Long-term follow-up of topical 5-aminolaevulinic acid photodynamic therapy diode laser single session for non-melanoma skin cancer

Photodynamic therapy (PDT) is based on the association of a light source and tight sensitive agents in order to cause the selective death of tumor cells. To evaluate topical 5-aminolaevulinic acid (5-ALA) and diode laser photodynamic single session therapy single session for non-melanoma skin cancer (NMSC), a long-term follow-up was performed. Nineteen Bowen`s disease (BD) and 15 basal cell. carcinoma (BCC) lesions were submitted to 6-h topical and occlusive 20% 5-ALA plus DMSO and EDTA, and later were exposed to 630 nm diode laser, 100 or 300 J cm(-2) dose. At 3 months tumor-free rate was 91.2% (31/34) whereas at 60 months, 57.7% (15/26), slightly higher in BCC (63.6%; 7/11). The relation between the reduction of the clinical response and the increase of tumor dimension observed at 18 months was lost at 60 months. The sBCC recurrence was earlier compared to the nBCC one. ALA-PDT offered important advantages: it is minimally invasive, an option for patients under risk of surgical complications; clinical feasibility; treatment of multiple lesions in only one session or lesions in poor heating sites and superior esthetical results. However, the recurrence rate increase after ALA-PDT diode laser single session can be observed at tong-term follow-up, and the repetitive sessions, an additional. advantage of the method, is strongly recommended. The clinical response and recurrence time seem to be related to the laser light dose and NMSC types/sub-types, thickness and dimension, which must be considered for the choice of the ALA-PDT. (C) 2009 Elsevier B.V. All rights reserved.

Orthodontic brackets removal under shear and tensile bond strength resistance tests - a comparative test between light sources

We have investigated if a new LEDs system has enough efficient energy to promote efficient shear and tensile bonding strength resistance under standardized tests. LEDs 470 +/- 10 nm can be used to photocure composite during bracket fixation. Advantages considering resistance to tensile and shear bonding strength when these systems were used are necessary to justify their clinical use. Forty eight human extracted premolars teeth and two light sources were selected, one halogen lamp and a LEDs system. Brackets for premolar were bonded through composite resin. Samples were submitted to standardized tests. A comparison between used sources under shear bonding strength test, obtained similar results; however, tensile bonding test showed distinct results: a statistical difference at a level of 1% between exposure times (40 and 60 seconds) and even to an interaction between light source and exposure time. The best result was obtained with halogen lamp use by 60 seconds, even during re-bonding; however LEDs system can be used for bonding and re-bonding brackets if power density could be increased.

L-(2-Quinolyl)-2-naphthol: A new intra-intermolecular photoacid-photobase molecule

Photochemical and photophysical properties of 1-(2-quinolyl)-2-naphthol (2QN) in water and organic solvents, as well in glassy media were studied to investigate the occurrence of intramolecular excited state prototropic reactions between the naphthol and quinoline rings. Spectral data show the two chromophores apparently behaving independently. However, in acid aqueous media or in low polarity solvents a new electronic transition red shifted band with respect to that of the parent compounds assigned to an intramolecular H-bond and to a quinoid form, respectively, shows up. Model calculations and R-X data lend support to a minimum energy conformer having a dihedral angle of similar to 39 degrees between the two groups. Singlet excited state properties (S-1) show a high suppressive effect of one ring over the other, resulting in very low emission yields at room temperature. The occurrence of excited state intramolecular proton transfer is observed in water (zwitter ion form) and in low polarity media (quinoid form) and originates from a previously CT H-bonded state. Phosphorescence data allowed a reasonable description of the electronic states of 2QN. In addition two new derivatives were prepared having the N atom blocked by methylation and both the N and O groups blocked by a CH2 bridge. The spectral data of these two compounds confirmed the attributions made for 2QN. (C) 2007 Elsevier B.V. All rights reserved.

Synthesis of new fluorous modular chiral ligand derivatives from amino alcohols and application in enantioselective carbon-carbon bond-forming alkylation reactions

N-Trifluoracyl beta-chalcogeno amides and N-perfluoracyl beta-thio amide ligands were prepared by a simple and efficient reaction sequence. These new ligands were evaluated in palladium-catalyzed alkylation of rac-(E)-1,3-diphenyl-2-propenyl acetate in the presence of dimethyl malonate and an enantioselectivity of up to 99% was obtained. After catalysis, the fluorous ligand can be easily recovered by liquid-liquid extraction and reused without loss in the activity. (C) 2010 Elsevier Ltd. All rights reserved.

