Orientadores: Rogério de Fraga, Paulo César Rodrigues Palma / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T13:53:02Z (GMT). No. of bitstreams: 1 Portugal_HelioSergioPinto_M.pdf: 2598145 bytes, checksum: dc80f2aa29eafa9cfc4a4e9612a4e9a7 (MD5) Previous issue date: 2011 / Resumo: Introdução e objetivos: O estudo da Anatomia humana se faz imprescindível para o conhecimento e compreensão do corpo humano como um todo, na importância e interação de todas as suas estruturas e características de cada um de seus órgãos ou partes, como meio essencial para promover a vida e cura dos males, intenção primária no ato de cuidar, enquanto técnica, arte e ciência, no seu mais expressivo compromisso (1). Além disto, a aula prática com o uso de componentes anatômicos manipuláveis é essencial para um bom processo de ensino e aprendizagem. Portanto, o componente pedagógico do material utilizado é essencial, de forma que as ferramentas escolhidas possam agregar valor na construção de uma aprendizagem significativa dos alunos. Os objetivos deste estudo foram avaliar: 1- o Modelo Anatômico Sintético de Assoalho Pélvico (MASAP) como uma ferramenta didática, comparando o mesmo com a pelve cadavérica (PC) durante a aula prática de Anatomia, e 2- a satisfação dos estudantes com ambos os métodos. Materiais e métodos: Foram utilizadas pelves cadavéricas e modelos anatômicos sintéticos de pelve. A pesquisa foi do tipo experimental, desenvolvida através de estudo prospectivo longitudinal. Sessenta e sete estudantes de Medicina, voluntários para este estudo, foram submetidos a um teste teórico preliminar (TTP) e a uma aula teórica de anatomia do assoalho pélvico. Após esta aula os estudantes foram randomizados em três grupos: G1, G2 e G3. G1 submeteu-se a aula prática tradicional de anatomia (APT) com o uso de PC, e G2 submeteu-se à aula prática proposta com uso do MASAP (APM). G3, denominado grupo controle, não foi submetido à aula prática. Um teste teórico final (TTF) foi aplicado para todos os grupos G1, G2 e G3. G1 e G2 foram submetidos a uma avaliação de satisfação relativa ao método utilizado para realização da aula prática (Avaliação do método - AM). Resultados: A média de idade foi 19.41 (± 1.58) em G1, 19.31 (± 3.43) em G2 e 19.42 (± 3.35) em G3. A análise estatística foi realizada utilizando-se ANOVA e teste não paramétrico Mann-Whitney. O nível de significância foi determinado como p ? 0.05. Ao TTF G3 apresentou escores mais baixos do que G1 (p=0,041) e G2 (p=0,000). Não foi encontrada diferença estatisticamente significante entre G1 e G2 (p>0,05). G2 apresentou maior satisfação com o método (p=0,001). Conclusão: PC e MASAP provaram serem ferramentas didáticas efetivas. G3 apresentou escores inferiores em relação a G1 e G2 possivelmente por não ser submetido a aulas práticas. G2 apresentou maior satisfação / Abstract: The study of human anatomy is indispensable for knowledge and understanding of the human body as a whole, that is to say, the importance and interaction of all its structures and characteristics of each of its organs or parts, as an essential means to promote life and healing ills, primary intention in the act of caring, while technical, art and science, in its most significant commitment (1). Furthermore, the practice class using a comprehensive and manageable anatomic component is fundamental for a good teaching and learning process. The goals of this study were to evaluate: 1- the synthetic anatomic model of pelvic floor (SAMPF) as a didactic tool comparing it to the traditional anatomic class using cadaveric pelvis (CP) and 2- the satisfaction of the students with both didactic methods. Sixty seven medicine students, volunteers for this study, received a conventional theoretic anatomy class. Following this class, all students were randomized in 3 groups (G1, G2 and G3). G1 and G2 attended anatomical classes with different didactic methods, respectively: traditional practice