Use of CPAP to Reduce Arterial Stiffness in Moderate-to-Severe Obstructive Sleep Apnoea, Without Excessive Daytime Sleepiness (STIFFSLEEP): an Observational Cohort Study Protocol

INTRODUCTION: Sleepiness is a cardinal symptom in obstructive sleep apnoea (OSA) but most patients have unspecific symptoms. Arterial stiffness, evaluated by pulse wave velocity (PWV), is related to atherosclerosis and cardiovascular (CV) risk. Arterial stiffness was reported to be higher in patients with OSA, improving after treatment with continuous positive airway pressure (CPAP). This study aims to assess whether the same effect occurs in patients with OSA and without sleepiness. METHODS AND ANALYSIS: This observational study assesses the CV effect of CPAP therapy on a cohort of patients with moderate-to-severe OSA; the effect on the subcohorts of sleepy and non-sleepy patients will be compared. A systematic and consecutive sample of patients advised CPAP therapy will be recruited from a single outpatient sleep clinic (Centro Hospitalar de Lisboa Central-CHLC, Portugal). Eligible patients are male, younger than 65 years, with confirmed moderate-to-severe OSA and apnoea-hypopnea index (AHI) above 15/hour. Other sleep disorders, diabetes or any CV disease other than hypertension are exclusion criteria. Clinical evaluation at baseline includes Epworth Sleepiness Scale (ESS), and sleepiness is defined as ESS above 10. OSA will be confirmed by polygraphic study (cardiorespiratory, level 3). Participants are advised to undertake an assessment of carotid-femoral PWV (cf-PWV) and 24 hours evaluation of ambulatory blood pressure monitoring (ABPM), at baseline and after 4 months of CPAP therapy. Compliance and effectiveness of CPAP will be assessed. The main outcome is the variation of cf-PWV over time.

Minimally Invasive Approach of a Retrocaval Ureter

The retrocaval ureter is a rare congenital entity, classically managed with open pyeloplasty techniques. The experience obtained with the laparoscopic approach of other more frequent causes of ureteropelvic junction (UPJ) obstruction has opened the method for the minimally invasive approach of the retrocaval ureter. In our paper, we describe a clinical case of a right retrocaval ureter managed successfully with laparoscopic dismembered pyeloplasty. The main standpoints of the procedure are described. Our results were similar to others published by other urologic centers, which demonstrates the safety and feasibility of the procedure for this condition.

Symptom Clusters and Survival in Portuguese Patients with Advanced Cancer

This study aimed to identify clusters of symptoms, to determine the patient characteristics associated with identified, and determine their strength of association with survival in patients with advanced cancer (ACPs). Consecutively eligible ACPs not receiving cancer-specific treatment, and referred to a Tertiary Palliative Care Clinic, were enrolled in a prospective cohort study. At first consultation, patients rated 9 symptoms through the Edmonton Symptom Assessment System (0-10 scale) and 10 others using a Likert scale (1-5). Principal component analysis was used in an exploratory factor analysis to identify. Of 318 ACPs, 301 met eligibility criteria with a median (range) age of 69 (37-94) years. Three SCs were identified: neuro-psycho-metabolic (NPM) (tiredness, lack of appetite, lack of well-being, dyspnea, depression, and anxiety); gastrointestinal (nausea, vomiting, constipation, hiccups, and dry mouth) and sleep impairment (insomnia and sleep disturbance). Exploratory factor analysis accounted for 40% of variance of observed variables in all SCs. Shorter survival was observed for patients with the NPM cluster (58 vs. 23, P < 0.001), as well as for patients with two or more SCs (45 vs. 21, P = 0.005). In a multivariable model for survival at 30-days, age (HR: 0.98; 95% CI: 0.97-0.99; P = 0.008), hospitalization at inclusion (HR: 2.27; 95% CI: 1.47-3.51; P < 0.001), poorer performance status (HR: 1.90, 95% CI: 1.24-2.89; P = 0.003), and NPM (HR: 1.64; 95% CI: 1.17-2.31; P = 0.005), were associated with worse survival. Three clinically meaningful SC in patients with advanced cancer were identifiable. The NPM cluster and the presence of two or more SCs, had prognostic value in relation to survival.

