Gasto de bolsillo en rehabilitación

En el presente estudio aunque se encontraron dificultades en cuanto a información sobre el gasto de bolsillo en rehabilitación en los diferentes continentes, se establecieron diferentes perspectivas que nos llevaron a tener un acercamiento de manera cuantitativa y cualitativa del gasto de bolsillo que requieren las personas en discapacidad específicamente en la ciudad de Bogotá, para poder acceder a los servicios de Rehabilitación, estos gastos no son reconocidos por el plan de beneficios en salud lo que conlleva a la generación de una problemática que esta directamente relacionada con el desmejoramiento de las condiciones económicas y sociales de esta población estado y aun más cuando los costos son más altos y el acceso es mas restringido a nivel de rehabilitación.

Eficacia de la melatonina en insomnio primario en el adulto mayor: revisión sistemática de la literatura

Introducción: La melatonina, una sustancia cronobiótica endógena, es cada vez más empleada para el manejo de los problemas del sueño en adultos mayores por su aparente eficacia y buen perfil de eventos adversos. En este sentido, se intentó evaluar la eficacia de la melatonina en el tratamiento del insomnio primario en el adulto mayor (≥55 años) comparado con benzodiacepinas, zopiclona y placebo a la luz de la evidencia disponible en los últimos cinco años. Métodos: Revisión sistemática de la literatura. Resultados: En comparación con placebo, al parecer la melatonina mejora la calidad y los hábitos de sueño, no así la latencia de inicio de sueño en mediciones subjetivas ni objetivas (polisomnografía); a diferencia de otros medicamentos hipnóticos, no altera la arquitectura del sueño ni genera síntomas diurnos. Conclusiones: No se encontró evidencia que soporte el uso de melatonina en adultos mayores de 55 años para la reducción de la latencia de sueño, aumento del tiempo total de sueño, mejoría de la eficiencia del sueño, disminución de despertares nocturnos o mejoría de la calidad de sueño. Es necesario adelantar más estudios en comparación con placebo y otros medicamentos.

On blame-freeness and reciprocity: an experimental study

The theory of reciprocity is predicated on the assumption that people are willing to reward nice or kind acts and to punish unkind ones. This assumption raises the question as to how to define kindness. In this paper we offer a new definition of kindness that we call “blame-freeness.” Put most simply, blame-freeness states that in judging whether player i has been kind or unkind to player j in a social situation, player j would have to put himself in the strategic position of player i, while retaining his preferences, and ask if he would have acted in a manner that was worse than i did under identical circumstances. If j would have acted in a more unkind manner than i acted, then we say that j does not blame i for his behavior. If, however, j would have been nicer than i was, then we say that “j blames i” for his actions (i’s actions were blameworthy). We consider this notion a natural, intuitive and empirically relevant way to explain the motives of people engaged in reciprocal behavior. After developing the conceptual framework, we then test this concept in a laboratory experiment involving tournaments and find significant support for the theory.

Functional genomics in zebrafish permits rapid characterization of novel platelet membrane proteins

In this study, we demonstrate the suitability of the vertebrate Danio rerio (zebrafish) for functional screening of novel platelet genes in vivo by reverse genetics. Comparative transcript analysis of platelets and their precursor cell, the megakaryocyte, together with nucleated blood cell elements, endothelial cells, and erythroblasts, identified novel platelet membrane proteins with hitherto unknown roles in thrombus formation. We determined the phenotype induced by antisense morpholino oligonucleotide (MO)–based knockdown of 5 of these genes in a laser-induced arterial thrombosis model. To validate the model, the genes for platelet glycoprotein (GP) IIb and the coagulation protein factor VIII were targeted. MO-injected fish showed normal thrombus initiation but severely impaired thrombus growth, consistent with the mouse knockout phenotypes, and concomitant knockdown of both resulted in spontaneous bleeding. Knockdown of 4 of the 5 novel platelet proteins altered arterial thrombosis, as demonstrated by modified kinetics of thrombus initiation and/or development. We identified a putative role for BAMBI and LRRC32 in promotion and DCBLD2 and ESAM in inhibition of thrombus formation. We conclude that phenotypic analysis of MO-injected zebrafish is a fast and powerful method for initial screening of novel platelet proteins for function in thrombosis.

Epidemic K-Means clustering

The K-Means algorithm for cluster analysis is one of the most influential and popular data mining methods. Its straightforward parallel formulation is well suited for distributed memory systems with reliable interconnection networks. However, in large-scale geographically distributed systems the straightforward parallel algorithm can be rendered useless by a single communication failure or high latency in communication paths. This work proposes a fully decentralised algorithm (Epidemic K-Means) which does not require global communication and is intrinsically fault tolerant. The proposed distributed K-Means algorithm provides a clustering solution which can approximate the solution of an ideal centralised algorithm over the aggregated data as closely as desired. A comparative performance analysis is carried out against the state of the art distributed K-Means algorithms based on sampling methods. The experimental analysis confirms that the proposed algorithm is a practical and accurate distributed K-Means implementation for networked systems of very large and extreme scale.

