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Für die Versorgung intraligamentärer vorderer Kreuzbandrupturen wurde bei Patienten im Wachstumsalter, aufgrund der Sorge vor dauerhaften Wachstumsstörungen durch eine Schädigung der Wachstumsfugen, eine Vielzahl verschiedener operativer Techniken entwickelt. Noch hat sich keines der praktizierten Therapieverfahren eindeutig etablieren können. In dieser Arbeit wurden verschiedene aktuell angewandte Operationsverfahren hinsichtlich ihrer klinischen Ergebnisse und Risiken bei Patienten bis zu einem Alter von zwölf Jahren und vergleichend für alle Patienten im Wachstumsalter, untersucht. Hierfür wurden zum einen in einer retrospektiven nationalen Multicenterstudie Patienten im Alter von bis zu zwölf Jahren, die mit einer vorderen Kreuzbandoperation versorgt worden waren, nachuntersucht. Zum anderen wurden im Rahmen einer systematischen Literaturanalyse die Literaturdatenbanken Medline und Embase, die Cochrane Library sowie die Springer- und die Thieme-Verlagsdatenbank durchsucht und operative Versorgungen von Patienten im Wachstumsalter mit einer vorderen Kreuzbandruptur erfasst. In den zehn Kliniken, die in die Multicenterstudie eingeschlossen waren, wurden 25 Patienten nachuntersucht. In der systematischen Literaturanalyse wurden insgesamt 59 Artikel mit 860 operativen Versorgungen von Patienten im Wachstumsalter erfasst. Die Kreuzbandnaht zeigte insgesamt schlechtere klinische Ergebnisse als die Kreuzbandersatzplastik. Fugenkreuzende und fugenschonende Operationstechniken führten zu ähnlich guten klinischen Ergebnissen. Die Rate an Beinlängendifferenzen oder Achsenabweichungen war jedoch bei den fugenschonenden Techniken deutlich höher. Zwischen den verwendeten Transplantaten (Patellasehne, Hamstring, Quadrizepssehne, Fascia lata und Allograft) und auch zwischen gelenknaher und gelenkferner Transplantatfixierung wurden keine wesentlichen Unterschiede in den Ergebnissen festgestellt. Hinsichtlich der Technik zur Bohrung des femoralen Knochenkanals war der anteromediale Zugangsweg nicht mit einer höheren Rate an Beinlängendifferenzen oder Achsenabweichungen assoziiert als der transtibiale Zugang. Insgesamt lassen sich für Patienten im Alter von bis zu zwölf Jahren mit einer Kreuzbandplastik gute bis sehr gute klinische Ergebnisse erzielen. Die Gefahr mit der Operation eine irreversible Beinlängendifferenz oder Achsenabweichung zu verursachen ist jedoch beachtlich und bei Patienten bis zu zwölf Jahren vermutlich größer als bei älteren Patienten, die sich kurz vor Abschluss ihres Wachstums befinden.

