Mechanical heart valve (MHV) flows are characterized by high shear stress, regions of recirculation, and high levels of turbulent fluctuations. It is well known that these flow conditions are hostile to blood constituents, which could lead to thromboembolism. In the ongoing effort to reduce long-term complications and morbidity, it is imperative that we better understand the flow characteristics of the natural valve as well as that of the mechanical valve. In this study, we overcome many of the limitations imposed by other measurement techniques by employing a powerful, high-speed Time-Resolved Digital Particle Image Velocimetry (TRDPIV) system to map the flow field. We compare the flows downstream from a St. Jude Medical bileaflet MHV, a porcine mitral valve (MV), and a combination of both valves to simulate the technique of chordal preservation. Instantaneous velocity fields and vorticity maps are presented, which provide detailed information about the development of the flow. Time-averaged velocity, vorticity, and turbulent kinetic energy measurements are also discussed. Asynchronous leaflet behavior was observed in all cases involving the mechanical valve. Extensive vortex formation and propagation are present distal to the MHV, which leads to high levels of jet dispersion. The porcine mitral jet exhibits lateral oscillatory behavior, but it does not disperse like the MHV. In the MHV/porcine combination system, the native tissue limits vortex propagation and jet dispersion. The results presented provide insight on the hemodynamic characteristics of natural and MHVs, reveal the detrimental character of asynchronous leaflet opening, document the mechanism of vortex formation and interaction distal to the valve, and illustrate the importance of chordal preservation. These results may improve MHV replacement clinical practice and/or motivate and aid the design of MHVs that better mimic natural mitral flow patterns. / Master of Science

Heart valve disease is currently one of the leading forms of heart disease. Current literature has shown that endothelin I, angiotension II and 5-HT are vasoactive agents which cause concentration dependent contractions in aortic valve leaflet tissue. This study tested the mechanical properties of leaflets cut in the radial direction after they were exposed to the agents at varied concentrations or for 0.5, 6 or 24 hours. The elastic modulus, ultimate tensile strength and the yield strength were calculated. In the time trials the elastic modulus and the ultimate tensile strength both showed a significant increase at 24-hours. However, there were no significant differences found between the concentrations. Indicating the amount of vasoactive agent is not as significant as the length of exposure.

[pt] Com o envelhecimento da população brasileira o número de pacientes de doenças crônicas aumenta acentuadamente. A informação adequada ao paciente é elemento fundamental para que este seja parte ativa, aumentando assim a eficiência do tratamento. As bulas dos medicamentos podem contribuir de forma significativa para a informação dos pacientes. Entretanto, para que isto ocorra, é necessário que a bula seja projetada levando em consideração as necessidades do usuário. A hipótese desta pesquisa é que a desconsideração do usuário no projeto das bulas presentes no tratamento de doenças cardiovasculares acarreta dificuldade na legibilidade e leiturabilidade destas, gerando riscos pelo uso inadequado do medicamento. Esta pesquisa tem o objetivo de colaborar para o aumento da segurança dos pacientes crônicos na administração de medicamentos, através da identificação dos fatores que prejudicam a legibilidade e leiturabilidade das bulas. Para se alcançar estes objetivos foram utilizados métodos e técnicas em duas etapas. Primeiramente, foram realizadas entrevistas com médicos e pacientes, e avaliações heurísticas de duas bulas de um medicamento antihipertensivo largamente usado. Em seguida, foram realizados questionários junto a médicos e pacientes do Instituto Nacional de Cardiologia, no Rio de Janeiro, a respeito da legibilidade e leiturabilidade das bulas, assim como sua colaboração na compreensão da enfermidade e tratamento. Através destes métodos, foram confirmados problemas graves na legibilidade e leiturabilidade das bulas presentes no tratamento de doentes cardíacos, gerando insegurança do paciente e perigo no uso de medicamentos. / [en] Due the increasing aging of Brazilian population, it is also increasing the number of chronic diseases´ patients. Adequate information is vital for the patient to take an active role on treatment, increasing treatments´ efficiency. Patient packages inserts may contribute significantly for patients´ information. This research is based on the hypotheses that there is a lack on users´ needs during the patient leaflets design. This lack may cause legibility and readability problems and, consequently, risks by the inadequate use of medicine. The aim of the present research is to contribute to the safe use of medicines from cardiovascular patients. Factors that may prejudice leaflets´legibility and readability were investigated. The research techniques used were: Firstly interview with physicians and patients, and heuristic evaluation of two leaflets of the most widely sold anti hypertensive medicine in Brazil. Then, two questionnaires were applied; one with physicians and the other with patients of the Instituto Nacional de Cardiologia (National Institute of Cardiology), in Rio de Janeiro. Those two questionnaires concerned on the leaflets´ legibility and readability, and its cooperation on the patients´ comprehension of their disease and treatment. Serious legibility and readability problems were identified on the leaflets, generating patient insecurity and unsafe medicines´use.

