The presence of rib fractures in deceased infants is generally considered to be highly specific of non-accidental injury, with some pathologists considering them to be evidence of abuse. Although rib fractures may occur during resuscitative efforts in adults, the general consensus is that such injuries are exceptional in infants owing to inherent plasticity within the thoracic region. The recommendation for cardiopulmonary resuscitation (CPR) of infants since the year 2000 has been for the use of the “two-thumb” technique. However, there has been limited biomechanical investigation to what injuries may occur subsequent to this specific form of CPR. The overall aim of this thesis was to determine if two-thumb CPR can cause similar rib injuries to those seen in abusive squeezing cases. In particular, whether or not this CPR technique allows for over excessive levering of the posterior rib over the transverse process of the spine. To this end, physical experimentation simulating both two-thumb CPR and abusive squeezing was performed on an immature swine model of the infant thorax. The results of these tests did not show any significant difference in the force required to compress the thorax by one third its original anterior-posterior diameter in the two scenarios. One third being the recommended depth for CPR compressions. Fractures resultant from the testing were assessed with radiography and computed tomography, techniques commonly used by post-mortem pathologists. The type and nature of the injuries observed were remarkably similar in both scenarios. Rib injuries were primarily seen in the anterior part of the thoracic cage in both CPR and abusive specimens. The specific site of rib fracture was typically close to or within the costochondral joints. There was however an apparent absence of posterior rib fractures in the abusively tested cohort. This is in part due to the slight difference in profile of the neck and head areas within the ribs of the surrogate model. This acts to reduce the mechanical advantage offered by levering over the transverse processes of the spine. This study has shown anterior fractures of the ribs result from two-thumb CPR, challenging the long held belief that CPR cannot produce rib fractures. X-ray CT offered a significant improvement on the ability to detect costochondral junction injuries. This would offer further support to the routine use of X-ray CT in post-mortem examinations of infants where the cause of death is unknown. This has the potential to offer differential interpretation to the cause of rib injuries, especially in cases of sudden unexpected deaths in infancy, where otherwise child abuse may be diagnosed.

The standard model of particle physics is the most precisely verified scientific theory in the history of mankind. However, extended theories are already in place, ready to supersede the standard model should it fail to describe any new physics that may be observed in the next generation of high energy particle accelerators. One such minimal extension is the Two Higgs Doublet Model (2HDM). However, the appearance of additional symmetries to those of the gauge symmetries in the 2HDM can have consequences for the cosmological viability of the model, with the possibility for non-trivial topological defects forming during spontaneous symmetry breaking phase transitions.In this research we perform a systematic study of six accidental Higgs Family and CP symmetries that can occur in the 2HDM potential, by introducing and utilizing our Majorana scalar-field formalism. General sufficient conditions for convexity and stability of the scalar potential are derived and analytical solutions for two non-zero neutral vacuum expectation values of the Higgs doublets for each of the six symmetries are presented, in terms of the parameters of the theory. We identify the topological defects associated with the spontaneous symmetry breaking of each symmetry by means of a homotopy-group analysis. We find the existence of domain walls from the breaking of Z2, CP1 and CP2 discrete symmetries, vortices in models with broken U(1)PQ and CP3 symmetries and a global monopole in the SO(3)HF-broken model. We study the associated topological defect solutions as functions of the potential parameters via gradient flow methods. We also consider the cosmological implications of the topological defects and are able to derive bounds on physical observables of the theory in order to avoid contradictions with the theoretical limits on topological defects. The application of our Majorana scalar-field formalism in studying more general scalar potentials that are not constrained by the U(1)Y hypercharge symmetry is discussed. In particular, the formalism may be used to properly identify seven previously hidden symmetries that may be manifest in a U(1)Y invariant scalar potential for particular choices of the model parameters.

