Risk of Potential Drug-Drug Interactions among Brazilian Elderly A Population-Based, Cross-Sectional Study

Background: Drug-drug interactions (DDIs) are one of the main causes of adverse reactions related to medications, being responsible for up to 23% of hospital admissions. However, only a few studies have evaluated this problem in elderly Brazilians. Objectives: To determine the prevalence of potential DDIs (PDDIs) in community-dwelling elderly people in Brazil, analyse these interactions with regard to severity and clinical implications, and identify associated factors. Methods: A population-based cross-sectional study was carried out involving 2143 elderly (aged 60 years) residents of the metropolitan area of Sao Paulo, Brazil. Data were obtained from the SABE (Saude, Bem estar e Envelhecimento [Health, Well-Being, and Aging]) survey, which is a multicentre study carried out in seven countries of Latin America and the Caribbean, coordinated by the Pan-American Health Organization. PDDIs were analysed using a computerized program and categorized according to level of severity, onset, mechanism and documentation in the literature. The STATA software statistical package was used for data analysis, and logistic regression was conducted to determine whether variables were associated with PDDIs. Results: Analysis revealed that 568 (26.5%) of the elderly population included in the study were taking medications that could lead to a DDI. Almost two-thirds (64.4%) of the elderly population exposed to PDDIs were women, 50.7% were aged >= 75 years, 71.7% reported having fair or poor health and 65.8% took 2-5 medications. A total of 125 different PDDIs were identified; the treatment combination of an ACE inhibitor with a thiazide or loop diuretic (associated with hypotension) was the most frequent cause of PDDIs (n=322 patients; 56.7% of individuals with PDDIs). Analysis of the PDDIs revealed that 70.4% were of moderate severity, 64.8% were supported by good quality evidence and 56.8% were considered of delayed onset. The multivariate analysis showed that the risk of a PDDI was significantly increased among elderly individuals using six or more medications (odds ratio [OR] 3.37) and in patients with hypertension (OR 2.56), diabetes mellitus (OR 1.73) or heart problems (OR 3.36). Conclusions: Approximately one-quarter of the elderly population living in Sao Paulo could be taking two or more potentially interacting medicines. Polypharmacy predisposes elderly individuals to PDDIs. More than half of these drug combinations (57.6%, n = 72) were part of commonly employed treatment regimens and may be responsible for adverse reactions that compromise the safety of elderly individuals, especially at home. Educational initiatives are needed to avoid unnecessary risks.

Precise Insertion of Orthodontic Miniscrews with a Stereolithographic Surgical Guide Based on Cone Beam Computed Tomography Data: A Pilot Study

Purpose: Orthodontic miniscrews are commonly used to achieve absolute anchorage during tooth movement. One of the most frequent complications is screw loss as a result of root contact. Increased precision during the process of miniscrew insertion would help prevent screw loss and potential root damage, improving treatment outcomes. Stereo lithographic surgical guides have been commonly used for prosthetic implants to increase the precision of insertion. The objective of this paper was to describe the use of a stereolithographic surgical guide suitable for one-component orthodontic miniscrews based on cone beam computed tomography (CBCT) data and to evaluate implant placement accuracy. Materials and Methods: Acrylic splints were adapted to the dental arches of four patients, and six radiopaque reference points were filled with gutta-percha. The patients were submitted to CBCT while they wore the occlusal splint. Another series of images was captured with the splint alone. After superimposition and segmentation, miniscrew insertion was simulated using planning software that allowed the user to check the implant position in all planes and in three dimensions. In a rapid-prototyping machine, a stereolithographic guide was fabricated with metallic sleeves located at the insertion points to allow for three-dimensional control of the pilot bur. The surgical guide was worn during surgery. After implant insertion, each patient was submitted to CBCT a second time to verify the implant position and the accuracy of the placement of the miniscrews. Results: The average differences between the planned and inserted positions for the ten miniscrews were 0.86 mm at the coronal end, 0.71 mm at the center, and 0.87 mm at the apical tip. The average angular discrepancy was 1.76 degrees. Conclusions: The use of stereolithographic surgical guides based on CBCT data allows for accurate orthodontic mini screw insertion without damaging neighboring anatomic structures. INT J ORAL MAXILLOFAC IMPLANTS 2011;26:860-865

