Drug therapy complexity: the importance of pharmacotherapeutic follow-up

Nowadays, the phenomenon of population ageing represents an worldwide problem, which assumes particular significance in Portugal. As they get older, individuals present more comorbidities and consequently consume an increasing number of drugs, which contributes to a growing drug therapy complexity. The institutionalized elders are particularly affected by this occurrence. Drug therapy complexity is defined as the conciliator of several characteristics of the pharmacotherapy and can affect patient’s safety and medication adherence. It can be measured with Medication Regimen Complexity Index (MRCI). This study aims to determine the drug therapy complexity of institutionalized elders in order to assess the need of pharmacotherapeutic follow-up.

Arrow Plot: a new graphical tool for selecting up and down regulated genes and genes differentially expressed on samples subgroups

Background: A common task in analyzing microarray data is to determine which genes are differentially expressed across two (or more) kind of tissue samples or samples submitted under experimental conditions. Several statistical methods have been proposed to accomplish this goal, generally based on measures of distance between classes. It is well known that biological samples are heterogeneous because of factors such as molecular subtypes or genetic background that are often unknown to the experimenter. For instance, in experiments which involve molecular classification of tumors it is important to identify significant subtypes of cancer. Bimodal or multimodal distributions often reflect the presence of subsamples mixtures. Consequently, there can be genes differentially expressed on sample subgroups which are missed if usual statistical approaches are used. In this paper we propose a new graphical tool which not only identifies genes with up and down regulations, but also genes with differential expression in different subclasses, that are usually missed if current statistical methods are used. This tool is based on two measures of distance between samples, namely the overlapping coefficient (OVL) between two densities and the area under the receiver operating characteristic (ROC) curve. The methodology proposed here was implemented in the open-source R software. Results: This method was applied to a publicly available dataset, as well as to a simulated dataset. We compared our results with the ones obtained using some of the standard methods for detecting differentially expressed genes, namely Welch t-statistic, fold change (FC), rank products (RP), average difference (AD), weighted average difference (WAD), moderated t-statistic (modT), intensity-based moderated t-statistic (ibmT), significance analysis of microarrays (samT) and area under the ROC curve (AUC). On both datasets all differentially expressed genes with bimodal or multimodal distributions were not selected by all standard selection procedures. We also compared our results with (i) area between ROC curve and rising area (ABCR) and (ii) the test for not proper ROC curves (TNRC). We found our methodology more comprehensive, because it detects both bimodal and multimodal distributions and different variances can be considered on both samples. Another advantage of our method is that we can analyze graphically the behavior of different kinds of differentially expressed genes. Conclusion: Our results indicate that the arrow plot represents a new flexible and useful tool for the analysis of gene expression profiles from microarrays.

Theoretical Analysis of Multimodal Four-Wave Mixing in Optical Microwires

Optical fiber microwires (OFMs) are nonlinear optical waveguides that support several spatial modes. The multimodal generalized nonlinear Schrodinger equation (MM-GNLSE) is deduced taking into account the linear and nonlinear modal coupling. A detailed theoretical description of four-wave mixing (FWM) considering the modal coupling is developed. Both, the intramode and the intermode phase-matching conditions is calculated for an optical microwire in a strong guiding regime. Finally, the FWM dynamics is studied and the amplitude evolution of the pump beams, the signal and the idler are analyzed.

Start-up circuit for low-power indoor light energy harvesting applications

A start-up circuit, used in a micro-power indoor light energy harvesting system, is described. This start-up circuit achieves two goals: first, to produce a reset signal, power-on-reset (POR), for the energy harvesting system, and secondly, to temporarily shunt the output of the photovoltaic (PV) cells, to the output node of the system, which is connected to a capacitor. This capacitor is charged to a suitable value, so that a voltage step-up converter starts operating, thus increasing the output voltage to a larger value than the one provided by the PV cells. A prototype of the circuit was manufactured in a 130 nm CMOS technology, occupying an area of only 0.019 mm(2). Experimental results demonstrate the correct operation of the circuit, being able to correctly start-up the system, even when having an input as low as 390 mV using, in this case, an estimated energy of only 5.3 pJ to produce the start-up.

Assesing multileaf collimator effect on the build-up region using Monte Carlo method

Previous Monte Carlo studies have investigated the multileaf collimator (MLC) contribution to the build-up region for fields in which the MLC leaves were fully blocking the openings defined by the collimation jaws. In the present work, we investigate the same effect but for symmetric and asymmetric MLC defined field sizes (2×2, 4×4, 10×10 and 3×7 cm2). A Varian 2100C/D accelerator with 120-leaf MLC is accurately modeled fora6MVphoton beam using the BEAMnrc/EGSnrc code. Our results indicate that particles scattered from accelerator head and MLC are responsible for the increase of about 7% on the surface dose when comparing 2×2 and 10×10 cm2 fields. We found that the MLC contribution to the total build-up dose is about 2% for the 2×2 cm2 field and less than 1% for the largest fields.

