Implementation of bayesian therapeutic drug monitoring in modern patient care

The variability observed in drug exposure has a direct impact on the overall response to drug. The largest part of variability between dose and drug response resides in the pharmacokinetic phase, i.e. in the dose-concentration relationship. Among possibilities offered to clinicians, Therapeutic Drug Monitoring (TDM; Monitoring of drug concentration measurements) is one of the useful tool to guide pharmacotherapy. TDM aims at optimizing treatments by individualizing dosage regimens based on blood drug concentration measurement. Bayesian calculations, relying on population pharmacokinetic approach, currently represent the gold standard TDM strategy. However, it requires expertise and computational assistance, thus limiting its large implementation in routine patient care. The overall objective of this thesis was to implement robust tools to provide Bayesian TDM to clinician in modern routine patient care. To that endeavour, aims were (i) to elaborate an efficient and ergonomic computer tool for Bayesian TDM: EzeCHieL (ii) to provide algorithms for drug concentration Bayesian forecasting and software validation, relying on population pharmacokinetics (iii) to address some relevant issues encountered in clinical practice with a focus on neonates and drug adherence. First, the current stage of the existing software was reviewed and allows establishing specifications for the development of EzeCHieL. Then, in close collaboration with software engineers a fully integrated software, EzeCHieL, has been elaborated. EzeCHieL provides population-based predictions and Bayesian forecasting and an easy-to-use interface. It enables to assess the expectedness of an observed concentration in a patient compared to the whole population (via percentiles), to assess the suitability of the predicted concentration relative to the targeted concentration and to provide dosing adjustment. It allows thus a priori and a posteriori Bayesian drug dosing individualization. Implementation of Bayesian methods requires drug disposition characterisation and variability quantification trough population approach. Population pharmacokinetic analyses have been performed and Bayesian estimators have been provided for candidate drugs in population of interest: anti-infectious drugs administered to neonates (gentamicin and imipenem). Developed models were implemented in EzeCHieL and also served as validation tool in comparing EzeCHieL concentration predictions against predictions from the reference software (NONMEM®). Models used need to be adequate and reliable. For instance, extrapolation is not possible from adults or children to neonates. Therefore, this work proposes models for neonates based on the developmental pharmacokinetics concept. Patients' adherence is also an important concern for drug models development and for a successful outcome of the pharmacotherapy. A last study attempts to assess impact of routine patient adherence measurement on models definition and TDM interpretation. In conclusion, our results offer solutions to assist clinicians in interpreting blood drug concentrations and to improve the appropriateness of drug dosing in routine clinical practice.

La colección Marca Hispanica, un ambicioso proyecto de traducción de José Agustín Goytisolo

In May 1985 José Agustín Goytisolo launched an ambitious project to translate into Spanish works originally written in Catalan. To this end, with a small group of collaborators he founded the Marca Hispanica collection. Its aim was to spread Catalan literature beyond its borders to reach millions of readers of Spanish through schools, teachers and language academies around the world. The initial idea was to make available in bilingual editions a hundred representative works of Catalan literature but, in the event, only twenty-two volumes were ever published. Based on access to unpublished documents, in this article we defend this endeavour, report on its progress and relate the circumstances, beyond the control of the participants, that led to its demise.

Acción educativa para la prevención y el tratamiento de la neglicencia parental en el barrio de Can Rull del municipio de Sabadell

