Rapid diagnosis in pediatric infectious diseases: The past, the present and the future

The focus of rapid diagnosis of infectious diseases of children in the last decade has shifted from variations of the conventional laboratory techniques of antigen detection, microscopy and culture to that of molecular diagnosis of infectious agents. Pediatricians will need to be able to interpret the use, limitations and results of molecular diagnostic techniques as they are increasingly integrated into routine clinical microbiology laboratory protocols. PCR is the best known and most successfully implemented diagnostic molecular technology to date. It can detect specific infectious agents and determine their virulence and antimicrobial genotypes with greater speed, sensitivity and specificity than conventional microbiology methods. Inherent technical limitations of PCR are present, although they are reduced in laboratories that follow suitable validation and quality control procedures. Variations of PCR together with advances in nucleic acid amplification technology have broadened its diagnostic capabilities in clinical infectious disease to now rival and even surpass traditional methods in some situations. Automation of all components of PCR is now possible. The completion of the genome sequencing projects for significant microbial pathogens, in combination with PCR and DNA chip technology, will revolutionize the diagnosis and management of infectious diseases.

Digital radiology and Picture Archiving and Communication System (PACS)

Plain radiography still accounts for the vast majority of imaging studies that are performed at multiple clinical instances. Digital detectors are now prominent in many imaging facilities and they are the main driving force towards filmless environments. There has been a working paradigm shift due to the functional separation of acquisition, visualization, and storage with deep impact in the imaging workflows. Moreover with direct digital detectors images are made available almost immediately. Digital radiology is now completely integrated in Picture Archiving and Communication System (PACS) environments governed by the Digital Imaging and Communications in Medicine (DICOM) standard. In this chapter a brief overview of PACS architectures and components is presented together with a necessarily brief account of the DICOM standard. Special focus is given to the DICOM digital radiology objects and how specific attributes may now be used to improve and increase the metadata repository associated with image data. Regular scrutiny of the metadata repository may serve as a valuable tool for improved, cost-effective, and multidimensional quality control procedures.

O controlo interno nos serviços e fundos autónomos

Mestrado em Auditoria

Compact SMB chromatography for binary separation

A thesis submitted for the degree of Doctor of Philosophy

Desenvolvimento de um jogo de simulação do sistema de produção Lean ferramentas: balanceamento da linha, VSM e SMED

Uma grande parte do tempo de uma organização é despendida em atividades que não criam qualquer tipo de valor. Este tipo de atividades são consideradas como desperdícios, pois consomem recursos e tempo, como é o caso de deslocações, controlos, ajustes, armazenamento de materiais, resolução de problemas, entre tantos outros, levando a um elevado custo dos produtos disponibilizados. Em 1996 a designação de Lean Thinking foi usada, pela primeira vez, por Womack e Jones, onde é falada como uma filosofia de gestão, que tem como principal objetivo reduzir os desperdícios num processo produtivo. Reduzindo os desperdícios aumenta-se a qualidade e diminui-se os tempos de processamento e, consequentemente, os custos de produção. É nesta base que assenta o documento aqui presente, que tem o objetivo de criar e desenvolver um jogo de simulação onde seja possível aplicar várias ferramentas Lean. O jogo de simulação é uma continuação de uma pesquisa e estudo teórico de um aluno de erasmus e faz parte de um projeto internacional do Lean Learning Academy (LLA). Criou-se um processo produtivo de montagem de canetas que fosse o mais semelhante ao que se encontram nas empresas, com todos os acessórios para o pleno funcionamento da simulação, como é o caso de instruções de montagem, procedimentos de controlo e ordens de produção, para assim posteriormente ser possível analisar os dados e as dificuldades encontradas, de modo a aplicar-se as ferramentas Lean. Apesar de serem abordadas várias ferramentas Lean neste trabalho, foram trabalhadas mais detalhadamente as seguintes: - Value Stream Mapping (VSM); - Single Minute Exchange of Dies (SMED); - Balanceamento da linha. De modo a ser percetível o conteúdo e as vantagens das três ferramentas Lean mencionadas no trabalho, estas foram aplicadas e simuladas, de forma a existir uma componente prática no seu estudo, para mais fácil compreensão e rápida aprendizagem.

