O iodeto de mercúrio em sua fase vermelha, \"alfa\"-\"HgI IND.2, é um material semicondutor que desperta grande interesse tecnológico devido à sua potencial aplicação como detector, a temperatura ambiente, de raios-\"gama\" e X. Sua imediata aplicação como detector de radiação, no entanto, ainda sofre algumas restrições devido às dificuldades de controle sobre a concentração de defeitos pontuais e extensos, durante sua síntese, e sua fácil degradação quando exposto ao ambiente. A presença destes defeitos gera uma redução na mobilidade de portadores de carga, diminuindo a eficiência de detecção. Neste trabalho, realizamos uma investigação teórica das propriedades estruturais, eletrônicas e ópticas do \"alfa\"-\"HgI IND.2\" e do \"ZnI IND.\", cuja estrutura cristalina é análoga à do \"alfa\"-\"HgI IND.2\". Estudamos, também, o comportamento de tais propriedades do material contendo vacâncias de Hg e de I para entendermos o papel desempenhado por estes defeitos nas propriedades do material. Na análise dos resultados, sempre que possível, são apresentadas comparações com outros resultados teóricos e com dados experimentais. Nossos cálculos foram efetuados dentro do formalismo do funcional da densidade em combinação com duas diferentes aproximações para o termo de exchange e correlação. Utilizamos o método Augmented Plane Wave plus local orbitals (APW+lo), que é um método de primeiros princípios e inclui todos os elétrons do sistema (all electron). Adicionalmente, foram utilizados esquemas que incluem efeitos relativísticos e polarização de spin. O estudo dos defeitos foi simulado através do esquema da supercélula / Mercuric iodide \"alfa\"-\"HgI IND.2 in its red tetragonal crystalline phase is a semiconducting material of great technological interest due to the potential applications as a detector for y- and X-ray spectroscopy to be operated at room temperatures.

Diversos tipos de defeitos superficiais estão presentes em barras laminadas (e produtos longos) e a presença destes defeitos pode ser muito prejudicial ao desempenho de peças, principalmente, quando se trata de aços para aplicação na cadeia automotiva, onde os níveis de exigência durante o forjamento da peça e durante a sua aplicação são extremamente elevados. Neste trabalho buscou-se determinar as condições operacionais mais apropriadas para a melhoria da qualidade superficial do produto laminado bruto com conseqüente redução de refugo e retrabalho ao longo de toda a cadeia de produção. O objetivo do trabalho é mostrar os defeitos de superficiais de dobra e escama como conseqüência de condições operacionais inapropriadas. Para isto aplicou-se uma metodologia que envolve a análise dos principais pontos de geração de defeitos, possibilitando um levantamento das causas. Com as ações propostas, buscou-se tornar o processo mais estável. Obtiveram-se melhorias significativas na qualidade superficial do material com acentuada redução no refugo por qualidade de aço produzido. / Several types of defects are present in rolled bars and their effects can be very harmful to the performance of mechanical parts, especially in the case of steels for application in the automotive industry, where quality requirements during forging and during its application are high. In this study we sought to determine the most appropriate operating conditions for the reduction of scrap caused by defects that originate in the rolling process, the analyzed defects were the so called overlap of rolling, scales and risks. For this a methodology that involved the analysis of the main points of generation of defects, allowing a survey of the causes was applied. With the proposed actions it was aimed at making the process more stable. This led to a significant improvement in surface quality of the material with marked reduction in scrap for each kind of steel.

Congenital increase in cardiac outflow tract resistance would lead to chronic ventricular pressure overloading, and eventually ventricular hypertrophy and dysfunction. Conventional echocardiographic assessment of global ventricular systolic and diastolic function is far from ideal because of the lack of sensitivity. There is a pressing need in developing a clinical tool to unveil the degree of myocardial dysfunction as well as to monitor the treatment effect in these patients. M-mode and tissue Doppler recordings of the left and right atrioventricular rings' motion in a longitudinal cardiac axis allowed us to assess segmental ventricular function in a more sensitive and specific way. This thesis aimed to assess ventricular long axis function in patients with congenital outflow tract obstructions. It is based on the anatomical observation that a major part of long axis function is subtended by subendocardial fibers, and the hypothesis that the function of these fibers might be more sensitive to effect of pressure overload than circumferential ones. / Normal values for left and right ventricular (RV) long axis function (in left, septal and tricuspid sites of atrioventricular rings) were first established by studying normal healthy volunteers without cardiovascular diseases with M-mode and pulse wave (PW) tissue