Pre-operative tractography of the facial nerve in vestibular schwannomas: inter-observer agreement with surgical findings

Pre-operative diffusion tensor (DT) tractography is currently employed in our institutions. We use it to predict the course of the facial nerve (FN) in the vicinity of vestibular schwannomas (VS) of the cerebellopontine angle (CPA). In this study we were interested to assess the inter-observer reproducibility of this method. Two Neuroradiologists (PMGP and TT) determined independently the location of the FN by tractography and compared the results with in-vivo findings of microsurgery of VS.

Agreement between data obtained from repeated interviews with a six-years interval

The objective of the study was to compare information collected through face-to-face interviews at first time and six years later in a city of Southeastern Brazil. In 1998, 32 mothers (N=32) of children aged 20 to 30 months answered a face-to-face interview with structured questions regarding their children's brushing habits. Six years later this same interview was repeated with the same mothers. Both interviews were compared for overall agreement, kappa and weighted kappa. Overall agreement between both interviews varied from 41 to 96%. Kappa values ranged from 0.00 to 0.65 (very bad to good) without any significant differences. The results showed lack of agreement when the same interview is conducted six years later, showing that the recall bias can be a methodological problem of interviews.

Aspecto da polissemia nominal em língua gestual portuguesa

A Língua Gestual Portuguesa (LGP) foi, em 1997, reconhecida como a língua oficial dos surdos portugueses. Os trabalhos pioneiros de William Stokoe, na década de 60, sustentaram a evidência de que os surdos possuem a sua própria língua, que adquirem de forma natural sempre que expostos a um ambiente linguístico que lhes permita a sua aquisição e desenvolvimento plenos. A LGP é uma língua natural e apresenta uma complexidade estrutural equivalente à das línguas orais, sendo possível distinguir elementos descritivos da mão, tais como a configuração, o local de articulação, o movimento, a orientação e ainda os componentes não-manuais. A LGP desenvolve-se num ―espaço sintáctico‖, espaço em frente do gestuante, onde se organizam as relações morfológicas e sintácticas. Neste artigo, pretendemos descrever e classificar alguns processos de polissemia nominal que detectámos em LGP. Partindo duma abordagem bottom-up, com base num corpus de cem gestos nominais, observámos os processos polissémicos presentes. Tendo como referência um enquadramento teórico-conceptual de cariz cognitivista da noção de polissemia, detectámos processos metonímicos, de denominação através de características estereotípicas de um determinado referente e de possível contacto linguístico entre a Língua Gestual Portuguesa e a Língua Portuguesa Escrita. Também foram encontrados processos de polissemia que parecem assentar numa sinonímia visual e cuja polissemia se reveste de uma identificação sinónima, através de uma imagem comum, entre um referente e outro. Salientaremos ainda que este trabalho se considera exploratório, relativamente, aos processos de polissemia em LGP, sendo nossa intenção continuar a estudar com mais dados este fenómeno.

Towards network-on-chip agreement protocols

Demands for functionality enhancements, cost reductions and power savings clearly suggest the introduction of multiand many-core platforms in real-time embedded systems. However, when compared to uni-core platforms, the manycores experience additional problems, namely the lack of scalable coherence mechanisms and the necessity to perform migrations. These problems have to be addressed before such systems can be considered for integration into the realtime embedded domain. We have devised several agreement protocols which solve some of the aforementioned issues. The protocols allow the applications to plan and organise their future executions both temporally and spatially (i.e. when and where the next job will be executed). Decisions can be driven by several factors, e.g. load balancing, energy savings and thermal issues. All presented protocols are analytically described, with the particular emphasis on their respective real-time behaviours and worst-case performance. The underlying assumptions are based on the multi-kernel model and the message-passing paradigm, which constitutes the communication between the interacting instances.

