Submitted by Jaqueline Duarte (1157279@mackenzie.br) on 2018-11-06T19:51:50Z No. of bitstreams: 2 Felipe Cesar Jose Matos Rebêlo p.pdf: 2414345 bytes, checksum: f8d860ef63b12b68c90f066a9f01a45f (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Paola Damato (repositorio@mackenzie.br) on 2018-11-14T14:43:05Z (GMT) No. of bitstreams: 2 Felipe Cesar Jose Matos Rebêlo p.pdf: 2414345 bytes, checksum: f8d860ef63b12b68c90f066a9f01a45f (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-11-14T14:43:05Z (GMT). No. of bitstreams: 2 Felipe Cesar Jose Matos Rebêlo p.pdf: 2414345 bytes, checksum: f8d860ef63b12b68c90f066a9f01a45f (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2018-08-08 / The work developed concentrates its focus on the specific analysis of the doctrine of David Held, regarding the instrumentalization of global social democracy in the face of current challenges for democratic improvement. In this sense, there is a discussion about the responsible control of Public Administration, a process of accountability that fulfills social demands in a degree of legitimacy related and as close as possible to the peculiarities of a given society. The structuring of global social democracy is found with emphasis on the regional scope. However, it is concatenated the thoughts developed considering the national bases as well as the global scope as a whole, in order to see the democratic regime closest to the control and effectiveness, in case of including the most diverse social actors in the process of debate and public deliberations. The concrete instrumentalization of global social democracy, therefore, is developed with concepts such as localism, globalization, global governance in interaction with participatory democracy, and therefore the development of institutional and political instruments of more effective participatory scope. At the end of the process, the prevalence of fundamental and human rights stands out as the fulcrum of the systematized democratic element, seeking the possible realization of popular participation in the public thing as the guarantor of those rights. / O trabalho desenvolvido concentra seu foco de atuação na análise específica da doutrina de David Held, no que concerne à instrumentalização da democracia social global face aos questionamentos atuais pelo aprimoramento democrático. Nesse sentido, caminha a discussão pelo controle responsável da Administração Pública, um processo de prestação de contas que preencha as demandas sociais em um grau de legitimidade correlato e mais próximo possível às peculiaridades de dada sociedade. Averigua-se a estruturação da democracia social global com ênfase no âmbito regional. No entanto, se concatena o pensamento considerando as bases nacionais, bem como o âmbito global como um todo, de forma a se enxergar o regime democrático mais próximo ao controle e efetividade caso em consonância à inclusão dos mais diversos atores sociais no processo de debate e deliberação públicos. A instrumentalização concreta da democracia social global, portanto, se desenvolve tendo-se em pauta conceitos como o localismo, globalização, governança global em interação com a democracia participativa, e, por conseguinte, o desenvolvimento de instrumentos institucionais e políticos de abrangência participativa mais efetiva. Ao final do processo, a prevalência dos direitos fundamentais e humanos se destaca como fulcro do elemento democrático sistematizado, buscando-se a concreção possível da participação popular na coisa pública como garante daqueles direitos.

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Abstract The purpose of the present research was (I-II) to evaluate the effects of clinical, hand-held Doppler (HHD) and duplex ultrasonographic examinations on the planning of operative procedure for primary varicose veins, (III) to assess the feasibility, safety and efficacy of endovenous saphenous vein obliteration with radiofrequency-resistive heating and (IV) to compare endovenous saphenous vein obliteration with conventional stripping operation in terms of short-term recovery and costs. Sixty-two legs (in 49 consecutive patients) and 142 legs (in 111 consecutive patients) with primary uncomplicated varicose veins were examined clinically and with HHD and duplex ultrasonography for planning the subsequent treatment. At the saphenous-femoral junction (SFJ) and at the saphenous-popliteal junction (SPJ), sensitivity was 56-64% and 23%, specificity 93-97% and 96%, positive predictive value 97-98% and 43% and negative predictive value 44-45% and 91%, respectively. In 9% of the cases, the treatment plan was modified on the basis of the duplex ultrasound findings. The present study showed that, in primary uncomplicated varicose veins, the accuracy of HHD is unsatisfactory. Thirty legs of 27 patients with varicose veins were treated using an endovenous catheter (Closure® System, VNUS Medical Technologies, Inc., Sunnyvale, CA), which was inserted under ultrasound guidance via a percutaneous puncture or a skin incision. The persistence of vein occlusion and complications potentially attributable to the endovenous treatment were assessed at 1-week, 6-week, 3-month, 6-month and 1-year follow-up visits. By the time of the last follow-up visit, occlusion of the treated segment of the LSV had been achieved in 22 (73.3%) legs. Persisting patency or recanalization of LSV was detected in 8 legs (26.7%). Postoperative complications included saphenous nerve paresthesia in 3 legs (10%) and thermal skin injury in one limb (3.3%). Twenty-eight selected patients admitted for operative treatment of varicose veins in the tributaries of the primary long saphenous were randomly assigned to endovenous obliteration (n = 15) or stripping operation (n = 13). The patients were followed up for 7-8 weeks postoperatively and examined by duplex ultrasonography. The comparison of costs included both direct medical costs and costs due to lost of productivity. All operations were successful, and the complication rates were similar in the two groups. The sick leaves were significantly shorter in the endovenous obliteration group [6.5 (SD 3.3) vs. 15.6 (SD 6.0), 95 % CI 5.4 to 12.9, p < 0.001, t-test]. When the value of the lost working days was included, the endovenous obliteration was societally cost-saving.

