Tradução e validação para o português do Medication Regimen Complexity Index

FUNDAMENTO: A complexidade da farmacoterapia consiste de múltiplas características do regime prescrito, incluindo o número de diferentes medicações no esquema, o número de unidades de dosagem por dose, o número total de doses por dia e os cuidados na administração dos medicamentos. O Medication Regimen Complexity Index (MRCI) é um instrumento específico, validado e utilizado para medir a complexidade da farmacoterapia, desenvolvido originalmente em língua inglesa. OBJETIVO: Tradução transcultural e validação desse instrumento para o português do Brasil. MÉTODOS: Foi desenvolvido um estudo transversal envolvendo 95 pacientes com diabete do tipo 2 utilizando múltiplas medicações. O processo de validação teve início pela tradução, retrotradução e pré-teste do instrumento, gerando uma versão adaptada chamada Índice de Complexidade da Farmacoterapia (ICFT). Em seguida foram analisados parâmetros psicométricos, incluindo validade convergente, validade divergente, confiabilidade entre avaliadores e teste-reteste. RESULTADOS: A complexidade da farmacoterapia medida pelo ICFT obteve média de 15,7 pontos (desvio padrão = 8,36). O ICFT mostrou correlação significativa com o número de medicamentos em uso (r = 0,86; p < 0,001) e a idade dos pacientes (r = 0,28; p = 0,005). A confiabilidade entre avaliadores obteve correlação intraclasse igual a 0,99 (p < 0,001) e a confiabilidade teste-reteste obteve correlação de 0,997 (p < 0,001). CONCLUSÃO: Os resultados demonstraram que o ICFT apresenta bom desempenho de validade e confiabilidade, podendo ser utilizado como ferramenta útil na prática clínica e em pesquisas envolvendo análise da complexidade da terapia.

Procesos adaptativos y dimensiones del comportamiento biosocial en cazadores recolectores del SW de la provincia de La Pampa.