Os (in)sofismáveis caminhos do storytelling : Woody Allen e o documentário ficcionado

ABSTRACT: Between pure documentary and pure fiction there are, more and more, a reasonable number of cinematic alternatives that convey a dimension of non-reality. Between the pointedly factual discourse and the irrational belief in an entirely narrative world, there intervenes an informed conviction in a truthful but nonexistent universe, in which the formal enunciation sells an image of objectivity. In a path that leads us from the forms and contents of reflexive and performative documentaries, according to Bill Nichols, and ends up in fake documentary itself, we will have the opportunity to stress the filmic construction and its inherent narrative purpose, be it a fictional story or the creator himself as character (others would say subject) of the cinematic construct. In a boomerang kind of logic, the more the objects direct us to a referent, the more they restore us a creative/authorial reference and, along with it, the narrative idea that instills it. In Woody Allen’s case, this storytelling manifests itself in the fake documentary genre, which works as if it is the reality, only to better manifest the sole reality that interests the director: that of the metacinema, or the cinema as self-referencial reality. The practical examples will be derived from the following films: Take the Money and Run (1969) e Husbands and Wives (1992).

Aplicações e algoritmos de segurança rodoviária com o uso de sistemas de GPS e de comunicações WAVE

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia de Electrónica e Telecomunicações

A importância do follow-up na auditoria interna em Portugal

Mestrado em Auditoria

Happiness, hope, and affection as predictors of quality of life and functionality of individuals with heart failure at three-month follow-up

The scientific evidence supporting the management of the chronically ill in a positive psychological perspective in opposition to traditional pathological approach is scarce. This study examines issues associated with recovery of health status in heart failure, in particular hope, affection, and happiness. We use a longitudinal study of 128 symptomatic patients who after medical intervention reported improved quality of life and function at 3-month follow-up. We evaluated the contribution of happiness, hope and affection, individually and as a whole, in the quality of life and functionality of individuals with heart failure. Happiness (Subjective Happiness Scale), Hope (HOPE Scale), and affection (PANAS (positive and negative affect schedule)) were determined before medical intervention. Individually, we found that happiness is correlated with the quality of life and functionality, hope to self-efficacy dimension of the quality of life scale, positive affect to functionality and negative affect with symptoms dimension, quality of life dimension, and overall sum of the quality of life scale. Overall, we found that happiness has a unique contribution to the quality of life, except in self-efficacy dimension where hope takes this contribution and positive affect has a unique contribution to the functionality in this short-term follow-up. The results highlight the importance of positive variables to health outcomes for people with heart failure and should be considered in intervention programs for this syndrome.

A CMOS micro power switched-capacitor DC-DC step-up converter for indoor light energy harvesting applications

This paper presents a micro power light energy harvesting system for indoor environments. Light energy is collected by amorphous silicon photovoltaic (a-Si:H PV) cells, processed by a switched capacitor (SC) voltage doubler circuit with maximum power point tracking (MPPT), and finally stored in a large capacitor. The MPPT fractional open circuit voltage (V-OC) technique is implemented by an asynchronous state machine (ASM) that creates and dynamically adjusts the clock frequency of the step-up SC circuit, matching the input impedance of the SC circuit to the maximum power point condition of the PV cells. The ASM has a separate local power supply to make it robust against load variations. In order to reduce the area occupied by the SC circuit, while maintaining an acceptable efficiency value, the SC circuit uses MOSFET capacitors with a charge sharing scheme for the bottom plate parasitic capacitors. The circuit occupies an area of 0.31 mm(2) in a 130 nm CMOS technology. The system was designed in order to work under realistic indoor light intensities. Experimental results show that the proposed system, using PV cells with an area of 14 cm(2), is capable of starting-up from a 0 V condition, with an irradiance of only 0.32 W/m(2). After starting-up, the system requires an irradiance of only 0.18 W/m(2) (18 mu W/cm(2)) to remain operating. The ASM circuit can operate correctly using a local power supply voltage of 453 mV, dissipating only 0.085 mu W. These values are, to the best of the authors' knowledge, the lowest reported in the literature. The maximum efficiency of the SC converter is 70.3 % for an input power of 48 mu W, which is comparable with reported values from circuits operating at similar power levels.

Density measurements of compressed dipropyl, dibutul, bis (2-ethylhexyl) adipates from (293 to 373K) at pressures up to about 68MPa

The article reports density measurements of dipropyl (DPA), dibutyl (DBA) and bis(2-ethylhexyl) (DEHA) adipates, using a vibrating U-tube densimeter, model DMA HP, from Anton Paar GmbH. The measurements were performed in the temperature range (293 to 373) K and at pressures up to about 68 MPa, except for DPA for which the upper limits were 363 K and 65 MPa, respectively. The density data for each liquid was correlated with the temperature and pressure using a modified Tait equation. The expanded uncertainty of the present density results is estimated as 0.2% at a 95% confidence level. No literature density data at pressures higher than 0.1 MPa could be found. DEHA literature data at atmospheric pressure agree with the correlation of the present measurements, in the corresponding temperature range, within +/- 0.11%. The isothermal compressibility and the isobaric thermal expansion were calculated by differentiation of the modified Tait correlation equation. These two parameters were also calculated for dimethyl adipate (DMA), from density data reported in a previous work. The uncertainties of isothermal compressibility and the isobaric thermal expansion are estimated to be less than +/- 1.7% and +/- 1.1%, respectively, at a 95% confidence level. Literature data of isothermal compressibility and isobaric thermal expansivity for DMA have an agreement within +/- 1% and +/- 2.4%, respectively, with results calculated in this work. (C) 2014 Elsevier B.V. All rights reserved.