Doppler Imaging (TDI). These values included: / 1) M-mode derived systolic amplitude of motion (displacement) / 2) Any long axis incoordination (long axis shortening after end of ejection which was reported as a sign of coronary ischemia after excluding interventricular conduction abnormalities) / 3) TDI-derived peak systolic and diastolic velocities. / The following groups of patients with congenital outflow tract obstructions were therefore studied: / 1) Congenital aortic valve stenosis and subaortic stenosis (21 patients, study 1). / 2) Congenital coarctation of aorta (23 patients, study 2). / 3) Congenital pulmonary valve stenosis (43 patients, study 3). / Study 1 investigated the presence of "isolated" diastolic disease, defined as reduced long axis early diastolic velocity with normal systolic velocity in 21 young patients with congenital aortic valve stenosis (AVS). Most patients with normal left ventricular (LV) ejection fractions in fact had depressed long axis systolic velocities. This work demonstrated the selective sensitivity of long axis function in unveiling myocardial dysfunction in AVS patients. Moreover, good correlation was found between long axis systolic and diastolic velocities which suggested isolated diastolic disease is unlikely. / Patients with coarctation of aorta (CoA) are often less symptomatic (fewer reported chest pain or heart failure) that AVS patients despite having similar degree of outflow resistance. Study 2 addressed such phenomenon by studying the long axis function in 23 CoA patients and the results were compared to 23 AVS patients and normal controls. This work again confirmed the presence of LV long axis impairment in patients with chronic increase in LV afterload. Moreover, a worse deterioration of LV long axis function and a higher prevalence of long axis incoordination independent of LV outflow resistance is seen in patients with proximally increased LV afterload (AVS) compared with distal disease (CoA) that might account for their difference in clinical behavior. / Data are scant to address the impact of chronic increase in RV outflow resistance on RV diastolic performance. Study 3 evaluated the relationship of restrictive RV physiology (defined as the presence of antegrade pulmonary arterial flow in late diastole measured by conventional PW Doppler echocardiography) to RV long axis function and patients' symptoms in 43 patients with pulmonary valve stenosis (PVS). Restrictive RV physiology was found in 42% studied patients who were more symptomatic and had more severe RV long axis dysfunction. This work implied regular follow-up of adult PVS patients using simple qualitative RV Doppler echocardiographic measurements should guide toward early identification of myocardial dysfunction and the need for removal of outflow tract obstruction before irreversible damage occurs. / Given the selective sensitivity of long axis function in assessing myocardial damage In patients with pressure overloaded ventricle, I further studied the effect of interventions on change of long axis behavior in patients with CoA: / 1) Before and 14 month after successful endovascular stenting (21 patients, study 4). / 2) Long term follow up after surgical correction, by either angioplasty or endovascular stenting (80 patients, study 5). / Study 4 prospectively evaluated the effect of endovascular stenting on intermediate-term biventricular function in 21 adults with CoA and the results were compared with surgically repaired patients and normal controls. LV long axis disturbances were improved with sparing of RV long axis function after intervention. Subclinical myocardial dysfunction was observed in both stented and repaired patients compared with normal controls. This work supported aortic stenting in patients with anatomically suitable lesions. It also prompted further studies on the clinical significance of persistent myocardial dysfunction in "corrected" CoA patients. / In study 5, I went on to examine the prevalence of LV long axis diastole dysfunction (defined as septal PW TDI early diastolic velocity 8cm/s) in a relatively large cohort of CoA patients (n=80) and its relationships to patient demo graphics and aortic elastic properties. Forty-seven patients (59%) were found to have LV long axis dysfunction. As a group, they were older when received treatment and had higher ascending aortic stiffness indices despite similar systemic blood pressure, prevalence of anti-hypertensive use and associated bicuspid aortic valve as compared to other CoA patients. This work addressed the age at intervention and increased aortic stiffness are important determinants of persistent myocardial dysfunction after intervention. Intervention at an early age before structural damage to proximal aorta and appropriate medications to reduce central aortic stiffness might preserve LV long axis function in "corrected" CoA patients and further improve their long term prognosis. / CONCLUSIONS: / In conclusion, conventional global echocardiographic assessment is inadequate for assessing patients with congenital outflow tract obstructions. Segmental ventricular long axis function is frequently abnormal at rest in these patients. The site of these disturbances corresponds to the ventricle that is subjected to pressure overloading. Assessment of long axis function is simple and sensitive. It has considerable potential in investigating the natural course of myocardial damage, to clarify the basis of abnormal ventricular function, particularly during diastole and to evaluate treatment effect on myocardial recovery in patients with congenital outflow tract obstructions. Further studies should focus on the role of long axis function in determining prognosis for these patients. / Lam, Yat Yin. / "November 2011." / Thesis (M.D.