Resumen del proyecto: Este resumen se incluirá en la base de datos de la Biblioteca Digital del Ministerio, por lo que se debe elaborar el mismo sobre la base de la siguiente estructura y completar todos los campos que se indican a continuación: identificación y caracterización del problema objeto del estudio, hipótesis, planteo de objetivos, materiales y métodos a utilizar, resultados esperados, importancia del proyecto (extensión del campo 4000 caracteres). Proyecto diseñado para aportar al conocimiento de los procesos adaptativos y la dinámica biosocial de las sociedades del pasado prehistórico argentino. Propone analizar y evaluar el potencial documental de los restos bioarqueológicos con fehaciente asociación contextual para posibilitar la realización de inferencias sobre procesos biosociales de naturaleza adaptativa o no adaptativa. Está centrado en el análisis osteológico y biocultural de materiales esqueletales (aproximadamente cien individuos) correspondientes a poblaciones aborígenes prehistóricas del actual territorio de la provincia de La Pampa (Médano Petroquímica, Departamento Puelén). Entre otros muchos aspectos, la importancia de estos materiales reside en que son asignables a sociedades con economía cazadora-recolectora y cuya cronología corresponde al Holoceno tardío final (Entierros datados en 393 ± 41 cal AP AMS.), una época particularmente interesante por la dinámica sucesión de eventos socioculturales y poblacionales que la caracterizan. La evidencia recuperada da cuenta de prácticas funerarias complejas que consisten en la realización de enterratorios colectivos, indirectos, secundarios, y presencia de eventos de violencia y/o tensión social. Los métodos y técnicas consisten en la descripción e identificación basados en observación y registro de marcadores esqueléticos conforme a prácticas estándares de nuestro laboratorio: Planillas de observación y registro durante excavaciones de la Archaeological Summer Field School (ASFS) de la Universidad de Chicago y planillas de los “Standards” de Buikstra y Ubelaker, modificadas y adaptadas por nuestro grupo de trabajo, entre otros). Los datos obtenidos serán empleados para graficación (estadística descriptiva) y también se realizará sobre ellos análisis multivariados y estadística no paramétrica (etapa inferencial). Se tendrán en cuenta aspectos descriptivos y analíticos vinculados con el reconocimiento de la edad y el sexo, hábitos dietarios (marcadores morfológicos y químicos de hueso y dientes), economía de subsistencia, patrones de diferenciación social, exploración de eventuales relaciones de parentesco, roles vinculados con el sexo, el uso del cuerpo, dieta, salud y enfermedad, en relación con la economía de subsistencia, etc. (Buikstra y Beck 2006, Larsen, 1997, White y Folkens 2000). Dado la naturaleza y complejidad de los hallazgos, caracterizados por la conformación de entierros colectivos secundarios e indirectos, un capítulo de interés lo constituye el análisis de las dimensiones sociales del comportamiento mortuorio y la discusión de los indicadores de violencia y/o tensión social asociados a los hallazgos (O´Shea 1984, Rakita et al. 2005, entre otros). Dado el hecho de que se cuenta con la disponibilidad de materiales adecuados para este tipo de estudios, la información relevante y los datos a analizar serán obtenidos mediante la aplicación de métodos y técnicas bioarqueológicas específicas antes mencionados, con la finalidad de observar y discutir tendencias y proponer modelos de interpretación sujetos a ulterior validación, particularmente toda vez que se cuente con una mayor representación numérica y casuística tanto a nivel de individuos como de sitios bioarqueológicos excavados. El proyecto se enmarca en la firma de un Convenio Específico de Trabajo entre la UNRC y el Gobierno de La Pampa. Palabras clave: Ingrese hasta 5 palabras clave, distintas de las utilizadas en el título del proyecto y que describan la naturaleza del objeto de estudio. bioarqueología economía cazadora-recolectora adaptación biosocial comportamiento mortuorio Violencia y tensión social. Abstract: Resumen del proyecto en inglés (extensión del campo 2000 caracteres). This project has been designed to improve the knoledge on adaptive processes and biosocial dynamics among aborigine past societies in Argentina. This research is focused on the analysis and evaluation of documentary potential of bioarchaeological skeletal remains with reliable contextual associations. It is specifically centered in the osteological as well as cultural analysis of more than one hundred skeletons from native prehistoric populations from a prehistoric collective burial site in La Pampa province. (Médano Petroquímica, Departamento Puelén). Among other aspects, the importance of the materials to be analyzed lies in the fact that they correspond to a subsistence economy based on hunting and gathering, and have been chronologically assigned to Late Holocene times (burials dated 393 ± 41 cal AP AMS), a period denoting particular interest due to the dynamic succession of sociocultural events that characterized it. Evidence so far recovered accounts for complex funerary practices consisting of indirect, secondary collective burials, as well as the presence of events of violence and/o social tension. Methods and techniques consist in the description and identification based on the observation, and recording of skeletal markers, according to laboratory as well as field work standards: The University of Chicago Archaeological Summer Field School (ASFS) forms, and the “Standards” forms from Buikstra y Ubelaker (1994), modified and adapted by our research team, among others. Data obtained shall be used for graphic (descriptive statistics) as well as multivariate analyses and non parametric statistics (inferential stage). Descriptive as well as analytical aspects such as those related to age and sex determination, feeding habits (morphological as well as chemical markers of bones and teeth), subsistence economy, patterns of social differentiation, kinship patterns, sex-linked roles, body use, diet, health and disease, all of them in close relationship with the hunter-gatherer subsistence economy (Buikstra y Beck 2006, Larsen, 1997, White y Folkens 2000). Given the nature and complexity of the burial disposals, characterized by complex collective burials, a core chapter of our interest is that of social dimensions of mortuary behavior as well as the discussion and interpretation of markers of violence and/or social tension. Given the amount of evidence gathered so far, relevant information as well as data to be analyzed will be obtained by specific bioarchaeological methods and techniques, trying to observe and discuss possible trends as well as to formulate interpretive models to be verified or rejected with the arrival of new, reliable data both at individual level as well as at the archaeological sites to be excavated. This project has been particularly considered in a bilateral agreement between UNRC and the Government of La Pampa Province.

Clinical Coronary In-Stent Restenosis Follow-Up after Treatment and Analyses of Clinical Outcomes