anatomy class (TPC), practice anatomy class with SAMPF (SPC). G3 denominated control group which had no practice class. A preliminary theoretical test (PTT) was applied to all groups. The G1 underwent to a TC and G2 to a SC. A final theoretical test (FTT) was applied to all groups G1, G2 and G3. G1 and 2 underwent to the evaluation of their satisfaction about the anatomic component used for the practice class (Evaluation of the method - EM). The mean age was 19.41 (± 1.58) in G1, 19.31 (± 3.43) in G2 and 19.42 (± 3.35) in G3. Statistical analysis was done using ANOVA and Mann-Whitney test. At FTT G3 presented lower scores than G1 (p=0.041) and G2 (p=0.000). Difference between G1 and G2 was not found (p > 0.05). G2 presented more satisfaction with the method (p = 0.001). We concluded that CP and SAMPF proved to be effective didactic tools. G3 presented lower scores than G1 and G2 possibly for not having attended to practical classes. G2 showed higher satisfaction / Mestrado / Fisiopatologia Cirúrgica / Mestre em Ciências

Orientadores: Paulo César Giraldo, Rose Luce Gomes do Amaral / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-21T18:50:12Z (GMT). No. of bitstreams: 1 Souza_SamanthadeMirandaFerreira_M.pdf: 2352034 bytes, checksum: 0109448068875c097377e02f427e2449 (MD5) Previous issue date: 2013 / Resumo: Introdução: O treinamento dos músculos do assoalho pélvico (TMAP) é uma técnica amplamente utilizada pela fisioterapia com o objetivo de aumentar a força muscular, aumentar o fluxo sanguíneo local e a mobilidade pélvica, além de informar a mulher sobre a sua anatomia e melhorar a conscientização corporal. O treinamento com esse foco poderia influenciar de maneira positiva a função dos músculos do assoalho pélvico (MAP) e a função sexual feminina. Objetivo: Avaliar as funções muscular e sexual feminina pré e pós TMAP de mulheres em idade reprodutiva sem disfunção uroginecológica e/ou sexual. Métodos: Ensaio clínico incluindo 68 mulheres nulíparas em idade reprodutiva sem disfunção uroginecológica e/ou sexual. A função dos MAP foi mensurada pré e pós TMAP pelas pressões intravaginais, potencial eletromiográfico de superfície (sEMG) e palpação bidigital. A função sexual foi avaliada pré e pós TMAP pelo questionário Female Sexual Function Index (FSFI) que enfatiza seis domínios (desejo, excitação, lubrificação, orgasmo, satisfação sexual e dor). O TMAP foi realizado em grupo, uma vez por semana durante 8 semanas, com 45 minutos de duração, usando 11 diferentes posições. Para cada posição foram solicitadas 5 contrações tônicas sustentadas por 6 segundos com igual tempo de relaxamento entre cada contração e 5 contrações fásicas, totalizando 110 contrações a cada sessão. As voluntárias foram orientadas a realizar em casa 30 contrações todos os dias da semana. Resultados: Foram observadas diferenças significativas ao compararmos os valores máximos das avaliações das pressões intravaginais pré e pós TMAP das contrações fásicas 41,7±13,7 vs. 47±14 (p=0,0023), tônicas de 10 segundos 42,7±13,8 vs. 47,7±15 (p=0,0085) e tônicas de 60 segundos 42,1±13 vs. 47,5±14,5 (p=0,0013) respectivamente. Também foram observadas diferenças significativas nos valores máximos do sEMG das avaliações pré e pós TMAP das contrações fásicas 27,7±11,2 vs. 31,3±12,6 (p=0,0009), tônicas de 10 segundos 27,7±10,9 vs. 31,5±13,6 (p=0,0017), tônicas de 60 segundos 28,6±11,8 vs. 31,1±13 (p=0,0232) e tempo de contração em segundos 41,7±22,1 vs. 49,3±27,7 (p=0,0252) respectivamente. Foram encontradas diferenças significativas pré e pós TMAP no escore total do FSFI 29,8±3,7 vs. 31,9±2,7 (p<0,0001) e nos domínios desejo 4,4±0,9 vs. 4,7±0,8 (p=0,0076), excitação 4,8±0,8 vs. 5,2±0,5 (p=0,0001), lubrificação 5,2±0,8 vs. 5,5±0,5 (p=0,0140) e orgasmo 4,5±1,4 vs. 5,3±0,9 (p<0,0001) respectivamente. Conclusão: O TMAP aumenta a função dos MAP e melhora a função sexual de mulheres em idade reprodutiva sem disfunção uroginecológica