggest that qigong may be used as a complementary tool to mitigate burnout (including that induced by COVID-19) among nurses, thus improving health care services and capacity.

Can Yoga, Qigong, and Tai Chi Breathing Work Support the Psycho-Immune Homeostasis during and after the COVID-19 Pandemic? A Narrative Review.

Breathing is crucial in life; nevertheless, the healthcare community often overlooks the health potential of breathing techniques. Conscious manipulation of breathing to achieve specific health goals is found in yoga, Qigong and Tai Chi. This paper reviews the value of breathing exercises as a foremost mechanism for promoting, recuperating and maintaining health. Practices involving breathing techniques are described, and their prophylactic or therapeutic characteristics are explored. The main goals of this review are: (i) to summarize the evidence supporting the hypothesis that breathing practices have a significant beneficial impact on human health; (ii) to provide a deeper understanding of traditional biofeedback practices, particularly yoga, Qigong and Tai Chi, and outline their focus on breathing techniques; (iii) to outline specific immune-related responses, relevant for COVID-19 disorders; and (iv) to call for committed attention and action from the scientific community and health agencies in promoting the implementation of a practical and costless health program based on breathing techniques. This review shows the health potentials of breathing practices and exercises, which, by having a high benefit-cost ratio, could be selected and implemented as a primary standard routine in public health programs.

Qigong in Perceptual Auditory Attention: Tool to Improve Sound Integration in Autism Spectrum Disorders.

Context: Qigong, a mind-body practice in traditional Chinese medicine (TCM), can improve cognitive functions, emotional balance, attention, multitask management, stress-coping, and well-being. One limitation of Qigong research is a lack of adequate controls. Objective: The current study intended to evaluate whether a single 5-min practice of a White Ball (WB) Qigong exercise could improve the perceptual auditory attention, divided and focused, in adults and whether obtaining potential effects would require a minimum level of training. Design: The research team designed a prospective, randomized, placebo-controlled, and single-blinded study. Setting: The study took place at the Institute of Biomedical Sciences (ICBAS) at the University of Porto in Porto, Portugal. Participants: Participants were 55 students at the University of Porto, 30 of whom were students attending the second year of medical school at ICBAS with no experience in Qigong and 25 of whom were students in the specialization and Master's programs in TCM with experience in Qigong. Intervention: The research team randomly distributed the 30 participants without experience into two groups, a negative control group (n = 15), who watched a wildlife video for 5 min in an orthostatic position, and a positive control group , the verum Qigong group (n = 15), who participated in 5 min of Qigong practice. The Qigong-practitioner group (n = 25), the intervention group, participated in the same 5-min Qigong, doing it with expertise. Outcome Measures: The study measured reaction time (RT) under two experimental conditions, one an auditory RT task and the second an auditory RT task with visual distraction. The procedure was constant for all the studied groups. Results: Postintervention, the reaction time (RT) in the negative control and the verum Qigong groups hadn't changed significantly (P > .05), while that of the Qigong-practitioner group had decreased significantly, with shorter RTs under the two experimental conditions, with P = .006 for the auditory RT and P = .003 for the auditory + visual distraction. Qigong may induce a conditioning effect that comes with regular practice. Conclusions: The WB Qigong had a positive effect on the AA mechanism, with a significant reduction in RT. The results support the importance of practice to achieve positive effects. People with neurodevelopmental disorders, such as autism and ADHD, struggle every day for sensory integration of AA mechanisms. Qigong can be taught and easily learned from the age of 2 years until senior ages, and it's a safe and very low-cost intervention that deserves to be researched further in clinical trials. These potential benefits of Qigong should be confirmed by future studies.

Taijiquan and qigong as a mindfulness cognitive-behavioural based therapy on the treatment of cothymia in school-age children - A preliminary study.

INTRODUCTION: The development and well-being of children are directly linked to several aspects. Among those aspects, physical activity, an adequate nutrition, and a healthy mind, seem to be of crucial importance. Psychopathologies, such as anxiety and depression, have a negative impact on life, especially when co-occurring (mixed-anxiety depression disorder/cothymia), and the clinical implications include a higher risk of suicide and psychiatric hospitalization, elevated disability, decreased compliance with medical treatment, and considerably increased usage of medical services. Thus, research in conventional and nonconventional modalities is necessary to address this issue. The main objective of this study was to understand if TJQ and QG could be effective as a mindfulness cognitive-behavioural based therapeutic tool with body movement, for the treatment of children suffering from cothymia. METHODS: In this small study, six selected children, four males and two females aged between 7 and 11 years old, were taught a set of exercises of TaijiQuan (TJQ) and Qi Gong (QG). To obtain the results, the Achenbach Teacher's Report Form (TRF) was applied at the beginning of the experimental period, as well as at the ending of the experimental period. The resulting scores were analysed to observe the difference between both moments of evaluation. RESULTS: Results showed some improvements in symptoms, with an average improvement of 46%. CONCLUSION: TJQ and QG seem to be a promising complementary therapeutic tool in cognitive-behavioural approaches for children who suffer from cothymia, as well as prevention and control for children who may not display symptoms at a clinical level. However, further research is needed in order to understand the full potential of these therapeutic exercises.