Strategies for price reduction of HIV medicines under a monopoly situation in Brazil

ABSTRACT OBJECTIVE To analyze Government strategies for reducing prices of antiretroviral medicines for HIV in Brazil. METHODS Analysis of Ministry of Health purchases of antiretroviral medicines, from 2005 to 2013. Expenditures and costs of the treatment per year were analyzed and compared to international prices of atazanavir. Price reductions were estimated based on the terms of a voluntary license of patent rights and technology transfer in the Partnership for Productive Development Agreement for atazanavir. RESULTS Atazanavir, a patented medicine, represented a significant share of the expenditures on antiretrovirals purchased from the private sector. Prices in Brazil were higher than international references, and no evidence was found of a relationship between purchase volume and price paid by the Ministry of Health. Concerning the latest strategy to reduce prices, involving local production of the 200 mg capsule, the price reduction was greater than the estimated reduction. As for the 300 mg capsule, the amounts paid in the first two years after the Partnership for Productive Development Agreement were close to the estimated values. Prices in nominal values for both dosage forms remained virtually constant between 2011 (the signature of the Partnership for Productive Development Agreement), 2012 and 2013 (after the establishment of the Partnership). CONCLUSIONS Price reduction of medicines is complex in limited-competition environments. The use of a Partnership for Productive Development Agreement as a strategy to increase the capacity of local production and to reduce prices raises issues regarding its effectiveness in reducing prices and to overcome patent barriers. Investments in research and development that can stimulate technological accumulation should be considered by the Government to strengthen its bargaining power to negotiate medicines prices under a monopoly situation.

Paired indices for clustering evaluation correction for agreement by chance

In the present paper we focus on the performance of clustering algorithms using indices of paired agreement to measure the accordance between clusters and an a priori known structure. We specifically propose a method to correct all indices considered for agreement by chance - the adjusted indices are meant to provide a realistic measure of clustering performance. The proposed method enables the correction of virtually any index - overcoming previous limitations known in the literature - and provides very precise results. We use simulated datasets under diverse scenarios and discuss the pertinence of our proposal which is particularly relevant when poorly separated clusters are considered. Finally we compare the performance of EM and KMeans algorithms, within each of the simulated scenarios and generally conclude that EM generally yields best results.

Agreement between premortem and postmortem diagnoses in patients with acquired immunodeficiency syndrome observed at a brazilian teaching hospital

Acquired immunodeficiency syndrome (AIDS) is one of the main causes of death in adults worldwide. More commonly than in the general population, in patients with AIDS there is substantial disagreement between causes of death which are clinically suspected and those established by postmortem examination. The findings of 52 postmortem examinations were compared to the premortem (clinical) diagnoses, and there was 46% agreement between them. Fifty two percent of the patients had more than one postmortem diagnosis, and 48% had at least one AIDS-related disease not suspected clinically. Cytomegalovirus infection was the commonest (30.7%) autopsy finding, but not a single case had been suspected premortem. Bacterial infection, tuberculosis, and histoplasmosis were also common, sometimes not previously suspected, postmortem findings. This study shows that multiple infections occur simultaneously in AIDS patients, and that many among them are never suspected before the postmortem examination. These findings suggest that an aggressive investigation of infections and cancers should be done in patients with AIDS, particularly in those who do not respond to therapy of an already recognized condition

