京都大学 / 新制・課程博士 / 博士(医学) / 甲第25188号 / 医博第5074号 / 京都大学大学院医学研究科医学専攻 / (主査)教授 永井 純正, 教授 椛島 健治, 教授 安達 泰治 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Bombom é o produto constituído por massa de chocolate ou por um núcleo formado de recheios diversos, recobertos por uma camada de chocolate. Alimentos para fins especiais (diet) são aqueles nos quais ocorrem modificações no conteúdo de nutrientes, e são adequados à utilização em dietas diferenciadas, atendendo às necessidades de pessoas em condições metabólicas e fisiológicas específicas. O termo light pode ser utilizado quando for cumprido o atributo de redução mínima de 25% no valor energético total ou no conteúdo de nutrientes de alimentos comparados. Propriedade funcional é aquela relativa ao papel metabólico ou fisiológico que o nutriente ou não nutriente tem nas funções do organismo humano. O presente trabalho visou o desenvolvimento de recheios diet e light para bombons com adição de ingrediente com propriedade funcional (inulina). Foram desenvolvidos um bombom controle e dez formulações de bombom diet e light, sendo apenas uma (F9) selecionada. Um bombom comercial foi utilizado como referência. Foram feitas as análises de atividade de água, pH, umidade, lipídios totais, proteína, fibra alimentar, carboidrato por diferença, perfil de textura (dupla compressão, em analisador de textura TA-XT2) em diferentes temperaturas e tempos de armazenamento. Os bombons (controle e F9) foram comparados através de análise sensorial, sendo apresentados como amostras independentes em um teste de aceitação com escala hedônica híbrida. A substituição dos açúcares por edulcorantes e agentes de corpo foi satisfatória, assim como o uso do substituto de gordura Benefat®. A inulina Raftiline® ST apresentou textura melhor que a inulina Raftiline® HP-Gel, não sendo percebida na boca. A análise do perfil de textura mostrou que o bombom comercial e o de controle apresentaram maior durabilidade que o bombom F9, que apresentou perda de dureza e aumento da mastigabilidade. Na análise sensorial, o bombom F9 obteve altos níveis de intenção de compra, podendo nesta análise ser considerado como um produto de grande potencial de mercado. / Chocolate confectionery is a product consisting of either chocolate mass or a nucleus containing several fillings covered with a chocolate layer. Food for special purposes are those in which modifications are made in what is related to the nutrients content, adapted to the utilization in differentiated diets, in order to fulfill the needs of people showing specific metabolic and physiological disorders. The term light is applied to a product providing it accomplishes the attribute of a 25% minimum reduction in the total energetic value or nutrients content if compared to a similar, standard product. The functional property is relative to the metabolic or physiological role (function) the nutrient or the non-nutrient plays in the human organism o The present work aimed at the development of diet and light fillings for chocolate confectionery using an ingredient (inulin) with a functional property. Two series of chocolate confectionery samples were prepared: a control sample and ten diet and light formulations. One of these formulations, F9, was selected. A commercial chocolate confectionery was used as reference. Analyses were performed to evaluate the water activity, pH, humidity, total lipids, protein, carbohydrate per difference (including fibers), texture profile (double compression, using a texturometer HAS-XT2) in several controlled environments at different temperatures and stored during different periods of time. The chocolate confectionery samples (Control and F9) were compared using sensorial analysis. Independent samples were offered in an acceptance test with hedonic hybrid scale. The substitution of sugars by sweeteners and body agents was satisfactory, as well as the use of a fat substitute, Benefat®. The Inulin Raftiline® ST presented better texture than the Inulin Raftiline® HP-Gel, but no difference was noticed on the mouth feel test. The texture profile showed that both the commercial and the control chocolate confectionery samples presented longer durability than the F9 sample, which presented increased hardness and loss of chewiness. In the sensorial analysis, the chocolate confectionery F9 obtained high levels of purchase intention and thus can be considered as a great product from a market potential point of view.