Este trabajo se inscribe en el ámbito de la prevención de la negligencia parental. Basado en un proceso teórico-práctico, el programa de intervención está sujeto a la línea de los programas de formación de padres, por lo que sigue una dinámica psico-educativa y comunitaria. Para la realización del trabajo se ha partido de la idea que la familia es la base del desarrollo personal de los humanos y que el buen desarrollo de los menores dependerá en gran parte de las relaciones intrafamiliares. Se establece como objetivo principal ofrecer un servicio específico, estable y continuo, vinculado a los servicios de atención a la infancia y a la familia, que trabaje con el fin de conseguir un cambio conductual en aquellas familias en las que se presente una dinámica parental negligente. La metodología utilizada ha combinado diferentes técnicas de investigación. Para el trabajo de documentación se ha realizado una búsqueda bibliográfica alrededor del concepto de negligencia parental, se han analizado las acciones que se llevan a cabo a nivel institucional y se ha establecido el marco conceptual en el que se incluye tanto los aspectos legal de las diferentes áreas de la administración como aquellos conceptos que forman la estructura de una intervención en el ámbito de la infancia y la familia. También se ha tenido en cuenta la comunicación directa con algunos profesionales del ámbito social, sanitario y educativo como parte importante y determinante del proceso de ejecución del programa. El diseño del programa sigue la metodología del planeamiento estratégico e incluye un diagnóstico preliminar, un plan de acción detallado de las diferentes fases de implementación de la propuesta de intervención, la previsión de mecanismos de evaluación y un presupuesto detallado. En la primera parte del trabajo se refleja la gravedad y el impacto que tiene la negligencia parental en nuestra sociedad, observando la evolución histórica del concepto y la visualización de la problemática a la que va asociado. También se expone la necesidad de crear programas destinados a trabajar esta problemática y una revisión del marco legal que regula la atención a la infancia por parte de las administraciones públicas. En una segunda parte, se propone un programa específico destinado a trabajar la negligencia parental desde una perspectiva de reeducación y cambio conductual. Este proyecto de intervención se ubica en el barrio de Can Rull en Sabadell, del cual se detallan sus especificidades socioeconómicas y su realidad institucional.

The whereabouts of an ancient wonderer: Global phylogeography of the solitary ascidian Styela plicata

Genetic tools have greatly aided in tracing the sources and colonization history of introduced species. However, recurrent introductions and repeated shuffling of populations may have blurred some of the genetic signals left by ancient introductions. Styela plicata is a solitary ascidian distributed worldwide. Although its origin remains unclear, this species is believed to have spread worldwide by travelling on ship's hulls. The goals of this study were to infer the genetic structure and global phylogeography of S. plicata and to look for present-day and historical genetic patterns. Two genetic markers were used: a fragment of the mitochondrial gene Cytochrome Oxidase subunit I (COI) and a fragment of the nuclear gene Adenine Nucleotide Transporter/ADP-ATP Translocase (ANT). A total of 368 individuals for COI and 315 for ANT were sequenced from 17 locations worldwide. The levels of gene diversity were moderate for COI to high for ANT. The Mediterranean populations showed the least diversity and allelic richness for both markers, while the Indian, Atlantic and Pacific Oceans had the highest gene and nucleotide diversities. Network and phylogenetic analyses with COI and ANT revealed two groups of alleles separated by 15 and 4 mutational steps, respectively. The existence of different lineages suggested an ancient population split. However, the geographic distributions of these groups did not show any consistent pattern, indicating different phylogeographic histories for each gene. Genetic divergence was significant for many population-pairs irrespective of the geographic distance among them. Stochastic introduction events are reflected in the uneven distribution of COI and ANT allele frequencies and groups among many populations. Our results confirmed that S. plicata has been present in all studied oceans for a long time, and that recurrent colonization events and occasional shuffling among populations have determined the actual genetic structure of this species.

Managing induced tourism image : relational patterns and the life cycle

The tourism image is an element that conditions the competitiveness of tourism destinations by making them stand out in the minds of tourists. In this context, marketers of tourism destinations endeavour to create an induced image based on their identity and distinctive characteristics.A number of authors have also recognized the complexity of tourism destinations and the need for coordination and cooperation among all tourism agents, in order to supply a satisfactory tourist product and be competitive in the tourism market. Therefore, tourism agents at the destination need to develop and integrate strategic marketing plans.The aim of this paper is to determine how cities of similar cultures use their resources with the purpose of developing a distinctive induced tourism image to attract tourists and the extent of coordination and cooperation among the various tourism agents of a destination in the process of induced image creation.In order to accomplish these aims, a comparative analysis of the induced image of two cultural cities is presented, Girona (Spain) and Perpignan (France). The induced image is assessed through the content analysis of promotional brochures and the extent of cooperation with in-depth interviews of the main tourism agents of these destinations.Despite the similarities of both cities in terms of tourism resources, results show the use of different attributes to configure the induced image of each destination, as well as a different configuration of the network of tourism agents that participate in the process of induced image creation

Tools and data services registry: a community effort to document bioinformatics resources.