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 134-160). / ABSTRACT --- p.1 / Chapter PART1 --- HISTORIC REVIEW --- p.5 / Chapter Chapter1 --- VENTRICULAR OUTFLOW TRACT OBSTRUCTION SYNDROME --- p. 6 / Chapter 1.1 --- BACKGROUND --- p.7 / Chapter 1.2 --- AORTIC VALVULAR STENOSIS --- p.8 / Chapter 1.2.1 --- Anatomy pathophysiology and clinical features --- p.8 / Chapter 1.2.2 --- Investigations --- p.9 / Chapter 1.2.3 --- Treatment --- p.9 / Chapter 1.3 --- COARCTATION OF AORTA --- p.9 / Chapter 1.3.1 --- Anatomy pathophysiology and clinical features --- p.9 / Chapter 1.3.2 --- Investigations --- p.11 / Chapter 1.3.3 --- Treatment --- p.11 / Chapter 1.4 --- PULMONARY VALVULAR STENOSIS --- p.12 / Chapter 1.4.1 --- Anatomy pathophysiology and clinical features --- p.12 / Chapter 1.4.2 --- Investigations --- p.13 / Chapter 1.4.3 --- Treatment --- p.13 / Chapter Chapter2 --- VENTRICULAR RESPONSE TO HIGH AFTERLOAD --- p.14 / Chapter 2.1 --- VENTRICULAR ADAPTATION IN AORTIC VALVULAR STENOSIS --- p.15 / Chapter 2.2 --- VASCULAR STIFFENING AORTIC COARCTATION --- p.17 / Chapter 2.3 --- VENTRICULAR ADAPTATION IN PULMONARY VALVULAR STENOSIS --- p.18 / Chapter 2.4 --- LIMITATIONS OF CONVENTIONAL ECHOCARDIOGRAPHY --- p.19 / Chapter Chapter3 --- MYOCARDIAL FIBER ARCHITECTURE AND LONG AXIS FUNCTION --- p.21 / Chapter 3.1 --- MYOCARDIAL FIBER STRUCTURE AND LONG AXIS FUNCTION --- p.22 / Chapter 3.2 --- NOMRAL LONG AXIS EXCURSION AND TIMING --- p.25 / Chapter 3.3 --- QUANTIFICATION OF LONG AXIS MOTIONS --- p.26 / Chapter 3.3.1 --- M-mode --- p.26 / Chapter 3.3.2 --- Clinical applications of atrio-ventricular plane displacement --- p.27 / Chapter 3.3.3 --- Tissue Doppler Imaging --- p.28 / Chapter 3.3.4 --- Clinical application of tissue Doppler imaging --- p.30 / Chapter 3.3.5 --- Limitations of M-mode and TDI in the assessment of long axis function --- p.31 / Chapter Chapter4 --- HYPOTHESIS AND SPECIFIC OBJECTIVES OF THE THESIS --- p.32 / Chapter 4.1 --- INTRODUCTION --- p.33 / Chapter 4.2 --- HYPOTHESIS --- p.34 / Chapter Chapter5 --- METHODOLOGY --- p.35 / Chapter 5.1 --- STUDY PATIENTS --- p.36 / Chapter 5.1.1 --- Patients with ventricular outflow tract obstruction --- p.36 / Chapter 5.1.2 --- Normal controls --- p.36 / Chapter 5.2 --- CLINICAL ASSESSMENT --- p.37 / Chapter 5.3 --- ECHO CARDIOGRAPHIC ASSESSMENT --- p.37 / Chapter 5.3.1 --- Imaging acquisition protocol --- p.37 / Chapter 5.3.2 --- Assessment of severity of outflow tract obstruction --- p.38 / Chapter 5.3.3 --- Assessment of global ventricular structure and function --- p.40 / Chapter 5.3.4 --- Assessment of long axis function --- p.42 / Chapter 5.3.5 --- Evaluation of restrictive RV physiology in PVS patients --- p.42 / Chapter 5.3.6 --- Determination of aortic elastic properties in CoA patients --- p.43 / Chapter 5.3.7 --- Reproducibility --- p.45 / Chapter 5.4 --- CARDIAC CATHETERIZATON AND ENDOVASCULAR STENTING FOR COARCTATION OF AORTA --- p.45 / Chapter 5.5 --- STATISTICS --- p.46 / Chapter PART 2 --- CLINICAL STUDIES --- p.48 / Chapter Chapter6 --- "ISOLATED" DIASTOLIC DYSFUNCTION IN LEFT VENTRICULAR OUTFLOW TRACT OBSTRUCTION --- p.49 / Chapter 6.1 --- INTRODUCTION --- p.50 / Chapter 6.2 --- METHODS --- p.50 / Chapter 6.2.1 --- Study population --- p.50 / Chapter 6.2.2 --- Echocardiographic examination --- p.51 / Chapter 6.2.3 --- Reproducibility --- p.51 / Chapter 6.2.4 --- Statistics --- p.51 / Chapter 6.3 --- RESULTS --- p.52 / Chapter 6.3.1 --- Baseline characteristics --- p.52 / Chapter 6.3.2 --- Echocardiographic measurements --- p.52 / Chapter 6.3.3 --- Correlation analysis between long axis variables --- p.55 / Chapter 6.3.4 --- Reproduci bility --- p.58 / Chapter 6.4 --- DISCUSSION --- p.58 / Chapter 6.4.1 --- Selective sensitivity oflong axis function --- p.58 / Chapter 6.4.2 --- Close coupling of long axis systolic and diastolic function --- p.59 / Chapter 6.4.3 --- Limitations --- p.60 / Chapter 6.5 --- CONCLUSIONS --- p.61 / Chapter Chapter7 --- EFFECT OF CHRONIC AFTERLOAD INCREASE ON LEFT VENTRICULAR MYOCARDIAL FUNCTION IN PATIENTS WITH CONGENITAL LEFT-SIDED OBSTRUCTIVE LESIONS --- p.62 / Chapter 7.1 --- INTRODUCTION --- p.63 / Chapter 7.2 --- METHODS --- p.63 / Chapter 7.2.1 --- Study population --- p.63 / Chapter 7.2.2 --- Echocardiographic examination --- p.64 / Chapter 7.2.3 --- Reproducibility --- p.65 / Chapter 7.2.4 --- Statistics --- p.65 / Chapter 7.3 --- RESULTS --- p.66 / Chapter 7.3.1 --- Baseline characteristics --- p.66 / Chapter 7.3.2 --- Patients versus