Responsabilidade social empresarial: o caso de uma indústria alimentícia no estado do Pará

The theme of corporate social responsibility (CSR) provides discussion and analysis and relatively recent, particularly in the last twenty years, has grown into the world as well as in Brazil, the interest on the involvement of the business sector in social activities or projects facing combating poverty. However, a lack of socialization of successful experiences in the practice of CSR and clarity and consensus concepts generate deviations of understanding on the subject and the structuring of interventions. This research aimed to reveal how corporate social responsibility of the IMA Food was developed from Project Nursery Saci. The research took place under a qualitative approach of descriptive-explanatory, conducted through semi-structured interviews and non-participatory observation and interviewed 35 people in total. The interpretation and analysis of data occurred through a categorical content analysis, having as theoretical approach to socioeconomic CSR. The results showed that the major form of social responsibility of the Food IMA is based on a classical approach of CSR, focusing on philanthropy. The absence of a more systematic management of the project and reflect the fragility, instability and lack of commitment towards the community. The contributions generated by the project are substantial and important, but do not reach the development occasioned by the company. However, none of this invalidates the initiative of the organization's commitment to the community, however, requires a reassessment and restructuring of the proposal in a way that leverages the performance of the project and the company itself and it can more effectively contribute to society

Internal mammary artery smooth muscle cells resist migration and possess high antioxidant capacity

Objective- This study investigated whether differences exist in atherogen-induced migratory behaviors and basal antioxidant enzyme capacity of vascular smooth muscle cells (VSMC) from human coronary (CA) and internal mammary (IMA) arteries. Methods- Migration experiments were performed using the Dunn chemotaxis chamber. The prooxidant [NAD(P)H oxidase] and antioxidant [NOS, superoxide dismutase, catalase and glutathione peroxidase] enzyme activities were determined by specific assays. Results- Chemotaxis experiments revealed that while both sets of VSMC migrated towards platelet-derived growth factor-BB (1-50 ng/ml) and angiotensin II (1-50 nM), neither oxidized-LDL (ox-LDL, 25-100 �g/ml) nor native LDL (100 �g/ml) affected chemotaxis in IMA VSMC. However, high dose ox-LDL produced significant chemotaxis in CA VSMC that was inhibited by pravastatin (100 nM), mevastatin (10 nM), losartan (10 nM), enalapril (1 �M), and MnTBAP (a free radical scavenger, 50��M). Microinjection experiments with isoprenoids i.e. geranylgeranylpyrophosphate (GGPP) and farnesylpyrophosphate (FPP) showed distinct involvement of small GTPases in atherogen-induced VSMC migration. Significant increases in antioxidant enzyme activities and nitrite production along with marked decreases in NAD(P)H oxidase activity and O2 .- levels were determined in IMA versus CA VSMC. Conclusions- Enhanced intrinsic antioxidant capacity may confer on IMA VSMC resistance to migration against atherogenic agents. Drugs that regulate ox-LDL or angiotensin II levels also exert antimigratory effects.

Discontinuous Galerkin Methods for the Biharmonic Problem

This work is concerned with the design and analysis of hp-version discontinuous Galerkin (DG) finite element methods for boundary-value problems involving the biharmonic operator. The first part extends the unified approach of Arnold, Brezzi, Cockburn & Marini (SIAM J. Numer. Anal. 39, 5 (2001/02), 1749-1779) developed for the Poisson problem, to the design of DG methods via an appropriate choice of numerical flux functions for fourth order problems; as an example we retrieve the interior penalty DG method developed by Suli & Mozolevski (Comput. Methods Appl. Mech. Engrg. 196, 13-16 (2007), 1851-1863). The second part of this work is concerned with a new a-priori error analysis of the hp-version interior penalty DG method, when the error is measured in terms of both the energy-norm and L2-norm, as well certain linear functionals of the solution, for elemental polynomial degrees $p\ge 2$. Also, provided that the solution is piecewise analytic in an open neighbourhood of each element, exponential convergence is also proven for the p-version of the DG method. The sharpness of the theoretical developments is illustrated by numerical experiments.

An A Posteriori Error Indicator for Discontinuous Galerkin Approximations of Fourth Order Elliptic Problems

We introduce a residual-based a posteriori error indicator for discontinuous Galerkin discretizations of the biharmonic equation with essential boundary conditions. We show that the indicator is both reliable and efficient with respect to the approximation error measured in terms of a natural energy norm, under minimal regularity assumptions. We validate the performance of the indicator within an adaptive mesh refinement procedure and show its asymptotic exactness for a range of test problems.