Background: Clinical in-stent restenosis (CISR) is the main limitation of coronary angioplasty with stent implantation. Objective: Describe the clinical and angiographic characteristics of CISR and the outcomes over a minimum follow-up of 12 months after its diagnosis and treatment. Methods: We analyzed in 110 consecutive patients with CISR the clinical presentation, angiographic characteristics, treatment and combined primary outcomes (cardiovascular death, nonfatal acute myocardial infarction [AMI]) and combined secondary (unstable angina with hospitalization, target vessel revascularization and target lesion revascularization) during a minimal follow-up of one year. Results: Mean age was 61 ± 11 years (68.2% males). Clinical presentations included acute coronary syndrome (ACS) in 62.7% and proliferative ISR in 34.5%. CISR was treated with implantation of drug-eluting stents (DES) in 36.4%, Bare Metal Stent (BMS) in 23.6%, myocardial revascularization surgery in 18.2%, balloon angioplasty in 15.5% and clinical treatment in 6.4%. During a median follow-up of 19.7 months, the primary outcome occurred in 18 patients, including 6 (5.5%) deaths and 13 (11.8%) AMI events. Twenty-four patients presented a secondary outcome. Predictors of the primary outcome were CISR with DES (HR = 4.36 [1.44–12.85]; p = 0.009) and clinical treatment for CISR (HR = 10.66 [2.53–44.87]; p = 0.001). Treatment of CISR with BMS (HR = 4.08 [1.75–9.48]; p = 0.001) and clinical therapy (HR = 6.29 [1.35–29.38]; p = 0.019) emerged as predictors of a secondary outcome. Conclusion: Patients with CISR present in most cases with ACS and with a high frequency of adverse events during a medium-term follow-up.

Development-oriented refugee assistance : sustainable, efficient and gender-sensitive? ; theoretical and practical analyses based on a case study of the Rhino camp in Uganda

Magdeburg, Univ., Fak. für Humanwiss., Diss., 2012

Polynomial-time complexity for instances of the endomorphism problem in free groups

We say the endomorphism problem is solvable for an element W in a free group F if it can be decided effectively whether, given U in F, there is an endomorphism Φ of F sending W to U. This work analyzes an approach due to C. Edmunds and improved by C. Sims. Here we prove that the approach provides an efficient algorithm for solving the endomorphism problem when W is a two- generator word. We show that when W is a two-generator word this algorithm solves the problem in time polynomial in the length of U. This result gives a polynomial-time algorithm for solving, in free groups, two-variable equations in which all the variables occur on one side of the equality and all the constants on the other side.

The complexity of random ordered structures

"Vegeu el resum a l'inici del document del fitxer adjunt."

Data size sufficiency analyses of haplotype inference algortihms

We present experimental and theoretical analyses of data requirements for haplotype inference algorithms. Our experiments include a broad range of problem sizes under two standard models of tree distribution and were designed to yield statistically robust results despite the size of the sample space. Our results validate Gusfield's conjecture that a population size of n log n is required to give (with high probability) sufficient information to deduce the n haplotypes and their complete evolutionary history. The experimental results inspired our experimental finding with theoretical bounds on the population size. We also analyze the population size required to deduce some fixed fraction of the evolutionary history of a set of n haplotypes and establish linear bounds on the required sample size. These linear bounds are also shown theoretically.

On the complexity of the Whitehead minimization problem

The Whitehead minimization problem consists in finding a minimum size element in the automorphic orbit of a word, a cyclic word or a finitely generated subgroup in a finite rank free group. We give the first fully polynomial algorithm to solve this problem, that is, an algorithm that is polynomial both in the length of the input word and in the rank of the free group. Earlier algorithms had an exponential dependency in the rank of the free group. It follows that the primitivity problem – to decide whether a word is an element of some basis of the free group – and the free factor problem can also be solved in polynomial time.

Comprehensive Expression Analyses of Neural Cell-Type-Specific miRNAs Identify New Determinants of the Specification and Maintenance of Neuronal Phenotypes.

MicroRNAs (miRNAs) have been shown to play important roles in both brain development and the regulation of adult neural cell functions. However, a systematic analysis of brain miRNA functions has been hindered by a lack of comprehensive information regarding the distribution of miRNAs in neuronal versus glial cells. To address this issue, we performed microarray analyses of miRNA expression in the four principal cell types of the CNS (neurons, astrocytes, oligodendrocytes, and microglia) using primary cultures from postnatal d 1 rat cortex. These analyses revealed that neural miRNA expression is highly cell-type specific, with 116 of the 351 miRNAs examined being differentially expressed fivefold or more across the four cell types. We also demonstrate that individual neuron-enriched or neuron-diminished RNAs had a significant impact on the specification of neuronal phenotype: overexpression of the neuron-enriched miRNAs miR-376a and miR-434 increased the differentiation of neural stem cells into neurons, whereas the opposite effect was observed for the glia-enriched miRNAs miR-223, miR-146a, miR-19, and miR-32. In addition, glia-enriched miRNAs were shown to inhibit aberrant glial expression of neuronal proteins and phenotypes, as exemplified by miR-146a, which inhibited neuroligin 1-dependent synaptogenesis. This study identifies new nervous system functions of specific miRNAs, reveals the global extent to which the brain may use differential miRNA expression to regulate neural cell-type-specific phenotypes, and provides an important data resource that defines the compartmentalization of brain miRNAs across different cell types.