Controlo interno na Administração Local implantação de um novo procedimento numa Autarquia

Trabalho de Projeto Apresentado ao Instituto de Contabilidade e Administração do Porto para a obtenção do grau de Mestre em Auditoria, sob orientação do Mestre Carlos Mendes e coorientação da Engª Sónia Rodrigues

Manual de procedimentos administrativos para projetos financiados

Trabalho de Projeto apresentado ao Instituto de Contabilidade e Administração do Porto para a obtenção do grau de Mestre em Auditoria, sob orientação da Professora Doutora Alcina Augusta Sena Portugal Dias

EuroDia: a beta-cell gene expression resource.

Type 2 diabetes mellitus (T2DM) is a major disease affecting nearly 280 million people worldwide. Whilst the pathophysiological mechanisms leading to disease are poorly understood, dysfunction of the insulin-producing pancreatic beta-cells is key event for disease development. Monitoring the gene expression profiles of pancreatic beta-cells under several genetic or chemical perturbations has shed light on genes and pathways involved in T2DM. The EuroDia database has been established to build a unique collection of gene expression measurements performed on beta-cells of three organisms, namely human, mouse and rat. The Gene Expression Data Analysis Interface (GEDAI) has been developed to support this database. The quality of each dataset is assessed by a series of quality control procedures to detect putative hybridization outliers. The system integrates a web interface to several standard analysis functions from R/Bioconductor to identify differentially expressed genes and pathways. It also allows the combination of multiple experiments performed on different array platforms of the same technology. The design of this system enables each user to rapidly design a custom analysis pipeline and thus produce their own list of genes and pathways. Raw and normalized data can be downloaded for each experiment. The flexible engine of this database (GEDAI) is currently used to handle gene expression data from several laboratory-run projects dealing with different organisms and platforms. Database URL: http://eurodia.vital-it.ch.

Survey on image quality and dose levels used in Europe for mammography.

Quality assurance programmes are becoming a common practice in the field of mammography. At the present time several recommendations exist and different test objects are used to optimize this radiological procedure. The goal of this study was to check if geographically distant centres using different quality control procedures were comparable when using a common objective way of assessing image quality. The results show that consensus still needs to be found among radiologists to reach a satisfactory level of harmony between patient doses and image quality in Europe.

Iowa Comprehensive Annual Financial Report, 2005

In accordance with Iowa Code Section 8A.502(8) we are pleased to submit the Comprehensive Annual Financial Report (CAFR) for the State of Iowa for the fiscal year ended June 30, 2005. The report is presented in three sections as follows: • The Introductory Section includes this transmittal letter, the Government Finance Officers Association (GFOA) Certificate of Achievement for the fiscal year 2004 CAFR, an organizational chart of State government, and a list of principal State officials. • The Financial Section contains the independent auditor’s report on the Basic Financial Statements, Management’s Discussion and Analysis (MD&A), the Basic Financial Statements, and Notes to the Financial Statements. The Financial Section also contains Required Supplementary Information (RSI), other than the MD&A, and supplementary information in the form of combining financial statements and schedules. This letter is intended to be read in conjunction with the MD&A. • The Statistical Section highlights selected financial and demographic information, generally presented on a multi-year basis. The Department of Administrative Services is responsible for both the accuracy of the presented data, and the completeness and fairness of the presentation. We believe the information presented is accurate in all material respects and the necessary disclosures have been made which enable the reader to obtain an understanding of the State’s financial activity. This report has been prepared in accordance with U.S. generally accepted accounting principles (GAAP) for governments as promulgated by the Governmental Accounting Standards Board (GASB). As a part of the statewide accounting system upgrade during fiscal year 2005, the implementation team performed a comprehensive review of the adequacy of internal controls and budgetary controls of the system. The team determined that internal controls continue to be in place to provide reasonable, but not absolute, assurance that assets are safeguarded against unauthorized use or disposition, and that financial records from all appropriate sources are reliable for preparing financial statements and maintaining accountability. The concept of reasonable assurance recognizes the cost of internal controls should not exceed the benefits likely to be derived from their use. To monitor the adequacy of internal controls, the Auditor of State reviews internal control procedures as an integral part of departmental audits.