Indicadores de qualidade para a contratualização de cuidados paliativos

RESUMO - Âmbito e objectivos: O presente trabalho incide sobre a área dos cuidados paliativos, nomeadamente, visa contribuir para uma maior efectividade do processo de aquisição e acompanhamento deste tipo de cuidados. Neste contexto, e como objectivo principal do estudo, foram identificados os indicadores chave, na vertente da qualidade, indispensáveis para a conceptualização de um modelo de contratualização e, consequentemente, para assegurar a monitorização, acompanhamento e avaliação da actividade realizada. Método e metodologias: Numa primeira fase, foi conduzida uma pesquisa documental tendente ao levantamento dos indicadores, na dimensão da qualidade, em utilização nos cuidados paliativos em vários países, tendo sido escolhidos aqueles que apresentavam indicadores já validados, designadamente, o Canadá, Reino Unido, Austrália, Espanha e EUA. Desta forma, foram seleccionados os indicadores comuns aos vários países estudados, para efeitos de discussão e consensualização, no âmbito de uma Técnica de Grupo Nominal, passíveis de integrarem um modelo de contratualização nesta área em Portugal. Apresentação e discussão de resultados: Da pesquisa documental resultaram 188 indicadores na dimensão qualidade, em utilização nos países estudados, tendo sido identificados 19 indicadores comuns. Estes indicadores foram submetidos a discussão e consensualização em reunião de peritos, tendo sido hierarquizados os sete indicadores mais adequados para a contratualização em cuidados paliativos: composição de uma equipa interdisciplinar; capacidade de resposta doentes tratados/pedido de acesso; avaliação inicial e periódica das necessidades (oito domínios); acessibilidade farmacológica; congruência entre os cuidados prestados e os desejados; prática regular de reuniões multidisciplinares; conferência familiar, pelo menos 2 vezes. Conclusões: No panorama nacional, não se conhecem indicadores unanimemente ratificados como adequados à avaliação da efectividade, qualidade e eficiência dos cuidados paliativos. Por outro lado, atento o objectivo do presente trabalho, a informação recolhida a nível internacional devolveu indicadores aplicáveis maioritariamente num contexto da avaliação da prestação dos cuidados paliativos, e Indicadores de Qualidade para a Contratualização de Cuidados Paliativos em Portugal x/ 93 não tanto num contexto de um processo de contratualização efectivo. Assim, partindo destes indicadores, em utilização nos vários países estudados, o estudo permitiu identificar sete indicadores considerados como adequados para a contratualização destes cuidados, em Portugal. -------------- ABSTRACT - Scope and objectives: This work focuses on the palliative care area, in particular, aims to contribute to greater effectiveness of the monitoring and procurement process of this type of care. In this context, as the main objective of the study, key indicators were identified regarding the quality issue, crucial to the conceptualization of a contracting model, and consequently to ensure the monitoring, supervising and evaluating of the undertaken activities. Method and methodology: Initially, a documentary research was held. That research aimed to surveying the indicators in their dimension of quality, regarding their use in palliative care throughout several countries. The chosen countries already had validated indicators, namely, Canada, United Kingdom , Australia, Spain and the USA. Thus, the indicators selected were common to all the above mentioned countries, for discussion purposes and agreement, as part of a Nominal Group Technique, that could integrate a model of contracting in this area in Portugal. Presentation and result discussion: The documentary research resulted in 188 quality indicators in use in the referred countries, 19 of those indicators were common to all countries. These indicators were submitted for discussion and agreement at a meeting of experts, having been ranked the seven most appropriate indicators for palliative care contracting: composition of an interdisciplinary team; response ability to the patients / access requests, initial and periodic assessment of the needs (eight areas), pharmacology accessibility; congruence between the desired care and its effective provision and regular practice of multidisciplinary meetings, family conferences, at least two times. Conclusions: In the national scene, unanimously ratified as suitable indicators to assess the effectiveness, efficiency and quality of palliative care are unknown. On other hand, given the objective of this work, the international collection of information has given applicable indicators mostly in the context of assessing the provision of palliative care, rather than an effective contracting process context. Thus, based on these indicators in use in the studied countries, the study itself identified seven indicators considered appropriate for the contracting of such care in Portugal.

Flexão Nominal e nominalizações agentivas instrumentais em crianças com perturbações específicas do desenvolvimento da linguagem. Estudo de caso comparativo

Dissertação apresentada para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Desenvolvimento e Perturbações da Linguagem na Criança, área de especialização em Terapia da Fala e Perturbações da Linguagem

Selection of a co-operation agreement between EMOVE – Innovative Technologies and WavEC – Wave Energy Center

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics

Nominal and inflation-linked government bonds: An assessment of arbitrage opportunities in UK Gilt Market

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Finance from the NOVA – School of Business and Economics

Polissemia nominal diacrônica. Do conceito ao linguístico: relações lexicias a partir dos corpora de especialidade

Tese apresentada para cumprimento dos requisitos necessários à obtenção do grau de Doutor em Linguística – Lexicologia, Lexicografia e Terminologia e e Tese apresentada para cumprimento dos requisitos necessários à obtenção do grau de Doutor em Filologia e Língua Portugesa na Faculdade de Filosofia Letras e Ciências Humanas da Universidade de São Paulo