Cytotoxicity of resin-based light-cured liners

Purpose: To evaluate the cytotoxic effects of resin-based light-cured liners on culture of pulp cells. Methods: Discs measuring 4 mill in diameter and 2 mm thick were fabricated from TheraCal (TCMTA), Vitrebond (VIT), and Ultrablend Plus (UBP). These specimens were immersed in serum-free culture medium (DMEM) for 24 hours or 7 days to produce the extracts. After incubating the pulp cells for 72 hours, the extracts were applied on the cells and the cytotoxic effects were determined based on the cell metabolism (MTT), total protein expression and cell morphology (SEM). In the control group, fresh DMEM was used. Data from MTT analysis and protein expression were submitted to Kruskal-Wallis and Mann-Whitney tests at the preset level of significance of 5%. Results: When in contact with the 24-hour extract, TCMTA, VIT, and UBP decreased the cell metabolism by 31.5%, 73.5% and 71.0%, respectively. The total protein expressed by the cells in contact with VIT and UBP was lower than TCMTA and DMEM (Mann-Whitney, P< 0.05). When in contact with the 7-day extract, TCMTA, VIT, and UBP decreased the metabolic activity by 45.9%, 77.1% and 64.4%, respectively. All the liners expressed statistically lower amounts of proteins when compared to the control. A reduction in the number of cells was observed for all liners. The remaining cells from TCMTA group resembled those from the control group while for VIT and UBP the cells presented significant morphological alterations. (Ani J Dent 2009;22:137-142).

Caries-preventive Efficacy and Retention of a Resin-modified Glass lonomer Cement and a Resin-based Fissure Sealant: A 3-year Split-mouth Randomised Clinical Trial

Purpose: This prospective clinical trial compared the retention rate and caries-preventive efficacy of two types of sealant modalities over a 3-year period. Materials and Methods: Using a split-mouth randomised design, 1280 sealants were randomly applied on sound permanent second molars of 320 young patients aged between 12 and 16 years. Half of the teeth (n = 640) were sealed with a resin-modified glass ionomer cement (RMGIC) (Vitremer (TM), 3M ESPE) and the other half (n = 640) with a conventional light-cure, resin-based fissure sealant (LCRB) (Fluoroshield (R), Dentsply Caulk). Teeth were evaluated at baseline, 6-, 12-, 18-, 24-, 30- and 36-month intervals with regard to retention and new caries development. Results: On the sealed occlusal surfaces after 3 years, 5.10% of RMGIC and 91.08% of LCRB sealants were totally intact and 6.37% of RMGIC and 7.65% of LCRB sealants were partially intact. New caries lesions were found in 20.06% of RMGIC sealed occlusal surfaces, compared to 8.91% for LCRB sealants. Conclusions: The findings of the present clinical study suggest that RMGIC should be used only as a transitional sealant that can be applied to newly erupting teeth throughout the eruptive process, whereas LCRB sealants are used to successfully prevent occlusal caries lesions once an effective rubber dam can be achieved. It can be concluded that there are differences between the RMGIC and LCRB sealants over a 3-year period in terms of the retention rate and caries-preventive efficacy. RMGIC can serve as a simple and economic sealing solution, however provisional. Due to its poor retention rate, periodic recalls are necessary, even after 6 months, to eventually replace the lost sealant.

Effect of a bleaching agent on abrasion of resin-based restoratives

Purpose: To evaluate the effect of a 10% carbamide peroxide-containing bleaching agent on brushing abrasion of esthetic restorative materials. Methods: Using a randomized complete block design, 150 specimens (n = 15) measuring 3 x 3 x 2 mm were fabricated into acrylic resin cylinders, using one of the restorative materials: a microfilled resin composite (At), a hybrid resin composite (Ch), a flowable resin composite (Wa), a resin-modified glass-ionomer cement (Fj) and a polyacid-modified resin composite (Dy). The bleaching agent or artificial saliva (control) was applied for 2 hours/day. After that, 120 brushing strokes were simulated automatically and the samples were kept in artificial saliva. Such bleaching/brushing cycle was performed daily for 21 days. Wear depth was assessed using profilometry. Results: Bleaching did not show significant effect on wear depth. There was a significant difference among the restorative materials. Tukey`s test showed that (Al=Ch) < (Wa) < (Fj) and that Dy was only different from Fj. (Am J Dent 2009;22:171-174).

