A hiperacusia e o zumbido representam alterações na percepção dos sons, estando freqüentemente associados. Ambos refletem um estado de hiperatividade da via auditiva, gerado por alterações na plasticidade neuronal geralmente associadas à super estimulação ou deprivação sensorial. A hiperacusia refere-se a uma disfunção na percepção da intensidade de sons externos, o zumbido refere-se à percepção de um som interno que não tem uma fonte geradora externa. Afetam adultos e crianças e podem ocasionar limitações na qualidade de vida. Ainda são muito negligenciados por otorrinolaringologistas e pediatras, apesar da sua presença não ser incomum na infância. Delineamos um estudo populacional transversal randomizado entre crianças de 5 a 12 anos cujo objetivo principal foi estimar a prevalência da hiperacusia e do zumbido. O objetivo secundário foi avaliar a associação a possíveis fatores de risco e a causalidade entre os sintomas. Foram avaliadas 506 crianças em ambiente escolar. Os dados foram coletados por meio de questionário aos pais ou responsáveis, entrevista com as crianças, otoscopia e testes auditivos. A classificação dos resultados seguiu critérios previamente estabelecidos. Participaram 240 meninas (47,4%) e 266 meninos (52,6%), idade média 9.46 anos (DP= 2.09). Os limiares auditivos foram classificados como normais em 81%, disacusia de grau mínimo/leve em 14% e disacusia de grau moderado/ profundo em 4% das crianças. A prevalência da sensação de zumbido foi 37,5%, incômodo com zumbido 19,6% e hiperacusia 3,2%. Os fatores de risco foram analisados por um modelo de regressão multivariado. Em relação ao zumbido, os fatores associados foram: idade, gênero, perda auditiva, história de exposição aos sons e cinetose. Para a hiperacusia, o único fator de risco encontrado foi a perda auditiva leve na orelha esquerda. A presença de hiperacusia demonstrou ser o maior fator de risco associado ao incomodo com o zumbido / Hyperacusis and tinnitus are altered states of sound perception and are frequently associated. Both reflect a hyperactivity of the auditory pathway as an expression of neural plasticity which is often triggered by over stimulation or deprivation of sensorial stimuli. Hyperacusis is a dysfunction on loudness perception of external sounds and tinnitus a perception of an internal sound without an external source. They might affect adults and children causing interference on quality of life. They are still neglected by otolaryngologysts and pediatricians. A prospective cross sectional study was designed to estimate tinnitus and hyperacusis prevalence and evaluate association to possible risk factors and causality among them. Children from 5 to 12 years of age were evaluated in the school environment. Data was collected searching parental information, children\'s interview, otoscopy and audiometric tests. The symptoms were classified according to previous established criteria. The final sample counted on 240 girls and 266 boys, mean age 9.46 (SD= 2.09). Hearing thresholds were classified as normal in 81%, minimum to mild hearing loss in 14% and moderate to profound hearing loss in 4% of the children. Prevalence of tinnitus sensation was found to be 37.5%, tinnitus suffering 19.6% and hyperacusis 3.2%. Age, gender, hearing loss, history of noise exposure and motion sickness were risk factors to tinnitus. Left ear hearing loss was a risk factor for hyperacusis. The presence of hyperacusis demonstrated to be the highest risk factor to tinnitus suffering

