Descrição de outras doenças sexualmente transmissíveis em pessoas infectadas pelo vírus da imunodeficiência humana do tipo 1

Noventa pacientes soropositivos para o HIV-1 foram estudados, visando-se a descrição de manifestações clínicas e de marcadores de outras doenças sexualmente transmissíveis, assim como de fatores demográficos e comportamentais que possam estar relacionados com a infecção pelo HIV-1 e em pacientes com SIDA/AIDS. A maioria dos entrevistados (83,3%) foi do sexo masculino, apresentou a média de idade 31,4 anos (variando entre 18 e 60 anos) e a distribuição da renda familiar mensal mostrou que 79,5% tinham um ganho inferior a cinco salários mínimos. Pelos menos um tipo de droga, foi consumido por 51,1%, sendo que 20.7% usaram droga não medicamentosa de uso injetável. Destes, 94,4% referiram antecedentes de doenças sexualmente transmissíveis. A observação dos hábitos sexuais revelou que 41,6% eram bissexuais, 38,2% heterossexuais e 20,2% eram homossexuais. Cerca de 51,1% dos bissexuais usaram drogas injetáveis e todos referiram a prática de sexo anal e foram positivos para a presença de anticorpos para Chlamydia. A média de idade da primeira relação sexual com penetração foi de 14.7 anos, enquanto que a média de idade em que ocorreu a primeira doença sexualmente transmissível foi de 20.6 anos. A quase totalidade (95,5%) dos entrevistados tiveram múltiplos parceiros sexuais, antes do conhecimento da soropositividade para o HIV-1. Dentre os 90 soropositivos, 73,3% referiram antecedentes de doenças sexualmente transmissíveis. Destes, 82,2% referiram a presença de secreção uretraI, de sífilis e de herpes simples. No momento da avaliação, 36,6% (33/90) apresentaram secreção uretral, anal e/ou vaginal, lesão genital, anal, perianal e/ou adenopatia inguinal, assim discriminado: Secreção (51,1%), vesículas (18,1%), lesão verrucosa (18,1%), Adenopatias iguinais ( 18,1% ), úlceras ( 12,1 %) e pápulas (6% ). A reação do VDRL foi positiva em 13,7% (11/80), sendo que neste grupo, 90,9% referiram a prática do sexo anal e 81,8% revelaram antecedentes de DST. Cerca de 96,4% (81/84) apresentaram anticorpos para Chlamydia, sendo que 81,8% revelaram a prática do sexo anal e 72,8% relataram antecedentes de DST .

An investigation about Brazilian mango and grape exports

Purpose - The objective of this paper is to characterise the transactions between European buyers and Brazilian mango and grape producers. Design/methodology/approach - The method selected for this paper was multiple case studies. The Brazilian mango and grape supply chains' export activities to Europe were investigated. The field research was undertaken in Brazil, Germany, The Netherlands and the UK. In total, 41 face-to-face interviews were carried out. Findings - The supermarkets' literature tends to generalise the strategies of retailers focusing on differentiation and preferred suppliers. However, in empirical research conducted in the UK, Germany and The Netherlands it is possible to conclude that the procurement strategies of supermarkets can vary sharply. The results reveal the presence of different agents who demand different quality standards. The level of intensity depends on consumer behaviour, the features of product commercialised and the characteristics of the production segment in each country. Research limitations/implications - First, in relation to the empirical method there is a limitation because the case study does not allow statistical generalisation. Consequently, it will be interesting to undertake quantitative research in order to quantify the variables presented and their impact on the structure of value chains. Second, the research focuses only on two stages of the supply chain, producers and buyers. Practical implications - The differences between UK and German supermarkets challenge the supermarket literature, which tends to generalise the strategies of retailers focusing on differentiation and preferred suppliers. Originality/value - The study shows that the issue of influence and activities of retail agents along the value chain can be analysed taking several variables into consideration: the products commercialised; the distribution segment; and the consumer market. This result opens the way for analysing different structures of the value chain and the impact of these differences on the entry of producers for developing countries into the global market.