The effectiveness of land sharing and land sparing (LS/LS) approaches to conservation in the face of rising agricultural demands has been widely debated. While numerous studies have investigated the LS/LS framework from an ecological lens (yield-biodiversity relationship) the relevance of the framework to real life depends on broader considerations. Some of the key caveats include: i) limited knowledge regarding the feasibility of interventions given diverse stakeholders’ interests, ii) the social acceptability (uptake) of these contrasting strategies to direct land users, and iii) limited knowledge regarding their impacts on individuals’ livelihoods and food security. Without considering these social science dimensions proponents of the framework risk an incomplete picture that is not grounded in local realities and can paradoxically force into opposition the very conservation and development interests they seek to reconcile. Using a Companion Modelling approach, which comprises the development of a role-playing game (RPG) and an agent-based model (ABM), this thesis addressed these caveats. The research was based in the Nilgiris of Western Ghats India, a tropical agricultural system at the forest frontier. The main findings show that through engaging local stakeholders in a participatory process, plausible land use strategies that align with their objectives could be identified. Stakeholders proposed three land use interventions. Two of them resemble a form of land sparing (‘monofunctional’ landscapes) on the farms: sparing land for Wildflower Meadows or Tree Plantations while increasing yield on the remaining land. The third intervention asks farmers to accept yield penalties for Intercropping more trees on their farms, a form of land sharing (‘integrated’ landscapes). In terms of decision-making regarding the adoption of these three interventions by direct land users, the study reveals several findings. Firstly there are three main types of motivations that influence farmers’ decision to adopt interventions, in order of importance: monetary benefits, pro-environmental motivations and social norms. Secondly, land use, the type of management preferred on the farm and whether land users accept trees on the farm or not are factors that influence what type of interventions is socially acceptable on individual farms. These factors have been detected in the in-depth household survey and also validated by the RPG. When assessing the adoption of the three interventions, ex ante their implementation, using an ABM, there are some important differences observed between the interventions. Wildflower Meadows is the intervention adopted by the largest number of households, whereas Intercropping is adopted across the largest area of land. Forest Plantations is significantly more unpopular than the other two interventions. The third line of investigation, about the outcomes of adoption, has important policy implications. Adding a socioeconomic dimension to the ecological one adds a level of complexity and creates a less straightforward choice between the LS/LS strategies. None of the three interventions can provide optimal outcomes for production, aspects of biodiversity conservation, livelihoods and food security. Each intervention has indicators that score better compared to the other two interventions. The findings demonstrate that the ecological focus of the LS/LS framework is insufficient to deal with real-world complexities and lends itself to overly simplistic policy prescriptions. More meaningful policies could be achieved when bridging natural and social sciences to better understand the merits and limitations of the LS/LS approaches.

Made available in DSpace on 2016-05-02T13:55:33Z (GMT). No. of bitstreams: 1 CelioLuizBernardes-Dissertacao.pdf: 591497 bytes, checksum: 3c6604ea02d2ceebbbe446b5f072e787 (MD5) Previous issue date: 2012-03-05 / This study evaluated the influence of different carbohydrate/lipid ratios (CHO:L) in the diet of hybrid catfishes, carnivorous Pseudoplastitoma reticulatum x omnivorous Leiarius marmoratus, on the performance, body composition and nutrient utilization. Four isoproteic diets were formulated containing 43% crude protein, with increasing levels of lipids with CHO: diet I, 1.3; diet II, 1.1; diet III, 0.9; diet IV, 0.8. The fishes were fed at 5% of the living body weight (LBW) for the triplicate groups of 6 fishes (18 ± 1.5 g) during 8 weeks. Although the final weight and the absolute weight gain decreased with the increase of lipids in the diet, no significant difference was found in the ration daily consumption (DC) between the treatments. In addition, the viscerosomatic index (VSI) and the hepatosomatic index (HIS) showed no statistic difference between the dietary treatments. Protein efficiency retention (PER), lipid efficiency retention (LER) and protein gain (PG) were higher in the 1.3 CHO:L group, but no significant difference was found between the 0.9 and 0.8 CHO:L groups. In conclusion, high CHO:L ratios around 1.3 produced great benefit due to the best growth performance in the studied hybrid model. / Avaliou-se a influência de diferentes níveis de carboidratos / lipídios na dieta de peixes (CHO/ L) sobre o desempenho , composição corporal e utilização de nutrientes de híbrido, carnívoros (Pseudoplastistoma reticulatum ) x onívoros (Leiarius marmoratus) . Quatro dietas isoproteicas foram formuladas contendo proteína bruta a 43%, com aumento dos níveis de lipídios na dieta, usando-se o CHO com os seguintes índices: L: dieta 1, 1,3; dieta 2, 1,1; dieta 3, 0,9. e dieta 4, 0,8. Os peixes foram alimentados a 5% do peso vivo (PV) para os grupos triplicados, de 6 peixes (18 ± 1,5 g) durante 8 semanas. Apesar do peso final e do ganho em peso absoluto ter diminuído com o aumento de lipídios na dieta, não houve diferença significativa no consumo diário de ração (CD) entre os tratamentos. Além disso, o índice viscerossomático (IVS) e índice hepatossomático (IHS) não apresentaram nenhuma diferença estatística entre os tratamentos dietéticos. O teor de proteína muscular foi alto e significativo para os peixes alimentados com a dieta 1. Contudo, houve a diminuição de umidade e lipídios nos peixes alimentados com a dieta 4. A retenção de eficiência protéica (ERP), a retenção de eficiência lipídica (ERL) e o ganho de proteína (GP) foram superiores no grupo 1,3 CHO/L, mas nenhuma diferença significante foi encontrada entre os grupos 0.9 e 0.8 CHO:L. Em conclusão, CHO alta: cerca de 1,3 L relações apresentaram grande benefício, pelo melhor crescimento no modelo estudado no híbrido.