controls --- p.66 / Chapter 7.3.3 --- Aortic valvular stenosis versus coarctation patients --- p.70 / Chapter 7.3.4 --- Reproducibility --- p.70 / Chapter 7.4 --- DISCUSSION --- p.72 / Chapter 7.4.1 --- Long axis function in patients with increased LV afterload --- p.72 / Chapter 7.4.2 --- Difference between aortic valvular stenosis and coarctation patients --- p.72 / Chapter 7.4.3 --- Limitations --- p.74 / Chapter 7.5 --- CONCLUSIONS --- p.74 / Chapter Chapter8 --- RESTRICTIVE RIGHT VENTRICULAR PHYSIOLOGY: ITS PRESENCE AND SYMPTOMATIC CONTRIBUTION IN PATIENTS WITH PULMONARY STENOSIS --- p.75 / Chapter 8.1 --- INTRODUCTION --- p.76 / Chapter 8.2 --- METHODS --- p.77 / Chapter 8.2.1 --- Study population --- p.77 / Chapter 8.2.2 --- Echocardiographic examination --- p.77 / Chapter 8.2.3 --- Reproducibility --- p.78 / Chapter 8.2.4 --- Statistics --- p.78 / Chapter 8.3 --- RESULTS --- p.79 / Chapter 8.3.1 --- Baseline characteristics --- p.79 / Chapter 8.3.2 --- Patients versus controls --- p.81 / Chapter 8.3.3 --- Comparison between patient groups --- p.81 / Chapter 8.3.4 --- Predictors for symptoms --- p.84 / Chapter 8.3.5 --- Reproducibility --- p.85 / Chapter 8.4 --- DISCUSSION --- p.85 / Chapter 8.4.1 --- Main findings --- p.85 / Chapter 8.4.2 --- Characterization of diastolic performance in pulmonary valvuar stenosis patients --- p.85 / Chapter 8.4.3 --- Mechanism for restrictive RV physiology in PVS patients --- p.87 / Chapter 8.4.4 --- Study inlplications --- p.89 / Chapter 8.4.5 --- Limitations --- p.90 / Chapter 8.5 --- CONCLUSIONS --- p.90 / Chapter Chapter9 --- EFFECT OF ENDOVASCULAR STENTING OF AORTIC COARCTATION ON BIVENTRlCULAR FUNCTION IN ADULTS --- p.91 / Chapter 9.1 --- INTRODUCTION --- p.92 / Chapter 9.2 --- METHODS --- p.92 / Chapter 9.2.1 --- Study population --- p.92 / Chapter 9.2.2 --- Implantation procedure --- p.93 / Chapter 9.2.3 --- Echocardiographic examination --- p.94 / Chapter 9.2.4 --- Reproducibility --- p.94 / Chapter 9.2.5 --- Statistics --- p.95 / Chapter 9.3 --- RESULTS --- p.95 / Chapter 9.3.1 --- Baseline characteristics --- p.95 / Chapter 9.3.2 --- Blood pressure data --- p.96 / Chapter 9.3.3 --- Echocardiographic measurements --- p.97 / Chapter 9.3.3.1 --- Pre-stenting versus post-stenting (group 1) --- p.97 / Chapter 9.3.3.2 --- Stenting (group 1) versus post-surgical repair (group 2) --- p.101 / Chapter 9.3.3.3 --- Coarctation patients (group 1 post-stenting and group 2) versus control (group 3) --- p.101 / Chapter 9.3.4 --- Reproducibility --- p.101 / Chapter 9.4 --- DISCUSSION --- p.103 / Chapter 9.4.1 --- Main findings --- p.103 / Chapter 9.4.2 --- Potential impact of stenting on cardiovascular outcome --- p.103 / Chapter 9.4.2.1 --- BP control --- p.103 / Chapter 9.4.2.2 --- LV mass and long axis function --- p.104 / Chapter 9.4.3 --- RV function after stenting --- p.105 / Chapter 9.4.4 --- Subclinical LV myocardial function in coarctation patients --- p.105 / Chapter 9.4.5 --- Limitations --- p.106 / Chapter 9.5 --- CONCLUSIONS --- p.107 / Chapter Chapter10 --- LEFT VENTRICULAR LONG AXIS DYSFUNCTION IN ADULTS WITH "CORRECTED" AORTIC COARCTATION IS RELATED TO AN OLDER AGE AT INTERVENTION AND INCREASED AORTIC STIFFNESS --- p.108 / Chapter 10.1 --- INTRODUCTION --- p.109 / Chapter 10.2 --- METHODS --- p.110 / Chapter 10.2.1 --- Study population --- p.110 / Chapter 10.2.2 --- Echocardiographic examination --- p.111 / Chapter 10.2.3 --- Reproducibility --- p.111 / Chapter 10.2.4 --- Statistics --- p.112 / Chapter 10.3 --- RESULTS --- p.112 / Chapter 10.3.1 --- Patients versus controls --- p.112 / Chapter 10.3.2 --- Patients with long axis dysfunction (LAD) versus without LAD --- p.113 / Chapter 10.3.3 --- Predictors of LAD --- p.117 / Chapter 10.3.4 --- Reproducibility --- p.120 / Chapter 10.4 --- DISCUSSION --- p.120 / Chapter 10.4.1 --- Main findings --- p.120 / Chapter 10.4.2 --- LV dysfunction and adverse remodeling in "corrected" aortic coarctation --- p.120 / Chapter 10.4.3 --- Mechanism behind LV dysfunction in "corrected" aortic coarctation --- p.121 / Chapter 10.4.4 --- Study implications --- p.124 / Chapter 10.4.5 --- Limitations --- p.124 / Chapter 10.5 --- CONCLUSIONS --- p.125 / Chapter Chapter 11 --- DISCUSSION --- p.126 / Chapter 11.1 --- DISCUSSION --- p.127 / Chapter 11.2 --- LIMITATIONS --- p.129 / Chapter 11.3 --- THE FUTURE --- p.129 / Chapter Chapter12 --- CONCLUSIONS --- p.131 / APPENDIX --- p.133 / BIBLIOGRAPHY --- p.134