Progettare l'ospitalità: turismi e turisti della città contemporanea

La ricerca si pone come obbiettivo principale quello di individuare gli strumenti in grado di controllare la qualità di una progettazione specifica che risponde alle forti richieste della domanda turistica di un territorio. Parte dalle più semplici teorie che inquadrano una costante condizione dell’uomo, “il VIAGGIARE”. La ricerca si pone come primo interrogativo quello definire una “dimensione” in cui le persone viaggiano, dove il concetto fisico di spazio dedicato alla vita si è spostato come e quanto si sposta la gente. Esiste una sorta di macroluogo (destinazione) che comprende tutti gli spazi dove la gente arriva e da cui spesso riparte. Pensare all'architettura dell’ospitalità significa indagare e comprendere come la casa non è più il solo luogo dove la gente abita. La ricerca affonda le proprie tesi sull’importanza dei “luoghi” appartenenti ad un territorio e come essi debbano riappropriarsi, attraverso un percorso progettuale, della loro più stretta vocazione attrattiva. Così come si sviluppa un’architettura dello stare, si manifesta un’architettura dello spostarsi e tali architetture si confondono e si integrano ad un territorio che per sua natura è esso stesso attrattivo. L’origine terminologica di nomadismo è passaggio necessario per la comprensione di una nuova dimensione architettonica legata a concetti quali mobilità e abitare. Si indaga pertanto all’interno della letteratura “diasporica”, in cui compaiono le prime configurazioni legate alla provvisorietà e alle costruzioni “erranti”. In sintesi, dopo aver posizionato e classificato il fenomeno turistico come nuova forma dell’abitare, senza il quale non si potrebbe svolgere una completa programmazione territoriale in quanto fenomeno oramai imprescindibile, la ricerca procede con l’individuazione di un ambito inteso come strumento di indagine sulle relazioni tra le diverse categorie e “tipologie” turistiche. La Riviera Romagnola è sicuramente molto famosa per la sua ospitalità e per le imponenti infrastrutture turistiche ma a livello industriale non è meno famosa per il porto di Ravenna che costituisce un punto di riferimento logistico per lo scambio di merci e materie prime via mare, oltre che essere, in tutta la sua estensione, caso di eccellenza. La provincia di Ravenna mette insieme tutti i fattori che servono a soddisfare le Total Leisure Experience, cioè esperienze di totale appagamento durante la vacanza. Quello che emerge dalle considerazioni svolte sul territorio ravennate è che il turista moderno non va più in cerca di una vacanza monotematica, in cui stare solo in spiaggia o occuparsi esclusivamente di monumenti e cultura. La richiesta è quella di un piacere procurato da una molteplicità di elementi. Pensiamo ad un distretto turistico dove l’offerta, oltre alla spiaggia o gli itinerari culturali, è anche occasione per fare sport o fitness, per rilassarsi in luoghi sereni, per gustare o acquistare cibi tipici e, allo stesso tempo, godere degli stessi servizi che una persona può avere a disposizione nella propria casa. Il percorso, finalizzato a definire un metodo di progettazione dell’ospitalità, parte dalla acquisizione delle esperienze nazionali ed internazionali avvenute negli ultimi dieci anni. La suddetta fase di ricerca “tipologica” si è conclusa in una valutazione critica che mette in evidenza punti di forza e punti di debolezza delle esperienze prese in esame. La conclusione di questa esplorazione ha prodotto una prima stesura degli “obbiettivi concettuali” legati alla elaborazione di un modello architettonico. Il progetto di ricerca in oggetto converge sul percorso tracciato dai Fiumi Uniti in Ravenna. Tale scelta consente di prendere in considerazione un parametro che mostri fattori di continuità tra costa e città, tra turismo balneare e turismo culturale, considerato quindi come potenziale strumento di connessione tra realtà spesso omologhe o complementari, in vista di una implementazione turistica che il progetto di ricerca ha come primo tra i suoi obiettivi. Il tema dell’architettura dell’ospitalità, che in questo caso si concretizza nell’idea di sperimentare l’ALBERGO DIFFUSO, è quello che permette di evidenziare al meglio la forma specifica della cultura locale, salvandone la vocazione universale. La proposta progettuale si articola in uno studio consequenziale ed organico in grado di promuovere una riflessione originale sul tema del modulo “abitativo” nei luoghi di prossimità delle emergenze territoriali di specifico interesse, attorno alle quali la crescente affluenza di un’utenza fortemente differenziata evidenzia la necessità di nodi singolari che si prestino a soddisfare una molteplicità di usi in contesti di grande pregio.

