Aggressive behavior in patients with intellectual disability can be resistant to pharmacological treatment and have detrimental consequences to themselves, family members, and caregivers. Hypothalamic deep brain stimulation (DBS) has been used to improve this type of behavior in severe and refractory cases. Here, we present the description and analysis of DBS of the posteromedial hypothalamus (PMH) and its long-term impact as treatment to improve severe and refractory aggressive behaviors, even with previous bilateral hypothalamotomy without improvement in patients with intellectual disability. Eleven patients underwent bilateral DBS of the PMH. Their medical records were reviewed, and the impact on behavior was measured using preoperative and postoperative Modified Overt Aggression Scale (MOAS) during the last follow-up medical visit. Nine of 11 patients presented a significant decrease in the severity of aggressive behavior, with a preoperative and postoperative MOAS average value of 50.5 and 18.7, respectively. An overall improvement of 63% was seen with a mean follow-up time of 4 years. A patient who previously underwent a bilateral hypothalamotomy via radiofrequency was included in this group. During follow-up, 3 patients presented deterioration of symptoms subsequent to pulse generator depletion but made a full clinical recovery after battery replacement. We posit that DBS of the PMH may be a safe and effective in improving severe and refractory aggressive behavior in patients with long-term intellectual disability.
RESUMO:O processo da retrolavagem consiste na passagem da água através do filtro em sentido contrário ao fluxo de filtragem com o objetivo de remover partículas orgânicas e inorgânicas retidas no meio filtrante. O projeto de filtros de areia com configurações ineficientes e a ocorrência de condições operacionais inadequadas contribuem para limitar o desempenho desse processo, causando deficiências na limpeza dos meios filtrantes e comprometendo o funcionamento dos sistemas de irrigação localizada. O objetivo do presente trabalho é proporcionar uma revisão sobre os conceitos associados ao processo da retrolavagem nos filtros de areia, relacionando informações existentes na literatura com experiências de laboratório. Foi gerado um texto básico com informações técnico-científicas sobre o tema, visando a criar um momento de reflexão sobre o processo de retrolavagem e a contribuir para a melhoria do desempenho desses equipamentos na irrigação localizada. PALAVRAS-CHAVE:filtração, fluidização, camada filtrante. BACKWASH PROCESS IN SAND FILTERS USED IN LOCALIZED IRRIGATION ABSTRACT:The backwash process consists of water passing through the filter in the opposite direction of the filtering flow to remove organic and inorganic particles of media filter. Inefficient sand filters designs and the occurrence of inadequate operating conditions contribute to restrict the process performance, causing deficiencies in the filter cleaning and compromise the operation of localized irrigation systems. The objective of this study is to provide a review about concepts associated with the backwash process in sand filters, relating literature information with laboratory experiments. A basic documentation was produced with technical and scientific information on this subject to create a reflection about the backwash process and contribute to the improvement of the equipment performance in the localized irrigation. KEYWORDS:Filtration, fluidization, filtering bed. INTRODUÇÃOOs filtros de areia são dispositivos que contêm uma camada de material filtrante para reter partículas orgânicas e inorgânicas presentes na água, sendo recomendados na presença de contaminação orgânica e de algas, devido a sua capacidade de retenção que ocorre entre o meio granular do material filtrante. Esses equipamentos possuem duas operações básicas de operação: filtração, para a remoção de matéria em suspensão presente na água mediante sua passagem pela areia, e a retrolavagem, etapa utilizada para a limpeza ou retirada da matéria ou de impurezas acumuladas ao longo da camada filtrante. A determinação da capacidade de filtração e o entendimento do processo de retrolavagem são essenciais para a operação adequada desses equipamentos.Segundo CRUZ & ZANINI (2010), a elevada concentração de sólidos grosseiros (areia) nas águas utilizadas na irrigação vem comprometendo a eficiência dos sistemas, principalmente pela obstrução dos emissores. Esse processo de entupimento é o principal indicador que o sistema de filtração não está funcionando corretamente, principalmente po...
RESUMO:A dinâmica de operação dos filtros de areia afeta o desempenho hidráulico do sistema de irrigação, elevando a perda de carga e alterando a altura manométrica total do sistema. Buscando entender parte dessa dinâmica, o objetivo deste trabalho foi determinar o efeito da estrutura interna de filtros de areia na perda de carga de três modelos de equipamentos fabricados no Brasil, sem a presença do elemento filtrante e utilizando água limpa. Adicionalmente, com o ajuste do modelo matemático exponencial aos dados experimentais, procurou-se estabelecer comparações entre os tipos de estrutura dos filtros avaliados. Os ensaios foram realizados em um módulo experimental construído no Laboratório de Hidráulica e Irrigação da FEAGRI/UNICAMP. Os resultados mostraram que a estrutura hidráulica interna dos filtros determinou comportamentos hidráulicos diferenciados e que os tipos de estruturas (placa difusora e drenos) alteraram o padrão de operação dos modelos ensaiados. A função matemática proposta representou, significativamente, o fenômeno físico de perda de carga para as condições do experimento. PALAVRAS-CHAVE:irrigação localizada, placa difusora, drenos. CONTRIBUTION OF THE INTERNAL STRUCTURE IN THE SAND FILTERS HEAD LOSS USED IN IRRIGATION ABSTRACT:The dynamic of operation of sand filters affect the hydraulic performance of irrigation systems, increasing the head loss and changing the total dynamic head of the system. Trying to understand part of this dynamic, the objective of this research was to determine the effect of internal hydraulic structures in the head loss of three sand filters of commercial models, manufactured in Brazil and operating without the filter layer and with clean water. In addition, using an exponential mathematical model adjusted to the experimental data, comparisons among types of structure of each evaluated filter were performed. The trails were accomplished in the experimental module developed in the Laboratory of Hydraulics and Irrigation of FEAGRI / UNICAMP. The results showed that the filters structures determined differentiate hydraulic behaviors and each type of structures (diffuser plate and drains) change the standard operation for the evaluated filters. The mathematical function proposed represented significantly the head loss physical phenomenon for the experimental conditions.
In this paper, we investigated how justifications for price increases are associated with risky decision making and emotional responses. Across two studies with paired lottery choices and sequential decisions, we found that participants presented with a justification for price increases based on increasing demand decided to invest in a comparatively riskier asset more often than participants presented with a justification for price increases based on increasing tax or those presented with no justification at all. We also found that participants presented with justifications for price increases based on increasing demand also reported higher arousal and displayed higher galvanic skin response than people in the other two justification conditions. Together, these studies provide evidence that only the increasing demand condition underlying a price increase of a risky asset can influence the decision to buy and suggests that emotional activation has a crucial role in such a decision process.
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