Submitted by Rosivalda Pereira (mrs.pereira@ufma.br) on 2017-07-19T19:10:18Z No. of bitstreams: 1 RicardoCosta.pdf: 8300627 bytes, checksum: 1b02c04a1a94111338012bbd4c2b4e6f (MD5) / Made available in DSpace on 2017-07-19T19:10:18Z (GMT). No. of bitstreams: 1 RicardoCosta.pdf: 8300627 bytes, checksum: 1b02c04a1a94111338012bbd4c2b4e6f (MD5) Previous issue date: 2017-04-26 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / The typography is shown as a primary element when it comes to the transmission of reports via text. In the case of patient information leaflets, typography and its bad articulation can result in an inefficient readability and thus the misunderstanding of the information contained therein (Hammerschmidt, 2014, p. 218). Therefore it is understood that the research in question is relevant because it seeks to understand how the typographic articulation adopted in the mobile application MedSUS impacts on reading the patient information leaflets and comprehension. For this, a usability test was performed with smartphone with regular users (patients) in order to evaluate the readability and readability of texts found in the medication package inserts. A cooperative evaluation was then carried out with technical users (medical) to find relevant problems related to the MedSUS application interface. As a result, there was an improvement of satisfaction of regular users regarding the use of the application with the improved typographic aspects and the technical users evaluated as being of low utility the application in question for the use in medical care. Finally, recommendations are presented for the use of typography in the presentation of texts of drug inserts in mobile application MedSUS. / A tipografia se mostra como elemento primordial quando se trata da transmissão da informação através de texto. Em se tratando de bulas de medicamentos, a tipografia e sua má articulação podem resultar em uma ineficiente leiturabilidade e assim no mal entendimento das informações ali contidas (HAMMERSCHMIDT, 2014, p. 218). Por isso entende-se que a pesquisa em questão é relevante pois visa compreender como a articulação tipográfica adotada no aplicativo móvel MedSUS impacta na leitura das bulas de medicamentos e na compreensão das mesmas. Para isso, foi realizado um teste de usabilidade com smartphone com usuários comuns (pacientes) com o objetivo de avaliar a legibilidade e leiturabilidade dos textos encontrados nas bulas dos medicamentos. Em seguida foi realizada uma avaliação cooperativa com usuários técnicos (médicos) que visou encontrar problemas relevantes e relacionados à interface do aplicativo MedSUS. Como resultados, obteve-se uma melhora na satisfação dos usuários comuns com relação ao uso do aplicativo com os aspectos tipográficos aperfeiçoados e os usuários técnicos avaliaram como sendo de baixa utilidade o aplicativo em questão para o uso em atendimento médico. Por fim, são apresentados recomendações para o uso da tipografia na apresentação de textos das bulas de medicamentos no aplicativo móvel MedSUS.

The aortic valve functions in a complex mechanical environment which leads to force dependent cellular and tissue responses. Characterization of these responses provides a fundamental understanding of valve pathogenesis. The aim of this work was to develop an ex vivo organ culture system capable of simulating physiological aortic pressures and flow rates, and study the biological characteristics of native porcine aortic valves cultured in the system. Collagen, sGAG and elastin content of the valve leaflets were measured and cusp morphology, cell phenotype, cell proliferation and apoptosis were examined. Presence of endothelial cells (ECs) on the leaflet surface was also evaluated. The differences in collagen, sGAG and elastin contents were not significant (p greater than0.05) between the cultured and fresh valve leaflets. The cultured valves maintained the structural integrity of the leaflets while preserving the native morphology and cell phenotype. Cell phenotype in leaflets incubated statically under atmospheric conditions decreased compared to fresh and cultured valve leaflets, indicating the importance of mechanical forces in maintaining the natural biology of the valve leaflets. ECs were retained on the surfaces of cultured leaflets with no remodeling of the leaflets. The number of apoptotic cells in the cultured leaflets was significantly (p less than 0.05) less than in the statically incubated leaflets and comparable to fresh leaflets. The sterile ex vivo organ culture system thus maintained the viability and native biological characteristics of the aortic valves that were cultured under dynamic conditions for a period of 48 hours.