Optimierung einer partikulären Cytomegalovirus-Vakzine

Pränatale Infektionen mit dem humanen Cytomegalovirus (HCMV) sind die häufigste Ursache frühkindlicher Schädigung, noch vor dem Down-Syndrom oder dem fetalen Alkoholsyndrom. Reaktivierung dieses Herpesvirus ist darüber hinaus als lebensbedrohliche Komplikation in der Transplantationsmedizin gefürchtet. Von Experten wurde daher die Entwicklung einer Vakzine vielfach angemahnt. Trotz unterschiedlicher Ansätze zu ihrer Entwicklung ist bisher jedoch kein Impfstoff verfügbar. Die Verwendung von subviralen Dense Bodies (DB) des Virus als Vakzinegrundlage stellt eine vielversprechende Strategie zur HCMV-Impfstoffentwicklung dar. DB enthalten bereits in ihrer natürlichen Form wichtige Zielantigene der humoralen und zellulären Immunantwort gegen HCMV. Durch gezielte Mutation des 230.000 Basenpaare umfassenden Genoms des HCMV konnte in Vorarbeiten der Beweis erbracht werden, dass DB hinsichtlich ihres antigenen Repertoires optimierbar sind. Allerdings waren Immunogenität und erzielte Ausbeuten noch unbefriedigend. Ziel der vorliegenden Arbeit war es, den Ansatz der Verwendung modifizierter DB als Impfstoff-Grundlage weiter zu entwickeln und Erkenntnisse über die für die Partikelbildung entscheidenden molekularen Mechanismen zu erarbeiten. In einem ersten Abschnitt wurde der Ansatz der Modifikation von DB durch Insertion heterologer Peptidantigene in das virale Tegumentprotein pp65 verfeinert. Das pp65 ist die mengenmäßig dominante Komponente von DB. Durch Herstellung und Austestung definierter HCMV Mutanten konnte die Position 175 des pp65 als geeignete Insertionsstelle für virale wie für nicht-virale Antigene identifiziert werden. In einem zweiten Schritt der Arbeit wurde die Rolle des pp65 im Verlauf der viralen Vermehrung und Morphogenese näher untersucht. Grundlage für diese Analysen war eine Virusmutante, die eine dominant-negative Variante des pp65 exprimierte. Vergleichende massenspektrometrische Untersuchungen unter Einbeziehung von pp65-kompetenten und pp65-negativen Virusmutanten zeigten, dass pp65 in der spät-infizierten Zelle mit dem viralen RNA-Exportfaktor pUL69 und der virale Kinase pUL97 komplexiert vorkommt. Das pp65 wurde als Substrat von pUL97 identifiziert. Daneben wurden essentielle Proteine des viralen Replikationsapparates, sowie zelluläre Proteine des RNA-Metabolismus und Transports und virale DNA in diesen Komplexen gefunden. Die Ergebnisse deuteten darauf hin, dass pp65 zu späten Zeitpunkten der viralen Infektion zu Stellen viraler DNA rekrutiert wird und dort regulatorisch in posttranskriptionelle Vorgänge von RNA Prozessierung oder RNA Transport eingreift. Die Hypothese, dass pp65 einen regulatorischen Einfluss auf die RNA-Exportfunktion von pUL69 nimmt, liegt nahe und ist nun in weiteren Analysen prüfbar.

[The abdominal catastrophe]

Patients with an abdominal catastrophe are in urgent need of early, interdisciplinary medical help. The treatment plan should be based on medical priorities and clear leadership. First priority should be given to achieve optimal oxygenation of blood and stabilization of circulation during all treatment-phases. The sicker the patient, the less invasive the (surgical) treatment should to be, which means "damage control only". This short article describes 7 important, pragmatic rules that will help to increase the survival of a patient with an abdominal catastrophe. Preexisting morbidity and risk factors must be included in the overall risk-evaluation for every therapeutic intervention. The challenge in patients with an abdominal catastrophe is to carefully balance the therapeutic stress and the existing resistance of the individual patient. The best way to avoid abdominal disaster, however, is its prevention.

