Blood Donation in the Hospital de S. José. A 11-Year Retrospective Analysis of Deferrals and Exclusions

Background: Approximately 5% of the population donates blood each year in developed countries. Recruiting and maintaining a pool of altruistic and healthy blood donors is a challenging task. Blood donation as a dynamic process must naturally co-exist with the arguably essential deferrals. Aims: To analyse a 11-year cohort of donors and blood donations in order to determine the profile of the average donor and the typical donation. Characterize the donor’s population in terms of gender, age, number of donations, most common causes for deferral and exclusion and the possible relationships between them. Establish the tendency flow of donations per year. Methods: Analysis of 95861 blood donations from 31550 donors collected between 2000 and 2010 (11 years) in the Immunohemotherapy Department of the ‘‘Centro Hospitalar Lisboa Central - Hospital de Sa˜o Jose´’’ (Lisboa, Portugal). Prior to blood donation, donors were required to fill out a form of informed consent, a questionnaire of 21 ‘‘yes or no’’ questions and were submitted to a clinical assessment and physical examination including: measurement of weight, blood pressure, pulse and capillary hemoglobin levels. Post-donation, the collected blood was tested for ALT elevation and blood-borne viral agents (HBV, HCV, HIV 1 and 2 and HTLV 1 and 2) and other infections (Treponema pallidum). Blood donors and donations were registered in a database and statistically studied in terms of: gender and age distribution, number of donations, most common causes for deferral and exclusion. The frequency of blood donations throughout the period of observation was analyzed and statistically significant relationships between the collected variables were investigated. Results: From the population of 31550 donors 61% were male and a mean age of 41.5 years (± 12.5 years) was found. From the total of 95682 blood donations collected 78% were successful while the most common causes for deferral were: donation incompatible hemoglobin levels (5% of the blood donations and 22% of deferrals), ALT elevation (3% and 14%), positive blood screening test for Treponema pallidum (1% and 6%), medication (1% and 4%), positive serological blood markers for HBV (1% and 4%), endoscopy in the previous 12 months (1% and 3%), arterial hypertension (1% and 3%), infectious conditions (1% and 3%), influenza or influenza-like symptoms (1% and 2%) and positive serological blood markers for HCV (1% and 2%). Summary/Conclusions: Several factors may have contributed to a limited number of new regular donors in the population, namely: ageing population, the alienation of the individual from the community induced by modern lifestyles and job precariousness. It is of the utmost importance to refine our blood donation campaigns according to the existing population of donors. The optimization of the blood donation potential of a population of donors must be achieved through the development of reliable and consistent screening methods. In order to appeal to new donors it is important to promote blood donations considering the profile of the regular and healthy blood donor of the existing population.

Information flow analysis using data-dependent logical propositions

Dissertação para obtenção do Grau de Mestre em Engenharia Informática

Real-time Task-Splitting scheduling algorithms framework

Nos dias de hoje, os sistemas de tempo real crescem em importância e complexidade. Mediante a passagem do ambiente uniprocessador para multiprocessador, o trabalho realizado no primeiro não é completamente aplicável no segundo, dado que o nível de complexidade difere, principalmente devido à existência de múltiplos processadores no sistema. Cedo percebeu-se, que a complexidade do problema não cresce linearmente com a adição destes. Na verdade, esta complexidade apresenta-se como uma barreira ao avanço científico nesta área que, para já, se mantém desconhecida, e isto testemunha-se, essencialmente no caso de escalonamento de tarefas. A passagem para este novo ambiente, quer se trate de sistemas de tempo real ou não, promete gerar a oportunidade de realizar trabalho que no primeiro caso nunca seria possível, criando assim, novas garantias de desempenho, menos gastos monetários e menores consumos de energia. Este último fator, apresentou-se desde cedo, como, talvez, a maior barreira de desenvolvimento de novos processadores na área uniprocessador, dado que, à medida que novos eram lançados para o mercado, ao mesmo tempo que ofereciam maior performance, foram levando ao conhecimento de um limite de geração de calor que obrigou ao surgimento da área multiprocessador. No futuro, espera-se que o número de processadores num determinado chip venha a aumentar, e como é óbvio, novas técnicas de exploração das suas inerentes vantagens têm de ser desenvolvidas, e a área relacionada com os algoritmos de escalonamento não é exceção. Ao longo dos anos, diferentes categorias de algoritmos multiprocessador para dar resposta a este problema têm vindo a ser desenvolvidos, destacando-se principalmente estes: globais, particionados e semi-particionados. A perspectiva global, supõe a existência de uma fila global que é acessível por todos os processadores disponíveis. Este fato torna disponível a migração de tarefas, isto é, é possível parar a execução de uma tarefa e resumir a sua execução num processador distinto. Num dado instante, num grupo de tarefas, m, as tarefas de maior prioridade são selecionadas para execução. Este tipo promete limites de utilização altos, a custo elevado de preempções/migrações de tarefas. Em contraste, os algoritmos particionados, colocam as tarefas em partições, e estas, são atribuídas a um dos processadores disponíveis, isto é, para cada processador, é atribuída uma partição. Por essa razão, a migração de tarefas não é possível, acabando por fazer com que o limite de utilização não seja tão alto quando comparado com o caso anterior, mas o número de preempções de tarefas decresce significativamente. O esquema semi-particionado, é uma resposta de caráter hibrido entre os casos anteriores, pois existem tarefas que são particionadas, para serem executadas exclusivamente por um grupo de processadores, e outras que são atribuídas a apenas um processador. Com isto, resulta uma solução que é capaz de distribuir o trabalho a ser realizado de uma forma mais eficiente e balanceada. Infelizmente, para todos estes casos, existe uma discrepância entre a teoria e a prática, pois acaba-se por se assumir conceitos que não são aplicáveis na vida real. Para dar resposta a este problema, é necessário implementar estes algoritmos de escalonamento em sistemas operativos reais e averiguar a sua aplicabilidade, para caso isso não aconteça, as alterações necessárias sejam feitas, quer a nível teórico quer a nível prá