Optical imaging is an emerging technology towards non-invasive breast cancer diagnostics. In recent years, portable and patient comfortable hand-held optical imagers are developed towards two-dimensional (2D) tumor detections. However, these imagers are not capable of three-dimensional (3D) tomography because they cannot register the positional information of the hand-held probe onto the imaged tissue. A hand-held optical imager has been developed in our Optical Imaging Laboratory with 3D tomography capabilities, as demonstrated from tissue phantom studies. The overall goal of my dissertation is towards the translation of our imager to the clinical setting for 3D tomographic imaging in human breast tissues. A systematic experimental approach was designed and executed as follows: (i) fast 2D imaging, (ii) coregistered imaging, and (iii) 3D tomographic imaging studies. (i) Fast 2D imaging was initially demonstrated in tissue phantoms (1% Liposyn solution) and in vitro (minced chicken breast and 1% Liposyn). A 0.45 cm3 fluorescent target at 1:0 contrast ratio was detectable up to 2.5 cm deep. Fast 2D imaging experiments performed in vivo with healthy female subjects also detected a 0.45 cm3 fluorescent target superficially placed ~2.5 cm under the breast tissue. (ii) Coregistered imaging was automated and validated in phantoms with ~0.19 cm error in the probe’s positional information. Coregistration also improved the target depth detection to 3.5 cm, from multi-location imaging approach. Coregistered imaging was further validated in-vivo, although the error in probe’s positional information increased to ~0.9 cm (subject to soft tissue deformation and movement). (iii) Three-dimensional tomography studies were successfully demonstrated in vitro using 0.45 cm3 fluorescence targets. The feasibility of 3D tomography was demonstrated for the first time in breast tissues using the hand-held optical imager, wherein a 0.45 cm3 fluorescent target (superficially placed) was recovered along with artifacts. Diffuse optical imaging studies were performed in two breast cancer patients with invasive ductal carcinoma. The images showed greater absorption at the tumor cites (as observed from x-ray mammography, ultrasound, and/or MRI). In summary, my dissertation demonstrated the potential of a hand-held optical imager towards 2D breast tumor detection and 3D breast tomography, holding a promise for extensive clinical translational efforts.

化学シナプスにおいて、シナプス小胞内に蓄えられた神経伝達物質の開口放出によってシナプス伝達が起こる。開口放出後、シナプス小胞はエンドサイトーシスによって細胞内へ回収されて再利用される。膜容量測定法とpHイメージングを併用して、開口放出とエンドサイトーシスに伴う小胞膜および小胞タンパク質の動態を同時測定した。Ca2+-カルモジュリン-Munc13シグナリングが小胞タンパク質の回収に関与していることが示唆された。 / Neurotransmitter is released at synapses by fusion of synaptic vesicles with the plasma membrane. To sustain synaptic transmission, membranes and vesicular proteins has to be retrieved for reuse. I have combined capacitance measurements and pH-imaging via a pH-sensitive vesicular protein marker, and compared the retrieval kinetics of membranes and synaptotagmin2 (Syt2) at the calyx of Held presynaptic terminal. Data in this thesis identifies a novel mechanism of stimulus- and Ca2+-dependent regulation of coordinated endocytosis of synaptic membranes and Syt2. / 博士(理学) / Doctor of Philosophy in Science / 同志社大学 / Doshisha University