Submitted by isabela.moljf@hotmail.com (isabela.moljf@hotmail.com) on 2016-08-12T11:35:34Z No. of bitstreams: 1 rafaelladesouzasalomaozanette.pdf: 856423 bytes, checksum: c95ae99e7ef9f490e08fd22c64f7237f (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-08-15T13:04:26Z (GMT) No. of bitstreams: 1 rafaelladesouzasalomaozanette.pdf: 856423 bytes, checksum: c95ae99e7ef9f490e08fd22c64f7237f (MD5) / Made available in DSpace on 2016-08-15T13:04:26Z (GMT). No. of bitstreams: 1 rafaelladesouzasalomaozanette.pdf: 856423 bytes, checksum: c95ae99e7ef9f490e08fd22c64f7237f (MD5) Previous issue date: 2016-02-25 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O coração é um órgão vital, que bombeia o sangue permitindo a sua circulação pelo corpo. A valva aórtica, e as suas estruturas de apoio ventriculares, formam a peça central do coração. Todas as câmaras do coração estão relacionadas diretamente à valva e seus folhetos são incorporados diretamente no esqueleto cardíaco. Falhas dos folhetos aórticos são as mais comuns entre as doenças relacionadas às valvas do coração, tendo como consequência o impacto negativo na vida do paciente, bem como nas despesas dos sistemas de saúde em todo o mundo. O desenvolvimento de materiais capazes de substituir com eficácia o tecido danificado da valva aórtica é de grande interesse na medicina regenerativa e engenharia de tecidos. As valvas mecânicas e biológicas têm sido amplamente estudadas, mas várias questões relacionadas com a integração ao hospedeiro ainda não foram resolvidas. Promissores protocolos para descelularização de tecidos de valva cardíaca têm sido investigados como uma alternativa para a preparação do material de substituição e para ser empregado como um substrato para a recelularização da matriz. No entanto, alguns protocolos de descelularização utilizados hoje em dia têm algumas limitações, uma vez que ainda não existe um método que permita a descelularização e ao mesmo tempo mantenha a estrutura da matriz extracelular para a posterior recelularização, evitando a rejeição após a implantação e futura substituição da prótese. Assim, o presente trabalho visa a obtenção de uma matriz biológica que satisfaça esses requisitos, por meio da descelularização dos folhetos aórticos de suínos e sua recelularização com células-tronco da polpa dentária humana. Foram testados três protocolos de descelularização, sendo que os protocolos que utilizaram tripsina foram reprodutíveis e forneceram matrizes com menor quantidade de DNA, quando comparados com o protocolo que utilizou apenas detergente e não foi reprodutível. As células-tronco podem ser isoladas de dentes decíduos (SHEDs) humanos e pesquisas apontam sua importância na medicina regenerativa visando à reconstrução de folhetos aórticos. Nesse trabalho, as SHEDs foram obtidas e caracterizadas fenotipicamente, sendo positivas para marcadores mesenquimais e embrionários e negativas para marcadores hematopoiéticos, além de apresentarem, in vitro, potencial de diferenciação osteogênica. Tais células foram então cultivadas em placas de petri com as matrizes descelularizadas, porém não houve sucesso na recelularização. Para tentar contornar esse problema, foi construído um biorreator a fim de aumentar a eficiência da recelularização do tecido, no entanto os resultados estão sendo testados. Vários pontos ainda devem ser abordados a fim de superar os obstáculos da técnica de descelularização do tecido para obter sucesso na recelularização. / Heart is a vital organ that pumps blood allowing its circulation through the body. The aortic valve and their ventricular support structures form the centerpiece of the heart. All chambers of the heart are directly related to the valve, and its leaflets are directly incorporated into the heart skeleton. Amongst heart valves diseases, failures in the aortic leaflets are the most common ones, leading to negative impacts on patients’ life, as well as increases on the costs for health systems worldwide. For regenerative medicine and tissue engineering, the development of materials capable of effectively replace damaged aortic valve tissue is of great interest. The mechanical and biological valves have been widely studied, but several issues related to integration to the host have not yet been resolved. Promising decellularization protocols for tissue heart valve have been investigated as an alternative for the preparation of replacement material and to serve as a substrate for matrix repopulation. However, some of the decellularization protocols used today have some limitations, since until now there is still no method which can achieve a complete decellularization while maintaining the structure of extracellular matrix for later repopulation, avoiding rejection after implantation and future replacement of the prosthesis. Thus, the present work aims at obtaining a biological matrix that satisfies such requirements through the decellularization of pigs aortic leaflets and its repopulation with stem cells isolated from human dental pulp. So far, we tested three decellularization protocols. The protocols using trypsin were shown reproducible and yielded a smaller amount of DNA, when compared to the protocol where only detergent was employed, which was also not reproducible. About the stem cells, they can be isolated from human deciduous teeth (SHEDs), with studies indicating its importance in regenerative medicine aimed at the reconstruction of aortic leaflets. In this work, SHEDs were obtained and phenotypically characterized, being positive for mesenchymal and embryonic markers and negative for hematopoietic markers, in addition to presenting in vitro osteogenic differentiation potential. The SHEDs were then cultured in Petri plates with the decellularized matrices, however there was no success in the matrix repopulation. In an attempt to overcome such problem, a bioreactor was built in order to increase the tissue repopulation efficiency, however the results are being tested. Several points still need to be addressed in order to overcome the obstacles of tissue decellularization technique and then achieve a successful recellularization.