by Chan Kwok Wai. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1997. / Includes bibliographical references (leaves 93-95). / ACKNOWLEDGEMENT --- p.i / ABSTRACT --- p.ii / LIST OF SYMBOLS --- p.iii / LIST OF FIGURES --- p.v / LIST OF TABLES --- p.vi / Chapter CHAPTER ONE --- INTRODUCTION --- p.1 / Chapter CHAPTER TWO --- SURVEYS ON ION IMPLANTATION DAMAGE STUDY --- p.6 / Chapter 2.1 --- Introduction --- p.6 / Chapter 2.1.1 --- Basic Theory --- p.7 / Chapter 2.1.2 --- Amorphization --- p.9 / Chapter 2.1.3 --- Amorphous Layer Regrowth --- p.10 / Chapter 2.1.4 --- Point Defect Sources --- p.11 / Chapter 2.1.5 --- Types of Extended Defects --- p.11 / Chapter 2.2 --- Nature of Point Defects --- p.15 / Chapter 2.2.1 --- Important Parameters --- p.15 / Chapter 2.2.2 --- Vacancy Centers in Semiconductor --- p.16 / Chapter 2.2.3 --- Self-interstitial in Silicon --- p.17 / Chapter 2.2.4 --- Distribution of Excess Point Defects --- p.18 / Chapter 2.2.5 --- Energy Level of Defect Species --- p.19 / Chapter CHAPTER THREE --- EXPERIMENTAL METHOD --- p.21 / Chapter 3.1 --- Experimental --- p.21 / Chapter 3.2 --- Spreading Resistance Profiling --- p.25 / Chapter CHAPTER FOUR --- MODELING OF SPREADING RESISTANCE PROFILES OF ION-IMPLANTED DAMAGE IN SILICON --- p.29 / Chapter 4.1 --- Introduction --- p.29 / Chapter 4.2 --- Basic equation --- p.30 / Chapter 4.3 --- Formation of Model --- p.34 / Chapter CHAPTER FIVE --- RESULTS AND DISCUSSION --- p.37 / Chapter 5.1 --- Results --- p.37 / Chapter 5.2 --- Discussion --- p.55 / Chapter CHAPTER SIX --- CONCLUSION AND SUGGESTIONS OF FURTHER WORK --- p.58 / Chapter 6.1 --- Conclusion --- p.58 / Chapter 6.2 --- Suggestions of further work --- p.59 / APPENDIX A --- p.60 / APPENDIX B / SPREADING RESISTIVITY PROFILES --- p.62 / REFERENCE --- p.93

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Estudos que abordem a acurÃcia das caracterÃsticas definidoras (CD) podem contribuir para o aprimoramento do raciocÃnio clÃnico, conduzindo, por conseguinte, a formulaÃÃo de diagnÃsticos de enfermagem mais condizentes com a situaÃÃo clÃnica do paciente. Diante do exposto, o estudo teve como objetivo determinar as medidas de acurÃcia das CD do diagnÃstico de enfermagem PadrÃo respiratÃrio ineficaz (PRI) em crianÃas e adolescentes com cardiopatias congÃnitas (CC). A amostra incluiu 61 crianÃas e adolescentes com idade de 5 a 17 anos, diagnosticados com CC. Estes indivÃduos foram examinados pela pesquisadora, que realizou um exame fÃsico, enfocando a avaliaÃÃo respiratÃria. Em seguida, o mÃdico que atendia o paciente foi consultado para autorizar a realizaÃÃo dos testes de funÃÃo pulmonar (espirometria e manovacuometria). As informaÃÃes obtidas a partir do exame fÃsico e realizaÃÃo dos testes foram analisadas pela pesquisadora para determinar a presenÃa ou ausÃncia das CD de PRI, com base em um protocolo previamente estabelecido. Ressalta-se que 30 crianÃas e adolescentes nÃo receberam anuÃncia mÃdica para realizar os testes de funÃÃo pulmonar. Apesar disto, estes sujeitos foram incluÃdos na amostra para determinaÃÃo do diagnÃstico apenas com base nas CD provenientes da entrevista e do exame fÃsico. Com isto, duas subamostras foram formadas, sendo a primeira composta por 30 crianÃas e adolescentes que nÃo realizaram os referidos testes, e a segunda por 31 indivÃduos que realizaram tais exames. O conjunto de CD para cada crianÃa e adolescente foi organizado em 92 planilhas. Nestas, foi assinalada a presenÃa ou ausÃncia da CD. Cada avaliaÃÃo dos indivÃduos da segunda subamostra deu origem a duas planilhas, uma apenas com as CD provenientes da entrevista e exame clÃnico, e outra com estes mesmos dados acrescidos Ãs informaÃÃes dos testes de funÃÃo pulmonar. Tais planilhas foram submetidas a dois enfermeiros diagnosticadores que determinaram a ocorrÃncia de PRI. A anÃlise das inferÃncias e as informaÃÃes sobre a ocorrÃncia das CD possibilitaram a estimativa das medidas de acurÃcia. Para a primeira subamostra, a caracterÃstica que evidenciou melhores medidas de acurÃcia foi taquipneia. As inferÃncias realizadas para a segunda subamostra, com base nos dados clÃnicos e de entrevista, apresentaram como principais CD: ortopneia e uso da musculatura acessÃria para respirar. Quando os resultados dos testes de funÃÃo pulmonar foram acrescidos, as inferÃncias dos diagnosticadores nÃo evidenciaram medidas de acurÃcia com significÃncia estatÃstica para nenhuma das CD. Com isto, os resultados do presente estudo levantam questionamentos acerca da importÃncia dos testes de funÃÃo pulmonar para a inferÃncia do diagnÃstico PRI. Ademais, algumas caracterÃsticas nÃo mostraram legitimidade para PRI, a saber: assumir uma posiÃÃo de trÃs pontos, bradipneia, diÃmetro Ãntero-posterior aumentado, capacidade vital diminuÃda, pressÃo expiratÃria diminuÃda e ventilaÃÃo-minuto diminuÃda. Assim, acredita-se que novas pesquisas sÃo necessÃrias tanto para confirmar estes achados, como para esclarecer a relaÃÃo de tais CD com o diagnÃstico em questÃo. As medidas de acurÃcia obtidas ajudaram a identificar quais CD sÃo mais representativas de PRI. AlÃm disto, os resultados possibilitaram reconhecer quais caracterÃsticas sÃo menos utilizadas durante a inferÃncia deste diagnÃstico em crianÃas e adolescentes com cardiopatias congÃnitas. / Studies which address the accuracy of the defining characteristics (DC) may contribute to the improvement of diagnostic reasoning, leading to the formulation of nursing diagnoses which are more consistent with the clinical situation of the patient. Thus, the study aimed to estimate the measures of accuracy of the DC of the nursing diagnosis Ineffective breathing pattern (IBP) in children and adolescents with congenital heart disease (CHD). The sample included 61 children and adolescents aged 5-17 years, diagnosed with CHD. These patients were examined by the researcher, who