The evolution of recent research on Catalan literature through the production of PhD theses: a bibliometric and social network analysis

Introduction. This paper studies the situation of research on Catalan literature between 1976 and 2003 by carrying out a bibliometric and social network analysis of PhD theses defended in Spain. It has a dual aim: to present interesting results for the discipline and to demonstrate the methodological efficacy of scientometric tools in the humanities, a field in which they are often neglected due to the difficulty of gathering data. Method. The analysis was performed on 151 records obtained from the TESEO database of PhD theses. The quantitative estimates include the use of the UCINET and Pajek software packages. Authority control was performed on the records. Analysis. Descriptive statistics were used to describe the sample and the distribution of responses to each question. Sex differences on key questions were analysed using the Chi-squared test. Results. The value of the figures obtained is demonstrated. The information obtained on the topic and the periods studied in the theses, and on the actors involved (doctoral students, thesis supervisors and members of defence committees), provide important insights into the mechanisms of humanities disciplines. The main research tendencies of Catalan literature are identified. It is observed that the composition of members of the thesis defence committees follows Lotka's Law. Conclusions. Bibliometric analysis and social network analysis may be especially useful in the humanities and in other fields which are lacking in scientometric data in comparison with the experimental sciences.

Auditing the management of vaccine-preventable disease outbreaks: the need for a tool

Public health activities, especially infectious disease control, depend on effective teamwork. We present the results of a pilot audit questionnaire aimed at assessing the quality of public health services in the management of VPD outbreaks. Audit questionnaire with three main areas indicators (structure, process and results) was developed. Guidelines were set and each indicator was assessed by three auditors. Differences in indicator scores according to median size of outbreaks were determined by ANOVA (significance at p (greater than or equal to) 0.05). Of 154 outbreaks; eighteen indicators had a satisfactory mean score, indicator "updated guidelines" and "timely reporting" had a poor mean score (2.84±106 and 2.44±1.67, respectively). Statistically significant differences were found according to outbreak size, in the indicators "availability of guidelines/protocol updated less than 3 years ago" (p = 0.03) and "days needed for outbreak control" (p = 0.04). Improving availability of updated guidelines, enhancing timely reporting and adequate recording of control procedures taken is needed to allow for management assessment and improvement.

eggNOG v4.0: nested orthology inference across 3686 organisms

With the increasing availability of various 'omics data, high-quality orthology assignment is crucial for evolutionary and functional genomics studies. We here present the fourth version of the eggNOG database (available at http://eggnog.embl.de) that derives nonsupervised orthologous groups (NOGs) from complete genomes, and then applies a comprehensive characterization and analysis pipeline to the resulting gene families. Compared with the previous version, we have more than tripled the underlying species set to cover 3686 organisms, keeping track with genome project completions while prioritizing the inclusion of high-quality genomes to minimize error propagation from incomplete proteome sets. Major technological advances include (i) a robust and scalable procedure for the identification and inclusion of high-quality genomes, (ii) provision of orthologous groups for 107 different taxonomic levels compared with 41 in eggNOGv3, (iii) identification and annotation of particularly closely related orthologous groups, facilitating analysis of related gene families, (iv) improvements of the clustering and functional annotation approach, (v) adoption of a revised tree building procedure based on the multiple alignments generated during the process and (vi) implementation of quality control procedures throughout the entire pipeline. As in previous versions, eggNOGv4 provides multiple sequence alignments and maximum-likelihood trees, as well as broad functional annotation. Users can access the complete database of orthologous groups via a web interface, as well as through bulk download.