Problems of scientific methodology related to placebo control in Qigong studies: A systematic review.

INTRODUCTION: Qigong is widespread in the West and used for preventive care, stress-induced conditions, emotional and vegetative symptoms like migraine and hypertension, as well as for better coordination in the elderly and quality of life enhancement in severe disease such as cancer. Adequate controls for Qigong research are lacking, compromising the level of efficacy evidence. Adequate Qigong placebo control exercises should match clear and standardized criteria. METHODS: Three computerized databases were assessed in January 2018 (Scopus, Web of Science and MEDLINE on PubMed) using the following keywords or their combinations: (Qigong OR Qi Gong OR Gong Qi OR Chi Kung OR Kung Chi OR Kiko OR Ki Gong OR Ki Kong) AND placebo. In addition, all reference lists were scanned for further relevant articles. Literature was examined for the effects of Qigong as compared to a control intervention. RESULTS: 110 articles were found, 78 of which were excluded after examining the title and abstract, and 16 because they were duplicates. Four more articles were found by searching in the bibliographies of published papers. A total of 20 studies were included in this systematic review. We found that, to the best of our knowledge, no criteria for placebo controls have been published in peer-reviewed journals so far. CONCLUSION: Placebo controls should be developed by the usage of vegetative functional assessments such as heart rate variability, thermography, and electrophysiological measurements, thus excluding major vegetative effects of the exercise, as well as by the usage of psychometric tests and other quantitative evaluations.

Can Qigong improve attention in adolescents? A prospective randomised controlled trial.

INTRODUCTION: The ability to direct and maintain attention is a prerequisite for learning. Qigong exercises are already commonly practiced in many developed countries to increase attention and memory. The main goal of this study was to examine whether Qigong would improve the attention levels of adolescents (12-14 years of age) when practiced as part of their physical education course. METHOD: Three groups of 22 individuals were considered: the verum group, which performed true Qigong; the control group, which performed sham, or placebo Qigong; and the waiting list group. In order to evaluate Qigong effects, attention tests (d2) were applied to all groups before the intervention period (t1) and after two and four weeks of practice (t2 and t3, respectively). RESULTS: At t1, there was no significant difference between the verum, control and waiting list groups in all measurable features. After 4 weeks of exercise, the verum group was significantly superior in all measurable features in comparison to the control group and the waiting list group. Values in the waiting list group were generally worse than in the control group (placebo Qigong), but there was no significant difference between the control and waiting list group, showing that the placebo offered an effect that was not significantly greater than the effect of no intervention at all. CONCLUSION: 'White Ball' Qigong was able to improve attention in adolescents after 4 weeks of practice, leading us to conclude that it may be a useful tool when integrated into physical education classes.

SEDENTARISMO NA ADOLESCÊNCIA E FATORES DETERMINANTES / PHYSICAL INACTIVITY IN YOUTH AND DETERMINANTS FACTORS / SEDENTARISMO EN LA ADOLESCENCIA Y FACTORES DETERMINANTES

Objetivo: este artigo tem como objetivo analisar o enfoque de pesquisas científicas voltadas para a temática do sedentarismo na adolescência e seus fatores determinantes. Métodos: realizou-se um levantamento dos artigos científicos disponíveis nos sites Bireme e Scielo entre os anos de 2003 e 2010 enfocando a temática do sedentarismo na adolescência, o que define um modelo de investigação. Resultados: constatou-se que, em se tratando dos 29 artigos investigados, os fatores comportamental, nutricional e econômico foram os de maior incidência como determinantes do sedentarismo na adolescência. Por outro lado, os fatores demográfico, ambiental, midiático, sociocultural e sociodemográfico, também apareceram como fatores determinantes, porém, em menor quantidade e quase sempre associados aos fatores comportamental, nutricional e econômico. Conclusão: mediante as discussões realizadas neste estudo, acreditamos que essa área de conhecimento apresenta um espaço aberto para investigações envolvendo as mais variadas vertentes.