Spatial genomic heterogeneity within localized, multifocal prostate cancer

Herein we provide a detailed molecular analysis of the spatial heterogeneity of clinically localized, multifocal prostate cancer to delineate new oncogenes or tumor suppressors. We initially determined the copy number aberration (CNA) profiles of 74 patients with index tumors of Gleason score 7. Of these, 5 patients were subjected to whole-genome sequencing using DNA quantities achievable in diagnostic biopsies, with detailed spatial sampling of 23 distinct tumor regions to assess intraprostatic heterogeneity in focal genomics. Multifocal tumors are highly heterogeneous for single-nucleotide variants (SNVs), CNAs and genomic rearrangements. We identified and validated a new recurrent amplification of MYCL, which is associated with TP53 deletion and unique profiles of DNA damage and transcriptional dysregulation. Moreover, we demonstrate divergent tumor evolution in multifocal cancer and, in some cases, tumors of independent clonal origin. These data represent the first systematic relation of intraprostatic genomic heterogeneity to predicted clinical outcome and inform the development of novel biomarkers that reflect individual prognosis.

Interview forms for integrating education for conservation in marine protected areas management in Colombia

Environmental Education (EE) is a key component in any marine protected area management. However, its visibility and action plans are still poorly developed and structured as a clear element in management procedures. The objective of this study is to contribute with a methodological route that integrates EE to the existing model of management planning and strategies, taking the Colombian National Natural Parks System as a case study. The creation of the route is proposed as a participatory research with different stakeholders in order to respond to the specific conservation needs and goals for the National Parks System. The EE national diagnosis has shown that its integration within the parks management structure is a first priority need, being a converging result on the two case studies on National Parks from the Pacific Coast of Colombia. The diagnosis also demonstrates that communication, participation, training and evaluation have to be reinforced, linking the community and stakeholders involved in the park management to the whole EE process. The proposed methodology route has been agreed upon by the National Parks staff and incorporates advice and recommendations from different stakeholders, in order to better include the park users. This step will help us to advance toward sustainable management in marine and coastal protected areas elsewhere, taking into account not only the biological but also the social-cultural prism. The main challenges in the management and conservation of coastal and marine ecosystems today are discussed.

Prioritization of Policies: A Prototype Model of a Flowchart Method

This paper builds a prototype model of how to prioritize policies by using a flowchart. We presented the following six steps to decide priorities of policies: Step 1 is to attain the social subsistence level (primary education, health care, and food sufficiency); Step 2 is to attain macroeconomic stability; Step 3 is to liberalize the economy by structural adjustment programs; Step 4 is capacity building specific to a growth strategy by facilitating sufficient infrastructure (physical infrastructure and institutions); Step 5 is to initiate a growth strategy; and Step 6 is to narrow income inequalities. We illustrated the effectiveness of our "flowchart method" in case studies of Morocco, Laos, Vietnam, and China. The first priority of reforms in Morocco was given to social sectors of primary education and health care, particularly in the rural areas at Step 1. Laos should not put much emphasis on growth strategy before educational reform, attainment of macroeconomic stability, and institutional capacity building at Steps 1, 2, and 3. Vietnam can focus on reforming the state-run enterprises and developing the stock markets at Step 5 of growth strategies. We found that we should apply our flowchart method to China not nation-wide but province-wide.

Factors influencing students in choosing to study pharmacy in Great Britain

Aim - To produce empirical evidence on the commitment to study pharmacy in terms of what motivates and influences students in their choice of subject and university. Design - Self-completion survey. Quantitative analysis by SPSS. Subjects and setting - Year 1 and year 4 undergraduates in schools of pharmacy in Great Britain. Results - The response rate was 35.2%. Students registered a high desire to study pharmacy; 73% of year 1 and 71% of year 4 placed it first priority at the time of application. Of those for whom it was not first choice, medicine was the preferred option. The two most important factors in choice were reputation of the school of pharmacy and reputation of the university. Conclusion - This study confirms that most applicants to study pharmacy were strongly committed to the subject. In addition, this study has allowed us to put an empirical figure to the proportion of students who at the time of applying for pharmacy would rather study medicine.