e/ou sexual / Abstract: Introduction: Pelvic floor muscles training (PFMT) is a technique widely used for physical therapy in order to increase muscle strength, increase local blood flow and pelvic mobility and inform women about their anatomy and improve awareness body. Training with this focus could positively influence the function of the pelvic floor muscles (PFM) and female sexual function. Objective: To evaluate the muscular function and female sexual function pre and post PFMT of women of reproductive age without urogynecologic and/or sexual dysfunction. Methods: A clinical trial including 68 nulliparous women of reproductive age without urogynecologic and/or sexual dysfunction. The function of the PFM was measured before and after the PFMT intravaginal pressures, potential surface electromyography (sEMG) and palpation bidigital. Sexual function was assessed before and after the PFMT the survey Female Sexual Function Index (FSFI) that emphasizes six domains (desire, arousal, lubrication, orgasm, sexual satisfaction, and pain). The PMAT group was performed once a week for 8 weeks, with 45 minutes using 11 different positions. For each position were requested 5 tonic contractions sustained for 6 seconds with equal relaxation time between contractions and 5 phasic contractions, totaling 110 contractions each session. The volunteers were instructed to perform 30 contractions at home every day of the week. Results: Significant differences were observed when comparing the maximum rating of intravaginal pressure pre and post PFMT of phasic contractions 41.7±13.7 vs. 47±14 (p=0.0023), tonic contractions of 10 seconds 42.7±13.8 vs. 47.7±15 (p=0.0085) and tonic of 60 seconds 42.1±13 vs. 47.5±14.5 (p=0.0013) respectively. There were also significant differences in the maximum values of sEMG pre and post PFMT of phasic contractions 27.7±11.2 vs. 31.3±12.6 (p=0.0009), tonic contractions of 10 seconds 27.7±10.9 vs. 31.5±13.6 (p=0.0017), tonics of 60 seconds 28.6±11.8 vs. 31.1±13 (p=0.0232) and contraction time in seconds 41.7±22.1 vs. 49.3±27.7 (p=0.0252), respectively. There were significant differences pre and post PFMT in total score FSFI of 29.8±3.7 vs. 31.9±2.7 (p<0.0001) and in those areas desire 4.4±0.9 vs. 4.7±0.8 (p=0.0076), arousal 4.8±0.8 vs. 5.2±0.5 (p=0.0001), lubrication 5.2±0.8 vs. 5.5±0.5 (p=0.0140) and orgasm 4.5±1.4 vs. 5.3±0.9 (p<0.0001) respectively. Conclusion: The PFMT increases the function of PFM and improves sexual function in women of reproductive age without urogynecologic and/or sexual dysfunction / Mestrado / Fisiopatologia Ginecológica / Mestra em Ciências da Saúde

Orientadores: Cássio Luís Zanettini Riccetto, Benedicto de Campos Vidal / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculade de Ciências Médicas / Made available in DSpace on 2018-08-21T00:28:08Z (GMT). No. of bitstreams: 1 Feitosa_IsabelCristinaAlbuquerque_M.pdf: 2111462 bytes, checksum: 4056f4a3329834819c83f886cc2bfe79 (MD5) Previous issue date: 2012 / Resumo: Introdução: A incontinência urinária é um problema de saúde muito prevalente, afetando entre 10% a 50% das mulheres em algum momento de sua vida, causando morbidade social e redução na qualidade de vida. Nas mulheres entre 40-59 anos a incontinência urinária de esforço é mais frequente e naquelas acima de 60 anos a urge-incontinência é mais prevalente. A mudança de padrão de incontinência com o aumento da idade pode sugerir que o envelhecimento em geral e as alterações fisiológicas decorrentes deste processo possam contribuir com a sua patogênese. Há vários anos foi demonstrado que os tecidos originados do seio urogenital são sensíveis aos hormônios sexuais, principalmente o estrógeno. Recentemente, tem surgido importante interesse no uso da suplementação de andrógenos nas mulheres. Embora existam significativos interesses nas aplicações clínicas dos andrógenos em mulheres, não se sabe exatamente como se dá a atuação destes hormônios