The purpose of this study was to determine whether hypnotic suggestions could influence the physiological mechanisms associated with breast growth to produce a significant increase in breast- size in an adult female population.

At the 2nd Diabetes Surgical Summit in 2015, the world’s leading researchers and professionals in the field of diabetes, surgery, and public health gathered to develop new surgical treatment guidelines for diabetes. This summit led to the recommendation of bariatric surgery as an official treatment for type II diabetes, outlining that the surgery be considered for diabetic patients with a Body Mass Index (BMI) of 30, a much lower threshold BMI than that of typical bariatric surgery patients. Despite incontrovertible evidence that bariatric surgery can reverse the progression of diabetes and even cause remission, the physiological mechanisms chiefly responsible for these effects remain controversial. Peer-reviewed published literature was collected to examine the evidence for mechanisms responsible for metabolic improvements following bariatric surgery, especially Roux-en-Y gastric bypass. This review considered the effects of calorie restriction, appetite modulators, incretins, intestinal adaptations, adipose tissue, gut microbiota, bile acid circulation and composition, and psychosocial and behavioral changes on surgery-induced metabolic improvements and sustained type II diabetes remission. Clinical considerations, such as the surgical risks and improved indicators for bariatric surgery were also explored to contextualize the physiological mechanisms under study. The “hind gut hypothesis” emerged as an important overarching mechanism potentially responsible for many of the observed improvements. The more rapid delivery of food to the distal intestine, as well as the delayed mixing of pancreatic, gastric and bile secretions with food, likely contributes to increased nutrient-stimulation of enteroendocrine cells and greater binding of bile acids with their receptors, farnesoid X receptor and TGR5. These changes in food and secretion delivery also appear to positively affect the gut microbiota to support a non-obese microbiota profile. Calorie restriction may be responsible for the early effects of bariatric surgery, including not just a reduction in fat mass but also epigenetic changes to induce β-cell proliferation and increased insulin secretion. However, long-term benefits of bariatric surgery appear to be more closely correlated to enteroendocrine changes, including the surgery-induced changes to levels of appetite modulators that, unlike pure calorie restriction, promote feelings of satiation and reduce rates of diet failure and weight regain. Fat distribution and adipocyte function are also important contributors to both the pathophysiology of obesity-related diabetes and improvements following bariatric surgery. While reductions in BMI and subcutaneous adipose tissue area were not correlated to diabetes remission, reductions in visceral adipose tissue area and enhanced adiponectin secretions were both independent factors associated with diabetes remission. The important role of adipocytes as endocrine organs has emerged as an important field of inquiry. Adipokines, adipocyte hormones, may either promote a pro-inflammatory profile or an anti-inflammatory profile, impacting the development of obesity-related diabetes or diabetes remission, respectively. The findings of this review support the 2nd Diabetes Surgical Summit’s recommendations of proactive bariatric surgery as a treatment for diabetes. The risks of complications and mortality following bariatric surgery are low, whereas the long-term survival after bariatric surgery is improved relative to non-surgical, matched controls. Single-nucleotide polymorphisms associated with obesity and diabetes may serve as early indicators for surgery, and inform both surgical method and follow-up protocols. Despite the benefits of bariatric surgery, only a small number of eligible candidates undergo treatment. In the United States, barriers such as physician and patient perceptions and cost may limit access to surgery. In places that experience a health workforce shortage, there may be no health care professionals or facilities available to perform bariatric surgery. Therefore, while the surgery amazingly causes diabetes remission, one of its greatest benefits may be to continue to inform the mechanisms responsible for metabolic improvements toward developing new pharmacological treatments. In the future, less invasive drug treatments that seek to replicate the effects of bariatric surgery may be more successful in tackling the global obesity and diabetes crisis.