Essential BIM input data study for housing refurbishment:homeowners’ preferences in the UK

Construction customers are persistently seeking to achieve sustainability and maximize value as sustainability has become a major consideration in the construction industry. In particular, it is essential to refurbish a whole house to achieve the sustainability agenda of 80% CO2 reduction by 2050 as the housing sector accounts for 28% of the total UK CO2 emission. However, whole house refurbishment seems to be challenging due to the highly fragmented nature of construction practice, which makes the integration of diverse information throughout the project lifecycle difficult. Consequently, Building Information Modeling (BIM) is becoming increasingly difficult to ignore in order to manage construction projects in a collaborative manner, although the current uptake of the housing sector is low at 25%. This research aims to investigate homeowners’ decision making factors for housing refurbishment projects and to provide a valuable dataset as an essential input to BIM for such projects. One-hundred and twelve homeowners and 39 construction professionals involved in UK housing refurbishment were surveyed. It was revealed that homeowners value initial cost more while construction professionals value thermal performance. The results supported that homeowners and professionals both considered the first priority to be roof refurbishment. This research revealed that BIM requires a proper BIM dataset and objects for housing refurbishment.

An edge-based matching kernel through discrete-time quantum walks

In this paper, we propose a new edge-based matching kernel for graphs by using discrete-time quantum walks. To this end, we commence by transforming a graph into a directed line graph. The reasons of using the line graph structure are twofold. First, for a graph, its directed line graph is a dual representation and each vertex of the line graph represents a corresponding edge in the original graph. Second, we show that the discrete-time quantum walk can be seen as a walk on the line graph and the state space of the walk is the vertex set of the line graph, i.e., the state space of the walk is the edges of the original graph. As a result, the directed line graph provides an elegant way of developing new edge-based matching kernel based on discrete-time quantum walks. For a pair of graphs, we compute the h-layer depth-based representation for each vertex of their directed line graphs by computing entropic signatures (computed from discrete-time quantum walks on the line graphs) on the family of K-layer expansion subgraphs rooted at the vertex, i.e., we compute the depth-based representations for edges of the original graphs through their directed line graphs. Based on the new representations, we define an edge-based matching method for the pair of graphs by aligning the h-layer depth-based representations computed through the directed line graphs. The new edge-based matching kernel is thus computed by counting the number of matched vertices identified by the matching method on the directed line graphs. Experiments on standard graph datasets demonstrate the effectiveness of our new kernel.

Peat Bog Ecosystems: Peatland Restoration

Peatland restoration involves giving aid to a complex ecosystem which has been damaged in some way. A reasonable analogy is a patient brought to a hospital for urgent treatment. When arriving at Accident & Emergency , the first priority of the medical team is to stabilise the patient’s condition. Only after the patient’s condition has been assessed and then stabilised can the team begin to think about the longer - term process of healing and recovery. A similar logic is applied to peatland s . First , stabilisation is required to prevent further degradation, following which restoration can focus on the recovery of the ecosystem.

Leveraging Multiple Features for Image Retrieval and Matching

The goal of image retrieval and matching is to find and locate object instances in images from a large-scale image database. While visual features are abundant, how to combine them to improve performance by individual features remains a challenging task. In this work, we focus on leveraging multiple features for accurate and efficient image retrieval and matching. We first propose two graph-based approaches to rerank initially retrieved images for generic image retrieval. In the graph, vertices are images while edges are similarities between image pairs. Our first approach employs a mixture Markov model based on a random walk model on multiple graphs to fuse graphs. We introduce a probabilistic model to compute the importance of each feature for graph fusion under a naive Bayesian formulation, which requires statistics of similarities from a manually labeled dataset containing irrelevant images. To reduce human labeling, we further propose a fully unsupervised reranking algorithm based on a submodular objective function that can be efficiently optimized by greedy algorithm. By maximizing an information gain term over the graph, our submodular function favors a subset of database images that are similar to query images and resemble each other. The function also exploits the rank relationships of images from multiple ranked lists obtained by different features. We then study a more well-defined application, person re-identification, where the database contains labeled images of human bodies captured by multiple cameras. Re-identifications from multiple cameras are regarded as related tasks to exploit shared information. We apply a novel multi-task learning algorithm using both low level features and attributes. A low rank attribute embedding is joint learned within the multi-task learning formulation to embed original binary attributes to a continuous attribute space, where incorrect and incomplete attributes are rectified and recovered. To locate objects in images, we design an object detector based on object proposals and deep convolutional neural networks (CNN) in view of the emergence of deep networks. We improve a Fast RCNN framework and investigate two new strategies to detect objects accurately and efficiently: scale-dependent pooling (SDP) and cascaded rejection classifiers (CRC). The SDP improves detection accuracy by exploiting appropriate convolutional features depending on the scale of input object proposals. The CRC effectively utilizes convolutional features and greatly eliminates negative proposals in a cascaded manner, while maintaining a high recall for true objects. The two strategies together improve the detection accuracy and reduce the computational cost.