Objective: this article has as objective to analyze the focus on scientific searches to the thematic of the Physical inactivity in youth and determinants factors. Method: we conducted a survey of scientific articles available in the Bireme and Scielo sites between the years 2003 and 2010 focusing on the issue of physical inactivity in adolescence, which defines a model of research. Results: it was found that, in the case of the 29 articles investigated, behavioral, nutritional and economic factors had the highest incidence and determinants of physical inactivity in adolescence. On the other hand, demographic, environmental factors, media, socio-cultural and sociodemographic, also appeared as determining factors, but fewer and often associated with behavioral, nutritional and economic factors. Conclusion: through the discussions in this study, we believe that this area of knowledge presents an open space for investigations involving the various aspects.

Objetivo: este artículo tiene como objetivo analizar el foco de la investigación científica centrada en el tema de la falta de actividad física en la adolescencia y sus determinantes. Método: hemos llevado a cabo un estudio de los artículos científicos disponibles en los sitios BIREME y Scielo entre los años 2003 y 2010 se centra en la cuestión de la falta de actividad física en la adolescencia, que define un modelo de investigación. Resultados: se encontró que, en el caso de los 29 artículos investigados, factores de comportamiento, nutricionales y económicos tuvieron la mayor incidencia y factores determinantes de la falta de actividad física en la adolescencia. Por otro lado, los factores demográficos, ambientales, medios de comunicación, socio-culturales y socio-demográfica, también aparecieron como factores determinantes, pero menos y, a menudo asociados con factores de comportamiento, nutricionales y económicos. Conclusión: a través de las discusiones en este estudio, creemos que esta área del conocimiento presenta un espacio abierto para investigaciones relacionadas con los distintos aspectos.

Qigong as a Traditional Vegetative Biofeedback Therapy: Long-Term Conditioning of Physiological Mind-Body Effects.

A contemporary understanding of Chinese Medicine (CM) regards CM diagnosis as a functional vegetative state that may be treated by vegetative reflex therapies such as acupuncture. Within this context, traditional mind-body exercises such as Qigong can be understood as an attempt to enhance physiological proprioception, by combining a special state of "awareness" with posture, movement, and breath control. We have formerly trained young auditing flutists in "White Ball" Qigong to minimize anxiety-induced cold hands and lower anxiety-induced heart rate. Functional changes occurred 2-5 min after training and were observed over the whole training program, allowing the children to control their symptoms. In our current work, we report that warm fingers and calm hearts could be induced by the children even without Qigong exercises. Thus, these positive changes once induced and "conditioned" vegetatively were stable after weeks of training. This may show the mechanism by which Qigong acts as a therapeutic measure in disease: positive vegetative pathways may be activated instead of dysfunctional functional patterns. The positive vegetative patterns then may be available in critical stressful situations. Qigong exercise programs may therefore be understood as an ancient vegetative biofeedback exercise inducing positive vegetative functions which are added to the individual reactive repertoire.

Are conduits superconductor-like and supported by tetrahedra structure of hyaluronic matrix in living systems? New perspectives.

All biological-medical treatments need a ground regulation in the intermeshed control loop system in animate matter. The focus of our contribution is to suggest a possible mechanism in this interconnected system that will work in order to supply/assist a higher ordered servo loop. Bonghan ducts indicate similarities to so-called meridians or conduits that are the central part in Chinese Medicine for the energy Qi. It is assumed that the nervous system demands a highly redundant and rapid communication system (RCS) probably established via the extracellular matrix (ECM) and triggered by a threshold value for the entire body. Metabolic processes could work in the picosecond's range while the nervous system is on the time scale at least one order of magnitude lower; probably most of them in the millisecond range. Long-range coherent electromagnetic phenomena and recent experiments indicate a structured superconducting-like system with the Josephson-effect behavior in biological systems. In the ECM are the components proteoglycans and glycosaminoglycans (PG/GAGs) and among them the ubiquitarian hyaluronic acid plays probably an important role and can behave as liquid crystals while the charge transport is performed via proton "jumping" in the proton-chains. Therefore, the water molecules have to be confident on a nanometer scale, lowering their energy states, and set up a phase transition with a rapid jumping of the protons through the water-carbon-chains. These partial chains could probably be modeled by tiny pyramids of the atoms. We propose that in order to set up those long-range coherent effects, a vortex is created. By doing Qi Gong, an energetic vortex through the body is established and the entire body can be modeled by two-base plane-faced pyramids acting as a tunable cavity resonator obeying electrodynamics laws. Therefore, the phenomenon's of pyramids should be considered in animate and inanimate matter in order to achieve long-range coherent effects, which by now controversially discussed and to go new ways to come over the clutter.