Orientadores: Maria Elena Guariento, André Fattori / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-22T03:14:25Z (GMT). No. of bitstreams: 1 Gubel_VanessaMariaCamargoAndradeRibeiro_M.pdf: 969445 bytes, checksum: 371eedd775785b6aea4193dba817ccfb (MD5) Previous issue date: 2013 / Resumo: Objetivos: Descrever a ocorrência de quedas em uma amostra de idosos do município de Campinas (SP); investigar as relações entre quedas e fragilidade. Métodos: Participantes: Amostra probabilística de 689 idosos sem déficit cognitivo sugestivo de demência recrutados em domicílio no contexto do estudo multicêntrico e multidisciplinar "Perfil de Fragilidade de Idosos Brasileiros" (Rede FIBRA). Procedimentos: Primeira parte: Aplicou se um questionário com levantamento de dados sociodemográficos; doenças crônicas e / ou sintomas auto-referidos; uso regular de medicamentos auto-referido; medidas do fenótipo de fragilidade (segundo Fried et al., 2001); antecedentes de quedas. Resultados: A média de idade foi 72,27 anos; 68,37% eram mulheres; 69,10% relataram quedas; 50,87% eram pré-frágeis e 4,81% foram classificados como frágeis. Houve associação significativa entre ocorrência de quedas e as variáveis: idade ? 80 anos (p=0,004), sexo feminino (p<0,001), déficit visual (p=0,002), artrite referida (p=0,002) e sintomas depressivos (p=0,005). A análise de regressão logística multivariada evidenciou que sexo feminino, déficit visual e presença de critérios de fragilidade foram os fatores que apresentaram maior associação com quedas. Conclusões: Faz-se necessário identificar os fatores associados ao maior risco de quedas para que se obtenha um efetivo controle das mesmas. Entre esses, há que se destacar a presença de um ou mais dos critérios que compõem o fenótipo de fragilidade / Abstract: Objectives: to describe the occurrence of falls in community-dwelling elders from Campinas (SP); to investigate the relationship between falls and fragility. Methods: Participants: 689 community-dwelling elderly recruited during the multicenter and multidisciplinary project "Estudo do Perfil de Fragilidade de Idosos Brasileiros-FIBRA.UNICAMP", that means Frailty Profile of the Brazilian Elderly. Procedures: Fist part: It was applied a questionnaire which collected socio-demographic data; daily life activities; presence of depressive symptoms; cognitive evaluation; self-referred diseases and / or symptoms; self-referred medicines; body mass index; measures of the frailty's phenotype (according Fried et al., 2001); previous falls. Results: Mean age was 72.27 years, 68.37% were women. 69.10% of the elderly reported falls, and 55.68% presented at least one frailty criteria. There was significant association between falls and the variables: age ? 80 years (p = 0.004), female gender (p <0.001), visual impairment (p = 0.002), reported arthritis (p = 0.002), and depressive symptoms (p = 0.005). Multivariate analysis showed that female gender; visual impairment and frailty criteria had a greater association with falls. Conclusions: It's necessary to identify the events which are associated to the biggest risk of falls to obtain an effective control of them. Therefore, as it was demonstrated in this study it's important to recognize the presence of the criteria of frailty (Fried et al., 2001) / Mestrado / Gerontologia / Mestra em Gerontologia

The classic metaphyseal lesion (CML) is considered to be a strong indicator of physical abuse in infants. These fractures extend through the metaphysis of a long bone near the growth plate, disrupting the trabecular bone structure. The mechanism(s) behind this fracture type are not entirely understood. The present study investigated experimentally the possible loading conditions required to generate CMLs in pig models. Fifty hindlegs from stillborn pigs were tested in torsion using a mechanical testing machine and a digital torque wrench. Fractures to the metaphysis that resemble CMLs were produced during a combined loading event which applied torsion to the knee joint (distal femur, proximal tibia, and proximal fibula). A visual assessment of the physeal surface of each specimen was performed after testing, and classic metaphyseal lesions were identified by comparison with findings from Love et al. (2011). The only fractures seen in both the femora and tibiae were CMLs, with both bone types having 60% (30 of 50) total fractures. The frequency of total fractures on fibulae was less, with 42% (21 of 50). The frequency of CMLs in the fibulae, however, is lower than the frequency of total fractures (38%, n=50), as physeal fractures also presented in some of those bones. Thus, the CML was the most common type of fracture produced due to the torque applied to the bones during testing. When assessing the number of CMLs that occurred on each limb, nine limbs had only one CML present, while 28 limbs had one or more CMLs. Additionally, complete CMLs made up 51.9% (41 of 79) of the total number, while partial made up 48.1% (38 of 79). Out of the 150 bones tested, 79 (52.7%) showed fractures resembling CMLs in human infants. A fracture was 35% more likely to occur in a femur or a tibia than in a fibula, and multiple CMLs per specimen were more common than single CMLs. The physeal surfaces of the specimens recorded as having CMLs showed damage to the trabecular bone. Three physeal fractures were noted; one Type IV physeal fracture on a proximal tibia and one on a proximal fibula, and a Type II physeal fracture on a proximal fibula. No diaphyseal fractures of any kind were produced. Further investigation of these conditions is encouraged to gain more insight into the injury mechanism.