While I spent 7 years of study, experience and dedication to this work, the building construction has passed evolution from construction boom to contemporary building crisis. Demand for cheap building construction, materials and family housing increased sharply. Energy prices are rising every year... It seems that we will all have to deal with our essential task today or in the near future . This task is mean to prevent the current rate of degradation and destruction of our planet's climate and our environment. In this point of view, it looks the question of energy-saving construction very topical. By entering the study was to examine the possibilities of environmental friendly housing in rural areas in terms of environmental issues. My hypothesis was if can I determine the suitable candidate for the construction of passive houses themselves by comparing their characteristic of pre-defined construction samples. My objective is to offer builders and designers overview of suitable building systems with the possibility to compare the various factors influencing the decision on the selection of a builder´s construction for a house. The thesis presents the comparison of seven structural systems as a basic element of architecture. In the implementation of energy-efficient house is an architectural form often conditioned by structure. For this reason it is necessary to offer this kind of overview with options and parameters of individual building systems, which can then be used by architect to design a house for the builder - free and easy realization of his own, let´s say DIY (do it yourself). For builders (mean investors) of DIY houses is economy and finance a crucial question, therefore, for this reason I will evaluate suitable building system which is relative performance vs. price in the end. It is necessary to take into account the architecture of the house and especially the space layout and design and the attitude with the context of the rural areas environment. My pupose was to prove that good architectural design can be used with of low-cost, energy-saving and environmental friendly house built in DIY way.

Amyloidosis is a term used for a whole group of diseases caused by deposition of a substance called amyloid into different tissues. Amyloid may be produced by a range of pathologic processes. Heart affliction is typical for only several types of amyloidoses. Heart involvement is then the patient`s prognosis major limiting factor. Diagnosis of heart amyloidosis is difficult especially for nonspecific symptoms and nonspecific findings obtained during common diagnostic procedures. The aim of this thesis was to evaluate usefulness of novel diagnostic methods, namely cardiac magnetic resonance with gadolinium enhancement and a simplified echocardiographic evaluation of left ventricular longitudinal strain, in diagnosing amyloid cardiomyopathy. In our first study we examined 22 patients with light chain amyloidosis by echocardiography and also with cardiac magnetic resonance with late gadolinium enhancement. We compared morphologic and functional parameters acquired by magnetic resonance examination, which is considered a gold standard for morphologic and functional measurements, with values obtained by echocardiographic measurement. Afterwards we evaluated the presence and eventually pattern of late gadolinium enhancement during cardiac magnetic resonance exam. From acquired data we conclude that the...