no assoalho pélvico e trato urinário inferior. Objetivo: Analisar o efeito da suplementação de metiltestosterona sobre as propriedades anisotrópicas das fibras musculares e colágenas periuretrais de ratas. Métodos: Foi realizado um estudo experimental com 30 ratas que foram divididas em dois grupos: 15 ratas submetidas a suplementação de metiltestosterona por 60 dias e 15 ratas controles. Posteriormente foi removida a bexiga, uretra e região perineal em bloco. A região periuretral foi analisada através de microscopia de polarização, com quantificação da birrefringência das fibras musculares e colágenas. Resultados: A densidade média de brilho da musculatura, no grupo controle foi de 65,3070. No grupo com suplementação de testosterona foi 84,7624, portanto com diferença estatisticamente significativa (p =0,006). Quanto às medidas da birrefringência do colágeno periuretral nos grupos controle e com suplementação de testosterona, foram obtidas com mediana de 95,9436 no controle e a mediana foi de 100,8646 no grupo com testosterona, com diferença estatisticamente significativa entre os dois grupos avaliados, com p = 0,005. Conclusão: O uso de testosterona promoveu um aumento nos valores de birrefringência das fibras colágenas e musculares periuretrais de ratas submetidas a suplementação de metiltestosterona quando comparadas com o grupo controle / Abstract: Introduction: Urinary incontinence is a prevalent health problem, affecting between 10% and 50% of women at some point in their lives, causing social morbidity and reduced quality of life. Among women between 40-59 years of age, stress urinary incontinence is more frequent and in those above 60 years of age urge incontinence is more prevalent. The changing pattern of incontinence with increasing age may suggest that the aging process and the physiological changes resulting from this process may play a role in its pathogenesis. It has been shown for the last years that the tissues derived from urogenital sinus are sensitive to estrogen. Recently, there has been significant interest in the use of androgen supplementation in women. Although there is significant interest in clinical applications of androgens in women, it is not known exactly how occurs the action of these hormones in the pelvic floor and lower urinary tract. Objective: To analyze the effect of methyltestosterone supplementation on the anisotropic properties of the periurethral collagen and muscle fibers of rats. Methods: We conducted an experimental study with 30 female rats that were divided into 2 groups: 15 rats subjected to supplementation of methyltestosterone for 60 days and 15 control rats. Bladder, urethra, and perineum were removed en block after sacrifice. The periurethral region was analyzed by polarized light microscopy with quantification of the birefringence of muscle and collagen fibers. Results: The mean density of brightness of the muscles in the control group was 65.3070. In the group with testosterone supplementation was 84.7624, so the difference was statistically significant (p = 0.006). The measurements of birefringence of periurethral collagen fibers in control and testosterone groups were obtained with a median of 95.9436 in control and 100.8646 in the testosterone group, with statistically significant difference between them, with p = 0.005. Conclusion: The use of testosterone promoted an increase in the values of birefringence of periurethral collagen fibers and muscle tissue of rats submitted to methyltestosterone supplementation when compared with the control group / Mestrado / Fisiopatologia Cirúrgica / Mestre em Ciências

