Anomalias congénitas associadas a técnicas de reprodução medicamente assistida

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Déterminer le lien entre l’hyperglycémie et/ou l’hypoinsulinémie et la dégradation clinique observée avant le diagnostic du Diabète Associé à la Fibrose Kystique

La Fibrose kystique (FK) est une maladie génétique qui se traduit par une destruction progressive des poumons et éventuellement, à la mort. La principale complication secondaire est le diabète associé à la FK (DAFK). Une dégradation clinique (perte de poids et de la fonction pulmonaire) accélérée est observée avant le diagnostic. L’objectif principal de mon projet de doctorat est de déterminer, par l’intermédiaire du test d’hyperglycémie provoquée par voie orale (HGPO), s’il existe un lien entre l’hyperglycémie et/ou l’hypoinsulinémie et la dégradation clinique observée avant le diagnostic du DAFK. Nous allons ainsi évaluer l’importance des temps intermédiaires de l’HGPO afin de simplifier le diagnostic d’une dysglycémie ainsi que d’établir des nouveaux marqueurs indicateurs de patients à risque d’une détérioration clinique. L’HGPO est la méthode standard utilisée dans la FK pour le diagnostic du DAFK. Nous avons démontré que les valeurs de glycémie obtenues au temps 90-min de l’HGPO seraient suffisantes pour prédire la tolérance au glucose des patients adultes avec la FK, autrement établie à l’aide des valeurs à 2-h de l’HGPO. Nous proposons des glycémies à 90-min de l’HGPO supérieure à 9.3 mmol/L et supérieure à 11.5 mmol/L pour détecter l’intolérance au glucose et le DAFK, respectivement. Une cause importante du DAFK est un défaut de la sécrétion d’insuline. Les femmes atteintes de la FK ont un risque plus élevé de développer le DAFK que les hommes, nous avons donc exploré si leur sécrétion était altérée. Contrairement à notre hypothèse, nous avons observé que les femmes avec la FK avaient une sécrétion d’insuline totale plus élevée que les hommes avec la FK, mais à des niveaux comparables aux femmes en santé. Le groupe de tolérance au glucose récemment proposé et nommé indéterminé (INDET : 60-min HGPO > 11.0 mais 2h-HGPO <7.8mmol/L) est à risque élevé de développer le DAFK. Par contre, les caractéristiques cliniques de ce groupe chez les patients adultes avec la FK n’ont pas été établies. Nous avons observé que le groupe INDET a une fonction pulmonaire réduite et similaire au groupe DAFK de novo et aucun des paramètres glucidiques et insulinémiques expliqueraient cette observation. Dans une population pédiatrique de patients avec la FK, une association a été rapportée entre une glycémie élevée à 60-min de l’HGPO et une fonction pulmonaire diminuée. Dans notre groupe de patients adultes avec la FK, il existe une association négative entre la glycémie à 60-min de l’HGPO et la fonction pulmonaire et une corrélation positive entre l’insulinémie à 60-min de l’HGPO et l’indice de masse corporelle (IMC). De plus, les patients avec une glycémie à 60-min HGPO > 11.0 mmol/L ont une fonction pulmonaire diminuée et une sensibilité à l’insuline basse alors que ceux avec une insulinémie à 60-min HGPO < 43.4 μU/mL ont un IMC ainsi qu’une fonction pulmonaire diminués. En conclusion, nous sommes le premier groupe à démontrer que 1) le test d’HGPO peut être raccourci de 30 min sans compromettre la catégorisation de la tolérance au glucose, 2) les femmes avec la FK démontrent une préservation de leur sécrétion de l’insuline, 3) le groupe INDET présente des anomalies précoces de la fonction pulmonaire comparable au groupe DAFK de novo et 4) la glycémie et l’insuline à la première heure de l’HGPO sont associées aux deux éléments clefs de la dégradation clinique. Il est crucial d’élucider les mécanismes pathophysiologiques importants afin de mieux prévoir la survenue de la dégradation clinique précédant le DAFK.