Traditionally, fish meal (FM) and fish oil (FO) have been used extensively in aquafeeds, mainly due to their excellent nutritional properties. However, various reasons dictate the use of sustainable alternatives and the reduction of the dependence on these commodities in fish feeds. Hence, the aim of the present thesis was to investigate the effects of the replacement of FM and FO with two vegetable oils (VO) and an oilseed meal on the growth performance, feed utilization, nutrient and fatty acids (FA) digestibility and tissue FA composition and metabolism in three commercially important European fish species. Specifically, in Experiment I crude palm oil (PO) was used to replace FO in diets for rainbow trout. In Experiments II and III FO was replaced with rapeseed oil (RO) in diets for Atlantic salmon at various dietary protein/lipid levels aiming also at further reductions of FM by using low protein (high lipid) diet formulations. In Experiments II and III the fish were reared at low and high water temperatures, respectively, in order to elucidate, also, the potential effects of temperature. Lastly, the effects of the replacement of FM with full fat soya meal (FFS) in Atlantic cod were investigated in Experiment IV. The results of the present thesis showed no negative effects on growth performance and feed utilization in rainbow trout when FO was replaced with PO. The dietary inclusion of RO improved the growth of Atlantic salmon, possibly, due to changes in the nutrient and FA digestibilities and FA catabolism while, the growth and feed utilization were unaffected by the dietary protein/lipid level. However, the growth of Atlantic cod was affected negatively by the replacement of FM with FFS. The proximate composition of the fish whole body was in most cases unaffected by dietary treatments. The changes in dietary formulations affected the dietary FA compositions and resulted in significant changes in the fish tissue FA compositions. It was clearly shown that the fish tissue total lipid FA composition reflects the FA composition of the diet, although specific FA were selectively utilized or retained in the tissues by the fish. These may have serious implications not only for fish metabolism and growth but also for the quality of the final product, especially in terms of possible reductions of n-3 HUFA.

This dissertation interrogates which principles should govern the interpretation of South African Double Tax Agreements (‘DTAs’). This field of study is complex because any DTAs have a dual nature. In the first place, it is an international agreement where two states are parties (a bilateral agreement); second, it also becomes part of domestic law. DTAs are governed by principles of customary international law some of which have been codified in the Vienna Convention on the Law of Treaties (‘VCLT’). Though South Africa is not a party to the VCLT, nevertheless, there is judicial support in South Africa for the notion that VCLT reflects general principles of international law [Harksen v President of the Republic of South Africa 1998 (2) SA 1011 (C)]. DTAs are incorporated into South African domestic law by way of statutory enactment in accordance with the dualist approach to international law. The first purpose of the dissertation is to systematise and analyse the structure of an OECD Model Tax Convention (‘OEC D MTC’) and the international methods (principles) of interpretation of DTAs in order to gain a better understanding of how this international methods functions. A number of issues relating to the interpretation of these methods are analysed. Since DTAs are applied by tax authorities, courts and taxpayers in a domestic law context, i.e. within the framework of the legal system of a particular state, the analysis focuses on the application in South Africa of the methods of the interpretation of South African DTAs. The second objective of the dissertation refers to international tax law principles (treaties and customary international law) derived from South Africa public international law and to evaluate a few selected issues related to South African DTAs and their relevance to South Africa domestic tax laws; the interpretation of DTAs and the implications of a DTA overriding or in conflict with South Africa domestic tax laws. It will also interrogate the legal status of a DTA under South African tax law and whether the anti-discrimination article in South Africa DTAs have the force of law in South Africa? / Dissertation (LLM)--University of Pretoria, 2014. / gm2014 / Mercantile Law / unrestricted