New visualization model for large scale biosignals analysis

Benefits of long-term monitoring have drawn considerable attention in healthcare. Since the acquired data provides an important source of information to clinicians and researchers, the choice for long-term monitoring studies has become frequent. However, long-term monitoring can result in massive datasets, which makes the analysis of the acquired biosignals a challenge. In this case, visualization, which is a key point in signal analysis, presents several limitations and the annotations handling in which some machine learning algorithms depend on, turn out to be a complex task. In order to overcome these problems a novel web-based application for biosignals visualization and annotation in a fast and user friendly way was developed. This was possible through the study and implementation of a visualization model. The main process of this model, the visualization process, comprised the constitution of the domain problem, the abstraction design, the development of a multilevel visualization and the study and choice of the visualization techniques that better communicate the information carried by the data. In a second process, the visual encoding variables were the study target. Finally, the improved interaction exploration techniques were implemented where the annotation handling stands out. Three case studies are presented and discussed and a usability study supports the reliability of the implemented work.

Quantifying consistency of Event Related Potentials across subjects based on single-trial topographic analysis

Introduction: Non-invasive brain imaging techniques often contrast experimental conditions across a cohort of participants, obfuscating distinctions in individual performance and brain mechanisms that are better characterised by the inter-trial variability. To overcome such limitations, we developed topographic analysis methods for single-trial EEG data [1]. So far this was typically based on time-frequency analysis of single-electrode data or single independent components. The method's efficacy is demonstrated for event-related responses to environmental sounds, hitherto studied at an average event-related potential (ERP) level. Methods: Nine healthy subjects participated to the experiment. Auditory meaningful sounds of common objects were used for a target detection task [2]. On each block, subjects were asked to discriminate target sounds, which were living or man-made auditory objects. Continuous 64-channel EEG was acquired during the task. Two datasets were considered for each subject including single-trial of the two conditions, living and man-made. The analysis comprised two steps. In the first part, a mixture of Gaussians analysis [3] provided representative topographies for each subject. In the second step, conditional probabilities for each Gaussian provided statistical inference on the structure of these topographies across trials, time, and experimental conditions. Similar analysis was conducted at group-level. Results: Results show that the occurrence of each map is structured in time and consistent across trials both at the single-subject and at group level. Conducting separate analyses of ERPs at single-subject and group levels, we could quantify the consistency of identified topographies and their time course of activation within and across participants as well as experimental conditions. A general agreement was found with previous analysis at average ERP level. Conclusions: This novel approach to single-trial analysis promises to have impact on several domains. In clinical research, it gives the possibility to statistically evaluate single-subject data, an essential tool for analysing patients with specific deficits and impairments and their deviation from normative standards. In cognitive neuroscience, it provides a novel tool for understanding behaviour and brain activity interdependencies at both single-subject and at group levels. In basic neurophysiology, it provides a new representation of ERPs and promises to cast light on the mechanisms of its generation and inter-individual variability.