No description available.

L’intégration des fibres naturelles cellulosiques de plantes annuelles ou de résidus agricoles ou agro-industriels dans l’élaboration de matériaux de structures composites et le développement de nouveaux liants biosourcés sont aujourd’hui un domaine de recherche d’intérêt croissant. La thèse s'est déroulée dans le cadre du programme « Eco-panneaux », dont les deux objectifs principaux furent tout d'abord de valoriser les fibres végétales d’origine tunisienne comme l’alfa, le jonc et les folioles de palme et ensuite d'évaluer le potentiel d'espèces végétales tunisiennes dont les écorces sont riches en tannins (fruit de grenade, racines du sumac et tronc de pin d’Alep). Les études de caractérisation des fibres ont montré que leurs masses volumiques sont inférieures à 1. Le calcul du point de saturation des fibres (FSP) montre des valeurs majoritairement comprises entre 60 et 100 %. Nous avons également pu caractériser la cinétique d'imprégnation d'eau pour chacune des fibres. L’imprégnation se stabilise après 24 h d’immersion. Riches en minéraux (concentrations supérieures à 1 %), les fibres ont montré des teneurs en cellulose, en lignines et en hémicellulose comparables à celles généralement rencontrées avec les fibres de bois. L’analyse thermogravimétrique (ATG) a permis de constater que les matrices végétales étudiées sont thermiquement stables pour des températures inférieures à 200°C. Le dosage colorimétrique pour étudier la composition en polyphénols des matrices tannifères, l’analyse infrarouge et l’étude structurale de l’extrait des tanins, ainsi que le calcul du « Stiasny number » , montrent la forte teneur de l’écorce de grenade en tanins hydrolysables et la richesse des écorces du tronc de pin d’Alep et des racines du sumac en tanins condensés. L’étude des propriétés thermiques des extraits de tanins par ATG montre que les tanins de pin d’Alep et du sumac sont thermiquement plus stables que ceux de la grenade. La colle formulée à partir d’hexamine et de tanins de pin d’Alep présente un module d’élasticité élevé. Alors que la colle à base de tanins de grenade forme le réseau le moins dense. Ces résultats ont été confirmés par l’étude de la résistance au cisaillement. L'étude réalisée sur les composites fibres-plâtre (mise en œuvre et caractérisation physico mécanique des composites) a montré que les fibres locales pourraient constituer une alternative aux fibres d'importation utilisées actuellement. Une première caractérisation de la conductivité thermique des panneaux isolants élaborés à partir des fibres locales et de colles de tanins montre une conductivité thermique moyenne de 0,106w/K.m. / The integration of natural cellulosic fibers from annual plants and agricultural residues and agro-industrial materials in the development of composite structures and the development of new bio-based adhesives, are now a research field with growing interest. The thesis was conducted within the framework of "Eco-panels" program, which its two main objectives were firstly, to enhance plant fibers of Tunisian origin as alfa, rush and palm leaflets and then to evaluate the potential of Tunisian plant species whose bark is rich in tannins (pomegranate fruit, sumac roots and Aleppo pine trunk). The characterization studies of fibers showed that their densities are less than 1. The calculation of the fiber saturation point (FSP) shows values mostly between 60 and 100 %. We were also able to characterize the impregnation kinetics of water for each of these fibers. The impregnation stabilizes after 24 h of immersion. Rich in minerals (concentrations greater than 1 %), the fibers showed levels of cellulose, lignin and hemicellulose comparable to those generally encountered with wood fibers. The thermogravimetric analysis (TGA) shows that the plant matrices are thermally stable for temperatures below 200 ° C. The colorimetric assay of the polyphenolic composition of tanniferous matrices, the infrared analysis and the structural study of the tannins extract, as well as the calculation of "Stiasny number" show the high content in hydrolysable tannins for pomegranate barks and richness of Aleppo pine trunk barks and sumac roots barks in condensed tannins. The study by TGA of the thermal properties of tannins extracts shows that Aleppo pine and sumac tannins are thermally more stable than those of pomegranate. The formulation made from hexamine and Aleppo pine tannins has the greatest elasticity modulus. While the formulation prepared from pomegranate tannins forms the least dense network. These results were confirmed by the study of the shear strength. The study conducted on fiber-plaster composites (implementation and physico-mechanical characterization of composites) showed that local fiber could be an alternative to imported fibers used currently. A first characterization of the thermal conductivity of insulation panels made from local plant fibers and tannins adhesives shows an average conductivity of 0,106 W / Km.