Bombom é o produto constituído por massa de chocolate ou por um núcleo formado de recheios diversos, recobertos por uma camada de chocolate. Alimentos para fins especiais (diet) são aqueles nos quais ocorrem modificações no conteúdo de nutrientes, e são adequados à utilização em dietas diferenciadas, atendendo às necessidades de pessoas em condições metabólicas e fisiológicas específicas. O termo light pode ser utilizado quando for cumprido o atributo de redução mínima de 25% no valor energético total ou no conteúdo de nutrientes de alimentos comparados. Propriedade funcional é aquela relativa ao papel metabólico ou fisiológico que o nutriente ou não nutriente tem nas funções do organismo humano. O presente trabalho visou o desenvolvimento de recheios diet e light para bombons com adição de ingrediente com propriedade funcional (inulina). Foram desenvolvidos um bombom controle e dez formulações de bombom diet e light, sendo apenas uma (F9) selecionada. Um bombom comercial foi utilizado como referência. Foram feitas as análises de atividade de água, pH, umidade, lipídios totais, proteína, fibra alimentar, carboidrato por diferença, perfil de textura (dupla compressão, em analisador de textura TA-XT2) em diferentes temperaturas e tempos de armazenamento. Os bombons (controle e F9) foram comparados através de análise sensorial, sendo apresentados como amostras independentes em um teste de aceitação com escala hedônica híbrida. A substituição dos açúcares por edulcorantes e agentes de corpo foi satisfatória, assim como o uso do substituto de gordura Benefat®. A inulina Raftiline® ST apresentou textura melhor que a inulina Raftiline® HP-Gel, não sendo percebida na boca. A análise do perfil de textura mostrou que o bombom comercial e o de controle apresentaram maior durabilidade que o bombom F9, que apresentou perda de dureza e aumento da mastigabilidade. Na análise sensorial, o bombom F9 obteve altos níveis de intenção de compra, podendo nesta análise ser considerado como um produto de grande potencial de mercado. / Chocolate confectionery is a product consisting of either chocolate mass or a nucleus containing several fillings covered with a chocolate layer. Food for special purposes are those in which modifications are made in what is related to the nutrients content, adapted to the utilization in differentiated diets, in order to fulfill the needs of people showing specific metabolic and physiological disorders. The term light is applied to a product providing it accomplishes the attribute of a 25% minimum reduction in the total energetic value or nutrients content if compared to a similar, standard product. The functional property is relative to the metabolic or physiological role (function) the nutrient or the non-nutrient plays in the human organism o The present work aimed at the development of diet and light fillings for chocolate confectionery using an ingredient (inulin) with a functional property. Two series of chocolate confectionery samples were prepared: a control sample and ten diet and light formulations. One of these formulations, F9, was selected. A commercial chocolate confectionery was used as reference. Analyses were performed to evaluate the water activity, pH, humidity, total lipids, protein, carbohydrate per difference (including fibers), texture profile (double compression, using a texturometer HAS-XT2) in several controlled environments at different temperatures and stored during different periods of time. The chocolate confectionery samples (Control and F9) were compared using sensorial analysis. Independent samples were offered in an acceptance test with hedonic hybrid scale. The substitution of sugars by sweeteners and body agents was satisfactory, as well as the use of a fat substitute, Benefat®. The Inulin Raftiline® ST presented better texture than the Inulin Raftiline® HP-Gel, but no difference was noticed on the mouth feel test. The texture profile showed that both the commercial and the control chocolate confectionery samples presented longer durability than the F9 sample, which presented increased hardness and loss of chewiness. In the sensorial analysis, the chocolate confectionery F9 obtained high levels of purchase intention and thus can be considered as a great product from a market potential point of view.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

This diploma work deals with homosexually oriented persons that want to establish a family or that already have a child and raise it up. It concerns to biological parentage or "only" psychological parentage or a relationship with same-sex partner or an individual care for a child. The work specifies basic terms and contains a short overview of homosexuality in view of history, religion and medicine. The work learns the reader in history and legislation differences of the registered partnership and matrimony. It also marginally deals with possibilities and rights of homosexual persons in the world. The work also includes opinion on family, its functions and types. It describes today's possibilities of homosexuals' ways to a child. The work also focuses on issue of rising up a child by homosexuals. To clarify links, it describes here gay and lesbian relations and families, including development of a child being raised up in a non-traditional family. Aim of the work is to document subjective opinions of the homosexuals themselves to the issue of rising up children by persons with such an orientation, to find out how they evaluate attitude of the society to this topic and how these persons are interested in LGBT situation. For the survey and reconnaissance of the opinions, on-line questionnaire was...