A multi-purpose grammar generating a multi-scale integrated analysis of Laos

In this study we propose an application of the MuSIASEM approach which is used to provide an integrated analysis of Laos across different scales. With the term “integrated analysis across scales” we mean the generation of a series of packages of quantitative indicators, characterizing the performance of the socioeconomic activities performed in Laos when considering: (i) different hierarchical levels of organization (farming systems described at the level of household, rural villages, regions of Laos, the whole country level); and (ii) different dimensions of analysis (economic dimension, social dimension, ecological dimension, technical dimension). What is relevant in this application is that the information carried out by these different packages of indicators is integrated in a system of accounting which establishes interlinkages across these indicators. This is a essential feature to study sustainability trade-offs and to build more robust scenarios of possible changes. The multi-scale integrated representation presented in this study is based on secondary data (gathered in a three year EU project – SEAtrans and integrated by other available statistical sources) and it is integrated in GIS, when dealing with the spatial representation of Laos. However, even if we use data referring to Laos, the goal of this study is not that of providing useful information about a practical policy issue of Laos, but rather, to illustrate the possibility of using a multipurpose grammar to produce an integrated set of sustainability indicators at three different levels: (i) local; (ii) meso; (iii) macro level. The technical issue addressed is the simultaneous adoption of two multi-level matrices – one referring to a characterization of human activity over a set of different categories, and another referring to a characterization of land uses over the same set of categories. In this way, it becomes possible to explain the characteristics of Laos (an integrated set of indicators defining the performance of the whole country) in relation to the characteristics of the rural Laos and urban Laos. The characteristics of rural Laos, can be explained using the characteristics of three regions defined within Laos (Northern Laos, Central Laos and Southern Laos), which in turn can be defined (using an analogous package of indicators), starting from the characteristics of three main typologies of farming systems found in the regions.

A first attempt of geographically-distributed Multi-scale integrated analysis of societal and ecosystem metabolism (MuSIASEM): mapping human time and energy throughput in metropolitan Barcelona

This study presents a first attempt to extend the “Multi-scale integrated analysis of societal and ecosystem metabolism (MuSIASEM)” approach to a spatial dimension using GIS techniques in the Metropolitan area of Barcelona. We use a combination of census and commercial databases along with a detailed land cover map to create a layer of Common Geographic Units that we populate with the local values of human time spent in different activities according to MuSIASEM hierarchical typology. In this way, we mapped the hours of available human time, in regards to the working hours spent in different locations, putting in evidence the gradients in spatial density between the residential location of workers (generating the work supply) and the places where the working hours are actually taking place. We found a strong three-modal pattern of clumps of areas with different combinations of values of time spent on household activities and on paid work. We also measured and mapped spatial segregation between these two activities and put forward the conjecture that this segregation increases with higher energy throughput, as the size of the functional units must be able to cope with the flow of exosomatic energy. Finally, we discuss the effectiveness of the approach by comparing our geographic representation of exosomatic throughput to the one issued from conventional methods.

Performance analysis and tuning in multicore environments

Performance analysis is the task of monitor the behavior of a program execution. The main goal is to find out the possible adjustments that might be done in order improve the performance. To be able to get that improvement it is necessary to find the different causes of overhead. Nowadays we are already in the multicore era, but there is a gap between the level of development of the two main divisions of multicore technology (hardware and software). When we talk about multicore we are also speaking of shared memory systems, on this master thesis we talk about the issues involved on the performance analysis and tuning of applications running specifically in a shared Memory system. We move one step ahead to take the performance analysis to another level by analyzing the applications structure and patterns. We also present some tools specifically addressed to the performance analysis of OpenMP multithread application. At the end we present the results of some experiments performed with a set of OpenMP scientific application.

Magnetic resonance imaging determinants of intraindividual variability in the elderly: combined analysis of grey and white matter.

Elderly individuals display a rapid age-related increase in intraindividual variability (IIV) of their performances. This phenomenon could reflect subtle changes in frontal lobe integrity. However, structural studies in this field are still missing. To address this issue, we computed an IIV index for a simple reaction time (RT) task and performed magnetic resonance imaging (MRI) including voxel based morphometry (VBM) and the tract based spatial statistics (TBSS) analysis of diffusion tensor imaging (DTI) in 61 adults aged from 22 to 88 years. The age-related IIV increase was associated with decreased fractional anisotropy (FA) as well as increased radial (RD) and mean (MD) diffusion in the main white matter (WM) fiber tracts. In contrast, axial diffusion (AD) and grey matter (GM) densities did not show any significant correlation with IIV. In multivariate models, only FA has an age-independent effect on IIV. These results revealed that WM but not GM changes partly mediated the age-related increase of IIV. They also revealed that the association between WM and IIV could not be only attributed to the damage of frontal lobe circuits but concerned the majority of interhemispheric and intrahemispheric corticocortical connections.