Life sciences are yielding huge data sets that underpin scientific discoveries fundamental to improvement in human health, agriculture and the environment. In support of these discoveries, a plethora of databases and tools are deployed, in technically complex and diverse implementations, across a spectrum of scientific disciplines. The corpus of documentation of these resources is fragmented across the Web, with much redundancy, and has lacked a common standard of information. The outcome is that scientists must often struggle to find, understand, compare and use the best resources for the task at hand.Here we present a community-driven curation effort, supported by ELIXIR-the European infrastructure for biological information-that aspires to a comprehensive and consistent registry of information about bioinformatics resources. The sustainable upkeep of this Tools and Data Services Registry is assured by a curation effort driven by and tailored to local needs, and shared amongst a network of engaged partners.As of November 2015, the registry includes 1785 resources, with depositions from 126 individual registrations including 52 institutional providers and 74 individuals. With community support, the registry can become a standard for dissemination of information about bioinformatics resources: we welcome everyone to join us in this common endeavour. The registry is freely available at https://bio.tools.

Collaborative group membership and access control for JXTA

Peer-reviewed

Transforming Maritime Safety Culture. Evaluation of the impacts of the ISM Code on maritime safety culture in Finland

The purpose of the METKU Project (Development of Maritime Safety Culture) is to study how the ISM Code has influenced the safety culture in the maritime industry. This literature review is written as a part of the Work Package 2 which is conducted by the University of Turku, Centre for Maritime Studies. The maritime traffic is rapidly growing in the Baltic Sea which leads to a growing risk of maritime accidents. Particularly in the Gulf of Finland, the high volume of traffic causes a high risk of maritime accidents. The growing risks give us good reasons for implementing the research project concerning maritime safety and the effectiveness of the safety measures, such as the safety management systems. In order to reduce maritime safety risks, the safety management systems should be further developed. The METKU Project has been launched to examine the improvements which can be done to the safety management systems. Human errors are considered as the most important reason for maritime accidents. The international safety management code (the ISM Code) has been established to cut down the occurrence of human errors by creating a safety-oriented organizational culture for the maritime industry. The ISM Code requires that a company should provide safe practices in ship operation and a safe working environment and establish safeguards against all identified risk. The fundamental idea of the ISM Code is that companies should continuously improve safety. The commitment of the top management is essential for implementing a safety-oriented culture in a company. The ISM Code has brought a significant contribution to the progress of maritime safety in recent years. Shipping companies and ships’ crews are more environmentally friendly and more safety-oriented than 12 years ago. This has been showed by several studies which have been analysed for this literature research. Nevertheless, the direct effect and influence of the ISM Code on maritime safety could not be isolated very well. No quantitative measurement (statistics/hard data) could be found in order to present the impacts of the ISM Code on maritime safety. In this study it has been discovered that safety culture has emerged and it is developing in the maritime industry. Even though the roots of the safety culture have been established there are still serious barriers to the breakthrough of the safety management. These barriers could be envisaged as cultural factors preventing the safety process. Even though the ISM Code has been effective over a decade, the old-established behaviour which is based on the old day’s maritime culture still occurs. In the next phase of this research project, these cultural factors shall be analysed in regard to the present safety culture of the maritime industry in Finland.