INTRODUÇÃO: A microcirurgia endoscópica transanal (TEM) é uma técnica minimamente invasiva segura e eficiente para o tratamento de neoplasia retal benigna e maligna precoce. As complicações pós operatórias podem ser graves. Existe controvérsia na literatura a respeito da sua incidência e gravidade. OBJETIVOS: Avaliar os fatores de risco relacionados a incidência e gravidade das complicações pós operatórias e seu comportamento temporal em pacientes com neoplasia retal tratados por TEM. MÉTODOS: Estudo prospectivo das complicações pós-operatórias usando a classificação e graduação de Clavien-Dindo. As características estudadas dos pacientes foram: idade, sexo, risco cirúrgico dado pela Associação Americana de Anestesiologia (ASA), quimiorradioterapia neoadjuvante, altura e tamanho da lesão, margens patológicas, histologia do tumor e tipo de sutura: por TEM ou por afastador anal convencional. RESULTADOS: Dentre os cinquenta e três pacientes tratados, a morbidade geral foi de 50%. Incontinência foi a complicação mais frequente (17,3%). Apenas uma paciente teve incontinência persistente. As taxas de complicações pós-operatórias grau I e grau II (GII) foram ambas 21,1%; para grau III (GIII) e IV também foram ambas: 3,8%. Não houve mortalidade. Dos pacientes que tiveram complicações pós-operatórias, 61,54% tinham lesões abaixo da primeira válvula retal, comparado com 38,46% dos pacientes com lesões acima da primeira válvula (p=0.039). Pacientes submetidos à quimiorradioterapia neoadjuvante tiveram 24 vezes mais chance de apresentarem complicações pós-operatórias GII (p=0,002), e 7,03 vezes mais chance de GIII (p=0,098). Quando a sutura da ferida cirúrgica foi realizada por TEM, houve 16 vezes menos chance de ocorrerem complicações pós-operatórias GIII (p=0,043). 53% das complicações pós-operatórias ocorreram em 10 dias e 95%, em 20 dias. CONCLUSÕES: Complicações pós-operatórias pós TEM são frequentes, aceitáveis e geralmente controladas com medicamentos. Pacientes com lesões mais distais têm mais complicações pós-operatórias. Pacientes que receberam quimiorradioterapia neoadjuvante e submetidos a sutura com afastador de ânus convencional tiveram complicações pós operatórias que requereram intervenção médica - cirúrgica ou endoscópica sobre sedação. O comportamento temporal das complicações é progressivo e inespecífico, a maioria ocorrendo nos primeiros 20 dias / INTRODUCTION: Transanal endoscopic microsurgery (TEM) is a safe and efficient minimally invasive treatment for rectal benign and early malignant neoplasia. Postoperative complications may be severe. Controversy exists with regard to incidence and severity. OBJECTIVES: Evaluate risk factors related to incidence and severity of postoperative complications, and time course, in patients with rectal neoplasia treated by TEM. METHODS: Prospective study of postoperative complications using the Clavien-Dindo classification and grading system. Patients\' characteristics included age, sex, ASA score, neoadjuvant chemoradiotherapy (CRT), lesion height and size, pathologic margins, tumor histology, and suture type: through TEM or conventional retractor. RESULTS: Among fifty-three patients treated,overall morbidity rate was 50%. Incontinence was the most frequent complication (17.3%). One patient had persistent incontinence. Grade I and Grade II (GII) postoperative complication rates were both 21.1%, and Grade III (GIII) and IV rates were both 3.8%. There was no mortality. Of the patients with postoperative complications, 61.54% had lesions under the first rectal valve, compared with 38.46% of patients with lesions over the first valve (p=0.039). Patients submitted to CRT had a 24-fold greater chance of presenting GII complications (p=0.002), and a 7.03-fold greater chance of GIII (p=0.098). When the surgical defect was treated using the TEM device to perform the suture, there was a 16-fold less chance of having GIII complications (p=0.043). Fifty-three percent of complications occurred in the first 10 days, and 95% within 20 days. CONCLUSIONS: Postoperative complications after TEM for the treatment of rectal neoplasia are frequent, acceptable, and usually controllable with pharmacologic treatment. Patients with more distal lesions have more postoperative complications. Patients receiving neoadjuvant CRT and submitted to suture with a conventional anal retractor have more postoperative complications that require intervention under sedation. Over time the nature of complications is progressive and nonspecific, with most occurring within the first 20 days

