Asthma management and asthma control in Sao Paulo, Brazil and Uppsala, Sweden: a questionnaire-based comparison

The Global Initiative Against Asthma (GINA) was developed to meet the global challenge of asthma. GINA has been adopted in most countries and comparison of asthma management in different parts of the world may be of help when assessing the global dissemination of the guideline. The overall goals in GINA include that asthma patients should be free of symptoms, acute asthma attacks and activity limitations. The aim of the present study was to compare asthma management and asthma control in Sao Paulo, Brazil and Uppsala, Sweden. Information was collected from asthmatics in Sao Paulo and Uppsala with a questionnaire. The questionnaire dealt with the following issues: symptoms, smoking, self-management, hospital visits, effect on school/work and medication. The Sao Paulo patients were more likely to have uncontrolled asthma (36% vs 13%, P < 0.001), having made emergency room visits (57% vs 29%, P < 0.001) and having lost days at school or work because of their asthma (46% vs 28%, P = 0.03) than the asthmatics from Uppsala. There were no difference in the use of inhaled corticosteroids, but the Brazilian patients were more likely to be using theophylline (18% vs 1%, P = 0.001) and less likely to be using long-acting beta-2 agonists (18% vs 37%, P < 0.001). We conclude that the level of asthma control was lower among the patients from Sao Paulo than Uppsala. Few of the patients in either city reached the goals set up by GINA. Improved asthma management may therefore lead to health-economic benefits in both locations. Please cite this paper as: Skorup P, Rizzo LV, Machado-Boman L and Janson C. Asthma management and asthma control in Sao Paulo, Brazil and Uppsala, Sweden: a questionnaire-based comparison. The Clinical Respiratory Journal 2009; 3: 22-28.

Global Gene Expression Analysis during Germination in the Chytridiomycete Blastocladiella emersonii

Blastocladiella emersonii is an aquatic fungus of the Chytridiomycete class. During germination, the zoospore, a motile nongrowing cell, goes through a cascade of morphological changes that culminates with its differentiation into the germling cell, capable of coenocytic vegetative growth. Transcriptome analyses of B. emersonii cells were carried out during germination induced under various environmental conditions. Microarray data analyzing 3,563 distinct B. emersonii genes revealed that 26% of them are differentially expressed during germination in nutrient medium at at least one of the time points investigated. Over 500 genes are upregulated during the time course of germination under those conditions, most being related to cell growth, including genes involved in protein biosynthesis, DNA transcription, energetic metabolism, carbohydrate and oligopeptide transport, and cell cycle control. On the other hand, several transcripts stored in the zoospores are downregulated during germination in nutrient medium, such as genes involved in signal transduction, amino acid transport, and chromosome organization. In addition, germination induced in the presence of nutrients was compared with that triggered either by adenine or potassium ions in inorganic salt solution. Several genes involved in cell growth, induced during germination in nutrient medium, do not show increased expression when B. emersonii zoospores germinate in inorganic solution, suggesting that nutrients exert a positive effect on gene transcription. The transcriptome data also revealed that most genes involved in cell signaling show the same expression pattern irrespective of the initial germination stimulus.

Global Gene Expression Analysis during Sporulation of the Aquatic Fungus Blastocladiella emersonii

The Blastocladiella emersonii life cycle presents a number of drastic biochemical and morphological changes, mainly during two cell differentiation stages: germination and sporulation. To investigate the transcriptional changes taking place during the sporulation phase, which culminates with the production of the zoospores, motile cells responsible for the dispersal of the fungus, microarray experiments were performed. Among the 3,773 distinct genes investigated, a total of 1,207 were classified as differentially expressed, relative to time zero of sporulation, at at least one of the time points analyzed. These results indicate that accurate transcriptional control takes place during sporulation, as well as indicating the necessity for distinct molecular functions throughout this differentiation process. The main functional categories overrepresented among upregulated genes were those involving the microtubule, the cytoskeleton, signal transduction involving Ca(2+), and chromosome organization. On the other hand, protein biosynthesis, central carbon metabolism, and protein degradation were the most represented functional categories among downregulated genes. Gene expression changes were also analyzed in cells sporulating in the presence of subinhibitory concentrations of glucose or tryptophan. Data obtained revealed overexpression of microtubule and cytoskeleton transcripts in the presence of glucose, probably causing the shape and motility problems observed in the zoospores produced under this condition. In contrast, the presence of tryptophan during sporulation led to upregulation of genes involved in oxidative stress, proteolysis, and protein folding. These results indicate that distinct physiological pathways are involved in the inhibition of sporulation due to these two classes of nutrient sources.