La rupture du Ligament Croisé Antérieur (LCA) est la blessure ligamentaire la plus fréquente avec une incidence de 1/3000. Elle est efficacement traitée aujourd’hui par une reconstruction par autogreffe tendineuse. Cependant, les problèmes causés par le prélèvement du greffon demeurent une limitation importante. Des substituts artificiels offrent une solution alternative mais la rupture et la génération de débris d’usure ont causé l’échec de la majorité des systèmes développés jusqu’à présent. Récemment, des travaux ont montré que des assemblages de fibres synthétiques d’hydrogel d’Alcool PolyVinylique (APV) reproduisent le comportement en traction du LCA humain. L’objectif principal de cette thèse a été d’explorer le potentiel de ces fibres pour la reconstruction ligamentaire en concevant et caractérisant des systèmes implantables pour une étude in vivo chez l’animal. Pour cela, j’ai réalisé une étude expérimentale depuis l’échelle de la fibre jusqu’à celle de l’implant complet. Deux types de fibres d’APV ont été caractérisés, obtenues par filage voie sèche (VS) et voie humide (VH). A l’échelle de la fibre, une étude microscopique et mécanique a mis en évidence un fort effet de l’orientation moléculaire sur le comportement en traction qui permet d’atteindre des modules élastiques très supérieurs à celui de films isotropes ayant un taux de gonflement équivalent. En particulier, les fibres VS présentent à 20°C un comportement en traction proche de celui du LCA. Cette étude montre également une forte dépendance en température du comportement mécanique et l’existence d’un phénomène de recouvrance par lequel des fibres étirées récupèrent leur comportement initial après un repos. Des observations in situ en diffraction des rayons X aux grands angles ont montré que la structure semi-cristalline des fibres résiste au gonflement et à une déformation représentative des sollicitations physiologiques. Un mécanisme microscopique basé sur ces résultats a été proposé qui explique le comportement mécanique des fibres par la dissociation et la reformation de liaisons hydrogène dans la phase amorphe. A l’échelle des assemblages de fibres, une étude systématique sur des structures torsadées et un modèle mécanique de structure double-hélice ont révélé que le gonflement confiné des fibres au sein des structures induit des états de contrainte interne permettant d’augmenter la rigidité des assemblages. A l’échelle de l’implant, des substituts compatibles avec le geste chirurgical ont été conçus grâce à une collaboration avec des partenaires cliniciens et biomécaniciens. Une étude in vivo sur modèle petit animal (lapin) de ligamentoplastie a permis de vérifier la bonne tolérance aux implants avec une encapsulation fibreuse modérée et a montré que le gonflement in vivo d’implants secs n’entraîne pas une réaction biologique délétère. L’ensemble de ces résultats a conduit à la conception d’implants complets à l’échelle du LCA humain qui ont été évalué dans un modèle grand animal (brebis) de ligamentoplastie. L’étude nécropsique et histologique sur les animaux implantés a montré une biocompatibilité comparable à celle observée sur les animaux reconstruits par autogreffe. En revanche, l’étude biomécanique révèle un taux de rupture intra-articulaire important (92%) des implants en fibres d’APV. Ces résultats permettent d’identifier des causes possibles d’endommagement et de proposer des pistes d’amélioration. Plus généralement, la bonne biocompatibilité des fibres d’hydrogel d’APV et leurs propriétés mécaniques en font des systèmes intéressants pour la reconstruction de tissus souples nécessitant une tenue en traction élevée. / The anterior cruciate ligament (ACL) rupture is the most frequent ligament injury with an occurrence of 1/3000. It is effectively treated nowadays by a reconstruction with tendinous autograft. However, the problems caused by the transplant harvest remain an important limitation. Artificial substitutes offer an alternative but the rupture rate and the generation of wear debris caused the