A web application for follow-up of results from a mobile device test battery for parkinson’s disease patients

Background: A test battery consisting of self-assessments and motor tests (tapping and spiral drawing) was developed for a hand computer with touch screen in a telemedicine setting. Objectives: To develop and evaluate a web-based system that delivers decision support information to the treating clinical staff for assessing PD symptoms in their patients based on the test battery data. Methods: The test battery is currently being used in a clinical trial (DAPHNE, EudraCT No. 2005-002654-21) by sixty five patients with advanced Parkinson’s disease (PD) on 9991 test occasions (four tests per day during in all 362 week-long test periods) at nine clinics around Sweden. Test results are sent continuously from the hand unit over a mobile net to a central computer and processed with statistical methods. They are summarized into scores for different dimensions of the symptom state and an ‘overall test score’ reflecting the overall condition of the patient during a test period. The information in the web application is organized and presented graphically in a way that the general overview of the patient performance per test period is emphasized. Focus is on the overall test score, symptom dimensions and daily summaries. In a recent preliminary user evaluation, the web application was demonstrated to the fifteen study nurses who had used the test battery in the clinical trial. At least one patient per clinic was shown. Results: In general, the responses from nurses were positive. They claimed that the test results shown in the system were consistent with their own clinical observations. They could follow complications, changes and trends within their patients. Discussion: In conclusion, the system is able to summarise the various time series of motor test results and self-assessments during test periods and present them in a useful manner. Its main contribution is a novel and reliable way to capture and easily access symptom information from patients’ home environment. The convenient access to current symptom profile as well as symptom history provides a basis for individualized evaluation and adjustment of treatments.

Self-assessment of the outcome of early medical abortion versus clinic follow-up in India : a randomised, controlled, non-inferiority trial

Background: The need for multiple clinical visits remains a barrier to women accessing safe legal medical abortion services. Alternatives to routine clinic follow-up visits have not been assessed in rural low-resource settings. We compared the effectiveness of standard clinic follow-up versus home assessment of outcome of medical abortion in a low-resource setting. Methods: This randomised, controlled, non-inferiority trial was done in six health centres (three rural, three urban) in Rajasthan, India. Women seeking early medical abortion up to 9 weeks of gestation were randomly assigned (1:1) to either routine clinic follow-up or self-assessment at home. Randomisation was done with a computer-generated randomisation sequence, with a block size of six. The study was not blinded. Women in the home-assessment group were advised to use a pictorial instruction sheet and take a low-sensitivity urine pregnancy test at home, 10-14 days after intake of mifepristone, and were contacted by a home visit or telephone call to record the outcome of the abortion. The primary (non-inferiority) outcome was complete abortion without continuing pregnancy or need for surgical evacuation or additional mifepristone and misoprostol. The non-inferiority margin for the risk difference was 5%. All participants with a reported primary outcome and who followed the clinical protocol were included in the analysis. This study is registered with ClinicalTrials.gov, number NCT01827995. Findings: Between April 23, 2013, and May 15, 2014, 731 women were recruited and assigned to clinic follow-up (n=366) or home assessment (n=365), of whom 700 were analysed for the main outcomes (n=336 and n=364, respectively). Complete abortion without continuing pregnancy, surgical intervention, or additional mifepristone and misoprostol was reported in 313 (93%) of 336 women in the clinic follow-up group and 347 (95%) of 364 women in the home-assessment group (difference -2.2%, 95% CI -5.9 to 1.6). One case of haemorrhage occurred in each group (rate of adverse events 0.3% in each group); no other adverse events were noted. Interpretation Home assessment of medical abortion outcome with a low-sensitivity urine pregnancy test is non-inferior to clinic follow-up, and could be introduced instead of a clinic follow-up visit in a low-resource setting.