Introduction : les effets indésirables associés à un traitement médicamenteux ou à la pose d'un dispositif médical implantable doivent être recherchés systématiquement après le début de leur commercialisation. Les études réalisées pendant cette phase sont des études observationnelles qui peuvent s'envisager à partir des bases de données hospitalières. L'objectif de ce travail est d'étudier l'intérêt de la ré-utilisation de données hospitalières pour la mise en évidence de tels effets indésirables.Matériel et méthodes : deux bases de données hospitalières sont ré-utilisées pour les années 2007 à 2013 : une première contenant 171 000 000 de séjours hospitaliers incluant les codes diagnostiques, les codes d'actes et des données démographiques, ces données étant chaînées selon un identifiant unique de patient ; une seconde issue d'un centre hospitalier contenant les mêmes types d'informations pour 80 000 séjours ainsi que les résultats de biologie médicale, les administrations médicamenteuses et les courriers hospitaliers pour chacun des séjours. Quatre études sont conduites sur ces données afin d'identifier d'une part des évènements indésirables médicamenteux et d'autre part des évènements indésirables faisant suite à la pose d'un dispositif médical implantable.Résultats : la première étude démontre l'aptitude d'un jeu de règles de détection à identifier automatiquement les effets indésirables à type d'hyperkaliémie. Une deuxième étude décrit la variation d'un paramètre de biologie médicale associée à la présence d'un motif séquentiel fréquent composé d'administrations de médicaments et de résultats de biologie médicale. Un troisième travail a permis la construction d'un outil web permettant d'explorer à la volée les motifs de réhospitalisation des patients ayant eu une pose de dispositif médical implantable. Une quatrième et dernière étude a permis l'estimation du risque thrombotique et hémorragique faisant suite à la pose d'une prothèse totale de hanche.Conclusion : la ré-utilisation de données hospitalières dans une perspective pharmacoépidémiologique permet l'identification d'effets indésirables associés à une administration de médicament ou à la pose d'un dispositif médical implantable. L'intérêt de ces données réside dans la puissance statistique qu'elles apportent ainsi que dans la multiplicité des types de recherches d'association qu'elles permettent. / Introduction:The adverse events associated with drug administration or placement of an implantable medical device should be sought systematically after the beginning of the commercialisation. Studies conducted in this phase are observational studies that can be performed from hospital databases. The objective of this work is to study the interest of the re-use of hospital data for the identification of such an adverse event.Materials and methods:Two hospital databases have been re-used between the years 2007 to 2013: the first contains 171 million inpatient stays including diagnostic codes, procedures and demographic data. This data is linked with a single patient identifier; the second database contains the same kinds of information for 80,000 stays and also the laboratory results and drug administrations for each inpatient stay. Four studies were conducted on these pieces of data to identify adverse drug events and adverse events following the placement of an implantable medical device.Results:The first study demonstrates the ability of a set of detection of rules to automatically identify adverse drug events with hyperkalaemia. The second study describes the variation of a laboratory results associated with the presence of a frequent sequential pattern composed of drug administrations and laboratory results. The third piece of work enables the user to build a web tool exploring on the fly the reasons for rehospitalisation of patients with an implantable medical device. The fourth and final study estimates the thrombotic and bleeding risks following a total hip replacement.Conclusion:The re-use of hospital data in a pharmacoepidemiological perspective allows the identification of adverse events associated with drug administration or placement of an implantable medical device. The value of this data is the amount statistical power they bring as well as the types of associations they allow to analyse.

A redox flow battery (RFB) is an electrochemical energy storage device in which the storage medium is in the form of liquid electrolyte, which is stored in external reservoirs separate from the cell stack. The storage capacity of such systems is limited by the size of the external tanks, making the RFB an ideal technology for grid level energy storage. The vanadium redox flow battery (VRB) is a particularly attractive variant of the RFB, due to its use of a single transition-metal element in both the positive and negative electrolytes. However, the performance of the VRB is affected by the cross-over of electrolytes through the ion-exchange membrane which separates the positive and negative electrolytes. Cross-over causes degradation of energy storage efficiency and long term capacity loss. Previous studies of ion cross-over have focused primarily on the measurement of ion diffusion across ion exchange membranes in the absence of electrical current. In this work a novel VRB cell is described in which ion cross-over can be measured directly in the presence and absence of electrical current. Measurements are made of cross-over using this cell with three different types of ion exchange membrane in both charge and discharge modes. The results reported in this work show that the rate of ion cross-over can be greatly enhanced or suppressed depending upon the magnitude of the current flow and its direction relative to the ion concentration gradient. / text

Thesis (Ph.D.). / Written for the Dept. of Epidemiology and Biostatistics. Title from title page of PDF (viewed 2008/07/24). Includes bibliographical references.

Over the last 30 years, the justice system has increased attention toward domestic violence. In many states, the emphasis has emerged to a specialization, separate dockets and specially trained judges (Center for Court Innovation 2009). Domestic violence courts have evolved, however the Ninth Circuit Court in Orange and Osceola County has yet to adopt this concept. At present, the Osceola County Courthouse utilizes the Unified Family Court (UFC), an integrated comprehensive approach which handles all cases simultaneously addressing the families involved in disputes, as well as the adults and the children of domestic violence. The Orange County Courthouse on the other hand, has the court rooms on one designated floor of the Orange County Courthouse which is dedicated to domestic relation’s cases. There are (3) specialized judges for domestic violence cases which rotate every (6) months. This thesis will explore the different challenges that are faced by the judicial system in domestic violence courts in Orange and Osceola County. One of those challenges is that there is no set “model” to develop a consistency in practices and policies; therefore there is no mutual understanding or agreement for the purposed outcome. With the study of case law, statutes, court research, court observation, and goal assessments, this thesis will explore the possibilities of change in this court system. The purpose of this study is to contribute awareness, present recommendations to the legal system, and state that it is not enough -although critical- to focus on the victim’s safety and the offender accountability, but also it is crucial to place an emphasis on specially trained judges and stakeholders in order to create a more unified structure.