Maritime transportation in the Gulf of Finland in 2007 and in 2015

The Gulf of Finland is said to be one of the densest operated sea areas in the world. It is a shallow and economically vulnerable sea area with dense passenger and cargo traffic of which petroleum transports have a share of over 50 %. The winter conditions add to the risks of maritime traffic in the Gulf of Finland. It is widely believed that the growth of maritime transportation will continue also in the future. The Gulf of Finland is surrounded by three very different national economies with, different maritime transportation structures. Finland is a country of high GDP/per capita with a diversified economic structure. The number of ports is large and the maritime transportation consists of many types of cargoes: raw materials, industrial products, consumer goods, coal and petroleum products, and the Russian transit traffic of e.g. new cars and consumer goods. Russia is a large country with huge growth potential; in recent years, the expansion of petroleum exports has lead to a strong economic growth, which is also apparent in the growth of maritime transports. Russia has been expanding its port activities in the Gulf of Finland and it is officially aiming to transport its own imports and exports through the Russian ports in the future; now they are being transported to great extend through the Finnish, Estonian and other Baltic ports. Russia has five ports in the Gulf of Finland. Estonia has also experienced fast economic growth, but the growth has been slowing down already during the past couples of years. The size of its economy is small compared to Russia, which means the transported tonnes cannot be very massive. However, relatively large amounts of the Russian petroleum exports have been transported through the Estonian ports. The future of the Russian transit traffic in Estonia looks nevertheless uncertain and it remains to be seen how it will develop and if Estonia is able to find replacing cargoes if the Russian transit traffic will come to an end in the Estonian ports. Estonia’s own import and export consists of forestry products, metals or other raw materials and consumer goods. Estonia has many ports on the shores of the Gulf of Finland, but the port of Tallinn dominates the cargo volumes. In 2007, 263 M tonnes of cargoes were transported in the maritime traffic in the Gulf of Finland, of which the share of petroleum products was 56 %. 23 % of the cargoes were loaded or unloaded in the Finnish ports, 60 % in the Russian ports and 17 % in the Estonian ports. The largest ports were Primorsk (74.2 M tonnes) St. Petersburg (59.5 M tonnes), Tallinn (35.9 M tonnes), Sköldvik (19.8 M tonnes), Vysotsk (16.5 M tonnes) and Helsinki (13.4 M) tonnes. Approximately 53 600 ship calls were made in the ports of the Gulf of Finland. The densest traffic was found in the ports of St. Petersburg (14 651 ship calls), Helsinki (11 727 ship calls) and Tallinn (10 614 ship calls) in 2007. The transportation scenarios are usually based on the assumption that the amount of transports follows the development of the economy, although also other factors influence the development of transportation, e.g. government policy, environmental aspects, and social and behavioural trends. The relationship between the development of transportation and the economy is usually analyzed in terms of the development of GDP and trade. When the GDP grows to a certain level, especially the international transports increase because countries of high GDP produce, consume and thus transport more. An effective transportation system is also a precondition for the economic development. In this study, the following factors were taken into consideration when formulating the future scenarios: maritime transportation in the Gulf of Finland 2007, economic development, development of key industries, development of infrastructure and environmental aspects in relation to maritime transportation. The basic starting points for the three alternative scenarios were: • the slow growth scenario: economic recession • the average growth scenario: economy will recover quickly from current instability • the strong growth scenario: the most optimistic views on development will realize According to the slow growth scenario, the total tonnes for the maritime transportation in the Gulf of Finland would be 322.4 M tonnes in 2015, which would mean a growth of 23 % compared to 2007. In the average growth scenario, the total tonnes were estimated to be 431.6 M tonnes – a growth of 64 %, and in the strong growth scenario 507.2 M tonnes – a growth of 93%. These tonnes were further divided into petroleum products and other cargoes by country, into export, import and domestic traffic by country, and between the ports. For petroleum products, the share of crude oil and oil products was estimated and the number of tanker calls in 2015 was calculated for each scenario. However, the future development of maritime transportation in the GoF is dependent on so many societal and economic variables that it is not realistic to predict one exact point estimate value for the cargo tonnes for a certain scenario. Plenty of uncertainty is related both to the degree in which the scenario will come true as well as to the cause-effect relations between the different variables. For these reasons, probability distributions for each scenario were formulated by an expert group. As a result, a range for the total tonnes of each scenario was formulated and they are as follows: the slow growth scenario: 280.8 – 363 M tonnes (expectation value 322.4 M tonnes)