Re-framing risk transfer to assess integrative partnership opportunities: the S.A.R. approach and the AIG/BID/CNO regional surety bond facility of 2007

Identificar, compartilhar e gerenciar os riscos de contratar são preocupações que impedem o estabelicmento e a administração das Parcerias Públicos Particulares (PPP). Porem, gerentes das entidades públicas, bancos de formento, construtoras e seguradoras pesquisam e utilizam muitas técnicas para enfrentar a avaliação e gerenciamento dos riscos. A transferência de risco é uma indicação dos chamados benefícios que são inspirados pelos PPP, contudo devido às realidades contratuais e conceptuais, a entidade de cede o risco (o partido público) permanece quase sempre como o portador final do risco. Conseqüentemente, o partido público retem um interesse de resistência na gerência total destes riscos cedidos. Esta dissertação explora alguns defeitos das aproximações comuns a conceituar a gestão de risco no contexto de um PPP. Focalizando os conceitos da interdependência e da reciprocidade e usando na decisão para transferir o risco do projeto, esta dissertação molda a decisão para transferir o risco nos termos das realidades interdependentes de relacionamentos sistemáticos, alargam os conceitos técnicos do risco e da avaliação de risco, considerando o uso reflexivo das diferenças na analise de um estudo de caso. O autor explora estes conceitos em uma análise da decisão de um gerente de risco da empresa de construção civil brasileira Construtora Norberto Odebrecht (ODB) para projetar uma facilidade inovadora da ligação de garantia com Inter-American Development Bank (BID) e uma seguradora, American International Group (AIG), um negócio que ganhe o reconhecimento Trade Finance Magazine’s 2007 deal of the year. O autor mostra que por compreender a transferência de risco nos termos abordados nesta dissertação, um atore que transfere o risco pode identificar e criar mais oportunidades de estabelecer relacionamentos em longo prazo, através dos processos que a literatura atual do PPP ainda não considere. Os resultados devem fornecer contribuições para a pesquisas sobre a transferência do risco do projeto, na cooperação entre organizações e na seleção do sócio do projeto do potencial.

When a local competitor (slightly) shakes up the global giant: a case on the soft drink market

As marcas globais mantiveram muita atenção no campo do marketing (Kotler, 1997; Holt, Quelch, e Taylor, 2004; Özsomer e Altaras, 2008), enquanto as marcas locais foram subestimadas (Ger, 1999; Schuiling e Kapferer, 2004). No entanto, o debate adaptação contra padronização foi amplamente discutido. Centra-se na definição de como uma empresa internacional deve construir a sua estratégia: ao padronizar sua estratégia de marketing ou, adaptando para melhor atender a cultura e às necessidades locais (Levitt, 1983; Subhash, 1989; Herbig, 1998; Holt, 2004; Melewar e Vemmervik , 2004; Heerden e Barter, 2008). No entanto, este assunto não foi discutido no contexto específico do consumo alternativo oferecido por concorrentes locais específicos. Hoje em dia, um aumento na oferta de produtos alternativos é observado. O consumo socialmente responsável está crescendo (Sen e Bhattacharya, 2001; Holt, 2002; Loureiro, 2002; François-Lecompte e Valette-Florence, 2006). O mercado dos refrigerantes de cola é de interesse particular. Colas alternativas são refrigerantes de cola que surgiram durante a última década em algumas regiões ou zonas específicas do mundo. Estas colas claramente posicionam-se como uma alternativa ao refrigerante global Coca-Cola. A alternativa não é baseada no preço mas nas características especiais dos produtos que constituem uma proposição de valor específica, diferente da Coca-Cola. Na França, desde uma década, o número de colas regionais aumentou, sendo mais de quinze hoje. O refregirante Breizh Cola foi lançado em 2002 e atinge quase uma quota de mercado de 10% na região Bretanha hoje. Em 2009, a Coca-Cola Entreprise iniciou uma campanha de marketing específica, na Bretanha, baseada em recursos visuais e parcerias regionais. Este caso de adaptação em um contexto de concorrência local específico é explorado nesta dissertação que incide sobre as razões da preferência para Breizh Cola, de um lado, e sobre as acções empreendidas pela Coca-Cola na Bretanha, do outro lado. Este estudo mostra que a Coca-Cola anda nos passos de Breizh Cola, a fim de melhor atender às expectativas local.