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2014. / Flexion distraction chiropractic technique (FDCT) is a commonly used manual therapy technique which is purported to address various clinical pain syndromes. However, it lacks the credibility of appropriate evidence-based guidelines. An analysis of the literature would be able to inform the development of guidelines. Objectives: The aim of this systematic review was to determine the evidence to support the use of FDCT in clinical practice. Data sources: A systematic review of PubMed and Summons was conducted, using the following search terms: chiropractic, flexion distraction, protocol and / or technique. Study selection: All electronic or paper, English articles, which possessed the required key indexing terms and represented randomised and non-randomised controlled study designs were included. Data extraction: Blinded review of the articles was conducted by three independent reviewers utilising the PEDro (for randomised controlled trials) and NOS for (non-randomised controlled trials). This allowed the methodological rigour of the article to be ranked. This ranking was compared to a critical appraisal of the article in order to achieve an overall decision with regards to the contribution of the article to the level of evidence for FDCT. Data synthesis: 18 review outcomes were aggregated around four clinical categories; two articles each on neck pain, chronic pelvic pain, and physiological outcomes and the remaining twelve on low back pain. There was agreement that the evidence for pelvic pain and physiological function was limited to no evidence and limited respectively. Conflicting evidence existed for neck and low back pain (single and multimodal treatment) with limited and moderate evidence respectively. Conclusion: FDCT is clinically advocated for many conditions. The evidence provided in this review indicates that practitioners should be guarded in their use of FDCT, as the evidence to its widespread use is limited to only those conditions noted in this review. Therefore, further high quality and rigorous studies are required to develop appropriate treatment guidelines for use by practitioners to adequately provide evidence based care in clinical practice.

<p> Subcutaneous injection of formalin produced acute sodium deficiency in rats, characterized by marked hypovolemia and hyponatremia, due to an extravascular leakage of plasma and destruction of cells at the injection site. This reduction in intravascular fluid volume elicited both behavioral and physiological mechanisms of fluid restoration: sodium appetite and thirst as well as renal retention of sodium and water. Appetite and retention evolved together but intakes continued well after retention ceased and plasma volume and sodium concentration were restored to normal. These results indicate that appetite alone is not a true indicator or need, and that sodium and water balances (intake - excretion) must be considered in defining the deficient state.</p> / Thesis / Master of Arts (MA)

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2014. / Flexion distraction chiropractic technique (FDCT) is a commonly used manual therapy technique which is purported to address various clinical pain syndromes. However, it lacks the credibility of appropriate evidence-based guidelines. An analysis of the literature would be able to inform the development of guidelines. Objectives: The aim of this systematic review was to determine the evidence to support the use of FDCT in clinical practice. Data sources: A systematic review of PubMed and Summons was conducted, using the following search terms: chiropractic, flexion distraction, protocol and / or technique. Study selection: All electronic or paper, English articles, which possessed the required key indexing terms and represented randomised and non-randomised controlled study designs were included. Data extraction: Blinded review of the articles was conducted by three independent reviewers utilising the PEDro (for randomised controlled trials) and NOS for (non-randomised controlled trials). This allowed the methodological rigour of the article to be ranked. This ranking was compared to a critical appraisal of the article in order to achieve an overall decision with regards to the contribution of the article to the level of evidence for FDCT. Data synthesis: 18 review outcomes were aggregated around four clinical categories; two articles each on neck pain, chronic pelvic pain, and physiological outcomes and the remaining twelve on low back pain. There was agreement that the evidence for pelvic pain and physiological function was limited to no evidence and limited respectively. Conflicting evidence existed for neck and low back pain (single and multimodal treatment) with limited and moderate evidence respectively. Conclusion: FDCT is clinically advocated for many conditions. The evidence provided in this review indicates that practitioners should be guarded in their use of FDCT, as the evidence to its widespread use is limited to only those conditions noted in this review. Therefore, further high quality and rigorous studies are required to develop appropriate treatment guidelines for use by practitioners to adequately provide evidence based care in clinical practice.