No description available.

Medicina da Universidade de São Paulo. Objetivo: Esse estudo foi desenvolvido para avaliar o impacto dos poluentes do ar na morbidade nas crianças e adolescentes portadoras de anemia falciforme. Métodos: Foram utilizadas as associações entre as concentrações diárias entre as concentrações dos poluentes do ar (PM10, SO2, NO2, CO, e O3) e os atendimentos no Pronto Socorro de anemia falciforme (CID 10 - D57) no período de setembro de 1999 até dezembro de 2004. Foi utilizado o desenho de case - crossover com dias de exposição de referencia escolhidos utilizando-se uma abordagem estratificada por tempo onde as exposições no dia índice foram comparadas a exposições com dias do mesmo mês com o mesmo valor de temperatura como o caso índice, controlando-se para o dia da semana. Estação do ano, clima e covariantes variáveis lentas foram controladas por pareamento. Também foram adotados modelos onde as exposições do caso índice foram comparadas às exposições para o mesmo dia da semana ou a cada três dias. Os efeitos estimados também foram estratificados para as duas causas principais de atendimento no pronto socorro de pacientes falciformes, dor e infecção respiratória. Resultados: As variações de interquartile aumentaram nas médias móveis de PM10 (25.9 mg/m3), NO2 (64.8 mg/m3), SO2 (8.1 mg/m3), CO (1.2 ppm), e O3 (57.23 mg/m3) foram associadas com aumento de 19.2% (95% CI: 11.2 - 27.8), 15.6% (95% CI: 6.3 - 25.8), 14.5% (95% CI: 6.6 - 23.0), 15,1% (95% CI: 7.7 -23.1), e 10% (95% CI: 1,3 - 18,6) nos atendimentos totais dos pacientes falciformes no pronto socorro, respectivamente. Na análise estratificada para dor, que é a manifestação cardinal dos processos de vaso-oclusão, os aumentos nos atendimentos dos pacientes falciformes com dor (23.1%, 95%CI: 11.0 - 36.5) devido a um aumento na variação interquartile da média móvel de 3 dias do PM10 foi 43% maior que nos pacientes falciformes sem dor. Conclusão: esse estudo mostra que o efeito da poluição do ar na saúde da população pediátrica não se restringe às doenças respiratórias. Também , entre os pacientes falciformes a manifestação principal dos efeitos adversos foi associada com o processo inflamatório dos vasos, reproduzindo resultados já observados entre pacientes adultos e idosos saudáveis e não saudáveis. Finalmente, esse estudo mostrou que os efeitos da poluição do ar na saúde ainda não esta definitivamente estimados e outros resultados serão observados em mais investigações. / Objective: This study was developed to assess the impact of air pollutants on sickle cell morbidity in children and adolescents. Methods we examined the associations between daily air pollutants concentrations (PM10, SO2, NO2, CO, and O3) and sickle cell (ICD10th revision: D57) emergency room visits, from September 1999 to December 2004. We applied a case-crossover design with referent exposure days chosen using the time-stratified approach such that exposures on the case day were compared to exposures on days of the same month with the same value of temperature as the case day, controlling for day of the week. Season, weather, and slowly varying covariates were controlled for by matching. We also adopted models where exposures on the case day were compared to exposures on the same day of the week or on every third day. Effects estimates were also stratified by the two main causes of sickle cell emergency room visits, pain and respiratory infections. Results: interquartile range increases of the 3-day moving averages of PM10 (25.9 mg/m3), NO2 (64.8 mg/m3), SO2 (8.1 mg/m3), CO (1.2 ppm), and O3 (57.23 mg/m3) were associated with increases of 19.2% (95% CI: 11.2 - 27.8), 15.6% (95% CI: 6.3 - 25.8), 14.5% (95% CI: 6.6 - 23.0), 15,1% (95% CI: 7.7 - 23.1), and 10% (95% CI: 1,3 - 18,6) in total sickle cell emergency room visits, respectively. When the analyses were stratified by pain, the main clinical manifestation of vase-occlusion process, increases in visits of sickle cell patients with pain (23.1%, 95%CI:11.0 -36.5) due to an interquartile range increase of the 3-day moving averages of PM10 were 43% higher than in sickle cell patients without pain. Conclusions: this study found that the effects of air pollutants on children\'s health are not limited to respiratory diseases. Also, among sickle cell patients, the main manifestation of adverse effect was associated with inflammatory process of vases, reproducing results already observed among healthy and non-healthy adults and elderly people. Finally, this study showed that the burden of air pollution on health has not been definitively estimated and other outcomes deserve further investigation.