Externalities of Shipping in the Gulf of Finland until 2015

During the last few years, the discussion on the marginal social costs of transportation has been active. Applying the externalities as a tool to control transport would fulfil the polluter pays principle and simultaneously create a fair control method between the transport modes. This report presents the results of two calculation algorithms developed to estimate the marginal social costs based on the externalities of air pollution. The first algorithm calculates the future scenarios of sea transport traffic externalities until 2015 in the Gulf of Finland. The second algorithm calculates the externalities of Russian passenger car transit traffic via Finland by taking into account both sea and road transport. The algorithm estimates the ship-originated emissions of carbon dioxide (CO₂), nitrogen oxides (NO_x), sulphur oxides (SO_x), particulates (PM) and the externalities for each year from 2007 to 2015. The total NOx emissions in the Gulf of Finland from the six ship types were almost 75.7 kilotons (Table 5.2) in 2007. The ship types are: passenger (including cruisers and ROPAX vessels), tanker, general cargo, Ro-Ro, container and bulk vessels. Due to the increase of traffic, the estimation for NO_x emissions for 2015 is 112 kilotons. The NO_x emission estimation for the whole Baltic Sea shipping is 370 kilotons in 2006 (Stipa & al, 2007). The total marginal social costs due to ship-originated CO₂, NO_x, SO_x and PM emissions in the GOF were calculated to almost 175 million Euros in 2007. The costs will increase to nearly 214 million Euros in 2015 due to the traffic growth. The major part of the externalities is due to CO₂ emissions. If we neglect the CO2 emissions by extracting the CO₂ externalities from the results, we get the total externalities of 57 million Euros in 2007. After eight years (2015), the externalities would be 28 % lower, 41 million Euros (Table 8.1). This is the result of the sulphur emissions reducing regulation of marine fuels. The majority of the new car transit goes through Finland to Russia due to the lack of port capacity in Russia. The amount of cars was 339 620 vehicles (Statistics of Finnish Customs 2008) in 2005. The externalities are calculated for the transportation of passenger vehicles as follows: by ship to a Finnish port and, after that, by trucks to the Russian border checkpoint. The externalities are between 2 – 3 million Euros (year 2000 cost level) for each route. The ports included in the calculations are Hamina, Hanko, Kotka and Turku. With the Euro-3 standard trucks, the port of Hanko would be the best choice to transport the vehicles. This is because of lower emissions by new trucks and the saved transport distance of a ship. If the trucks are more polluting Euro 1 level trucks, the port of Kotka would be the best choice. This indicates that the truck emissions have a considerable effect on the externalities and that the transportation of light cargo, such as passenger cars by ship, produces considerably high emission externalities. The emission externalities approach offers a new insight for valuing the multiple traffic modes. However, the calculation of the marginal social costs based on the air emission externalities should not be regarded as a ready-made calculation system. The system is clearly in the need of some improvement but it can already be considered as a potential tool for political decision making.

Perspectivas tecnológicas: educação superior na Ibero-américa 2012-2017

La sèrie d'informes Horizon és el resultat més tangible del Projecte Horizon del New Media Consortium, un esforç de recerca qualitativa iniciat el 2002, que identifica i descriu les tecnologies emergents amb més potencial d'impacte en l'ensenyament, l'aprenentatge, la recerca i la expressió creativa en l'àmbit educatiu global. Aquest volum, Perspectivas tecnológicas: educação superior na Ibero-américa 2012-2017, és la segona edició del Projecte Horizon Iberoamèrica i se centra en la investigació en els països de la regió Iberoamericana (incloent-hi tota Llatinoamèrica, Espanya i Portugal) i en l'àmbit de l'educació superior. Ha estat produït pel NMC i l'eLearn Center de la Universitat Oberta de Catalunya.

Exposição ocupacional a compostos orgânicos voláteis na indústria naval

The scope of this study involved the evaluation of the concentration of some volatile organic compounds in the internal environmental air of a naval shipyard in the State of Rio de Janeiro, during painting activities in enclosed, semi-enclosed and open areas. Xylene was the volatile compound found in greatest abundance (25.20 to 191.66 ppm) in the locations researched. Benzene in the air, which is a carcinogenic substance, attained levels of 3.34 ppm in semi-enclosed environments and the highest levels of toluene, xylene and n-butanol were found in the enclosed space of the ship. Results obtained highlight the need to establish air quality control programs in these internal areas, in order to safeguard the health of the workers.