Raman spectroscopic characterization of a synthetic, non-stoichiometric Cu-Ba uranyl phosphate.

Crystals of phases belonging to the autunite group (general formula X(2+)(UO2)2(X(5+)O4)2·nH2O), specifically the uranyl phosphates (X(5+)=P) metauranocircite (X(2+)=Ba(2+)), metatorbernite (X(2+)=Cu(2+)) and a barian metatorbenite phase (X(2+)=Cu(2+)/Ba(2+)), have been synthesized in a silica gel medium and characterized by Raman spectroscopy. The Raman spectra showed bands in the range 750-1100 cm(-1), which were attributed to the ν1 and ν3 (PO(4))(3-) and (UO(2))(2+) stretching vibrations. By using the wavenumbers of the most intense and well defined ν1 (UO(2))(2+) vibration, the U-O bonds lengths were calculated for the three uranyl phosphate minerals. The results are in good agreement with previous single crystal structure analysis data. Bands in the spectra from 350 to 700 cm(-1) were attributed to the (PO(4))(3-) bending modes. Moreover, in the range 70-350 cm(-1), two groups of bands could be defined. The first group, with vibrations at lower wavenumbers, was attributed to the lattice modes and the second group, from 150 to 350 cm(-1), was assigned to the ν2 (UO(2))(2+) bending mode. Finally, in the case of the barian metatorbernite, bands in the range 1500-3800 cm(-1) were assigned to the OH stretching and the ν2 bending vibrations of water molecules. In this phase, all the vibrations show bandshifts when compared to the vibrations in metatorbernite. These bandshifts can be related to transitional Cu-O and Ba-O bond lengths.

Objectifying acupuncture effects by lung function and numeric rating scale in patients undergoing heart surgery.

Rationale. Poststernotomy pain and impaired breathing are common clinical problems in early postoperative care following heart surgery. Insufficiently treated pain increases the risk of pulmonary complications. High-dose opioids are used for pain management, but they may cause side effects such as respiratory depression. Study Design. We performed a prospective, randomized, controlled, observer-blinded, three-armed clinical trial with 100 patients. Group 1 (n = 33) and Group 2 (n = 34) received one 20 min session of standardized acupuncture treatment with two different sets of acupoints. Group 3 (n = 33) served as standard analgesia control without additional intervention. Results. Primary endpoint analysis revealed a statistically significant analgesic effect for both acupuncture treatments. Group 1 showed a mean percentile pain reduction (PPR) of 18% (SD 19, P < 0.001). Group 2 yielded a mean PPR of 71% (SD 13, P < 0.001). In Group 1, acupuncture resulted in a mean forced vital capacity (FVC) increase of 30 cm(3) (SD 73) without statistical significance (P = 0.303). In Group 2, posttreatment FVC showed a significant increase of 306 cm(3) (SD 215, P < 0.001). Conclusion. Acupuncture revealed specific analgesic effects after sternotomy. Objective measurement of poststernotomy pain via lung function test was possible.

In situ nanoscale observations of metatorbernite surfaces interacted with aqueous solutions.

Metatorbernite (Cu(UO(2))(2)(PO(4))(2)·8H(2)O) has been identified in contaminated sediments as a phase controlling the fate of U. Here, we applied atomic force microscopy (AFM) to observe in situ the interaction between metatorbernite cleavage surfaces and flowing aqueous solutions (residence time = 1 min) with different pHs. In contact with deionized water the features of (001) surfaces barely modify. However, changes are remarkable both under acidic and basic conditions. In acidic solutions (pH = 2.5) metatorbernite surface develops a rough altered layer and large pits nucleate on it. The altered layer shows a low adhesion and is removed by the AFM tip during the scanning. The large pits spread rapidly, at few tens of nm/s, indicating a collapse of the structure. The combination of dissolution and the presence of defects in the metatorbernite structure can explain both the collapse process and the alteration of the surfaces under acidic conditions. Other mechanisms such as ion exchange reactions remain speculative. In NaOH solutions (pH = 11.5) metatorbernite dissolves by formation of etch pits bounded by steps parallel to [100], the direction of the most straight periodic bond chains (PBCs) in metatorbernite structure. These steps retreat at ∼0.15 nm/s. Under these conditions dissolution is promoted by the formation of stable uranyl carbonate complexes in solution.