Abstract During the last decades significant changes in the buying behavior of customers can be observed. While in former days price sensitivity lead to more uniformed products, in present days manifold high-quality products and customization with reasonable prices and rapid delivery are demanded. As a consequence, the industry asks for manufacturing systems which allow for fast ramp-up, multi-variant production and rapid adaptability. In this environment, several scientific approaches such as agent-based and holonic manufacturing systems have been investigated within the last years. In order to cover all aspects of the foreseen future demands, the architectures for such systems are very complex and the system’s entities are characterized by very flexible behavior. Hence, the efforts for their implementation are rather high and the systems tend to exhibit non-deterministic behavior. Furthermore, the top down approach of most systems leads to a complete re-organization of the factory management. As a consequence the acceptance for such systems in real industrial environment at present day is very limited. Therefore, the objective of this thesis is to develop an architecture for flexible manufacturing systems which allows for easy take-up in the industry. It is based on a bottom-up approach with a new kind of flexible, intelligent shop-floor components called Manufactrons. The architecture covers all layers of traditional factory organization with special emphasis on the shop floor organization. The approach and results are based on the research activities of the European Research Project XPRESS in which representatives of three major industry branches collaborated in order to find a solution for their future demands on flexible manufacturing systems. The architecture has been implemented in the context of XPRESS in aerospace, automotive and electrical industry. The tests show the feasibility of the approach. The capability for a smooth integration of the new approach into existing manufacturing environment has successfully been demonstrated. / Tiivistelmä Viime vuosikymmeninä asiakkaiden ostokäyttäytyminen on muuttunut merkittävästi. Ennen asiakkaiden hintatietoisuus johti yhtenäisiin tuotteisiin, kun taas nykyään vaaditaan moninaisempia tuotteita ja muokattavuutta kohtuulliseen hintaan. Samaan aikaan odotetaan korkealaatuisia tuotteita ja nopeaa toimitusta. Nämä seikat ovat aiheuttaneet tuotantoteollisuudelle uusia haasteita. Reagoidakseen nopeasti asiakkaiden vaatimuksiin tuotannonsuunnittelussa on alettu keskittymään korkealaatuisten tuotemuunnelmien määrän kasvattamiseen. Tämän vuoksi tarvitaan tuotantojärjestelmiä, jotka mahdollistavat nopean Ramp Up -prosessin, moneenmuuntuvan tuotannon ja nopean mukautuvuuden. Tätä aihetta on viime vuosina lähestytty esimerkiksi agentteihin perustuvien ja holonisten tuotantojärjestelmien kautta. Kuitenkin näihin tulevaisuuden haasteisiin pystytään vastaamaan vain kompleksisilla arkkitehtuureilla ja järjestelmän entiteeteille ominaisia ovat hyvin mukautuvat käyttäytymismallit. Näiden toteuttamiseen tarvitaan paljon työtä ja järjestelmillä on tapana käyttäytyä epä-deterministisesti. Lisäksi ylhäältä alas lähestymistapa johtaa usein tehtaan täydelliseen uudelleenorganisointiin, minkä vuoksi lähestymistapaa ei suosita oikeissa teollisuusympäristöissä. Tämän väitöstyön tarkoituksena on kehittää mukautuville tuotantojärjestelmille arkkitehtuuri, joka mahdollistaa järjestelmien helpon käyttöönoton teollisuudessa. Arkkitehtuuri perustuu alhaalta ylös -lähestymistapaan ja sisältää uudenlaisen joustavan ja älykkään tuotantotilakomponentin, manufactronin. Arkkitehtuuri kattaa kaikki perinteisen tehdasorganisaation kerrokset keskittyen kuitenkin erityisesti tuotantotilojen organisointiin. Lähestymistapa ja tulokset perustuvat Euroopan Unionin XPRESS-tutkimusprojektiin. Projektissa tehtiin yhteistyötä kolmen suuren teollisuushaaran kanssa tarkoituksena löytää joustava tuotantojärjestelmäratkaisu tulevaisuutta varten. Arkkitehtuuria sovellettiin XPRESS-projektissa lentokone-, auto- ja elektoniikkateollisuuteen ja testit osoittivat lähestymistavan soveltuvuuden. Myös lähestymistavan sujuva integrointi olemassa oleviin teollisuusjärjestelmiin osoitettiin onnistuneesti.