Merimies on erimies? Organisaatiositoutuminen suomalaisessa risteilyvarustamossa. Case: Kristina Cruises Oy

Tutkimuksen tavoitteena on selvittää, miten organisaatioon sitoutuminen moniulotteisena käsitteenä ymmärretään yrityksen johtoryhmässä ja avainesimiesten kesken, kun työpaikkana on risteilyvarustamo ja -laiva. Tutkimuksen empiirisen aineiston muodostaa viisi haastattelua laivan palveluosastoilta sekä yrityksen johtoryhmän haastattelut. Teoriaosuudessa on keskitytty kuvailemaan sitoutumiseen vaikuttavia tekijöitä ottaen huomioon kohdeorganisaation toimintaympäristö. Tässä tutkimuksessa organisaatiositoutuminen ymmärretään yksilön henkilökohtaisten tarpeiden, tunnepitoisen kiinnittymisen ja työyhteisön vaikutuksen yhteenliittymänä. Tutkimus on laadullinen ja aineiston keräystapana on käytetty pääasiallisesti teemahaastattelua. Aineistoa on täydennetty muutamalla avoimella sähköpostikyselyllä. Analysointi tapahtui teemoittelun avulla, josta johtopäätöksiin edettiin induktiivisesti. Tutkimustulosten perusteella voidaan todeta, että organisaatiositoutuminen kohdeyrityksessä on ymmärretty lähes samalla tavalla sekä johtoryhmän että esimiesten kesken. Huomioon otettavia aiheita sitouttamista silmällä pitäen ovat yrityksen arvojen ja tavoitteiden merkitys läpi koko sitoutumisprosessin.

Contaminação ambiental por compostos organoestânicos

The occurrence and the effects of organotin compounds (OTs) have been studied since a long time, due to their widespread use and deleterious effects. Some OTs are used as pesticides in crops, or as biocides in antifouling paints, applied in the ship hulls to avoid attachment and growth of tube worms, mussels and barnacles. However, "nontarget" organisms may be exposed, resulting in the poisoning of biological system, originating mutations and sentencing species to extinction. In this work we reported a revision study on the history of OTs and the techniques developed for its assessment and control.

Position sensorless electrically excited synchronous motor drive for industrial use based on direct flux linkage and torque control

Synchronous machines with an AC converter are used mainly in large drives, for example in ship propulsion drives as well as in rolling mill drives in steel industry. These motors are used because of their high efficiency, high overload capacity and good performance in the field weakening area. Present day drives for electrically excited synchronous motors are equipped with position sensors. Most drives for electrically excited synchronous motors will be equipped with position sensors also in future. This kind of drives with good dynamics are mainly used in metal industry. Drives without a position sensor can be used e.g. in ship propulsion and in large pump and blower drives. Nowadays, these drives are equipped with a position sensor, too. The tendency is to avoid a position sensor if possible, since a sensor reduces the reliability of the drive and increases costs (latter is not very significant for large drives). A new control technique for a synchronous motor drive is a combination of the Direct Flux Linkage Control (DFLC) based on a voltage model and a supervising method (e.g. current model). This combination is called Direct Torque Control method (DTC). In the case of the position sensorless drive, the DTC can be implemented by using other supervising methods that keep the stator flux linkage origin centered. In this thesis, a method for the observation of the drift of the real stator flux linkage in the DTC drive is introduced. It is also shown how this method can be used as a supervising method that keeps the stator flux linkage origin centered in the case of the DTC. In the position sensorless case, a synchronous motor can be started up with the DTC control, when a method for the determination of the initial rotor position presented in this thesis is used. The load characteristics of such a drive are not very good at low rotational speeds. Furthermore, continuous operation at a zero speed and at a low rotational speed is not possible, which is partly due to the problems related to the flux linkage estimate. For operation in a low speed area, a stator current control method based on the DFLC modulator (DMCQ is presented. With the DMCC, it is possible to start up and operate a synchronous motor at a zero speed and at low rotational speeds in general. The DMCC is necessary in situations where high torque (e.g. nominal torque) is required at the starting moment, or if the motor runs several seconds at a zero speed or at a low speed range (up to 2 Hz). The behaviour of the described methods is shown with test results. The test results are presented for the direct flux linkage and torque controlled test drive system with a 14.5 kVA, four pole salient pole synchronous motor with a damper winding and electric excitation. The static accuracy of the drive is verified by measuring the torque in a static load operation, and the dynamics of the drive is proven in load transient tests. The performance of the drive concept presented in this work is sufficient e.g. for ship propulsion and for large pump drives. Furthermore, the developed methods are almost independent of the machine parameters.