Effects of qigong on performance-related anxiety and physiological stress functions in transverse flute music schoolchildren: a feasibility study.

OBJECTIVE: Based on individual cases of treatment, we were interested in whether the effects of a special kind of qigong, the "White Ball" exercises, can be objectified by physically measurable parameters and psychological scores. METHODS: We performed a preliminary prospective controlled interventional study with the waiting list design. In the qigong group eight children were included. They received specific qigong lessons of the "White Ball" qigong over seven weeks, twice a week, for 30 min with a waiting list design and instructions to perform the same exercises at home daily. In the control group eight children were included in a waiting list design with no qigong instruction. Subjective perception of anxiety was measured by the Portuguese version of the Depression, Anxiety and Stress Scale adapted for children. In addition, salivary cortisol, heart rate variability, blood pressure, surface electromyography of the trapezius muscle and reaction time were measured at the beginning and the end of the study prior to the regular public auditions. RESULTS: In comparison to the changes in the control group, the qigong group scored significantly lower in heart rate. Otherwise the groups did not differ significantly; however, the effect size was large for salivary cortisol, surface electromyography of the trapezius muscle and blood pressure. There were relevant reductions of subjective perception of anxiety, salivary cortisol levels and heart rate. CONCLUSION: The heart rate of performing schoolchildren can be potentially reduced by "White Ball" exercises. Based on a sample of 8/8, positive tendencies were also observed for anxiety and blood pressure. The next steps of objectifying possible qigong effects are to increase the sample size, to study young people in other situations arousing anxiety, to develop an appropriate control intervention, to solve the problem of blinding and double blinding, to find additional parameters that may be influenced by the "White Ball" qigong, and to compare the qigong effects with other methods reducing anxiety such as more traditional biofeedback or systematic desensitization.

Tratamento das fraturas da diáfise dos ossos do antebraço em crianças e adolescentes / Treatment of forearm fractures in children and adolescents

OBJETIVO: O tratamento e os desvios angulares tolerados nas fraturas diafisárias do antebraço em crianças evoca opiniões divergentes na literatura. Frente a esta indefinição, idealizamos este trabalho com o objetivo de avaliar transversalmente os métodos terapêuticos preferenciais para esta lesão durante o 39º Congresso Brasileiro de Ortopedia e Traumatologia. MÉTODO: Foram respondidos 759 questionários (13 por cento do total de inscritos). Abordamos os aspectos gerais da amostra estudada para traçar o perfil do ortopedista questionado. Foram expostas duas situações clínicas em indivíduos de 12 (CASO 1) e 5 anos (CASO 2), sendo apresentadas radiografias com fraturas do antebraço destes pacientes. Os dados obtidos foram compilados e submetidos à análise estatística. RESULTADO: O tratamento mais indicado no CASO 1 foi redução incruenta e fixação com fios de Kirschner (26 por cento), enquanto no CASO 2 foi redução incruenta seguida de aparelho gessado (46 por cento). CONCLUSÃO: Entre os ortopedistas com menos de 30 anos, a escolha por tratamentos menos invasivos e aceitação de maiores angulações prevaleceu para ambos os casos. Os traumatologistas aceitam menor angulação e tendem aos tratamentos invasivos, particularmente para o CASO 2. Já o ortopedista pediátrico opta por tratamentos menos invasivos e aceita maiores desvios angulares.

OBJECTIVE: The treatment and the angular deviations tolerated in diaphyseal forearm fractures in children evoke divergent opinions in literature. In view of this controversy, we idealized this study to evaluate the preferred treatment methods for this injury, during the 39th Brazilian Congress on Orthopedics and Traumatology. METHODS: A total 759 questionnaires were answered (13 percent of total entrants). We addressed the general aspects of the study sample to obtain a profile of the orthopedic surgeons questioned. RESULTS: Two clinical subjects were presented, aged 12 (CASE 1) and 5 years old (CASE 2), along with radiographs depicting forearm diaphyseal fractures of these patients. Data was gathered and submitted to statistical analysis. The overall preferred treatment in CASE 1 was closed reduction and fixation with Kirschner wires (26 percent), while in case 2 it was closed reduction followed by plaster cast (46 percent). CONCLUSION: Among orthopedic surgeons less than 30 years old, the choice for less invasive treatments and greater acceptance of angular values prevailed in both cases. The traumatologists accepted lower angular values and tended towards more invasive treatments, particularly for CASE 2. On the other hand, the pediatric orthopedic surgeon prefers less invasive treatments and accepts greater angular deviations.