Workers cooperation within the firm: an analysis using small and medium size firms

We investigate the determinants of teamwork and workers cooperation within the firm. Up to now the literature has almost exclusively focused on workers incentives as the main determinants for workers cooperation. We take a broader look at the firm's organizational design and analyze the impact that different aspects of it might have on cooperation. In particular, we consider the way in which the degree of decentralization of decisions and the use of complementary HRM practices (what we call the .rm.s vertical organizational design) can affect workers'collaboration with each other. We test the model's predictions on a unique dataset on Spanish small and medium size firms containing a rich set of variables that allows us to use sensible proxies for workers cooperation. We find that the decentralization of labor decisions (and to a less extent that of task planning) has a positive impact on workers cooperation. Likewise, cooperation is positively correlated to many of the HRM practices that seem to favor workers'interaction the most. We also confirm the previous finding that collaborative efforts respond positively to pay incentives, and particularly, to group or company incentives.

Development of spatial integration depends on top-down and interhemispheric connections that can be perturbed in migraine: a DCM analysis.

In humans, spatial integration develops slowly, continuing through childhood into adolescence. On the assumption that this protracted course depends on the formation of networks with slowly developing top-down connections, we compared effective connectivity in the visual cortex between 13 children (age 7-13) and 14 adults (age 21-42) using a passive perceptual task. The subjects were scanned while viewing bilateral gratings, which either obeyed Gestalt grouping rules [colinear gratings (CG)] or violated them [non-colinear gratings (NG)]. The regions of interest for dynamic causal modeling were determined from activations in functional MRI contrasts stimuli > background and CG > NG. They were symmetrically located in V1 and V3v areas of both hemispheres. We studied a common model, which contained reciprocal intrinsic and modulatory connections between these regions. An analysis of effective connectivity showed that top-down modulatory effects generated at an extrastriate level and interhemispheric modulatory effects between primary visual areas (all inhibitory) are significantly weaker in children than in adults, suggesting that the formation of feedback and interhemispheric effective connections continues into adolescence. These results are consistent with a model in which spatial integration at an extrastriate level results in top-down messages to the primary visual areas, where they are supplemented by lateral (interhemispheric) messages, making perceptual encoding more efficient and less redundant. Abnormal formation of top-down inhibitory connections can lead to the reduction of habituation observed in migraine patients.

Information and education in schistosomiasis control: an analysis of the situation in the State of Minas Gerais, Brazil

This paper presents the main ideas discussed in the round-table "Social and Educacional Aspects of Schistosomiasis Control", during the VII International Symposium of Schistosomiais. Considering the perspectives of schistosomiasis control in Brazil, it is described the example of the State of Minas Gerais , where the disease has been registered for more than seven decades. The importance of an extensive evaluation is now more important, considering the recent change in the Brazilian health system, since the Federal responsibility for the tropical diseases control programs have been replaced by the municipalities coordination. In this way, it is urgent to develop effective alternatives to assist the municipal staffs in the control task. In the specific case of health education, one observes a wide gap between the planned objectives and what is in fact carried out. Instant objectives and the utilization of traditional techniques prevail, which do not take into account the active participation of the population involved. Based on the authors' experience in the scientific and health education, the paper analyzes: (1) some data from a case study in the metropolitan region of Belo Horizonte, which presents the social representation and perception of schistosomiasis by the population; (2) an analysis of 35 different informative and educative materials used in Brazil since the sixties, and (3) some recommendations resulted from the studies that were carried out.

Conceptual models for designing information systems supporting the strategic analysis of technology environments

1 6 STRUCTURE OF THIS THESIS -Chapter I presents the motivations of this dissertation by illustrating two gaps in the current body of knowledge that are worth filling, describes the research problem addressed by this thesis and presents the research methodology used to achieve this goal. -Chapter 2 shows a review of the existing literature showing that environment analysis is a vital strategic task, that it shall be supported by adapted information systems, and that there is thus a need for developing a conceptual model of the environment that provides a reference framework for better integrating the various existing methods and a more formal definition of the various aspect to support the development of suitable tools. -Chapter 3 proposes a conceptual model that specifies the various enviromnental aspects that are relevant for strategic decision making, how they relate to each other, and ,defines them in a more formal way that is more suited for information systems development. -Chapter 4 is dedicated to the evaluation of the proposed model on the basis of its application to a concrete environment to evaluate its suitability to describe the current conditions and potential evolution of a real environment and get an idea of its usefulness. -Chapter 5 goes a step further by assembling a toolbox describing a set of methods that can be used to analyze the various environmental aspects put forward by the model and by providing more detailed specifications for a number of them to show how our model can be used to facilitate their implementation as software tools. -Chapter 6 describes a prototype of a strategic decision support tool that allow the analysis of some of the aspects of the environment that are not well supported by existing tools and namely to analyze the relationship between multiple actors and issues. The usefulness of this prototype is evaluated on the basis of its application to a concrete environment. -Chapter 7 finally concludes this thesis by making a summary of its various contributions and by proposing further interesting research directions.