Reconfigurable antenna for mobile devices

O trabalho descrito nesta dissertação de mestrado foca-se em geral na investigação de antenas impressas. São apresentados conceitos básicos, em conjunto com alguns exemplos desenvolvidos. No entanto, o principal foco prende-se com técnicas de miniaturização e reconfigurabilidade de antenas. A miniaturização de antenas é um tema de investigação de longa data, no entanto, novas técnicas e soluções são apresentadas regularmente. Nesta tese, é aplicada uma técnica recente, baseada na introdução de indutores encapsulados no elemento ressonante de uma antena, que permite miniaturizar um monopólio impresso com uma frequência de ressonância de 2.5 GHz. Outro assunto abordado neste trabalho é a reconfigurabilidade de antenas. Algumas das técnicas mais comuns na investigação actual são apresentadas e debatidas. Uma solução com recurso a díodos PIN é usada para estudar esta capacidade. Os conceitos e características deste tipo de componentes são apresentadas sendo feito o desenho e fabrico de um possível monopólio impresso reconfigurável para operação em dupla banda. Por fim, são combinadas as técnicas de miniaturização com inductor encapsulado e reconfigurabilidade através de díodos PIN, por forma a projectar uma antena reconfigurável muito pequena, para operação em duas bandas distintas. Os resultados são discutidos e com base nestes, algumas possíveis otimizações são propostas. The work reported in this dissertation is focused in the printed antenna research. Basic concepts of printed antennas are presented, along with a few examples that were developed. The main focus however, is around miniaturization and reconfigurability of antennas. Antenna miniaturization is a long time research subject, however, new techniques and solutions are presented everyday. In this thesis, a recent technique based on the introduction of chip inductors in the resonating element of a printed antenna is used in order to miniaturize a monopole with a resonating frequency at 2.5 GHz. Another issue approached in this work is antenna reconfigurability. Some common techniques used in antenna reconfiguration are presented and debated. A solution with PIN diodes is used to study this capability. The concepts and characteristics of this type of components are presented and an example of a reconfigurable printed monopole for dual-band operation is designed and fabricated. At last, miniaturization with chip inductor and reconfigurability through PIN diodes are used together to create a very small antenna for dual-band operation. The simulated and measured results are discussed and upon these, some possible optimizations are proposed.

Tourism mobile and recommendation systems - a state of the art

Recommendation systems have been growing in number for the last fifteen years. To evolve and adapt to the demands of the actual society, many paradigms emerged giving birth to even more paradigms and hybrid approaches. Mobile devices have also been under an incredible growth rate in every business area, and there are already lots of mobile based systems to assist tourists. This explosive growth gave birth to different mobile applications, each having their own advantages and disadvantages. Since recommendation and mobile systems might as well be integrated, this work intends to present the current state of the art in tourism mobile and recommendation systems, as well as to state their advantages and disadvantages.

Recommendation & mobile systems - a state of the art for tourism

Recommendation systems have been growing in number over the last fifteen years. To evolve and adapt to the demands of the actual society, many paradigms emerged giving birth to even more paradigms and hybrid approaches. These approaches contain strengths and weaknesses that need to be evaluated according to the knowledge area in which the system is going to be implemented. Mobile devices have also been under an incredible growth rate in every business area, and there are already lots of mobile based systems to assist tourists. This explosive growth gave birth to different mobile applications, each having their own advantages and disadvantages. Since recommendation and mobile systems might as well be integrated, this work intends to present the current state of the art in tourism mobile and recommendation systems, as well as to state their advantages and disadvantages.

PSiS Mobile

In this paper, we present a state of the art on applications of mobile devices to support decision of a tourist running on a trip. We focus on two types of applications, tourism recommendation and tourism guide, making a brief description of the main characteristics of each one of them. We also refer the main problems encountered on the development of applications for mobile devices, and present PSiS (Personalized Sightseeing Tours Recommendation System) Mobile, our proposal to a mobile recommendation and planning support system, which is designed to provide an effective support during the tourist visit, providing contextaware information and recommendations about places of interest (POI) to visit, based on tourist preferences and his current context.