Medicina da Universidade de São Paulo. Objetivo: Esse estudo foi desenvolvido para avaliar o impacto dos poluentes do ar na morbidade nas crianças e adolescentes portadoras de anemia falciforme. Métodos: Foram utilizadas as associações entre as concentrações diárias entre as concentrações dos poluentes do ar (PM10, SO2, NO2, CO, e O3) e os atendimentos no Pronto Socorro de anemia falciforme (CID 10 - D57) no período de setembro de 1999 até dezembro de 2004. Foi utilizado o desenho de case - crossover com dias de exposição de referencia escolhidos utilizando-se uma abordagem estratificada por tempo onde as exposições no dia índice foram comparadas a exposições com dias do mesmo mês com o mesmo valor de temperatura como o caso índice, controlando-se para o dia da semana. Estação do ano, clima e covariantes variáveis lentas foram controladas por pareamento. Também foram adotados modelos onde as exposições do caso índice foram comparadas às exposições para o mesmo dia da semana ou a cada três dias. Os efeitos estimados também foram estratificados para as duas causas principais de atendimento no pronto socorro de pacientes falciformes, dor e infecção respiratória. Resultados: As variações de interquartile aumentaram nas médias móveis de PM10 (25.9 mg/m3), NO2 (64.8 mg/m3), SO2 (8.1 mg/m3), CO (1.2 ppm), e O3 (57.23 mg/m3) foram associadas com aumento de 19.2% (95% CI: 11.2 - 27.8), 15.6% (95% CI: 6.3 - 25.8), 14.5% (95% CI: 6.6 - 23.0), 15,1% (95% CI: 7.7 -23.1), e 10% (95% CI: 1,3 - 18,6) nos atendimentos totais dos pacientes falciformes no pronto socorro, respectivamente. Na análise estratificada para dor, que é a manifestação cardinal dos processos de vaso-oclusão, os aumentos nos atendimentos dos pacientes falciformes com dor (23.1%, 95%CI: 11.0 - 36.5) devido a um aumento na variação interquartile da média móvel de 3 dias do PM10 foi 43% maior que nos pacientes falciformes sem dor. Conclusão: esse estudo mostra que o efeito da poluição do ar na saúde da população pediátrica não se restringe às doenças respiratórias. Também , entre os pacientes falciformes a manifestação principal dos efeitos adversos foi associada com o processo inflamatório dos vasos, reproduzindo resultados já observados entre pacientes adultos e idosos saudáveis e não saudáveis. Finalmente, esse estudo mostrou que os efeitos da poluição do ar na saúde ainda não esta definitivamente estimados e outros resultados serão observados em mais investigações. / Objective: This study was developed to assess the impact of air pollutants on sickle cell morbidity in children and adolescents. Methods we examined the associations between daily air pollutants concentrations (PM10, SO2, NO2, CO, and O3) and sickle cell (ICD10th revision: D57) emergency room visits, from September 1999 to December 2004. We applied a case-crossover design with referent exposure days chosen using the time-stratified approach such that exposures on the case day were compared to exposures on days of the same month with the same value of temperature as the case day, controlling for day of the week. Season, weather, and slowly varying covariates were controlled for by matching. We also adopted models where exposures on the case day were compared to exposures on the same day of the week or on every third day. Effects estimates were also stratified by the two main causes of sickle cell emergency room visits, pain and respiratory infections. Results: interquartile range increases of the 3-day moving averages of PM10 (25.9 mg/m3), NO2 (64.8 mg/m3), SO2 (8.1 mg/m3), CO (1.2 ppm), and O3 (57.23 mg/m3) were associated with increases of 19.2% (95% CI: 11.2 - 27.8), 15.6% (95% CI: 6.3 - 25.8), 14.5% (95% CI: 6.6 - 23.0), 15,1% (95% CI: 7.7 - 23.1), and 10% (95% CI: 1,3 - 18,6) in total sickle cell emergency room visits, respectively. When the analyses were stratified by pain, the main clinical manifestation of vase-occlusion process, increases in visits of sickle cell patients with pain (23.1%, 95%CI:11.0 -36.5) due to an interquartile range increase of the 3-day moving averages of PM10 were 43% higher than in sickle cell patients without pain. Conclusions: this study found that the effects of air pollutants on children\'s health are not limited to respiratory diseases. Also, among sickle cell patients, the main manifestation of adverse effect was associated with inflammatory process of vases, reproducing results already observed among healthy and non-healthy adults and elderly people. Finally, this study showed that the burden of air pollution on health has not been definitively estimated and other outcomes deserve further investigation.