conducted a physical examination, focusing on the respiratory evaluation. Then the doctor who attended the patient was consulted to authorize the performance of pulmonary function tests (spirometry and manovacuometry). The information obtained from physical examination and from the tests were analyzed by the researcher to determine the presence or absence of DC of IBP, based on a previously established protocol. It is highlighted that 30 children and adolescents have not received medical approval to perform the pulmonary function tests. Despite this, these patients were sampled to determine the diagnosis just based on the DC from the interview and physical examination. Thus, two subsamples were formed, the first with 30 children and adolescents who did not perform such tests, and the second with 31 individuals who carried out such tests. The set of DC for each child and teenager was organized into 92 spreadsheets. In these, it was indicated the presence or absence of the DC. Each evaluation of the patients in the second subsample resulted in two spreadsheets, one only with the DC from the interview and clinical examination, and another with these same data added information from the pulmonary function tests. These spreadsheets were submitted to two nurses diagnosticians which determined the occurrence of IBP. The analysis of the inferences and the information on the occurrence of DC allowed the estimation of measures of accuracy. For the first subsample, the DC that showed better measures of accuracy was tachypnea. The inferences made for the second subsample, based on clinical data and interviews, presented as main DC: orthopnea and use of accessory muscles to breathe. When the results of pulmonary function tests were added, the inferences of the diagnosticians showed accuracy measures without statistical significance for all DC. With this, the results of this study raise questions about the importance of pulmonary function tests for the inference of the nursing diagnosis IBP. Furthermore, some DC showed no legitimacy for IBP, as follows: assumption of three point position, bradypnea, increased anterior-posterior diameter, decreased vital capacity, decreased expiratory pressure, and decreased minute ventilation. Thus, it is believed that further research is needed to confirm these findings, as well as to clarify the relationship of such DC with the diagnosis IBP. The measures of accuracy obtained helped identify which DC is more representative of IBP. Moreover, the results allowed to recognize which features are less used during the inference of this diagnosis in children and adolescents with congenital heart disease.

Os defeitos superficiais são os maiores problemas de qualidade em barras laminadas a quente, representando inúmeros transtornos durante o processo produtivo, pois dependendo de suas características geram elevada rejeição durante o processo de inspeção. Elevada rejeição significa retrabalho e possível sucateamento. Dentre as diversas causas para a ocorrência de defeitos superficiais, estão os defeitos nos tarugos, a temperatura de laminação, conseqüência da temperatura de reaquecimento e ritmo de laminação e a remoção de carepa após o reaquecimento. Definiu-se o aço SAE 1043 para o desenvolvimento deste trabalho devido aos níveis de rejeição superficial e elevados volumes de produção, o que gera grande impacto na produção das linhas de inspeção. Os resultados obtidos a partir dos testes realizados demonstram que a temperatura de laminação até determinado limite não tem influência na rejeição superficial, mas que abaixo deste gera elevado índice de rejeição. O uso do descarepador tem grande influencia nos níveis de defeitos superficiais, e o controle de seus parâmetros principais é fundamental. O condicionamento superficial dos tarugos é o parâmetro que mais apresentou influência positiva sobre a rejeição superficial, demonstrando que defeitos pré-existentes na matéria-prima têm grande impacto no produto final da laminação. / Surface defects are major quality problems in hot rolled bars, representing numerous disturbances during the production process, as depending on their characteristics generate high rejection during the inspection process. High rejection means rework and scrap. Among the various causes for the occurrence of surface defects are defects in the billets, rolling temperature, a consequence of the reheating temperature and rate of roll and removal of scale after reheating. The steel SAE 1043 used in this work was selected due to its level of surface defects and high production volumes, which generates large impact on production inspection process. The results show that the rolling temperature of up to a certain limit does not influence the surface defects, but below this generates a high rate of rejection. The use of descaling has a large influence on the levels of surface defects, and control of its main parameters is essential. The surface conditioning of billets is the parameter that showed a positive influence on the reduction of surface defects, demonstrating that pre-existing defects in materials has large impact on the final rolled product.