Anal acoustic reflectometry (AAR) is a technique that is currently under investigation for the assessment of faecal incontinence. It uses reflected sounds waves to measure cross sectional area at different pressures leading to a profile of the anal canal, and in particular the high pressure zone of the anal sphincters. The cross sectional area from the high pressure zone is then plotted on a graph to give seven characteristic parameters. AAR has been shown to be reproducible and reliable, able to distinguish between continence and incontinence, correlate with the severity of incontinence and able to discriminate between the three patterns of incontinence (urge, passive and mixed). Opening pressure has been shown to be an independent predictor of success with peripheral nerve evaluation, the trial period before sacral nerve stimulation. This thesis aimed to validate AAR against manometry and explore its physiological and clinical potential. A retrospective analysis of 265 patients who had undergone AAR was undertaken in order to develop a surrogate marker for anal canal length. The surrogate marker did find the expected difference between men and women but this was not clinically significant. Furthermore, the surrogate marker was unable to differentiate between incontinence and continence. A technical limitation (Gibbs phenomenon) of AAR was subsequently shown to explain this unexpected result. Prior manometry could possibly interfere with the interpretation of AAR, and therefore a prospective randomised cohort study of 30 patients was conducted to assess two orders of data collection. Reassuringly it does not matter which one of these investigations is undertaken first. In order to test the hypothesis that the greater the challenge to the anal sphincter, the greater the response, the effect of two rates of anal canal stretch was investigated in a prospective randomised cohort study of 50 patients with faecal incontinence. No difference was found between normal or fast rates of AAR. This study has validated a faster method of AAR that can be used alongside manometry in any order. A pudendal nerve block was used to investigate whether AAR assesses primarily internal or external sphincter function in a prospective cohort study of 15 patients using both AAR and manometry. Bilateral pudendal nerve block reduced the function of the external anal sphincter but had no effect on the internal sphincter using both techniques. This study suggests that AAR at rest is predominately an investigation of the internal anal sphincter. A prospective study of 30 patients with faecal incontinence was carried out to establish if AAR can predict the outcome from posterior tibial nerve stimulation. Posterior tibial nerve stimulation improved rectal sensation, manometry squeeze pressures, quality of life, severity of incontinence and was more effective for patients with urge incontinence. A variety of demographic, clinical and physiological measures were unable to predict the success of posterior tibial nerve stimulation. The results presented in this thesis suggest that the full clinical potential of AAR has yet to be realised and it will be necessary to compare it with high resolution anal manometry in the future. Progress in this field would be greatly facilitated by establishing the normal values for this technique and the development of a robust AAR assessment of the external anal sphincter.

The aim of this thesis is to create a business plan for an existing company Design Bath, which operates as a wholesale and exclusive distributor of company PORCELANOSA Grupo on the Czech market of ceramic tiles. The plan is focused on building and extending current distribution network of PORCELANOSA Grupo products and should serve as a background for future decision making process and development of long-term strategy of company Design Bath. On the basis of this business plan we should be able to evaluate its feasibility. The theoretical part of this thesis contains basic introduction into business plans from theoretical point of view and market research methodology. The practical part includes the description of international and Czech market of ceramic tiles in order to understand the business opportunity. Description of competition, market research, proposal of suitable forms of distribution and financial plan are all included in the practical part in the way that the chapters logically follow each other. Financial plan revealed that the business plan is viable. Potential risks and conditions of successful realization complete the last part of the thesis.

This thesis seeks to explain the phenomenon of party switching (or floor-crossing) in the understudied case of the Canadian House of Commons. It uses Müller and Strøm’s “Policy, Office or Votes?” framework at the individual level of analysis and a mixed methods approach that combines document analysis and econometrics to assess the effects of individual and institutional variables on the decision to switch parties. The results inform a wider discussion regarding individual political behavior as well as the role, influence and evolution of political parties in the Canadian state. The research demonstrates that the electorate is adept at recognizing opportunism and tends to respect MPs who switch parties on principle while punishing those that switch for more self-centered reasons.

This study investigates the lithological characteristics, and lateral and vertical facies trends of poorly understood, deep-marine matrix-rich sedimentary rocks. Two laterally extensive, well-exposed outcrops of slope and proximal basin floor deposits were investigated from the Neoproterozoic Windermere Supergroup. Significantly, matrix-rich beds have been found to undergo the same lateral trends (over ~200-650 m) in both outcrops. Initially, thicker, clayey sandstone transitions laterally to a bipartite bed with the development of an upper, planar-based, more matrix-rich unit. Further laterally, the basal unit progressively thins until it pinches out, and all that remains is the upper, more matrix-rich unit – a sandy claystone. It too thins and then pinches out. Draping the entire transect is a thin, matrix-poor structured unit overlain by a mudstone or claystone cap. These trends are interpreted to reflect a progressive but rapid lateral evolution of flow structure controlled primarily by particle settling, namely sand, from mud-rich avulsion-related flows.