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / The occurrence of short droughts, during the growing season of cassava in Rio Grande do Sul, may cause several soil drying cycles which induce physiological disorders in plants, affecting cassava productivity in the state. The objectives of this study were to verify the physiological mechanisms used by plants during the first and second soil drying cycle, the recovery of leaf area in plants under water stress after rehydration, the response of plants under one drying cycle with two distinct physiological ages and the possibility of acclimation of plants under two drying cycles, in sequence. Two experiments were conducted with cassava plants, Fepagro RS 13 cultivar, inside a plastic house at Federal University of Santa Maria, RS, Brazil. Planting dates were on 29/09/2011 for EXP 1 and 24/11/2011 for EXP 2. Water regimes for the two experiments were RH1, without water deficit during the two periods (control treatment); RH2, with water deficit during the two periods (two cycling cycles); RH3, with one drying cycle on P1, matching with the first drying cycle on RH2 and RH4, with one drying cicle on P2, matching with the second drying cycle on RH2. FTSW is the portion of available water in the soil which plants use in the transpiration. The physiological mechanisms that stood out on P1 of RH2 and RH3 and P2 of RH4 were the reduction of total leaf area and stomatal control of cassava plants. On P2 of RH2, it was the reduction of total leaf area (without leaf senescence). RH3 plants showed fast recovering after rehydration on P2, with high NFE and CFA, regarding RH1. The drying cycles with low (RH3) and high (RH4) physiological age presented no difference on FTSW threshold for TR and CFR. The high CT of RH2, on P2 of EXP1, indicates that plants had lower activation of stomatal control during high DPV periods. Thus, plants of RH2 acclimated to the second drying cycle with FTSW threshold of 0,09 to CFR and 0,13 to TR, presenting late CFR and TR declines in comparison with drying cycles of RH3 and RH4. / A frequente ocorrência de curtas estiagens, durante o período de cultivo da mandioca no Rio Grande do Sul, pode provocar vários ciclos de secamento do solo que causam distúrbios fisiológicos nas plantas, afetando a produtividade da cultura no Estado. Os objetivos desta dissertação foram verificar os mecanismos fisiológicos das plantas durante o primeiro e segundo ciclo de secamento do solo; a capacidade de recuperação da área foliar em plantas com estresse hídrico após a reidratação; a resposta de plantas submetidas a um ciclo de secamento do solo em duas idades fisiológicas distintas e a possibilidade de aclimatação das plantas submetidas a dois ciclos de secamento do solo subsequentes. Dois experimentos foram conduzidos com plantas de mandioca, cultivar Fepagro RS 13, dentro de um abrigo telado no Departamento de Fitotecnia da Universidade Federal de Santa Maria, RS, Brasil. As datas de plantio do primeiro (EXP 1) e segundo (EXP 2) experimento foi 29/09/2011 e 24/11/2011, respectivamente. Os regimes hídricos do solo, para os dois experimentos, foram: RH1, sem deficiência hídrica nos dois períodos (testemunha); RH2, com deficiência hídrica nos dois períodos (dois ciclos de secamento do solo); RH3, com um ciclo de secamento no P1, coincidindo com o primeiro ciclo de secamento do RH2; e RH4, com um ciclo de secamento no P2, coincidindo com o segundo ciclo de secamento do RH2. A fração da água disponível do solo (FATS) é a parcela da água que a planta utiliza na transpiração. Os mecanismos fisiológicos mais evidenciados no P1 dos RH2 e RH3 e no P2 do RH4 foram a redução da área foliar total e o controle estomático das plantas de mandioca. Já, no P2 do RH2, foi a redução da área foliar total (sem senescência foliar). As plantas do RH3 demonstraram rápida recuperação após a reidratação no P2, com elevados NFE e CFA, em relação ao RH1. Os ciclos de secamento das plantas com menor (RH3) e maior (RH4) idade fisiológica não apresentaram diferença nas FATSc para TR e CFR. O elevado CT do RH2, no P2 do EXP 1, indica que as plantas tiveram menor ativação do controle estomático durante os períodos do dia de alto DPV. Com isso, as plantas do RH2 aclimataram-se ao segundo ciclo de secamento do solo com FATSc de 0,09 para CFR e de 0,13 para TR, apresentando os declínios de CFR e de TR mais tardiamente em comparação com os ciclos de secamento do RH3 e RH4.