Orofacial clefts (OFCs) are facial malformations that happen during early pregnancy and have a complex and heterogeneous etiology, involving both genetic and environmental risk factors. This project examined the association between maternal nutrition, folaterelated biomarkers, candidate genes involved in one-carbon metabolism (OCM), and OFCs in order to achieve more comprehensive knowledge of how nutrition and genetics influence OFC risk. First, the association between maternal periconceptional multivitamin (PCMV) use, maternal dietary patterns during the periconceptional period, and OFC risk was examined. This study showed that neither PCMV use nor healthy dietary pattern score alone was individually associated with OFC risk. However, the combination of PCMV use and a higher score reflecting the ideal Dietary Approach to Stop Hypertension diet was associated with 55% reduction in the risk of isolated OFCs, evidence that the prevention of OFCs may require attention to both PCMV use and improving maternal diets. Second, the association between maternal multivitamin use, folic acid supplemental intake, and measured blood folate levels in case mothers of OFC children and control mothers was examined. Mothers who had an OFC-affected pregnancy compared with control mothers had lower mean levels of plasma folate in both multivitamin users and non-users. At levels of folic acid intake >400µg/day, the difference in plasma folate between case mothers and control mothers narrowed, evidence that higher folate intake levels may be required for mothers with a history of OFC-affected pregnancy. The ability to utilize supplement folic acid might be modified by MTHFR C677T genotype. In mothers with 677CC genotype, both case and control mothers’ plasma folate concentrations responded to increased levels of folic acid supplemental intake, although case mothers’ plasma folate concentrations were always significantly lower than control mothers’ until folate supplemental intake reached 400µg. In mothers with 677CT genotype, control but not case mothers’ plasma folate concentrations responded to increased levels of folic acid supplemental intake. In mothers with 677TT genotype, case but not control mothers’ plasma folate concentrations responded to increased levels of folic acid supplemental intake. Lastly, variations in folate-related OCM genes were examined in association with risk of OFCs using GWAS data and the case-parent trio approach. Several genes in the OCM pathway were associated with isolated, non-syndromic OFCs with some through genetic effects alone but most through gene-environment interaction effects with maternal multivitamin supplementation during periconceptional period and maternal biomarker concentrations for OCM-related nutrients. These results emphasize the need to consider gene-environment interactions when searching for genes influencing isolated OFCs. Reduction in the prevalence of OFCs could have tremendous importance. The results of this dissertation may help identify factors important to OFCs etiology and in turn, provide valuable targets for preventive intervention. Children born with an OFC require medical care from birth until adulthood and encounter a higher mortality rate. The costs incurred from caring for children born with OFCs not only include the clinical care of many disciplines but also involve the emotional disturbance and social and employment exclusion for affected individuals. Reducing the risk of OFCs would lessen considerable financial and emotional burdens to families and societies.

Dextromethorphan and guaifenesin are the main active components in over-the-counter cough medications. Prenatal exposure to dextromethorphan has been shown to be teratogenic in animal models. Data from human studies for either dextromethorphan or guaifenesin are limited and inconclusive. We used data from the population-based National Birth Defects Prevention Study (NBDPS) to examine associations between maternal periconceptional (one month before through three months after conception) use of cough medications containing dextromethorphan, with or without guaifenesin, and isolated neural tube defects (NTDs). We also used NBDPS data to explore associations between such exposures and other isolated major birth defects, as well as associations between maternal periconceptional use of cough medications containing guaifenesin alone and isolated major birth defects. Enrolled cases comprised 19,538 live births, still births, and elective terminations with isolated major birth defects, and enrolled controls comprised 10,200 live births without defects delivered from October 1997 through December 2009. Telephone interview reports of pregnancy exposures, including periconceptional use of cough medications, were obtained from mothers of case and control infants. Two approaches were used to build multivariable models: backward model selection and comparing the change in odds ratios (ORs) by adding each covariable individually into the main effect models. Adjusted ORs (aORs) and 95% confidence intervals (CIs) for maternal periconceptional exposure of cough medications containing dextromethorphan, with or without guaifenesin, or guaifenesin alone, respectively, and 22 types of birth defects were estimated using multivariable logistic regression analysis. Applying our first multivariable model building approach, we observed that maternal periconceptional use of dextromethorphan, with or without guaifenesin, was marginally significantly associated with an increased risk of all NTDs combined (aOR=1.7, 95%CI=1.0-2.9), or spina bifida alone (aOR=1.9, 95%CI=1.0-3.5). Applying our second model-building approach confirmed the associations with all NTDs combined and spina bifida alone (aOR==1.9, 95% CI=1.2-3.0 and aOR=2.1, 95% CI=1.2-3.8; respectively). For other isolated birth defects, a positive, marginally significant association was observed for maternal periconceptional use of dextromethorphan, with or without guaifenesin, and cleft lip with or without cleft palate (aOR=1.3, 95%CI=1.0-1.7) applying our first model building approach. Our second model-building approach produced significant associations between such exposure and gastroschisis (aOR=1.8, 95%CI=1.2-2.8). With regard to maternal periconceptional use of cough medications containing guaifenesin alone, we observed marginally significant associations with all NTDs combined (aOR=1.9, 95%CI=1.1-3.5), spina bifida alone (aOR=2.3, 95%CI=1.1-4.4), or anorectal atresia (aOR=1.9, 95%CI=1.0-3.6) applying our first model-building approach. Applying our second model-building approach did not suggest significant associations between such exposure and birth defects. Our findings suggest that maternal periconceptional use of cough medications containing dextromethorphan or guaifenesin may produce selected major structural birth defects in offspring. These findings provide important evidence to better understand the safety of these cough medications and informs about the potential of this modifiable exposure to cause isolated birth defects. Additional population-based research is necessary to validate these positive associations between cough medications and selected isolated birth defects identified in our study.