The market strategies alternatives of an e-business start-up in Brazil

The e-business market is one of the fastest growing markets in Brazil, with e-business sales accounting for BRL 14.8 billion in 2010 and a growth of 40% per year (+1000% over the past 7 years). Sales-event clubs and collective bargaining websites are one of the most dynamic segments of the e-business market: the number of new players is increasing rapidly, with over 1200 collective bargaining websites currently operating in Brazil. In that context, growth and differentiation seem to be two key success factors for Coquelux. According to webshopper (23rd Edition, e-bit), growth can be achieved by targeting middle and low-income consumers from class C, who represent 50% of the total e-commerce sales. But Coquelux, which is specialized in desire and luxury brands, has built its reputation and competitive advantage through its “exclusivity”, by targeting wealthier consumers from classes A and B who are attracted by its fashionable and high-end positioning. The evolution (growth?) of this market and the development of its competition naturally raise a strategic question for Coquelux’s managers: can Coquelux grow and still maintain its competitive advantage? Should it grow by expanding its consumer base to class C? If so, how? Consumers from classes A, B or C must be targeted through the same online communication channels. Recent studies from the ABEP/ABIPEME emphasized the importance of social networks as a tool for converting new clients and gaining their loyalty, regardless of their social class. However, high-income and low-income e-consumers do not have the same consumption habits, do not respond to the same type of marketing strategies, and most importantly, do not share the same values. Thus, it seems difficult to expand Coquelux’s consumer base to class C without changing its marketing strategies and altering its image Three options were identified for Coquelux: reinforcing its leadership on the luxury segment and focusing on a small niche market (1), which would threaten its survival in the long run; completely changing its strategy and competing for a mass market through commercial brands (2), which requires major financial investments that managers don’t have access to; or finding an intermediary solution (3). This thesis’ recommendation for the third option consists in focusing on premium brands (rather than luxury) in order to increase sales volume (Coquelux’s most profitable sales happened with local desire brands) with products that appeal to class B but also attract the emerging class C which is looking for brand recognition. It could thus implement a slow entry strategy towards the mass market without damaging its main competitive advantage.

Trading-up e a nova classe trabalhadora: a ressignificação do consumo sob a ótica do capital simbólico

Esta dissertação tem como objetivo entender os hábitos de consumo das mulheres da nova classe trabalhadora para conhecer as aspirações, motivações e desejos que influenciam suas decisões de compra, e para identificar qual o significado, para elas, dos produtos característicos do “novo luxo”. A problemática deste trabalho envolve o entendimento do comportamento de consumo da ‘nova classe trabalhadora’ (Souza, 2012), e tem por objetivo compreender os novos hábitos de consumo dessa classe, no que tange ao consumo de bens constitutivos do chamado ‘novo luxo’ (Silverstein & Fiske, 2008). Os resultados desta pesquisa trarão entendimento às ressignificações de produtos de novo luxo para a nova classe trabalhadora, conhecimento sobre as preferências e prioridades dessa classe, e compreensão sobre o valor simbólico do consumo desse tipo de produto. No primeiro capítulo, foi abordado o comportamento do consumidor, mostrando a importância do estudo do comportamento de consumo para as estratégias mercadológicas, além de explorar a influência da cultura na tomada de decisão dos consumidores; o segundo capítulo abordou os conceitos de habitus, capital simbólico e cultural, em que são exploradas as questões relacionadas a valores, atitudes e hábitos, e a importância destes na expressão do indivíduo na sociedade e na formação de sua identidade; no terceiro capítulo, discutiu-se o conceito de classe social, trabalhando com as principais divergências encontradas nas premissas utilizadas por cada autor para identificar suas características distintivas, mencionando os principais argumentos relacionados aos conceitos de ‘nova classe média’ (Neri, 2011) e de ‘nova classe trabalhadora’ (Souza, 2012); por fim, o quarto capítulo tratou do fenômeno do trading-up (Silverstein & Fiske, 2008), que demonstra que o consumidor tem optado por produtos considerados de novo luxo, mesmo que paguem valores superiores para obtê-los. O produto de novo luxo é definido pelos autores como um produto premium, que apresenta melhorias e características superiores em relação a produtos similares, porém com preços mais acessíveis se comparados aos de luxo tradicional. A metodologia escolhida para este trabalho foi a pesquisa qualitativa de caráter exploratório-descritivo, considerando uma amostragem não probabilística, usando a seleção por julgamento. Os resultados da pesquisa demonstraram que, de fato, o fenômeno do trading-up está presente no dia-a-dia das mulheres da nova classe trabalhadora, ao priorizarem determinados itens que julgam importantes para o seu conforto, bem-estar, e melhoria na qualidade de vida.