Design Management för Remote Control Sweden AB

This Degree Project is a cooperativ work with the advertising agency PAX in Falun and the industrial companyRemote Control, who constructs and sells actuators for the global market.The assignment concerns bringing out a graphic profile, or with another expression a Design Management, forRemote Control AB graphic materials. Remote Control AB has a quality certification ISO 9000 and is workingwith, when this report was wrote, an environment certification ISO 14001.The Company has been paid attention to Internet and other media.The supervisors are familiar to that Design Management is a soon coming competition element, like quality andenvironment management.This Degree project contains research, analysis and the construction of graphic material. The research has beencommitted most of the time to trace the customer, the market and the competitor, because its the most importantphase. It’s also important looking at competitor’s way of working with marketing management, so you can separatethem from the own company.

Simplified follow-up after medical abortion using a low-sensitivity urinary pregnancy test and a pictorial instruction sheet in Rajasthan, India : study protocol and intervention adaptation of a randomised control trial

The World Health Organisation suggests that simplification of the medical abortion regime will contribute to an increased acceptability of medical abortion, among women as well as providers. It is expected that a home-based follow-up after a medical abortion will increase the willingness to opt for medical abortion as well as decrease the workload and service costs in the clinic. Trial design The study is a randomised, controlled, non-superiority trial . Methods Women screened to participate in the study are those with unwanted pregnancies and gestational ages equal to or less than nine weeks. Eligible women randomised to the home-based assessment group will use a low-sensitivity pregnancy test and a pictorial instruction sheet at home, while the women in the clinic follow-up group will return to the clinic for routine follow-up carried out by a doctor. The primary objective of the study is to evaluate the effectiveness of home-based assessment using a low-sensitivity pregnancy test and a pictorial instruction sheet 10-14 days after an early medical abortion. Providers or research assistants will not be blinded during outcome assessment. To ensure feasibility of the self-assessment intervention an adaption phase took place at the selected study sites before study initiation. This was to optimise and tailor-make the intervention and the study procedures and resulted in the development of the pictorial instruction sheet for how to use the low-sensitivity pregnancy test and the danger signs after a medical abortion. Discussion In this paper, we will describe the study protocol for a randomised control trial investigating the efficacy of simplified follow-up in terms of home-based assessment, 10-14 days after a medical abortion. Moreover, a description of the adaptation phase is included for a better understanding of the implementation of the intervention in a setting where literacy is low and the road-connections are poor. Trial registration: Clinicaltrials.gov NCT01827995. Registered 04 May 2013

Optimization Of Groundwater Remediation With New Efficient Parallel Algorithm For Global Optimization

Application of optimization algorithm to PDE modeling groundwater remediation can greatly reduce remediation cost. However, groundwater remediation analysis requires a computational expensive simulation, therefore, effective parallel optimization could potentially greatly reduce computational expense. The optimization algorithm used in this research is Parallel Stochastic radial basis function. This is designed for global optimization of computationally expensive functions with multiple local optima and it does not require derivatives. In each iteration of the algorithm, an RBF is updated based on all the evaluated points in order to approximate expensive function. Then the new RBF surface is used to generate the next set of points, which will be distributed to multiple processors for evaluation. The criteria of selection of next function evaluation points are estimated function value and distance from all the points known. Algorithms created for serial computing are not necessarily efficient in parallel so Parallel Stochastic RBF is different algorithm from its serial ancestor. The application for two Groundwater Superfund Remediation sites, Umatilla Chemical Depot, and Former Blaine Naval Ammunition Depot. In the study, the formulation adopted treats pumping rates as decision variables in order to remove plume of contaminated groundwater. Groundwater flow and contamination transport is simulated with MODFLOW-MT3DMS. For both problems, computation takes a large amount of CPU time, especially for Blaine problem, which requires nearly fifty minutes for a simulation for a single set of decision variables. Thus, efficient algorithm and powerful computing resource are essential in both cases. The results are discussed in terms of parallel computing metrics i.e. speedup and efficiency. We find that with use of up to 24 parallel processors, the results of the parallel Stochastic RBF algorithm are excellent with speed up efficiencies close to or exceeding 100%.