Tris(2-Ethylhexyl) trimellitate (TOTM) a potential reference fluid for high viscosity. Part I: viscosity measurements at temperatures from (303 to 373)K and pressures up to 65MPa, using a novel vibrating-wire instrument

No literature data above atmospheric pressure could be found for the viscosity of TOTIVI. As a consequence, the present viscosity results could only be compared upon extrapolation of the vibrating wire data to 0.1 MPa. Independent viscosity measurements were performed, at atmospheric pressure, using an Ubbelohde capillary in order to compare with the vibrating wire results, extrapolated by means of the above mentioned correlation. The two data sets agree within +/- 1%, which is commensurate with the mutual uncertainty of the experimental methods. Comparisons of the literature data obtained at atmospheric pressure with the present extrapolated vibrating-wire viscosity measurements have shown an agreement within +/- 2% for temperatures up to 339 K and within +/- 3.3% for temperatures up to 368 K. (C) 2014 Elsevier B.V. All rights reserved.

Tris(2-Ethylhexyl) trimellitate (TOTM) a potential reference fluid for high viscosity. Part II: density measurements at temperatures from (293 to 373)K and pressures up to 85MPa

In Part I of the present work we describe the viscosity measurements performed on tris(2-ethylhexyl) trimellitate or 1,2,4-benzenetricarboxylic acid, tris(2-ethylhexyl) ester (TOTM) up to 65 MPa and at six temperatures from (303 to 373)K, using a new vibrating-wire instrument. The main aim is to contribute to the proposal of that liquid as a potential reference fluid for high viscosity, high pressure and high temperature. The present Part II is dedicated to report the density measurements of TOTM necessary, not only to compute the viscosity data presented in Part I, but also as complementary data for the mentioned proposal. The present density measurements were obtained using a vibrating U-tube densimeter, model DMA HP, using model DMA5000 as a reading unit, both instruments from Anton Paar GmbH. The measurements were performed along five isotherms from (293 to 373)K and at eleven different pressures up to 68 MPa. As far as the authors are aware, the viscosity and density results are the first, above atmospheric pressure, to be published for TOTM. Due to TOTM's high viscosity, its density data were corrected for the viscosity effect on the U-tube density measurements. This effect was estimated using two Newtonian viscosity standard liquids, 20 AW and 200 GW. The density data were correlated with temperature and pressure using a modified Tait equation. The expanded uncertainty of the present density results is estimated as +/- 0.2% at a 95% confidence level. Those results were correlated with temperature and pressure by a modified Tait equation, with deviations within +/- 0.25%. Furthermore, the isothermal compressibility, K-T, and the isobaric thermal expansivity, alpha(p), were obtained by derivation of the modified Tait equation used for correlating the density data. The corresponding uncertainties, at a 95% confidence level, are estimated to be less than +/- 1.5% and +/- 1.2%, respectively. No isobaric thermal expansivity and isothermal compressibility for TOTM were found in the literature. (C) 2014 Elsevier B.V. All rights reserved.

Travelling wave profiles in some models with nonlinear diffusion

We study some properties of the monotone solutions of the boundary value problem (p(u'))' - cu' + f(u) = 0, u(-infinity) = 0, u(+infinity) = 1, where f is a continuous function, positive in (0, 1) and taking the value zero at 0 and 1, and P may be an increasing homeomorphism of (0, 1) or (0, +infinity) onto [0, +infinity). This problem arises when we look for travelling waves for the reaction diffusion equation partial derivative u/partial derivative t = partial derivative/partial derivative x [p(partial derivative u/partial derivative x)] + f(u) with the parameter c representing the wave speed. A possible model for the nonlinear diffusion is the relativistic curvature operator p(nu)= nu/root 1-nu(2). The same ideas apply when P is given by the one- dimensional p- Laplacian P(v) = |v|(p-2)v. In this case, an advection term is also considered. We show that, as for the classical Fisher- Kolmogorov- Petrovski- Piskounov equations, there is an interval of admissible speeds c and we give characterisations of the critical speed c. We also present some examples of exact solutions. (C) 2014 Elsevier Inc. All rights reserved.

Long-run consumption risk with durable goods : UK evidence for equity and bond markets

"It is a widely accepted fact that the consumption-based capital asset pricing model (CCAPM) fails to provide a good explanation of many important features of the behaviour of financial market returns in a large range of countries over a long period of time. However, within a representative consumer/investor model, it is hard to see how the basic structure of the consumption based model can be safely abandoned." [introdução]