The current energy and environmental scenario in the world demands acute attention on sustainable repurposing of waste CO2 to high value hydrocarbons that not only addresses the CO2 mitigation problem, but also provides pathways for a closed loop synthetic carbon cycle. Difference in the scales of global CO2 emissions (about 40 Gtpa, 2017) and the carbon capture and sequestration (CCS) facilities (estimated cumulative 40 Mtpa, 2018) provokes active research on this topic. Solar thermochemical (STC) and visible light photocatalysis are two of the most promising routes that have garnered attention for this purpose. While STC has the advantages of high CO2 conversion rates, it operates at high temperatures (more than 1000 °C) limiting its industrial implementation. Photocatalysis, on the contrary, is plagued by the poor quantum efficiency and conversion rates, although its exhibits the benefits of low temperature operation. Thus, any significant progress towards low temperature STC and visible light photocatalytic CO2 reduction is a giant leap towards a greener and sustainable energy solution. This dissertation is an effort towards improving both the STC and photocatalytic CO2 reduction. Reverse water gas shift - chemical looping (RWGS-CL) is a modified STC approach that has the potential for low temperature CO2 conversion. RWGS-CL process uses mixed metal oxides like perovskite oxides (ABO3) for the conversion to CO, a potential feedstock for subsequent hydrocarbon production. Generation of oxygen vacancy defects on these perovskite oxides is a key step of RWGS-CL and thus, oxygen vacancy formation energy has been found to be a key descriptor for this process. Using density functional theory based calculations, this intrinsic material property has been used towards rational design of better catalysts. Highest rate of CO2 conversion at the low temperatures of 450 °C was demonstrated by earth abundant perovskite oxide via RWGS-CL. This low temperature and stable CO2 conversion process enables thermal integration with subsequent Fischer Tropsch processes for the hydrogenation of CO to hydrocarbons. Parallel to the developments on materials discovery, another crucial parameter that deserves attention is the surface termination effects of the perovskite oxides. Hence, the site specificity of the bulk and surface oxygen vacancies have been probed in detail towards elucidating the CO2 conversion performance over these materials. In the view of recent progress on the growth of selective crystal facets and terminations, this study opens new avenues for enhanced CO2 conversion performance not only through bulk composition variation, but also via exposing desired crystal facets. Type-II semiconductor heterojunctions (staggered type) are promising candidates for efficient photocatalytic reactions, not only because of their capabilities of electronic density of states tuning, but also their ability to segregate the excited electrons and holes into different materials thereby restricting exciton recombination. Metal oxynitride heterojunctions have recently demonstrated promising activity on visible light water splitting. Elucidating the structure-function relationships for these materials can pave the way towards designing better CO2 conversion photocatalysts. This dissertation focuses on unravelling the roles of material composition, anion vacancy defects and lattice strain towards modulating the electronic density of states of lateral and vertical heterojunctions of (ZnO)X(AlN)1-X and (ZnO)X(GaN)1-X. The heterojunctions consist of periodic potential wells that allows for restricting interlayer charge transport. Increased ZnO concentration was explicitly shown to decrease the band gap due to N 2p and Zn-3d repulsion. Biaxial and vertical compressive strain effected increased band gap while tensile strain reduced the same. Oxygen vacancies was found to have different effect on the electronic state of the materials. When present in charged state (+2), it promotes mid gap state formation, while in neutral state it revealed increased electronic densities near the valence band and conduction band edges. These fundamental site specific material property tuning insights are essential for designing better photocatalysts for future.

Congenital heart disease is the most common form of birth defect, affecting approximately 1% of liveborn babies. Secundum atrial septal defect (ASD) is the second most common form of congenital heart disease (CHD). Most cases have no known cause. Chromosomal, syndromal and teratogenic causes account for a minority of cases. The hypothesis that mutations in the ASD genes NKX2-5 and GATA4 may cause apparently sporadic ASD was tested by sequencing them in unrelated probands with ASD. In this study, 1/102 individuals with ASD had an NKX2-5 mutation, and 1/129 had a deletion of the GATA4 gene. The cardiac transcription factor TBX20 interacts with other ASD genes but had not previously been associated with human disease. Of 352 individuals with CHD, including 175 with ASD, 2 individuals, each with a family history of CHD, had pathogenic mutations in TBX20. Phenotypes included ASD, VSD, valvular abnormalities and dilated cardiomyopathy. These studies of NKX2-5, GATA4 and TBX20 indicate that dominant ASD genes account for a small minority of cases of ASD, and emphasize the considerable genetic heterogeneity in dominant ASD (also caused by mutations in MYH6 and ACTC). A new syndrome of dominant ASD and the Marcus Gunn jaw winking phenomenon is reported. Linkage to known loci was excluded, extending this heterogeneity, but a whole genome scan did not identify a candidate locus for this disorder. Previous studies of inbred laboratory mice showed an association between patent foramen ovale (PFO) and measures of atrial septal morphology, particularly septum primum length (???flap valve length??? or FVL). In humans, PFO is associated with cryptogenic stroke and migraine, and is regarded as being in a pathological contiuum with ASD. Twelve inbred strains, including 129T2/SvEms and QSi5, were studied, with generation of [129T2/SvEms x QSi5] F1, F2 and F14 mice. Studies of atrial morphology in 3017 mice confirmed the relationship between FVL and PFO but revealed considerable complexity. An F2 mapping study identified 7 significant and 6 suggestive quantitative trait loci (QTL), affecting FVL and two other traits, foramen ovale width (FOW) and crescent width (CRW). Binary analysis of PFO supported four of these.