DCE: the dynamic conditional execution in a multipath control independent architecture

This thesis presents DCE, or Dynamic Conditional Execution, as an alternative to reduce the cost of mispredicted branches. The basic idea is to fetch all paths produced by a branch that obey certain restrictions regarding complexity and size. As a result, a smaller number of predictions is performed, and therefore, a lesser number of branches are mispredicted. DCE fetches through selected branches avoiding disruptions in the fetch flow when these branches are fetched. Both paths of selected branches are executed but only the correct path commits. In this thesis we propose an architecture to execute multiple paths of selected branches. Branches are selected based on the size and other conditions. Simple and complex branches can be dynamically predicated without requiring a special instruction set nor special compiler optimizations. Furthermore, a technique to reduce part of the overhead generated by the execution of multiple paths is proposed. The performance achieved reaches levels of up to 12% when comparing a Local predictor used in DCE against a Global predictor used in the reference machine. When both machines use a Local predictor, the speedup is increased by an average of 3-3.5%.

Gestão de risco em cadeia de suprimentos global: um estudo multicasos entre os membros da cadeia da manga

O propósito deste estudo é compreender como os diferentes membros gerenciam o risco na cadeia de suprimentos global. Por meio de um estudo multicaso na cadeia de exportação da manga brasileira para os Estados Unidos foram investigados os elos fornecedor, exportador, operador logístico e importador. Foi desenvolvido um protocolo de pesquisa conforme sugestão de Yin (2010) e adaptação de instrumento de coleta de dados semi-estruturado de Christopher, et al. (2011). A partir de entrevistas com organizações de apoio ao objeto da pesquisa, foi selecionado a amostra de empresas nas quais o fenômeno de gestão do risco poderia ser melhor observado. Baseado nas classificações de tipo de risco elaboradas por Christopher et al. (2011), é sugerida uma nova organização das categorias de risco (demanda, suprimentos, processo e controle, ambiental e sustentabilidade). Este trabalho apresenta uma descrição da cadeia de exportação de manga, bem como os principais riscos e as estratégias mitigadoras de risco empregadas pelos quatro membros da cadeia estudados. Conforme regra de Sousa (2001), foram realizadas comparações entre os tipos de risco e estratégias mitigadoras observadas na cadeia de suprimentos. Por fim, o estudo mostrou que a gestão do risco é heterogenia entre os membros da cadeia, o exportador é o mais penalizado pela consequência de risco à cadeia e a colaboração é a principal forma observada de mitigação.

Avaliação dos efeitos da reeducação postural global (rpg) em pacientes com espondilite anquilosante

The Ankylosing Spondylitis (AS) is a chronic inflammatory disease that primarily affects the axial skeleton, leading to limitation of spine mobility and functional disability. Physical therapy, especially exercise, is an important part in your treatment. The Global Postural Reeducation(GPR),a method that uses stretching based on evaluation of muscular chains, with significant interference in postural changes may be a complementary alternative for the treatment of this disease. The aim was to evaluate the effects of Global Postural Reeducation (GPR) in patients with Ankylosing Spondylitis (AS) and compare GPR with group conventional segmental self-stretching and breathing exercises. This is a controlled interventional study of 38 patients divided into 2 groups: a GPR group (n = 22) and a control group (n = 16). Both groups were treated over four months. With the GPR group patients, positions that stretched the shortened muscle chains were used. With the control group patients, conventional segmental self-stretching and breathing exercises were performed. The variables analyzed were: pain intensity, morning stiffness, spine mobility, chest expansion, functional capacity (Health Assessment Questionnaire - Spondyloarthropathies - HAQ-S), quality of life (Medical Outcome Study Short Form 36 Healthy Survey-SF-36), and disease activity (Bath Ankylosing Spondylitis Disease Activity Index - BASDAI). Statistical analysis was used with a significance level of p < 0.05. There was a statistically significant difference for all the parameters analyzed between pre and post-treatment in both groups. In the inter-group comparison the GPR group showed a statistically significant improvement in morning stiffness (p = 0.01), spine mobility parameters, except finger-floor distance (p = 0.11), in chest expansion (p = 0.02), and in the physical aspect component of the SF-36 (p = 0.00).Finally, we observed that this sample of patients with AS ,treatment with RPG 60 seems to have a better response in some clinical measures, than the conventional self stretching performed in groups. Further studies are needed to further evaluate this therapeutic alternative in the EA

Desenvolvimento de um Sistema de Visão Global para uma Frota de Mini-Robôs Móveis