Lightweight Internet Traffic Classification - A Subject Based Solution with Word Embeddings

Internet traffic classification is a relevant and mature research field, anyway of growing importance and with still open technical challenges, also due to the pervasive presence of Internet-connected devices into everyday life. We claim the need for innovative traffic classification solutions capable of being lightweight, of adopting a domain-based approach, of not only concentrating on application-level protocol categorization but also classifying Internet traffic by subject. To this purpose, this paper originally proposes a classification solution that leverages domain name information extracted from IPFIX summaries, DNS logs, and DHCP leases, with the possibility to be applied to any kind of traffic. Our proposed solution is based on an extension of Word2vec unsupervised learning techniques running on a specialized Apache Spark cluster. In particular, learning techniques are leveraged to generate word-embeddings from a mixed dataset composed by domain names and natural language corpuses in a lightweight way and with general applicability. The paper also reports lessons learnt from our implementation and deployment experience that demonstrates that our solution can process 5500 IPFIX summaries per second on an Apache Spark cluster with 1 slave instance in Amazon EC2 at a cost of $ 3860 year. Reported experimental results about Precision, Recall, F-Measure, Accuracy, and Cohen's Kappa show the feasibility and effectiveness of the proposal. The experiments prove that words contained in domain names do have a relation with the kind of traffic directed towards them, therefore using specifically trained word embeddings we are able to classify them in customizable categories. We also show that training word embeddings on larger natural language corpuses leads improvements in terms of precision up to 180%.

Shaping Tolerant Attitudes towards Immigrants: The Role of Welfare State Expenditures

This article contributes to the ongoing discussion on how tolerance may be fostered in Western European countries and to the question of how contextual factors such as welfare state expenditures may contribute to this formation. Tolerance is understood as a basic democratic principle that helps civil societies cope with rising levels of diversity stemming from increased immigration and individualism. Within the tolerance literature it is commonly agreed upon that a comprehensive welfare state is capable of bridging class divides and overcoming social categorization. However, over the past decades European welfare states experienced an ongoing influx of immigrants, challenging their general purpose and increasing notions of ‘welfare chauvinism’. Drawing on insights from both tolerance and welfare state solidarity literature, we implement hierarchical analyses based on Eurobarometer data to assess the potential influence of welfare state universalism on political and social tolerance in 15 Western European countries. Moreover, we demonstrate that this relationship is highly conditional on the degree of ethnic heterogeneity within a country.

Dalit Studies /

Analyzes the role of Dalits (formerly untouchables) in shaping modern India, including discourse about caste, and interrogates the dominant narratives that have been used to represent India's history. This title was made Open Access by libraries from around the world through Knowledge Unlatched.

Perceptions of Malingering or Factitious Disorder by Army Behavioral health Providers

Thesis (Master's)--University of Washington, 2016-06

Demographic and Geographic Heterogeneity between Subgroups of Cyclists

Thesis (Master's)--University of Washington, 2016-06

Predicting the Paths of Peripherals: The Interaction of Identification and Future Possibilities

Two studies investigated how both degree of identification and the individual's position within the group influence aspects of group loyalty. The authors considered ingroup position in terms of both the individual's current position within a group and expectations concerning the likelihood that one's position might change., in the future. Peripheral group members learned that their acceptance by other group members would improve in the future or that they could expect rejection by other group members. Various indices of group loyalty (ingroup homogeneity, motivation to work for the group, and evaluation of a motivated group member) showed that when group members anticipated future rejection, the lower the identification the less loyal they were. In contrast, those who expected future acceptance were more loyal (more motivated to work for the group) the lower their identification. Current group behavior depends on both intragroup future expectations and level of identification.

Leaders and their treatment of subgroups: implications for evaluations of the leader and the superordinate group

This experiment examined members' evaluations of a group leader and the group in contexts where a superordinate group comprised two subgroups and the group leader was aligned with one or other subgroup. The design varied group leader (ingroup, outgroup) and leader behavior (ingroup favoring, outgroup favoring) as well as the broader comparative context (intragroup, intergroup). Across a number of measures, results indicated a consistent Group Leader x Leader Behavior interaction that was independent of comparative context. Although group members were most satisfied with an ingroup leader who favored the ingroup, ingroup leaders were perceived positively irrespective of their behavior Outgroup leaders who unexpectedly favored the other subgroup were also perceived positively. However, outgroup leaders who favored their own subgroup were perceived as less fair and as more biased than other leaders. They also engendered less identification with the superordinate group and a less unified perception of the group. Results demonstrate the importance of social identity concerns to leadership in nested group contexts and emphasize the fact that perceptions of leader fairness and concern for the common group mediate responses to the superordinate category. Copyright (C) 2003 John Wiley Sons, Ltd.