Bakgrund En handhållen dynamometer (HHD) är ett kliniskt användbart mätverktyg för att mäta muskelstyrka. På Akademiska sjukhuset i Uppsala finns en HHD av märket MicroFET2® (Hoggan Scientific). Det finns ett fåtal studier gjorda som undersöker intrabedömarreliabiliteten vid mätningar av isometrisk muskelstyrka av knäledens muskelgrupper med denna dynamometer. Syfte Syftet med studien var att undersöka den absoluta och relativa reliabiliteten vid mätningar av maximal muskelstyrka i knäledens muskelgrupper med en HHD. Metod Psykometrisk design med test-retest förfarande. Totalt undersöktes 24 friska vuxna vid två mättillfällen med 6–8 dagars mellanrum. Den relativa reliabiliteten presenterades med Intraclass correlation coefficient (ICC 2,1). Den absoluta reliabiliteten presenteras i standard error of measurement (SEM), SEM% samt smallest detectable change (SDC). Resultat Resultaten visade mycket hög relativ reliabilitet för knäledens extensioner (ICC = 0,950,96) och för knäledens flexorer (ICC = 0,94–0,96). SEM varierade mellan 33,58N-34,81N för knäledens extensorer och 14,16N-17,16N för knäledens flexorer. SDC varierade mellan 93,08N–96,49N för knäledens extensorer och 39,25N-47,57N för knäledens flexorer. Konklusion Resultaten indikerar att HHD har mycket hög relativ reliabilitet för bedömning av styrka i knäledens stora muskelgrupper hos ett bekvämlighetsurval med friska vuxna människor.  Den relativa och absoluta reliabiliteten bedömdes överlag vara i enlighet med tidigare studier. För implementering i klinik behöver framtida studier utvärdera absolut och relativ reliabilitet på specifika patientpopulationer. / Background Hand held dynamometry (HHD) is a practical device for testing muscle strength. There is currently a HHD (MicroFET2® - Hoggan Scientific) available at Uppsala University hospital. Few reliability studies excist where the objective is to examine the intra-rater reliability of isometric maximal knee-strength using this device. Objective To examine the absolute and relative reliability of isometric maximal knee-strength using a MicroFET2. Method Psychometric design through test-retest with 6–8 days between measures on 24 healthy adults. The relative reliability expressed as Intra-class correlation coefficient (ICC 2,1) and the absolute reliability as standard error of measurement (SEM), SEM%, and smallest detecatble change (SDC). Results The results of this study showed very good reliability for both knee extensors (ICC = 0,950,96) and knee flexors (ICC = 0,94–0,96). Regarding the absolute reliability SEM ranged from 33,58N-34,81N for knee extensors and 14,16N-17,16N for knee flexors. SDC ranged from 93,08N-96,49N for knee extensors and 39,25N-47,57N for knee flexors. Conclusion The results indicate that HHD has a very good relative reliability for assessing strength in the large muscle groups of the knee joint when examined on a group of healty adults. The relative and absolute reliability was generally in accordance when compared with previous studies. Before being implemented in praxis, future studies need to evaluate absolute and relative reliability on specific patient populations.

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

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In this essay I examine how conceptions of gender can expand the emancipatory ability of feminism. To achieve this the essay analyzes and discusses two conceptions of gender. The first can be found in Virginia Held’s “The Ethics of Care”, while the second can be found in Chandra Talpade Mohanty’s “Feminism without Borders”. By comparing these the essay examines the limits of a stricter conception of gender, in comparison to a more complex conception of gender. These are in turn compared to Judith Butler’s “Gender Trouble” and Simone de Beauvoir’s “The Second Sex”.  Through the analysis and discussion, it is shown that stricter conceptions of gender give a more simplified view of the real lives of women in different parts of the world. These conceptions may include ideas about contextuality and social factors such as race, ethnicity, class, and sexuality, but these are added to an already established idea of “the woman”. Through complex conceptions of gender these social factors are instead viewed as intersected with gender. Gender is thus seen as a social construct, contextually differentiated by different conceptions of both sexuality and gender expression, as well as other social factors. These social factors are seen as both constructed and used by systems and power structures to oppress women. Complex conceptions of gender can thus expand the emancipatory ability of feminism by bringing both an intersectional and materialistic perspective into view. This perspective shows how gender can both be constructed in problematic ways through discursive representations and feminist theories, but also shows how gender is constructed through social practices and are used to affect women in a material way.