Proteomic and Metabolomic Analyses of Mitochondrial Complex I-deficient Mouse Model Generated by Spontaneous B2 Short Interspersed Nuclear Element (SINE) Insertion into NADH Dehydrogenase (Ubiquinone) Fe-S Protein 4 (Ndufs4) Gene.

Eukaryotic cells generate energy in the form of ATP, through a network of mitochondrial complexes and electron carriers known as the oxidative phosphorylation system. In mammals, mitochondrial complex I (CI) is the largest component of this system, comprising 45 different subunits encoded by mitochondrial and nuclear DNA. Humans diagnosed with mutations in the gene NDUFS4, encoding a nuclear DNA-encoded subunit of CI (NADH dehydrogenase ubiquinone Fe-S protein 4), typically suffer from Leigh syndrome, a neurodegenerative disease with onset in infancy or early childhood. Mitochondria from NDUFS4 patients usually lack detectable NDUFS4 protein and show a CI stability/assembly defect. Here, we describe a recessive mouse phenotype caused by the insertion of a transposable element into Ndufs4, identified by a novel combined linkage and expression analysis. Designated Ndufs4(fky), the mutation leads to aberrant transcript splicing and absence of NDUFS4 protein in all tissues tested of homozygous mice. Physical and behavioral symptoms displayed by Ndufs4(fky/fky) mice include temporary fur loss, growth retardation, unsteady gait, and abnormal body posture when suspended by the tail. Analysis of CI in Ndufs4(fky/fky) mice using blue native PAGE revealed the presence of a faster migrating crippled complex. This crippled CI was shown to lack subunits of the "N assembly module", which contains the NADH binding site, but contained two assembly factors not present in intact CI. Metabolomic analysis of the blood by tandem mass spectrometry showed increased hydroxyacylcarnitine species, implying that the CI defect leads to an imbalanced NADH/NAD(+) ratio that inhibits mitochondrial fatty acid β-oxidation.

Functional sphere profiling reveals the complexity of neuroblastoma tumor-initiating cell model.

Neuroblastoma (NB) is a neural crest-derived childhood tumor characterized by a remarkable phenotypic diversity, ranging from spontaneous regression to fatal metastatic disease. Although the cancer stem cell (CSC) model provides a trail to characterize the cells responsible for tumor onset, the NB tumor-initiating cell (TIC) has not been identified. In this study, the relevance of the CSC model in NB was investigated by taking advantage of typical functional stem cell characteristics. A predictive association was established between self-renewal, as assessed by serial sphere formation, and clinical aggressiveness in primary tumors. Moreover, cell subsets gradually selected during serial sphere culture harbored increased in vivo tumorigenicity, only highlighted in an orthotopic microenvironment. A microarray time course analysis of serial spheres passages from metastatic cells allowed us to specifically "profile" the NB stem cell-like phenotype and to identify CD133, ABC transporter, and WNT and NOTCH genes as spheres markers. On the basis of combined sphere markers expression, at least two distinct tumorigenic cell subpopulations were identified, also shown to preexist in primary NB. However, sphere markers-mediated cell sorting of parental tumor failed to recapitulate the TIC phenotype in the orthotopic model, highlighting the complexity of the CSC model. Our data support the NB stem-like cells as a dynamic and heterogeneous cell population strongly dependent on microenvironmental signals and add novel candidate genes as potential therapeutic targets in the control of high-risk NB.

Generalized multiresolution analyses with given multiplicity functions

Generalized multiresolution analyses are increasing sequences of subspaces of a Hilbert space H that fail to be multiresolution analyses in the sense of wavelet theory because the core subspace does not have an orthonormal basis generated by a fixed scaling function. Previous authors have studied a multiplicity function m which, loosely speaking, measures the failure of the GMRA to be an MRA. When the Hilbert space H is L2(Rn), the possible multiplicity functions have been characterized by Baggett and Merrill. Here we start with a function m satisfying a consistency condition which is known to be necessary, and build a GMRA in an abstract Hilbert space with multiplicity function m.