Vantagens e desvantagens no desenvolvimento de recursos educativos para dispositivos móveis. CV Learning Mobile - Software educativo sobre “Organização Administrativa de Cabo Verde”

Não é recente a contribuição das tecnologias de informação e comunicação em processos de ensino/aprendizagem, no sentido da proliferação de conhecimento, de forma fácil e rápida. Com a contínua evolução tecnológica, surgem novos conceitos relativamente a processos de ensino/aprendizagem assentes nessas tecnologias. A aprendizagem por meio de dispositivos móveis, o m-Learning, é um exemplo, sendo um campo de investigação educacional em franca evolução, que explora essencialmente a mobilidade e a interactividade. No âmbito desta dissertação, pretende-se analisar a tecnologia m-Learning, fazendo referência as principais vantagens e desvantagens desta tecnologia. Neste sentido, e por pretendermos dar o nosso contributo ao ensino cabo-verdiano, onde a utilização de tal tecnologia é ainda inexistente, desenvolveu-se a aplicação CV Learning Mobile, um software educativo sobre a “Organização Administrativa de Cabo Verde”, como resultado do estudo efectuado.

eTourism – Mobile Data Interface (Sistema de Apoio On-Line ao Turista em Dispositivos Móveis com Adaptação de Tours Personalizados)

O intuito principal desta Tese é criar um interface de Dados entre uma fonte de informação e fornecimento de Rotas para turistas e disponibilizar essa informação através de um sistema móvel interactivo de navegação e visualização desses mesmos dados. O formato tecnológico será portátil e orientado à mobilidade (PDA) e deverá ser prático, intuitivo e multi-facetado, permitindo boa usabilidade a públicos de várias faixas etárias. Haverá uma componente de IA (Inteligência Artificial), que irá usar a informação fornecida para tomar decisões ponderadas tendo em conta uma diversidade de aspectos. O Sistema a desenvolver deverá ser, assim, capaz de lidar com imponderáveis (alterações de rota, gestão de horários, cancelamento de pontos de visita, novos pontos de visita) e, finalmente, deverá ajudar o turista a gerir o seu tempo entre Pontos de Interesse (POI – Points os Interest). Deverá também permitir seguir ou não um dado percurso pré-definido, havendo possibilidade de cenários de exploração de POIs, sugeridos a partir de sugestões in loco, similares a Locais incluídos no trajecto, que se enquadravam no perfil dos Utilizadores. O âmbito geográfico de teste deste projecto será a zona ribeirinha do porto, por ser um ex-líbris da cidade e, simultaneamente, uma zona com muitos desafios ao nível geográfico (com a inclinação) e ao nível do grande número de Eventos e Locais a visitar.