O VIH e a mulher: “Um olhar sobre a sexualidade feminina e suas implicações”

Dissertação de Mestrado apresentada ao Instituto Superior de Psicologia Aplicada para obtenção de grau de Mestre na especialidade de Psicologia Clínica.

The taxonomy, zoogeography and ecology of amphibians and reptiles of Hin Nam No National Protected Area (Laos) in comparison with data from Phong Nha – Ke Bang National Park (Vietnam).

In this thesis the mostly unknown herpetofauna in Hin Nam No National Protected Area Laos in the northern Truong Son Range was for the first time intensively investigated, and its diversity was compared to the bordering, and well-investigated Phong Nha - Ke Bang National Park in Vietnam. Twelve new vertebrate species were described comprising 11 geckonids (Cyrtodactylus bansocensis, C. calamei, C. hinnamnoensis, C. jaegeri, C. rufford, C. sommerladi, C. soudthichaki, Gekko boehmei, G. bonkowskii, G. sengchanthavongi, G. thakhekensis, Lycodon banksi and one colubrid snake (Lycodon banksi). Seven species were discovered for the first time in Laos including three frogs (Gracixalus quyeti, G. supercornutus, Rhacophorus maximus), two geckos (Cyrtodactylus cryptus, C. pseudoquadrivirgatus) and two snakes (Lycodon futsingensis, L. ruhstrati abditus). The main hypothesis that the Truong Son Range acted as a biogeographic barrier for the distribution of amphibians and reptiles could be confirmed at least for karst adapted gekkonids. Compared to other herpetofaunal groups the number of gekkonids in karst formations was particularly high (seven bent-toed geckos, four true geckos). By comparing the relative amounts of shared species in Hin Nam No and Phong Nha - Ke Bang, it is interesting to note that fewer reptile species (38%) than amphibian species (66%) were shared between both regions. This might indicate that the Truong Son Range acts as a stronger biogeographical barrier for reptiles than for amphibians. Two pairs of karst-adapted cryptic gecko species (i.e. species with distinct genetic differences, but a similar phenotype) occurred on both sides of the Truong Son Range. Only in one case these were sibling species (Crytodactylus sommerladi in Laos versus C. roesleri in Vietnam), but not in the other (C. hinnamnoensis in Laos versus C. phongnhakebangensis in Vietnam). On the Laotian side, nine gecko species (Cyrtodactylus bansocensis, C. calamei, C. darevskii, C. hinnamnoensis, C. khammouanensis, C. multiporus, C. sommerladi, G. boehmei, G. sengchanthavongi) currently have to be regarded as endemic to the Hin Nam No region. On the Vietnamese side, seven species including two bent-toed geckos (Cyrtodactylus phongnhakebangensis and C. roesleri), three skinks (Lygosoma boehmei, Sphenomorphus tetradactylus and Tropidophorus noggei), and two snakes (Hebius andreae and Boiga bourreti) are currently only known from Phong Nha - Ke Bang and adjacent regions. These high numbers of potential endemic species together with the cryptic species complex in Cyrtodactylus provide strong evidence that the karst formations in the northern Truong Son Range represent a hot spot of reptile diversity and of speciation in Crytodactylus in particular. Correct species identification is a fundamental requirement for conservation measures. The discovery of cryptic species complexes poses a challenge for alpha taxonomy and species conservation, because the true distribution ranges of the species are in fact much smaller than previously assumed. Species conservation in this area of Laos is facing a number of further problems. New and potentially endemic species were discovered in highly populated and disturbed areas. Conversion of the Ho Chi Minh Trail into a highway provided easy access for farmers and still continues to accelerate the destruction of remote forest areas. Southern Hin Nam No with its high diversity of endemic species was identified as the first priority area for conservation. Also Ban Soc, an area isolated from Hin Nam No, should be among the conservation priorities because this region houses a so far overlooked population of the critically endangered Siamese crocodile. Efforts to establish a legal conservation status for this habitat are in progress.