Organisaatiokulttuurin muutos teleyhtiön sopeuttamisessa toimialamuutokseen

Työssä tarkasteltiin paikallisen teleyhtiön muutos- ja sopeuttamisprosessia vanhanaikaisesta puhelinyhtiöstänykyajan moderniksi teletoimijaksi. Selvitettiin, miten kaikki on saanut alkunsa ja minkälainen yritys on tänä päivänä. Yrityksen kehitykseen vaikuttaa väkisinkin organisaatiokulttuuri ja sen muuttuminen yrityksen toiminnan laajentuessa jamuuttuessa. Käytiin läpi orgäanisaatioteoriaa sekä siihen olennaisena osana liittyvää yrityksen arvomaailmaa ja yrityskuvaa. Tutkimus suoritettiin aikasarjana.Tutkimuksessa suoritettiin lyhyt historiakuvaus, jonka avulla selvitettiin tämän päivän kehitykseen vaikuttavat tekijät. Niitä olivat pääsääntöisesti yleinen teleliikennetoimialan kehittyminen ja viranomaisvalvonta. Asiaa tutkittiin kulttuurin kasvu- ja kehitysvaiheet menetelmää avuksi käyttäen. Empiirisenä aineistonakäytettiin paikallisen teleyhtiön vuosikertomuksia, otoksia julkisista lehti- ja internetartikkeleista sekä paikallisesta teleyhtiöstä ja yleisesti telealasta kertovaa kirjallisuutta. Lisäksi käytettiin hyväksi tutkijan omaa kokemusta pitkään telealalla työskennelleenä. Tutkimuksessa päädyttiin siihen tulokseen, että paikallisen teleyhtiön pitäisi näkyä enemmän valtakunnallisesti. Henkilöstön sopeuttaminen uuteen tilanteeseen tulee olemaan yritysjohdolle tärkein tehtävä. Tässä asiassa edesauttaa se, että yritysjohdolta löytyisi hyvät muutos-johtamisen ja vuorovaikuttamisen taidot. Viestinnän merkitys nousee myös erittäin tärkeäksi.Sen pitää toimia kumpaankin suuntaan, henkilöstön ja yritysjohdon välillä pitääolla kahdensuuntaista viestintää. Lisäksi todettiin, että todennäköisesti tapahtuu fuusioitumista joko niin, että isommat paikalliset teleyhtiöt ostavat pieniäyhtiöitä, ja markkinoille jää vain muutama iso paikallinen teleyhtiö, tai sitten kaikki paikalliset teleyhtiöt fuusioituvat yhteen isoon yhtiöön. Tulevaisuudessa kilpailun kiristyminen tulee luomaan tämänkaltaisia paineita. Tuote- ja palvelukehitykseen pitää tulevaisuudessa panostaa huomattavasti enemmän. Telealalla saadaan myös tottua siihen, että EU:n alueella tullaan vaatimaan kilpailun täyttävapautumista. Lisäksi viranomaiset tulevat seuraamaan telealaa jatkossakin erittäin tarkasti.

Improving globally distributed software development and support processes - A workflow view

We propose a new approach and related indicators for globally distributed software support and development based on a 3-year process improvement project in a globally distributed engineering company. The company develops, delivers and supports a complex software system with tailored hardware components and unique end-customer installations. By applying the domain knowledge from operations management on lead time reduction and its multiple benefits to process performance, the workflows of globally distributed software development and multitier support processes were measured and monitored throughout the company. The results show that the global end-to-end process visibility and centrally managed reporting at all levels of the organization catalyzed a change process toward significantly better performance. Due to the new performance indicators based on lead times and their variation with fixed control procedures, the case company was able to report faster bug-fixing cycle times, improved response times and generally better customer satisfaction in its global operations. In all, lead times to implement new features and to respond to customer issues and requests were reduced by 50%.