Fault tolerant decentralised K-Means clustering for asynchronous large-scale networks

The K-Means algorithm for cluster analysis is one of the most influential and popular data mining methods. Its straightforward parallel formulation is well suited for distributed memory systems with reliable interconnection networks, such as massively parallel processors and clusters of workstations. However, in large-scale geographically distributed systems the straightforward parallel algorithm can be rendered useless by a single communication failure or high latency in communication paths. The lack of scalable and fault tolerant global communication and synchronisation methods in large-scale systems has hindered the adoption of the K-Means algorithm for applications in large networked systems such as wireless sensor networks, peer-to-peer systems and mobile ad hoc networks. This work proposes a fully distributed K-Means algorithm (EpidemicK-Means) which does not require global communication and is intrinsically fault tolerant. The proposed distributed K-Means algorithm provides a clustering solution which can approximate the solution of an ideal centralised algorithm over the aggregated data as closely as desired. A comparative performance analysis is carried out against the state of the art sampling methods and shows that the proposed method overcomes the limitations of the sampling-based approaches for skewed clusters distributions. The experimental analysis confirms that the proposed algorithm is very accurate and fault tolerant under unreliable network conditions (message loss and node failures) and is suitable for asynchronous networks of very large and extreme scale.

Genetic evidence for a predominant role of PI3Kβ catalytic activity in ITAM- and integrin-mediated signaling in platelets.

Phosphatidylinositol 3-kinase (PI3K) isoforms PI3Kbeta and PI3Kgamma are implicated in platelet adhesion, activation, and aggregation, but their relative contribution is still unclear or controversial. Here, we report the first comparative functional analysis of platelets from mice expressing a catalytically inactive form of PI3Kbeta or PI3Kgamma. We demonstrate that both isoforms were similarly required for maximal activation of the small GTPase Rap1b and for complete platelet aggregation upon stimulation of G protein-coupled receptors for adenosine 5'-diphosphate (ADP) or U46619. Their contribution to these events, however, was largely redundant and dispensable. However, PI3Kbeta, but not PI3Kgamma, enzymatic activity was absolutely required for Akt phosphorylation, Rap1 activation, and platelet aggregation downstream of the immunoreceptor tyrosine-based activation motif (ITAM)-bearing receptor glycoprotein VI (GPVI). Moreover, PI3Kbeta was a major essential regulator of platelet adhesion to fibrinogen and of integrin alpha(IIb)beta(3)-mediated spreading. These results provide genetic evidence for a crucial and selective role of PI3Kbeta in signaling through GPVI and integrin alpha(IIb)beta(3).

Multidivisional vs metanational governance of the multinational enterprise

The effective and efficient management of diversified business firms that supply multiple products and operate in multiple, dynamic markets, especially large multinational enterprises (MNEs), builds upon a number of specific governance principles. These governance principles allow the alignment of environmental characteristics, strategy and organization. Given the rising need to “learn from the world”, Doz et al., in their influential Harvard Business School Press book entitled From Global to Metanational, have proposed a new set of governance principles described under the “metanational” umbrella concept. This paper revisits the metanational, using a comparative institutional perspective; here we contrast multidivisional and metanational governance principles. A comparative institutional analysis suggests that the metanational's application potential in terms of actually improving the effectiveness and efficiency of MNE governance may be subject to more qualification than suggested by Doz et al. Senior MNE management must therefore reflect carefully before substituting metanational governance principles for the more conventional, multidivisional ones with established contributions to managerial effectiveness and efficiency.

The end of the opportunism vs trust debate: bounded reliability as a new envelope concept in research on MNE governance

Modern transaction cost economics (TCE) thinking has developed into a key intellectual foundation of international business (IB) research, but the Williamsonian version has faced substantial criticism for adopting the behavioral assumption of opportunism. In this paper we assess both the opportunism concept and existing alternatives such as trust within the context of IB research, especially work on multinational enterprise (MNE) governance. Case analyses of nine global MNEs illustrate an alternative to the opportunism assumption that captures more fully the mechanisms underlying failed commitments inside the MNE. As a substitute for the often-criticized assumption of opportunism, we propose the envelope concept of bounded reliability (BRel), an assumption that represents more accurately and more completely the reasons for failed commitments, without invalidating the other critical assumption in conventional TCE (and internalization theory) thinking, namely the widely accepted envelope concept of bounded rationality (BRat). Bounded reliability as an envelope concept includes two main components, within the context of global MNE management: opportunism as intentional deceit, and benevolent preference reversal. The implications for IB research of adopting the bounded reliability concept are far reaching, as this concept may increase the legitimacy of comparative institutional analysis in the social sciences.