INTRODUÇÃO: A microcirurgia endoscópica transanal (TEM) é uma técnica minimamente invasiva segura e eficiente para o tratamento de neoplasia retal benigna e maligna precoce. As complicações pós operatórias podem ser graves. Existe controvérsia na literatura a respeito da sua incidência e gravidade. OBJETIVOS: Avaliar os fatores de risco relacionados a incidência e gravidade das complicações pós operatórias e seu comportamento temporal em pacientes com neoplasia retal tratados por TEM. MÉTODOS: Estudo prospectivo das complicações pós-operatórias usando a classificação e graduação de Clavien-Dindo. As características estudadas dos pacientes foram: idade, sexo, risco cirúrgico dado pela Associação Americana de Anestesiologia (ASA), quimiorradioterapia neoadjuvante, altura e tamanho da lesão, margens patológicas, histologia do tumor e tipo de sutura: por TEM ou por afastador anal convencional. RESULTADOS: Dentre os cinquenta e três pacientes tratados, a morbidade geral foi de 50%. Incontinência foi a complicação mais frequente (17,3%). Apenas uma paciente teve incontinência persistente. As taxas de complicações pós-operatórias grau I e grau II (GII) foram ambas 21,1%; para grau III (GIII) e IV também foram ambas: 3,8%. Não houve mortalidade. Dos pacientes que tiveram complicações pós-operatórias, 61,54% tinham lesões abaixo da primeira válvula retal, comparado com 38,46% dos pacientes com lesões acima da primeira válvula (p=0.039). Pacientes submetidos à quimiorradioterapia neoadjuvante tiveram 24 vezes mais chance de apresentarem complicações pós-operatórias GII (p=0,002), e 7,03 vezes mais chance de GIII (p=0,098). Quando a sutura da ferida cirúrgica foi realizada por TEM, houve 16 vezes menos chance de ocorrerem complicações pós-operatórias GIII (p=0,043). 53% das complicações pós-operatórias ocorreram em 10 dias e 95%, em 20 dias. CONCLUSÕES: Complicações pós-operatórias pós TEM são frequentes, aceitáveis e geralmente controladas com medicamentos. Pacientes com lesões mais distais têm mais complicações pós-operatórias. Pacientes que receberam quimiorradioterapia neoadjuvante e submetidos a sutura com afastador de ânus convencional tiveram complicações pós operatórias que requereram intervenção médica - cirúrgica ou endoscópica sobre sedação. O comportamento temporal das complicações é progressivo e inespecífico, a maioria ocorrendo nos primeiros 20 dias / INTRODUCTION: Transanal endoscopic microsurgery (TEM) is a safe and efficient minimally invasive treatment for rectal benign and early malignant neoplasia. Postoperative complications may be severe. Controversy exists with regard to incidence and severity. OBJECTIVES: Evaluate risk factors related to incidence and severity of postoperative complications, and time course, in patients with rectal neoplasia treated by TEM. METHODS: Prospective study of postoperative complications using the Clavien-Dindo classification and grading system. Patients\' characteristics included age, sex, ASA score, neoadjuvant chemoradiotherapy (CRT), lesion height and size, pathologic margins, tumor histology, and suture type: through TEM or conventional retractor. RESULTS: Among fifty-three patients treated,overall morbidity rate was 50%. Incontinence was the most frequent complication (17.3%). One patient had persistent incontinence. Grade I and Grade II (GII) postoperative complication rates were both 21.1%, and Grade III (GIII) and IV rates were both 3.8%. There was no mortality. Of the patients with postoperative complications, 61.54% had lesions under the first rectal valve, compared with 38.46% of patients with lesions over the first valve (p=0.039). Patients submitted to CRT had a 24-fold greater chance of presenting GII complications (p=0.002), and a 7.03-fold greater chance of GIII (p=0.098). When the surgical defect was treated using the TEM device to perform the suture, there was a 16-fold less chance of having GIII complications (p=0.043). Fifty-three percent of complications occurred in the first 10 days, and 95% within 20 days. CONCLUSIONS: Postoperative complications after TEM for the treatment of rectal neoplasia are frequent, acceptable, and usually controllable with pharmacologic treatment. Patients with more distal lesions have more postoperative complications. Patients receiving neoadjuvant CRT and submitted to suture with a conventional anal retractor have more postoperative complications that require intervention under sedation. Over time the nature of complications is progressive and nonspecific, with most occurring within the first 20 days