Start-up acquisition: motivations, difficulties and lesson learned

Em um esforço continuo de sobrevivência, corporações buscam meios para expandir seus negócios, seja dentro de seus mercados atuantes, ou na exploração de novos mercados. Para alcançar esse objetivo, inovações são realizadas pelos funcionários que, por meio de suas iniciativas, praticam o empreendedorismo coorporativo. São diversas formas em que o empreendedorismo corporativo se manifesta, dentre elas por meio de aquisições. Ao comprar uma outra empresa, a empresa compradora tem como motivação a busca de alguns atributos que complementem seus objetivos iniciais. Após a compra, o processo de integração entre as duas empresas é, por muitas vezes, complicado e penoso. O objetivo desse estudo é o de identificar quais são essas motivações de compra, os problemas enfrentados durante a integração entre as duas empresas, e quais são as lições aprendidas por grandes/médias corporações quando adquirem Start-ups. Muitos estudos atualmente tratam de temas relacionados à aquisição de empresas, porém, quando se trata de Start-ups, pouca literatura é encontrada. Os resultados dessa pesquisa são fruto de entrevistas com os gestores e empreendedores que participaram do processo de aquisição da SAMURAI pela Momentum e da Save-me pela Buscapé – empresas brasileiras. Os resultados são seis sugestões que devem ser consideradas por grandes/medias corporações antes e durante o processo de aquisição de uma strat-up: (i) A base de clientes da empresa comprada deve ser cuidadosamente considerada; (ii) um contato muito próximo entre os gestores das duas empresas é crucial antes da realização da aquisição; (iii) a contratação de uma empresa de consultoria em aquisições pode ser primordial durante o processo de integração; (iv) o empreendedor tem um papel de central importância para o future da nova empresa formada após a aquisição; (v) a forma como a integração entre as duas empresas ocorrerá após a compra deve ser cuidadosamente escolhida e (iv) a criação de uma corporate venture deve ser levada em consideração.

Windows of opportunities and knowledge networks: implications for the catch-up in developing countries

This document represents a doctoral thesis held under the Brazilian School of Public and Business Administration of Getulio Vargas Foundation (EBAPE/FGV), developed through the elaboration of three articles. The research that resulted in the articles is within the scope of the project entitled “Windows of opportunities and knowledge networks: implications for catch-up in developing countries”, funded by Support Programme for Research and Academic Production of Faculty (ProPesquisa) of Brazilian School of Public and Business Administration (EBAPE) of Getulio Vargas Foundation.

Da poética das lágrimas a uma poética do riso: de Aristóteles ao One-man show

Since the 1970s, the world observes the fragmentation, hybridity, plurality and miscegenation that are taking over the scenic arts. The contemporary poetry feels free of the classical rules; theater no longer obeys the requirements of the poetic "manuals"; the rigid boundaries between genres disappears; artists cease to represent to the public to talk with him. In the last decades of twentieth century and in the twenty-first century, emerges the laughable phenomenon of One-man Show in the brazilian scene, object of this research, as a result of this evolution of the performing arts. It is a form of theater that emerged in the brazilian context, snatching public attention in alternative spaces, theaters and, as it should be, also on the Internet, often confused with the Stand-up Comedy. It is necessary a research that delimitate and pursue to identify the essential characteristics of the brazilian One- Man Show, not only by the absence of theoretical references concerning this, but also to understand some aspects of the brazilian scene and the situation of laughter and comedy in it. In the first chapter, a discussion about comedy and laughter in classical antiquity is presented, using the writings of Plato and Aristotle as a starting point; in the second, some of the main classical theories of laughter are reviewed, attempting to identify the general characteristics that enable to understand the construction of the comedy; the third chapter generally dicusses about the moment of the brazilian theatrical scene in which emerges the One-man Show; and in the fourth chapter, there is an explanation about this phenomenon and a description of the practical exercise titled Experimento One-person Show: Damas