PSiS mobile

Os sistemas de recomendação têm vindo a ser cada vez mais utilizados nos últimos anos. Por isso, é imprescindível que estes sistemas se adaptem à evolução da sociedade incluindo cada vez mais novas funcionalidades, tais como a adaptação do sistema ao contexto da pessoa. Esta adaptação pode ser feita através de, por exemplo, dispositivos móveis, que têm vindo a apresentar uma taxa de crescimento de vendas muito grande. Dada a crescente integração dos sistemas de recomendação com os sistemas móveis, foi elaborado um estudo sobre o estado da arte dos sistemas de auxílio ao turista que utilizam dispositivos móveis, sendo apresentadas as suas vantagens e desvantagens. Estes sistemas móveis de auxílio a turistas foram divididos em dois grupos: os que apresentam apenas a informação sobre pontos de interesse e os sistemas que são capazes de efectuar recomendações, com base no perfil do turista. Um breve estudo sobre os sistemas operativos para dispositivos móveis é apresentado, sendo especialmente focado o sistema operativo Android que foi o escolhido para esta implementação. Como os dispositivos móveis, actualmente, ainda possuem várias limitações, estas foram descritas e apresentadas as boas práticas no desenvolvimento de aplicações para este tipo de sistemas. É também apresentado um estudo que visa descobrir qual é o método mais leve e mais rápido para trocar dados entre a parte servidora e a parte móvel. Com a parte introdutória apresentada, é exposto o projecto desenvolvido nesta tese, o PSiS Mobile. Este sistema é um módulo que faz parte do projecto PSiS e pretende trazer todas as vantagens dos sistemas móveis para o sistema base já implementado. O projecto PSiS foca-se no estabelecimento de planos de visita personalizados com indicação de percursos para turistas com tempo limitado. Apoiando a definição de planos de visitas de acordo com o perfil do turista (interesses, valores pessoais, desejos, restrições, deficiências, etc.) combinando os produtos de turismo mais adequados (locais de interesse, eventos, restaurantes, etc.) em itinerários eficientes. A utilização de dispositivos móveis para acompanhamento da visita permite uma rápida interacção entre o turista e o sistema. Assim, o PSiS poderá recolher informação contextual do utilizador para que o perfil do mesmo seja enriquecido. O sistema apresentado é composto por duas partes: a parte cliente e a parte servidora. Toda a informação, como por exemplo o perfil do turista, histórico de viagens e valores de similaridade entre utilizadores está presente na parte servidora. O processo de recomendação também é efectuado pela aplicação servidora, sendo esta a responsável pela atribuição de uma classificação aos pontos de interesse tendo em conta o perfil do utilizador em causa. A base de dados do PSiS possui toda a informação relativa aos pontos de interesse numa determinada cidade ou região e o portfólio completo do histórico de visitas de cada utilizador. A componente móvel é uma parte muito importante para o sistema, pois interage com o utilizador no terreno. Um dispositivo móvel como o PDA, não só permite a apresentação de informação relevante ao utilizador, como também permite a recolha automática de informação contextual (por exemplo, a localização). Toda esta informação contribui para a definição de um perfil completo e para uma melhor adaptação do sistema às necessidades do utilizador. De forma a nem sempre estar dependente do servidor, a aplicação móvel possui rotinas para a realização de recomendações básicas. Ou seja, a aplicação móvel não realiza a classificação dos pontos de interesse, mas apenas mostra os principais resultados já formados pela parte servidora. Por exemplo, se um utilizador gostar de comida Chinesa, um restaurante Chinês nas imediações irá ter uma boa classificação e, por isso, ser recomendado. A aplicação móvel mostra ao turista o percurso definido para o dia em que o mesmo se encontra, sendo feito o rastreio do trajecto que o mesmo efectua. Assim, o sistema consegue saber se o horário do planeamento está a ser cumprido ou não. Caso não esteja, é invocado um algoritmo de planeamento que irá tentar corrigir o atraso ou o adiantamento perante o horário inicial. Depois de visitar um ponto de interesse, é pedido ao utilizador para fornecer feedback sobre o mesmo. Se desejado também é possível mostrar os pontos de interesse existentes perto do turista (usando as coordenadas GPS obtidas pelo dispositivo móvel) organizados por categorias, raio de distância, etc. Apesar dos dispositivos móveis possuírem várias restrições, pretendeu-se proporcionar ao utilizador uma boa experiência, através de uma aplicação rápida, de fácil utilização e adaptável, incluindo funcionalidades de planeamento, realidade aumentada e integração com a rede social do sistema. Todos estes factores contribuem para a disponibilização de informação detalhada ao turista.

A SON Enhanced Algorithm for Observed Time Differences Based Geolocation in Real 3G Networks

Conferência - 16th International Symposium on Wireless Personal Multimedia Communications (WPMC)- Jun 24-27, 2013

A study on security grade assignment model for mobile users in urban computing

The relation between the information/knowledge expression and the physical expression can be involved as one of items for an ambient intelligent computing [2],[3]. Moreover, because there are so many contexts around user/spaces during a user movement, all appplcation which are using AmI for users are based on the relation between user devices and environments. In these situations, it is possible that the AmI may output the wrong result from unreliable contexts by attackers. Recently, establishing a server have been utilizes, so finding secure contexts and make contexts of higher security level for save communication have been given importance. Attackers try to put their devices on the expected path of all users in order to obtain users informationillegally or they may try to broadcast their SPAMS to users. This paper is an extensionof [11] which studies the Security Grade Assignment Model (SGAM) to set Cyber-Society Organization (CSO).

QoS-based surrogates selection and service proposal formulation in offloading environments

Resource constraints are becoming a problem as many of the wireless mobile devices have increased generality. Our work tries to address this growing demand on resources and performance, by proposing the dynamic selection of neighbor nodes for cooperative service execution. This selection is in uenced by user's quality of service requirements expressed in his request, tailoring provided service to user's speci c needs. In this paper we improve our proposal's formulation algorithm with the ability to trade o time for the quality of the solution. At any given time, a complete solution for service execution exists, and the quality of that solution is expected to improve overtime.