The aim of this work is a static analysis of the reinforced concrete frame structure loaded by the effects of seismic loading. The work deals with the solution of multi-storey reinforced concrete structure designed for common loading conditions and further for possibilities of strengthening of the structure on effect of seismic loading. In the first phase of the work, the static analysis and the design of the main load-bearing elements of the frame structure (columns and main girder) were carried out for the ultimate limit state for the standard design load. In the second phase, the static analysis of the structure for the effects of accidental actions from low and high seismicity was performed and it was assessed whether the main load-bearing elements of the structure would continue to comply. Given that the structure did not satisfy the accidental actions of seismic loading, various ways of structure strengthening were designed and analyzed for their impact on the global and local behaviour of the structure. Also the designing of additional steps for structural reliability were performed. Static analyzes were performed in Scia Engineering and RFEM Dlubal software.

Abstract [sv] När en konstruktions bärförmåga kontrolleras måste den verifieras för en exceptionell dimensioneringssituation. För att motverka att skadan vid en exceptionell dimensioneringssituation blir oproportionerligt stor tillämpas olika åtgärder. Krav och föreskrifter om åtgärderna finns i Eurokod SS-EN 1991-1-7 2006. Sveriges nationella val till Eurokod görs i EKS. Den 1 juli 2019 reviderades EKS och EKS 11 började gälla.   Syftet med examenarbetet var att utreda vilka förändringar som gjorts för exceptionella dimensioneringssituationer i och med införandet av EKS 11. Målet med arbetet var att tillämpa alla åtgärder för exceptionella dimensioneringssituationer på en referensbyggnad. För att sedan jämföra differensen mellan åtgärderna och analysera orsaken till skillnaderna utifrån EKS 10 och 11. För att inkludera alla åtgärder har två alternativa stommar använts i referensbyggnaden.   En avgränsning till arbete var att endast en sektion av byggnaden beaktades vid beräkningen. Ytterligare avgränsning var att påkörning enbart kunde ske av vägfordon. Referensbyggnaden var ett flervåningshus byggt i Umeå. Byggnaden var ett bostadshus som bestod av sex våningar med en våningshöjd på 2,5 m. Våningsplanen bestod av ett betongbjälklag med en tjocklek på 220 mm. Den bärande stommen för byggnaden utgjordes av 220 m tjocka betongväggar. Den alternativa stommen utgjordes av fyra betongpelare som hade dimensionerna 220x220 mm. Pelarna placerades ut med ett centrumavstånd på 4.2 m.   För alla åtgärder förutom vid dimensionering av pelare som väsentlig bärverksdel blev resultaten större för EKS 10 än för EKS 11. Skillnaden för pelare som dimensionerades som väsentlig bärverksdel ökade mellan EKS 10 och 11 desto större belastningen blev. Orsaken till detta låg hos olika värden på reduktionsfaktorn vid lastkombinationerna som tillämpades. Den vertikala förbandskraften för bärande väggar var betydligt större vid tillämpning av EKS 10 än vid EKS 11. Grunden till det var tolkningen till begrepp som användes vid uträkningen för förbandskraften.    Slutsatsen som drogs var att referensbyggnaden med bärande väggar överdimensioneras för olyckslast vid jämförelse av resultaten från EKS 10 gentemot EKS 11. För ramverk dimensioneras åtgärderna för referensbyggnaden på ett likartat sätt för både EKS 10 och 11. / Abstract [en] The resistance of a construction must be verified for an exceptional sizing situation. Different measurements must be made for an exceptional sizing situation in order to prevent the damage from becoming disproportionately large. Demands and regulations about the measurements can be found in the Eurocode SS-EN 1991-1-7 2006. Sweden’s national choices to the Eurocode is made in EKS. Which was revised on the 1 June 2019.   The purpose of the paper was to clarify uncertainties that Structor Umea experienced about the transition between EKS 10 and 11. The goal was to apply all the measurements for an exceptional sizing situation on a reference building. Thereafter compare the differential between the measurements for EKS 10 and 11 and analyze the cause behind it. An alternative supporting frame has been formed to include all measurements.   One limitation for the paper was to only take one section of the building into account during the calculation. Another limitation was that collision could only occur by road vehicles.   The reference building was a multistory house built in Umea. The building was a residence house that consisted of six floors with a height of 2.5 m in between every floor. Each system of joists was 220 mm thick and made from concrete.  The supporting frame consisted of 220 mm thick concreate walls along the short side of the building. The alternative supporting frame was made of concrete pillars with the dimensions 220x220 mm. Each pillar had a center distance of 4.2 m.   All actions experienced sizeable differences when EKS 10 was applied except the sizing of essential load-bearing pillars. The disparity for the pillars when sized as essential grew larger as the load increased. The cause was that the reduction factor had different values for the various load combinations. The vertical joint force for the load-bearing wall was considerably larger when EKS 10 was applied compared with EKS 11. Based on interpretation of the method when calculating the joint force.   The conclusion was when dimensioned for accidental load according to EKS 10 the reference building with walls as its supporting frame became overdimensioned. The actions for a supporting frame consisting of pillars was dimensioned in a similar way when applying either EKS 10 or 11.