Submitted by Josimara Dias Brumatti (bcgdigital@ndc.uff.br) on 2017-04-10T13:59:32Z No. of bitstreams: 1 Uma metodologia.pdf: 1412283 bytes, checksum: 9a4fe74670e47650eb81f9b516ebadb0 (MD5) / Approved for entry into archive by Josimara Dias Brumatti (bcgdigital@ndc.uff.br) on 2017-04-10T14:11:57Z (GMT) No. of bitstreams: 1 Uma metodologia.pdf: 1412283 bytes, checksum: 9a4fe74670e47650eb81f9b516ebadb0 (MD5) / Made available in DSpace on 2017-04-10T14:11:57Z (GMT). No. of bitstreams: 1 Uma metodologia.pdf: 1412283 bytes, checksum: 9a4fe74670e47650eb81f9b516ebadb0 (MD5) / A presente tese apresenta uma proposta de ensino de língua portuguesa para alunos do Programa Nacional de Integração da Educação Básica com a Educação Profissional na Modalidade de Educação de Jovens e Adultos (PROEJA), baseada na metodologia Molar de abordagem de textos gramaticais do Prof. Dr. Maurício da Silva. A metodologia foi aplicada ao estudo das regras de emprego do hífen explicitadas no texto das Bases XV e XVI do Acordo Ortográfico da Língua Portuguesa de 1990, tendo em vista a grande importância do assunto em razão da entrada em vigor do Acordo em 2016 e a grande dificuldade de apreensão das referidas regras, bem como das convenções ortográficas em geral, manifestada pelos discentes da referida modalidade de ensino. A proposta criada e descrita nesta tese apoiou-se, também, na utilização da teoria de Gêneros Textuais como forma de mediar a transposição didática dos pressupostos teóricos. Assim sendo, apresenta-se aqui a criação de um material didático em que se corporificou essa transposição para textos dos gêneros bula, propaganda e cápsulas hifênicas. / This thesis presents a proposal on Portuguese language teaching to students of the National Elementary Education Integration Program with Vocational Education in the Youth and Adult Education Mode (PROEJA) based on the Molar methodology approach to grammatical texts by Dr. Mauricio da Silva. The methodology was applied to the study of the rules on the use of the hyphen explained in the Bases XV and XVI of the 1990 Portuguese Language Orthographic Agreement, due to the great importance of the subject, which will come into effect in 2016, and the great difficulties in apprehension of those rules, as well as spelling conventions in general, shown by students of the aforementioned mode of education. The proposal created and described in this thesis was supported by the Genre theory as a way to mediate the didactic transposition of the theoretical assumptions. Therefore, this paper presents the creation of pedagogical material that embodied this transposition to texts of CMI (Consumer Medicine Information) leaflets, advertising and hyphenic capsules.

El objetivo de este estudio es investigar la noción semántica de la modalidad deóntica y sus concretas representaciones lingüísticas en los prospectos médicos. Mediante un método cuantitativo comparamos seis prospectos españoles con seis argentinos, a fin de comprobar semejanzas y diferencias con respecto al grado de la fuerza deóntica de las instrucciones, así como la preferencia por ciertas construcciones lingüísticas. Todas las instrucciones encontradas en los textos son colocadas en un escala deóntica de tres grados dependiendo del grado de obligación que expresan. El resultado señala una diferencia clara entre España y Argentina en cuanto a la distribución de la fuerza deóntica; mientras que los prospectos españoles tienen una preferencia por el tercer grado deóntico, predomina el segundo grado en los textos argentinos. Creemos que la diferencia regional se debe a una focalización distinta del grupo de receptores. Además mostramos que la distribución deóntica varía en las secciones de los prospectos dependiendo de su función comunicativa. Finalmente señalamos que pese a la preferencia por las mismas cuatro construcciones lingüísticas en ambos países, el orden interno varía. Mientras que el imperativo predomina en los prospectos españoles, cosa que refuerza el rasgo personal de los textos, los prospectos argentinos prefieren las construcciones modales, las construcciones impersonales y el infinitivo antes que el imperativo, lo cual les atribuye a los textos un carácter más formal.