Análise da contribuição de estagiários remunerados na força de trabalho em enfermagem

The present study analyses non obligatory and remunerated traineeships in nursing, as a contribution to work process in health and learning of students at nursing technician courses. It objectives to examine the contribution of medium level nursing students on scholarships at a teaching hospital s work force, at Natal/RN. It s a quantitative/qualitative, that uses descriptive statistics and analysis fulfilled with categories that emerged from research, through a dialog between the studied authors in the theoretical reference of nowadays work process, work force, non obligatory and remunerated traineeships, and night shifts. The collaborators of this research were 105 (73,43%) nursing technicians, medium level students on scholarships that fulfill remunerated traineeships at the hospital. The feminine gender was a major part of the collaborators, with 90 (85,70%), in which medium age was 29,71 years, 62 (59,00%) single, 57 (54,30%) don t have kids, 100 (95,23%) students on scholarships with complete medium level, 78,10% with professional experience before their insertion at the remunerated traineeships, 73 (69,50%) referred to enjoy the area, reason for the nursing technician course choice. About the technician course conclusion, 83 (79,00%) affirmed that happened between 2005 and 2008, and about traineeships time in the institution, 38 (36,20%) have between one and six months. About learning, 74 (70,50%) referred to learn with the nursing technicians and all fulfilled specialized courses, or grade up to bond with the school and be able to be trainees. These courses were considered low quality ones, what justifies the number of 54 (51,40%) students with scholarships that said their performance in studies is good and 75 (71,40%) are able to join it with the traineeships without problems. About remuneration as scholarship, 71 (67,60%) referred that helped to keep up with the studies, because this amount has specially this purpose, paying studies. About nonobligatory traineeships, the ABEn-RN affirmed that there s no following process to this traineeship mode, as long as there was never this concern, because obrigatory traineeships demand a lot of the efforts in the meetings. And COREN-RN doesn t supervise this way of contract. The present research observed that there is, in fact, a contribution of medium level nursing students on scholarships work force on the researched institution. Resigned to work circumstances established by the institution, representing the lack of human resources, materials, work conditions, and work insertion in night shifts, it s possible to affirm that the situation is irregular about the students on scholarships, besides the determinant risk factor to their lives and health. In addition to it, the students on scholarships, in order to maintain the quality of trainee in the institution, are obligated to fulfill courses to grade up, or specialized courses in nursing technician, at schools referred as bad quality ones

A busca de sintomáticos respiratórios de tuberculose na prática e perspectiva do agente comunitário de saúde nos distritos sanitários de Natal

The objective of this work - which is characterized analyze the search for symptomatic tuberculosis in practice and perspective of the Community Health Agent (ACS) in the districts of Natal. Methods: This is a cross-sectional study. The study population was 646 professionals, and conducted a probabilistic random sampling, stratified by districts. The data were collected from one instrument to collect data based on Primary Care Assesment Toll (PCAT) and analyzed by descriptive statistics. The sample consisted of ACS was 87% female. Among the study participants 58% completed high school and 120 months of exercise training (95% CI 111.9 to 129.5) on average. 90% were USF. The average follow-up of cases found were 2 cases of TB since the beginning of the career of the ACS and the last three years the average is presented in a case accompanied. The ACS received satisfactory ratings on the bond of trust with the user, so as access to homes in the community. The ACS reported for denying the fear of being positive result was the biggest reason for not performing the sputum. All units have a professional that responds to the Tuberculosis Control Program. Regarding the structural capacity of primary care settings for the diagnosis of TB, we observed satisfactory levels in different districts of pots for sputum collection, however, a point that deserves attention from managers is lack of materials for packaging sputum. Fear of positive result was one of the reasons for the refusal of sputum collection, followed by alcoholism. With regard to TB suspects, all responded that ACS always suspect when the user has TB coughs, but in all districts were noticed at low delivery of requests for applications for smear. BSR in TB control, is characterized in practice as a complex action goes beyond technical expertise and contact with the family that breaks with the Cartesian. The BSR is part of the ACS can perform them from the daily visits. We conclude that the ACS is difficult to achieve. This practice should not be the privilege of this actor, but the entire team of primary care. We must rethink the practices of TB care, seeing the health surveillance while aegis of the working process of primary care teams for early diagnosis and thereby reduce TB in communities