Navigation based on visual feedback for robots, working in a closed environment, can be obtained settling a camera in each robot (local vision system). However, this solution requests a camera and capacity of local processing for each robot. When possible, a global vision system is a cheapest solution for this problem. In this case, one or a little amount of cameras, covering all the workspace, can be shared by the entire team of robots, saving the cost of a great amount of cameras and the associated processing hardware needed in a local vision system. This work presents the implementation and experimental results of a global vision system for mobile mini-robots, using robot soccer as test platform. The proposed vision system consists of a camera, a frame grabber and a computer (PC) for image processing. The PC is responsible for the team motion control, based on the visual feedback, sending commands to the robots through a radio link. In order for the system to be able to unequivocally recognize each robot, each one has a label on its top, consisting of two colored circles. Image processing algorithms were developed for the eficient computation, in real time, of all objects position (robot and ball) and orientation (robot). A great problem found was to label the color, in real time, of each colored point of the image, in time-varying illumination conditions. To overcome this problem, an automatic camera calibration, based on clustering K-means algorithm, was implemented. This method guarantees that similar pixels will be clustered around a unique color class. The obtained experimental results shown that the position and orientation of each robot can be obtained with a precision of few millimeters. The updating of the position and orientation was attained in real time, analyzing 30 frames per second

Leprosy control: perspectives & epidemiological and operational aspects

OBJETIVOS: A partir de acervo de 200 textos acadêmicos e de documentos de organismos nacionais e internacionais voltados ao controle da hanseníase publicados no período de 1999 a 2008, procurou-se estudar respectivas possibilidades evolutivas futuras, empregando-se os subsídios do recurso de análise de cenários. MÉTODOS: A reconstrução metodológica adotada foi de natureza qualitativa, fulcrada nas técnicas de revisão bibliográfica e análise de conteúdo. Esta última foi empregada na tipificação documental categorial frequencial contigencial, de acordo com devida fundamentação pertinente. RESULTADOS: Recuperaram-se elementos atuais importantes de natureza epidemiológica e operacional, bem como de respectivas perspectivas. CONCLUSÕES: Projeta-se que a manutenção dos coeficientes de incidência da doença coloca reptos econômicos e sanitários a desafiar desde o modelo neoliberal de organização societária mundial até competências específicas das ações das equipes de saúde em campo.

Chemoenzymatic Synthesis of alpha-Hydroxy-beta-methyl-gamma-hydroxy Esters: Role of the Keto-Enol Equilibrium To Control the Stereoselective Hydrogenation in a Key Step

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

Global yields, chemical compositions and antioxidant activities of clove basil (Ocimum gratissimum L.) extracts obtained by supercritical fluid extraction

Clove basil (Ocimum gratissimum) extracts were obtained with supercritical CO2. Clove basil was cultivated using 0, 4, 8 and 12 kg/m(2) of organic fertilizer and was harvested in four seasons: winter, spring, summer and autumn, in the Southern Hemisphere. The extracts' global yields were determined at 40C and 150 bar for samples from all cultivation conditions and harvesting seasons. For selected samples, the extracts' global yields at 40C were determined for pressures of 100, 150, 200, 250 and 300 bar. The extracts were analyzed by gas chromatography-flame ionization detector. Antioxidant activity (AA) was assessed using the coupled reaction of beta-caroteneand linolenic acid. The extracts' global yields varied from 0.91 to 1.79% (dry basis), and the AAs varied from 62 to 84% compared with the control beta-carotene. Eugenol and beta-selinene were the major compounds. The relative proportion of eugenol varied from 35 to 60%, while the content of beta-selinene remained approximately constant (11.5-14.1%, area). The other substances quantified in the extracts were 1,8 cineole, trans-caryophyllene and alpha-selinene.

Global optimization approach for the H2-norm model reduction problem

A branch and bound algorithm is proposed to solve the H2-norm model reduction problem for continuous-time linear systems, with conditions assuring convergence to the global optimum in finite time. The lower and upper bounds used in the optimization procedure are obtained through Linear Matrix Inequalities formulations. Examples illustrate the results.

The effect of actuator and sensor placement on the active control of rotor unbalance

This paper investigates both theoretically and experimentally the effect of the location and number of sensors and magnetic bearing actuators on both global and local vibration reduction along a rotor using a feedforward control scheme. Theoretical approaches developed for the active control of beams have been shown to be useful as simplified models for the rotor scenario. This paper also introduces the time-domain LMS feedforward control strategy, used widely in the active control of sound and vibration, as an alternative control methodology to the frequency-domain feedforward approaches commonly presented in the literature. Results are presented showing that for any case where the same number of actuators and error sensors are used there can be frequencies at which large increases in vibration away from the error sensors can occur. It is also shown that using a larger number of error sensors than actuators results in better global reduction of vibration but decreased local reduction. Overall, the study demonstrated that an analysis of actuator and sensor locations when feedforward control schemes are used is necessary to ensure that harmful increased vibrations do not occur at frequencies away from rotor-bearing natural frequencies or at points along the rotor not monitored by error sensors.