Il existe différents facteurs pouvant altérer la récupération fonctionnelle de patients souffrant de traumatismes orthopédiques (TO), dont le fait de subir un traumatisme craniocérébral (TCC) concomitant. Le profil de traumatismes combinés (TCC et TO) a principalement été étudié en contexte de blessures jugées sévères (TCC modéré/sévère et multiples fractures), notamment dans un souci de maximiser la récupération de ces patients et le déploiement des ressources médicales. Par ailleurs, la littérature demeure limitée en ce qui a trait à l’impact de subir un TCC en contexte de blessures jugées moins sévères, soit un TCC léger (TCCL) et une fracture isolée (un seul os fracturé), bien qu’il s’agisse de deux blessures à très forte incidence et qu’elles partagent diverses similarités (p.ex. : mécanismes d’accidents et physiologiques communs). Ainsi, la présente thèse s’est spécifiquement intéressée à cette population aux prises avec une fracture isolée avec, ou sans, TCCL concomitant. Dans un premier temps, les travaux de la thèse ont permis d’investiguer la fréquence de TCCL concomitant en contexte de fracture isolée (article 1) ainsi que son impact sur la récupération post-fracture selon diverses mesures cliniques (articles 2, 3, 4). Les résultats ont démontré que le TCCL était fréquent, quoique fortement sous-diagnostiqué, chez des patients vus au département d’urgence (DU) pour une fracture isolée et que sa présence avait un impact significatif sur le niveau de douleur perçu, le délai pour retourner au travail et le risque de développer de l’ossification hétérotopique (forme de complications orthopédiques). Dans un deuxième temps, la présente thèse a utilisé une approche théorique (article 5) et clinique (article 6) afin d’étudier les mécanismes physiologiques sous-tendant la perception de douleur, symptôme clé suite à une fracture, dans un souci de limiter les risques de chronicisation de la douleur et de proposer des méthodes d’intervention ciblées selon la population étudiée. Les travaux ont notamment mis en lumière une association entre l’intensité de douleur rapportée par des patients en phase aiguë post-fracture et le degré d’atteintes des mécanismes d’excitabilité corticale du cortex moteur primaire mesurées par l’entremise de la stimulation magnétique transcranienne (SMT). Enfin, sur la base d’évidences théoriques soulevées dans un article de revue de la présente thèse, il semble y avoir une pertinence dans l’utilisation de la SMT auprès de la population orthopédique comme méthode d’investigation et d’intervention, considérant sa capacité à cibler les mécanismes physiologiques impliqués dans la transition de la douleur aiguë à la douleur chronique. / A variety of factors can affect the functional recovery of patients with an orthopedic trauma (OT), including concomitant traumatic brain injuries (TBI). The recovery profile of patients with combined traumas (OT and TBI) has been studied primarily in the context of severe injuries (moderate/severe TBI and multiple fractures), in order to maximize recovery and medical resources. On the other hand, there is limited evidence on the impact of concomitant TBI in the context of milder injuries, such as in patients sustaining a mild TBI combined with an isolated limb fracture, despite both injuries being highly prevalent and sharing various similarities (e.g., overlapping injury mechanisms and physiological mechanisms). The current thesis sought to bridge this knowledge gap via a multifaceted approach. We first investigated the risk of sustaining a concomitant mild TBI in patients with an isolated limb fracture (article 1) as well as its impact on post-fracture recovery according to various clinical measures (articles 2, 3, 4). The results showed that mild TBI was frequent, although highly underdiagnosed, in patients seeking care for an isolated limb fracture in the emergency department. Moreover, the presence of a concomitant mild TBI had a significant detrimental impact on the level of perceived pain, on return to work delays, and on the risks of developing heterotopic ossification (a type of orthopedic complication). Secondly, this thesis used a theoretical (article 5) and a clinical (article 6) approach to study the physiological mechanisms underlying pain perception, a key symptom following a fracture, in order to limit the risks for pain chronification and to propose intervention methods tailored to the studied population. In particular, results highlighted an association between pain intensity as perceived by patients in the acute phase post-fracture and the degree of cortical excitability impairments of the primary motor cortex, as measured by transcranial magnetic stimulation (TMS). Finally, based on theoretical evidence highlighted in a review article included in this thesis, there are evidence supporting the use of TMS in a traumatically injured population as a method to investigate and intervene given its ability to target key physiological mechanisms involved in the transition from acute to chronic pain.