Imagiologia dos Tumores malignos do pâncreas

As neoplasias malignas do pâncreas englobam vários tipos histologicos com características ima giológicas e comportamentos que permitem distingui-los entre si numa boa percentagem de situações. Contudo, nem sempre a sua diferenciação se toma possível sem o recurso às técnicas anátomo-patoló gicas, constituindo um grande desafio à imagiologia o diagnóstico diferencial com lesões benignas, com referencia particular às massas inflamatórias. O adenocarcinoma constitui cerca de 95% das neo plasias pancreáticas e é uma das grandes causas de morte por cancro nos países desenvolvidos. As técnicas de imagem aplicadas no diagnóstico e no estadiamento dos principais tumores do pâncreas são muito diversificadas, englobando meios inócuos, como a ecografia, métodos invasivos utilizando técnicas angiográficas ou recurso aos meios endoscópicos para acesso endocavitário. A utilidade de cada uma destas variedades técnicas depende essencialmente do tipo de tumor a estudar, tomando-se fundamental o correcto e o completo conhecimento das possibilidades e limitações de cada uma, com vista à aplicação racional dos meios na imagiologia do pâncreas.

Responsabilidade social empresarial: o caso de uma indústria alimentícia no estado do Pará

The theme of corporate social responsibility (CSR) provides discussion and analysis and relatively recent, particularly in the last twenty years, has grown into the world as well as in Brazil, the interest on the involvement of the business sector in social activities or projects facing combating poverty. However, a lack of socialization of successful experiences in the practice of CSR and clarity and consensus concepts generate deviations of understanding on the subject and the structuring of interventions. This research aimed to reveal how corporate social responsibility of the IMA Food was developed from Project Nursery Saci. The research took place under a qualitative approach of descriptive-explanatory, conducted through semi-structured interviews and non-participatory observation and interviewed 35 people in total. The interpretation and analysis of data occurred through a categorical content analysis, having as theoretical approach to socioeconomic CSR. The results showed that the major form of social responsibility of the Food IMA is based on a classical approach of CSR, focusing on philanthropy. The absence of a more systematic management of the project and reflect the fragility, instability and lack of commitment towards the community. The contributions generated by the project are substantial and important, but do not reach the development occasioned by the company. However, none of this invalidates the initiative of the organization's commitment to the community, however, requires a reassessment and restructuring of the proposal in a way that leverages the performance of the project and the company itself and it can more effectively contribute to society

ToLeRating UR-STD

A new emerging paradigm of Uncertain Risk of Suspicion, Threat and Danger, observed across the field of information security, is described. Based on this paradigm a novel approach to anomaly detection is presented. Our approach is based on a simple yet powerful analogy from the innate part of the human immune system, the Toll-Like Receptors. We argue that such receptors incorporated as part of an anomaly detector enhance the detector’s ability to distinguish normal and anomalous behaviour. In addition we propose that Toll-Like Receptors enable the classification of detected anomalies based on the types of attacks that perpetrate the anomalous behaviour. Classification of such type is either missing in existing literature or is not fit for the purpose of reducing the burden of an administrator of an intrusion detection system. For our model to work, we propose the creation of a taxonomy of the digital Acytota, based on which our receptors are created.

The deterministic Dendritic Cell Algorithm

The Dendritic Cell Algorithm is an immune-inspired algorithm originally based on the function of natural dendritic cells. The original instantiation of the algorithm is a highly stochastic algorithm. While the performance of the algorithm is good when applied to large real-time datasets, it is difficult to analyse due to the number of random-based elements. In this paper a deterministic version of the algorithm is proposed, implemented and tested using a port scan dataset to provide a controllable system. This version consists of a controllable amount of parameters, which are experimented with in this paper. In addition the effects are examined of the use of time windows and variation on the number of cells, both which are shown to influence the algorithm. Finally a novel metric for the assessment of the algorithms output is introduced and proves to be a more sensitive metric than the metric used with the original Dendritic Cell Algorithm.

Epidometria de Calophyllum brasiliense Camb. em plantios comerciais

Tese (doutorado)—Universidade de Brasília, Faculdade de Tecnologia, Departamento de Engenharia Florestal, Programa de Pós-Graduação em Ciências Florestais, 2016.

Estudio comparativo sobre tendencias en investigación de Ingenieros Administradores de Sistemas e Ingenieros Mecánicos Administradores.

El presente estudio compara el grado de desarrollo de competencias requeridas para el desarrollo de proyectos de investigación por estudiantes de ingeniería de la Universidad Autónoma de Nuevo León (UANL). Utilizando una muestra de 70 estudiantes de los programas educativos Ingeniero Administrador de Sistemas (IAS) e Ingeniero Mecánico Administrador (IMA) de la Facultad de Ingeniería Mecánica y Eléctrica (FIME) de la UANL. Se realizó un análisis exploratorio estudiando los datos cuantitativos mediante estadística descriptiva. Los resultados de la investigación permiten observar las características de los estudiantes de cada carrera y lo que fortalece su perfil profesional hacia la investigación de los estudiantes de la carrera Ingeniero Administrador de Sistemas (IAS) e Ingeniero Mecánico Administrador (IMA).