Falls remain one of the most reportable, serious and costly type of adverse events costing an estimated $3,500 to $27,000 depending on the injury. The research often focuses on the elderly and their risk for falls and injury. Increasingly higher rates of falls are being reported in the middle-age inpatient 45 to 64 years of age. While predictors of falls and injuries have been studied across all adult inpatients, research has not specifically addressed fall risk characteristics in the middle-age. The World Health Organization’s (WHO), “Risk factor model for fall in older age”, framework was adapted for the middle-age inpatient. This framework identifies extrinsic and intrinsic variables from four risk factor groupings of biological, socioeconomic, behavioral, environmental and related outcomes to describe characteristics of the middle-age inpatient’s fall injury risk. Hitcho et al. (2004) seminal article was also used to identify pertinent inpatient characteristics. The purpose of this exploratory retrospective quantitative study described fall risk factors specific to the middle-age inpatient. The aims: (1) described risk factors of falls and fall injury; (2) described unit specific data, fall numbers with type of falls, injuries from falls, and prevention strategies (3) compare the incidence of fall and injury rates in the middle-age (45- 64) patients to the other hospital adult age-groups (ages 21-44 and 65-90). This study used retrospective hospital occurrence data to identify middle-age inpatient falls and related characteristics reported by staff. Chart review of inpatient falls identified 439 individual falls occurring from January 2012 through July 2014. The study sample included inpatients that fell either one-time or had a repeat fall during the study period. Analysis for data included use of descriptive statistics, crosstabs, and Poisson regression. Outcomes collected included demographics, admitting diagnosis, chief complaints, cormorbities, and discharge status, type of falls and areas of falls. There was no significant difference in rates of falls between units or in staffing ratios that had a bearing on the middle-age inpatient. Fall prevention interventions were found to be universally applied, not specific to the individual, nor based on outcomes of risk screening of anticipated physiological risk factors. In comparison of the middle-age inpatient population with those age 65 -90 years of age the rates per 1000 patient days for both falls (p=.637) and injuries (p=.626) had no significant difference. Males fell at a significantly higher rate (p=.000) than females in the middle-age inpatient and those aged 64-90 years. The middle-age inpatient fell at an alarming rate of 42% of all falls. This research provided insight into a population with acute and multiple chronic disease conditions and comorbidities that contribute to altered mental status, abnormal gait and frequently awaking at night to void. This population often overestimates their limitations and strives to maintain their autonomy. The age of the patient should not influence staff assessment of alertness and orientation. The findings of the characteristics in this research provide rich information for further research in how to include the middle-age patient in clinical decision making and education of this age group.

This thesis reviews the parameters required to perform linear response history analysis according to Chapter 16 of the American Standard ASCE 7-10. A careful analysis is presented about the selection of ground motions using real records and using artificial records generated such that their response spectrum matches with a defined target spectrum; three different techniques are studied for the generation of these artificial records. Also, this document revises the scaling of ground motion techniques in the American Standard ASCE-7 as well as in other seismic codes. It presents a detailed analysis of the variables influencing the scaling of ground motions, and it suggests a new scaling technique for linear response history analysis. The assumptions made establishing the flexibility of the diaphragms are also analyzed as well as dynamic methods to include accidental torsion when doing a linear response history analysis. Other modeling issues such as the orientation of the ground motion axis, scaling of element forces and displacements, orthogonal loading, solution techniques, P-Delta effects, modeling of the basement, and calculation of drifts are also studied in the context of linear response history analysis. The thesis concludes with suggested code language for linear response history analysis intended to be considered in future editions of the American Standard ASCE 7. / Master of Science

Distributed memory systems have gained immense popularity due to their favorable price/performance ratios. This study seeks to reduce the complexities, involved in developing parallel applications for distributed memory systems. The Loci system is a coordination framework which was developed to eliminate most of the accidental complexities involved in numerical simulation software development. A distributed memory version of Loci is developed and has been tested and validated using a finite-rate chemically reacting flow solver developed in the sequential Loci framework. The application developed in the original sequential version of Loci was parallelized with minimal changes in its source code. A comparison with the results from the original sequential version guarantees a correct implementation. The performance measurements indicate that an efficient implementation has been achieved.

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