failure of the majority of the systems developed until now. Recently, studies showed that assemblies of Poly(Vinyl Alcohol) hydrogel fibers mimic the human ACL behavior. The main objective of this thesis was to explore the potential of theses fibers for the ligament reconstruction by designing and characterizing implantable systems for an in vivo animal study. For that purpose, I conducted an experimental study from the fiber scale to the complete implant scale. Two types of PVA fibers were characterized, one obtained from dry spinning (DS) and the other from wet spinning (WS). At the fiber scale, a microscopic and mechanical study highlighted a strong effect of the molecular orientation on the tensile behavior, which allows to reach a much higher elastic modulus than that of an isotropic film with the same swelling ratio. In particular, DS fibers at 20°C exhibit a tensile behavior close to that of the ACL. This study also shows a strong temperature dependence of the mechanical behavior and the existence of recovery phenomenon by which the stretched fibers recover their initial behavior after a rest. In situ wide angle X-rays scattering showed that the fibers semi-crystalline structure resists to swelling and physiological range stretching. A microscopic mechanism based on these results was proposed to explain the fibers mechanical behavior by the dissociation and reformation of hydrogen bonds in the amorphous phase. At the fiber assemblies scale, a systematic study on twister structures and a l double-helix structure mechanical model revealed that the fibers confined swelling inside a structure induce internal stress leading to an increase of the assemblies stiffness. At the implant scale, substitutes compatible with the surgery were conceived in collaboration with clinicians and biomechanists. An in vivo study on a small animal ligamentoplasty model (rabbit) allowed to verify the implants tolerance with a moderate fibrous encapsulation and showed that the implants in vivo swelling does not induce noxious biological reaction. These results led to the conception of human scale implants which were evaluated in a large animal ligamentoplasty model (sheep). The necropsy and histological study on implanted animals showed a biocompatibility similar to that observed with animals reconstructed with an autograft. However, the biomechanical study revealed an important intra-articular rupture rate (92%) for PVA fibers implants. These results allow to identify possible damage causes and to offer ways of improvement. In general, the good biocompatibility of PVA hydrogel fibers and their mechanical properties make them interesting systems for the reconstruction of soft tissues with high tensile strength.

This dissertation is concerned with the issues surrounding substitute family care in the Czech Republic and presents an analysis of its legal regulation as set out in both private law and public law regulations. The term substitute family care encompasses several independent legal institutions, which together form a system serving to protect children at risk who cannot grow up in their own family. The system of substitute care is divided into family-type individual care on the one hand and collective care provided in institutional facilities on the other. This dissertation examines the historical development of forms of substitute care, analyses their current legal regulation, including procedural regulation, and evaluates the interconnectedness and mutual harmoniousness of individual legal regulations. It analyses the inner workings of the substitute care system and delineates the rights and obligations of entities which enter into it in various capacities, with an emphasis on how the fulfilment of the rights of a minor is enforced and how their best interest is considered. Given the subject matter, the topic of the dissertation is approached in an interdisciplinary fashion, for the interdisciplinary cooperation of individual persons acting on behalf of the state in the legal relations of...