Physiotherapist-supervised pelvic floor muscle (PFM) training is the recommended first-line treatment for women with stress urinary incontinence (SUI); however, only up to 50% of women are cured with this treatment. The primary objective of this study was to develop a predictive model of successful physiotherapy intervention outcomes among women with SUI using predictors that are accessible to clinicians. The secondary objective of this study was to run a preliminary investigation of morphologic differences between women with SUI who were cured with a physiotherapy intervention and those who were not cured, using a subset of ultrasound imaging data. Seventy-nine women with SUI were assessed at baseline on measures of demographic data (i.e. age, body mass index, etc.), 3-day bladder diary, 30-minute standardized pad test, clinical assessments of PFM strength and tone, and transperineal ultrasound assessments of PFM morphology. Women then attended a 12-week physiotherapy intervention and returned for a follow-up assessment. The multivariate logistic regression model was significant (p < .001) with two predictors: baseline ICIQ-FLUTS UI subscale (SUI severity; p = .01) and parity (p = .06). A significant ROC curve for the ICIQ-FLUTS UI subscale (p ˂ .01) predicts physiotherapy intervention outcomes with 55.6% sensitivity and 80.8% specificity at a cut-off score of 7.50. Women most likely to be cured with a physiotherapy intervention were those with lower scores on the ICIQ-FLUTS UI subscale and those who have given birth to fewer children. Significant differences were found in a subset of data between women with SUI who are cured with the physiotherapy intervention and women who are not cured on morphologic measures in standing of bladder neck height at peak cough (p = .03), descent of the bladder neck during maximal Valsalva maneuver (MVM; p = .04), levator hiatus circumference at rest (p = .03) and at maximal voluntary contraction in both standing and supine (MVC; p = .01; p = .03). Variables that were trending towards significance included bladder neck height in standing at rest, levator plate length (LPL) at maximal excursion during a cough and MVM in standing, and mid-urethral wall cross-sectional area. These significant differences indicate potential value in using ultrasound imaging outcomes as predictors of a cure with physiotherapy intervention in future models, and a combination of demographic, clinical, and morphologic variables may build a more robust predictive model.

Ancient basin-floor strata are exceptionally well exposed in the Neoproterozoic Windermere Supergroup in the southern Canadian Cordillera. Data from the Castle Creek outcrop, where strata of the upper Kaza Group crop out, and the Mt. Quanstrom outcrop, where the middle Kaza is exposed, form the main dataset for this study. The aim of this study is to describe and interpret the strata starting at the bed scale, followed by stratal element scale, lobe scale and ultimately fan scale. Strata of the Kaza Group comprise six sedimentary facies representing deposition from a variety of fluid and cohesive sediment gravity flows. These, in turn, populate seven stratal elements that are defined by their basal contact, cross-sectional geometry and internal facies distribution. The lithological characteristics of stratal elements vary little from proximal to more distal settings, but their relative abundance and stacking pattern do, which, then, forms the basis for modeling the internal architecture of lobes. Lobes typically comprise an assemblage of stratal elements, which then are systematically and predictably arranged in both space (along a single depositional transect) and time (stratigraphically upward). Lobes typically became initiated by channel avulsion. In the proximal part of the system scours up to several meters deep, several tens of meters wide are interpreted to have formed by erosion downflow of the avulsion node. Erosion also charged the flow with fine-grained sediment and on the lateral margins and downflow avulsion splays were deposited. Later flows then exploited the basin-floor topography and on the proximal basin-floor carved a feeder channel, which then fed a downflow depositional lobe. At the mouths of feeder channels flows became dispersed through a network of distributary channels that further downflow shallow and widen until eventually merging laterally in sandstone-rich terminal splays. During the lifespan of a single lobe the feeder channel remains fixed, but the distributary channel network and its associated terminal splays wander, causing them to stack and be intercalated laterally and vertically. Eventually an upstream avulsion terminates local sediment supply, causing a new lobe to be initiated elsewhere on the fan, and the process repeats.