Classifying client goals in community-based ABI rehabilitation: a taxonomy for profiling service delivery and conceptualizing outcomes

Purpose: To develop, confirm and trial a framework for analysing the content of goals set within community-based rehabilitation. This framework (taxonomy) is proposed as a tool to assist in service evaluation and outcome exploration. Method: Qualitative thematic analysis and categorization of 1765 rehabilitation goal statements in a four phase process of synthesis, refinement, verification and application. Results: A taxonomy of goal content was developed comprising 21 categories within five domains, utilizing 125 descriptors. The taxonomy demonstrated good inter-rater consistency and was able to discriminate between similar but related data sets comprising goal statements. Conclusion: Structured analysis of the content of goal setting (particularly in community rehabilitation) utilizing a framework such as the proposed taxonomy has considerable potential as a 'window' into service delivery to broaden the parameters of existing service evaluation and to more clearly link outcome exploration to intervention.

Medicalizing meaning: demoralization syndrome and the desire to die

Objective: To critically analyse the proposed new psychiatric condition, demoralization syndrome, and the implications drawn by its proponents for the clinical-ethical status of requests by terminally ill patients for assistance to die. Method: The diagnostic features of demoralization syndrome, a proposed new psychiatric disorder, recognizable particularly in palliative care settings, are summarized. The consequences of proposed therapeutic interventions are described, one of which is relief of the desperation which motivates some demoralized patients to consider ending their lives and to seek assistance in dying. The connections between the proposed condition and the desire to die are analysed in the context of the continuing tensions surrounding the ontological status and sociopolitical implications of psychiatric categories and the pervasive medicalization of modern life. Results: The analysis suggests that by medicalizing existential cognitions at the end of life, the proposed diagnostic category also normalizes a particular moral view concerning assistance in dying. Conclusions: While further research into the issues described in this provisional syndrome may benefit some patients, the categorization of demoralization as a medical diagnosis is a questionable extension of psychiatry's influence, which could serve particular social, political and cultural views concerning the end of life.

Criticizing groups from the inside and the outside: An identity perspective on the intergroup sensitivity effect

Research on group criticism has demonstrated that criticisms are received less defensively when made by an ingroup member than when made by an outsider (the intergroup sensitivity effect). Three experiments tested the extent to which this effect is driven by social identity concerns or by judgments of how experienced the source of the criticism is. In Experiments I and 2, Australians who criticized Australia (ingroup critics) were met with less defensiveness than were foreigners who criticized Australia (outgroup critics), regardless of the amount of experience the foreigner had with Australia. Furthermore, the effects of speaker type on evaluations were mediated by perceptions of the extent to which the criticisms were intended to be constructive but not by perceptions of experience. Finally, Experiment 3 indicated that although experience does not help outgroup critics, a lack of experience can hurt ingroup critics. Recommendations are provided as to how people can reduce defensiveness when making group criticisms.

The social identity perspective - Intergroup relations, self-conception, and small groups

The historical development, metatheoretical background, and current state of the social identity perspective in social psychology are described. Although originally, an analysis mainly of intergroup relations between large-scale social categories, and more recently an analysis with a strong social cognitive emphasis, this article shows that the social identity perspective is intended to be a general analysis of group membership and group processes. It focuses on the generative relationship between collective self-conception and group phenomena. To demonstrate the relevance of the social identity perspective to small groups, the article describes social identity research in a number of areas: differentiation within groups; leadership; deviance; group decision making; organizations; computer mediated communication; mobilization, collective action, and social loafing; and group culture. These art the areas in which most work has been done and which arc therefore best placed for further developments in the near future.

Impact of social group processes and functional diversity on communication in networked organizations

This study examines the role of social group processes in perceptions of effective communication in Australian Cooperative Research Centres (CRCs). Communication professionals in 25 CRCs discussed the barriers and opportunities for communication in their diverse networked organizations. Thematic analysis of the transcripts highlighted the contribution of social group processes to both barriers and opportunities. Communication challenges implicated the social identity of organizational members, many of which were associated with distinct structural aspects of these organizations. Opportunities for communication frequently involved features that implicated social identity, including taking advantage of existing organizational or industry identities, preventing conflicting identities from becoming salient, and promoting a collective CRC identity.