Neste trabalho são apresentados dois modelos para o ensaio de destilação ASTM D-86, desenvolvidos no simulador EMSO e validados por dados experimentais de frações de petróleo disponíveis na literatura. Estes modelos apresentam índice algébrico-diferencial igual a um, diferentemente do primeiro modelo proposto na literatura que apresentava índice algébrico-diferencial igual a 2, o qual não possibilitava ser resolvido pelos simuladores atuais. As predições obtidas com os modelos propostos geraram resultados com desvio médio em torno de 0,6 % em relação aos dados experimentais da literatura. Em seguida, foi estudado o método proposto para determinação de mistura substituta de componentes reais e foram propostas algumas alterações. Esta metodologia pode ser dividida em duas etapas consecutivas. A primeira etapa determina um conjunto de componentes reais e a segunda calcula a composição da mistura substituta de componentes reais de modo a caracterizar misturas complexas de composição desconhecida, como frações de petróleo, substituindo o conceito de pseudo-componentes. Para isso, o algoritmo se baseia em dados experimentais tais como a curva PEV, o °API, a massa molar média da mistura e outras propriedades globais disponíveis. Foram obtidos resultados que se mostraram satisfatórios. Para finalizar este trabalho, foi proposto um novo método para determinação da mistura substituta que utiliza a primeira etapa do algoritmo de determinação de mistura substituta e modificado por este trabalho. Em seguida, é realizada uma estimação dinâmica de parâmetros de condição inicial utilizando um dos modelos desenvolvidos neste trabalho para o ensaio de destilação ASTM D-86. A estimação é baseada principalmente na curva experimental da destilação ASTM D-86 e na densidade à 60°F (ou °API). Os resultados desta nova metodologia foram comparados com outros métodos de determinação de mistura substituta e constatou-se uma melhora na aproximação das suas propriedades quando comparadas com a mistura original de composição desconhecida. / This work presents two models for the assay of distillation ASTM D-86, developed in the EMSO Simulator and validated using experimental data of petroleum fractions available in the literature. These models showed differential-algebraic index equal to one, differently from the first model proposed in the literature that showed differential-algebraic index equal to two. Problems with an index higher than one are usually impossible to solve by modern simulators. The predictions obtained with the proposed models generated results with average deviation of about 0,6% in relation to those in the literature. After this, a method proposed in the literature to determinate the substitute mixture of real compounds for petroleum fractions was studied and slightly modified. This methodology can be divided in the two following steps. The first one determines a group of real components and the second one calculates the composition of the substitute mixture of the real components in order to characterize a complex mixture of unknown composition, as petroleum fractions. This methodology aims at replace the pseudo-components concept. To make this, the algorithm is based in experimental data as the TBP curve, the °API, the average molar mass of the mixture and others global properties available. The obtained results showed to be suitable. Finally, this work proposes a new method to determine the substitute mixture that uses the first step of the algorithm of determination of substitute mixture and modified in this work. Next, it was used a dynamic estimation of parameters in initial conditions using one of the models proposed in this work for the distillation assay ASTM D-86. The estimation is mainly based on distillation experimental curve ASTM D-86 and the density at 60°F (or °API). The results of this new methodology were com pared to other methods of determination of substitute mixture and it was found an evolution in the similarity of its properties when compared to the original mixture with unknown composition.

FOSTER CARE FOR A TEMPORARY PERIOD This thesis describes and critically judges the legal regulation, practice and purpose of foster care for a temporary period in the Czech Republic. Children temporarily or permanently deprived of their family environment or children, who cannot be left in such environment, are entitled to a special protection and assistance granted by the state in one of alternative care forms. The Czech Republic is criticized for a long time by the international organizations because of numbers of children placed in any type of institutional care. Consequently, the amendment of the Act N. 359/1999 Coll., on social and legal protection of children, has been approved in June 2006. This amendment has established a new legal institute called "the foster care for a temporary period". The function of this institute is to avoid a placement of children to an institutional care in the case, when the children can not stay in the original family because of whatever reason however there is a presumption of re-entry to that original family. Parents still have their parental responsibilities and still have right to keep in touch with their child. The thesis is composed of six chapters, which are subdivided into subchapters. Chapter One deals with the historical development of foster care. Chapter Two...

<p>The current study aimed to describe the extent and reasons for substituting and switching HAART at the Katutura Intermediate Hospital in Windhoek, Namibia</p>