Genetic and Functional Evidence Implicating DLL1 as the Gene That Influences Susceptibility to Visceral Leishmaniasis at Chromosome 6q27

Background. Visceral leishmaniasis (VL) is caused by Leishmania donovani and Leishmania infantum chagasi. Genome-wide linkage studies from Sudan and Brazil identified a putative susceptibility locus on chromosome 6q27. Methods. Twenty-two single-nucleotide polymorphisms (SNPs) at genes PHF10, C6orf70, DLL1, FAM120B, PSMB1, and TBP were genotyped in 193 VL cases from 85 Sudanese families, and 8 SNPs at genes PHF10, C6orf70, DLL1, PSMB1, and TBP were genotyped in 194 VL cases from 80 Brazilian families. Family-based association, haplotype, and linkage disequilibrium analyses were performed. Multispecies comparative sequence analysis was used to identify conserved noncoding sequences carrying putative regulatory elements. Quantitative reverse-transcription polymerase chain reaction measured expression of candidate genes in splenic aspirates from Indian patients with VL compared with that in the control spleen sample. Results. Positive associations were observed at PHF10, C6orf70, DLL1, PSMB1, and TBP in Sudan, but only at DLL1 in Brazil (combined P = 3 x 10(-4) at DLL1 across Sudan and Brazil). No functional coding region variants were observed in resequencing of 22 Sudanese VL cases. DLL1 expression was significantly (P = 2 x 10(-7)) reduced (mean fold change, 3.5 [SEM, 0.7]) in splenic aspirates from patients with VL, whereas other 6q27 genes showed higher levels (1.27 x 10(-6) < P < .01) than did the control spleen sample. A cluster of conserved noncoding sequences with putative regulatory variants was identified in the distal promoter of DLL1. Conclusions. DLL1, which encodes Delta-like 1, the ligand for Notch3, is strongly implicated as the chromosome 6q27 VL susceptibility gene.

The leptospiral antigen Lp49 is a two-domain protein with putative protein binding function

Pathogenic Leptospira is the etiological agent of leptospirosis, a life-threatening disease that affects populations worldwide. Currently available vaccines have limited effectiveness and therapeutic interventions are complicated by the difficulty in making an early diagnosis of leptospirosis. The genome of Leptospira interrogans was recently sequenced and comparative genomic analysis contributed to the identification of surface antigens, potential candidates for development of new vaccines and serodiagnosis. Lp49 is a membrane-associated protein recognized by antibodies present in sera from early and convalescent phases of leptospirosis patients. Its crystal structure was determined by single-wavelength anomalous diffraction using selenomethionine-labelled crystals and refined at 2.0 angstrom resolution. Lp49 is composed of two domains and belongs to the all-beta-proteins class. The N-terminal domain folds in an immunoglobulin-like beta-sandwich structure, whereas the C-terminal domain presents a seven-bladed beta-propeller fold. Structural analysis of Lp49 indicates putative protein-protein binding sites, suggesting a role in Leptospira-host interaction. This is the first crystal structure of a leptospiral antigen described to date. (C) 2008 Elsevier Inc. All rights reserved.

Design of associative memories using cellular neural networks

Cellular neural networks (CNNs) have locally connected neurons. This characteristic makes CNNs adequate for hardware implementation and, consequently, for their employment on a variety of applications as real-time image processing and construction of efficient associative memories. Adjustments of CNN parameters is a complex problem involved in the configuration of CNN for associative memories. This paper reviews methods of associative memory design based on CNNs, and provides comparative performance analysis of these approaches.

Sanção e proteção no senado brasileiro: uma análise das condições de transgressão às leis, de sua sanção ou de seu acobertamento

Com o fortalecimento recente dos órgãos de controle, o avanço na adequação da legislação vigente no combate à corrupção e a atuação cada vez mais investigativa da mídia em casos de corrupção, o tema tem ganho destaque no cotidiano do cidadão brasileiro. Os avanços obtidos, refletem não somente a preocupação em relação aos efeitos da corrupção que incidem sobre a administração pública e sobre o cidadão, mas também com relação à legitimidade do sistema político. Apesar disso, por se tratar a corrupção, e outras transgressões às leis, de um fenômeno oculto, pouco se conhece acerca das condições de ocorrência deste mercado ilegal. O cidadão descontente reivindica das instituições sanção aos envolvidos neste mercado. A percepção da população acerca do caráter punitivo dos órgãos de controle é ainda de insuficiência. Nesse sentido, se faz necessário conhecer as configurações que desencadeiam na sanção e não sanção de parlamentares envolvidos em casos de corrupção a fim de compreender se, de fato, houve ou não leniência na condução dos processos investigativos e punitivos. Desta forma, este trabalho objetiva compreender quais fatores condicionam a ocorrência de sanção em casos de corrupção, assim como analisar as configurações que deflagram no impasse entre o agir coletivamente (protegendo o acusado e, consequentemente a rede de envolvidos) ou individualmente dos atores políticos (não protegendo o acusado e, o acusado não protegendo a rede) em diferentes casos. Os casos adotados foram: 1) do superfaturamento das obras do TRT-SP, 2) da criação e funcionamento de um mercado ilegal de jogos de azar no Estado de Goiás e, 3) da edição e não publicação de atos administrativos no Senado. Proponho uma análise qualitativa comparativa entre os casos, utilizando-me do método configuracional. Os resultados apresentados nesta pesquisa, não tem pretensão de explicar todo e qualquer caso de corrupção, mas contribuir para o debate acerca do tema.

New genes of Xanthomonas citri subsp citri involved in pathogenesis and adaptation revealed by a transposon-based mutant library

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)