La compréhension des propriétés de transport de charge des nanostructures métalliques et magnétiques est très importante pour le développement et la miniaturisation des dispositifs fonctionnels modernes. En particulier, les nanostructures synthétisées chimiquement sont intéressant car elles permettent de mieux contrôler leur forme et leur taille, ce qui peut être utilisé pour ajuster leurs propriétés de transport de charge. L'objectif de cette thèse est d'étudier les aspects différents des propriétés de transport de charge qui résultent de la petite taille et de la nature magnétique de différents types de nanostructures comprenant des nanoparticules de Pt (1,3-3 nm), des particules magnétiques FeCo (⁓10 nm), et complexe de coordination à base de triazole Fe (II). Pour préciser davantage, des phénomènes tels que le blocage de Coulomb, la magnétorésistance tunnel et la transition de spin seront mis en évidence. En fonction de la propriété souhaitée, ces nanostructures peuvent être exploitées pour leurs applications dans divers capteurs, actionneurs et dispositifs spintroniques, etc. / Understanding charge transport properties of metallic and magnetic nano-structures is highly important for the development and miniaturization of modern functional devices. In particular, chemically synthesized nano-structures are in focus as they provide better control over their shape and size, which can be used to tune their charge transport properties. The aim of this thesis is to study the various aspects of charge transport properties which emerge due to the small size and magnetic nature of different types of nanostructures which include Pt nanoparticles (1.3-3 nm), FeCo magnetic particles (⁓10 nm), and Fe (II) triazole based coordination complex. To further specify, phenomenon such as Coulomb blockade, tunnel magnetoresistance and spin-transition will be in focus. Depending on the desirable property, these nanostructures can be exploited for their applications in a variety of sensors, actuators and spintronic devices etc.

The question of this degree project is to investigate whether it is possible to convert one art form to another. The thesis has been about converting the art of painting into music. French post-impressionism has been transformed into contemporary chamber music. Setup The degree project “Toner i dubbel bemärkelse” (Tones in two Senses) is about the saxophonist and clarinettist Robert Nevén’s research on his experiences with synaesthesia, and how this has inspired him to compose music for an ensemble consisting of both improvisational and classical musicians. Synaesthesia is a neurological condition where one sensory impression triggers another. A common form of synaesthesia is when reading certain letters and/or numbers makes the synaesthete perceive specific colours. The person in question either sees the colour in front of the eyes, or imagines it in the head. Implementation Nevén believes he experiences synaesthesia to a certain extent, and in his case, it is as follows: Often when he plays a certain note it triggers the visual cortex so that he thinks of a specific colour. This has led to the idea of taking this the other way around for compositional inspiration purposes: Nevén has extracted the colours from five paintings of French post-impressionist painter Paul Gauguin, turned these colours into the musical pitches he associates them with, and written one composition for each painting’s tone material respectively. The five paintings are: Blue Trees Spirit of the Dead Watching (Manaò tupapaú) Redheaded Woman and Sunflowers The Loss of Virginity (Awakening of Spring) The Sorcerer of Hiva Oa (Marquesan Man in the Red Cape) In one composition, the musical form and instrumentation are derived directly from the painting. In others, the tone material is assembled more freely based upon different compositional concepts. The music was presented in concert at The Royal College of Music in Stockholm at March 20th, 2018. Conclusion The conversion of paintings to music is possible, but it requires a format so that the result faithfully follows the original. In this case, the format consisted of keeping the composition within the framework of a painting’s given tone material as much as possible. / <p><strong>Kompositör:</strong></p><p>Robert Nevén</p><p></p><p><strong>Repertoar:</strong></p><p>1) <em>Blue Trees</em></p><p>2) <em>Redheaded Woman and Sunflowers</em></p><p>3) <em>The Sorcerer of Hiva Oa (Marquesan Man in the Red Cape)</em></p><p>4) <em>Spirit of the Dead Watching (Manaò tupapaú)</em></p><p>5) <em>The Loss of Virginity (Awakening of Spring)</em></p><p></p><p><strong>Medverkande musiker:</strong></p><p>Robert Nevén - klarinett &amp; tenorsaxofon</p><p>Zaida Ponthin - violin</p><p>Oscar Edin - violin</p><p>Ragnhild Kvist - viola</p><p>Johannes Rydén - cello</p><p>Jonas Grumstedt - kontrabas</p><p>Kim Sundell - elgitarr</p><p>Rui Hallvares Andrade Paes - piano</p>