Triple Regimen with Rituximab, Plasmapheresis and Intravenous Immunoglobulin in the Treatment of Dialysis Dependent Acute Humoral-Mediated Rejection in Kidney Grafts

Introduction: The clinical importance of humoral-mediated acute rejection has been progressively recognised. Early recognition and treatment with plasmapheresis and intravenous immunoglobulin have recently improved short term prognosis. Case report: In this report we describe the clinical features of three 2nd transplant patients developing severe acute humoral rejection during the first week post-transplant while on anti-thymocyte globulin therapy. Treatment with plasmapheresis/ intravenous immunoglobulin/rituximab resulted in rapid reversal of oliguria,and recovery of renal function within the 1st week of treatment in 2/3 patients. Diagnosis was confirmed by graft biopsies revealing peritubular neutrophiles and C4d deposits. Sequential graft biopsies in all three patients revealed complete histological recovery within two weeks. One patient never recovered renal function, and one patient lost his graft at three months following hemorrhagic shock. After 2 years follow up, the remaining patient maintains a serum creatinine of 1.1mg/dl. Conclusion: The regimen using plasmapheresis plus intravenous immunoglobulin and rituximab was effective in rapidly reversing severe acute humoral rejection.

Identification of mechanisms controlling the transcriptional activity of nuclear factor kappa B (NF-κB) p65/RelA

Dissertação para a obtenção do grau de doutor em Biologia pelo Instituto de Tecnologia Química e Biológica. Universidade Nova de Lisboa.

Modelling and Forecasting Mortality Patterns

Thesis submitted in partial fulfillment of the requirements for the Degree of Doctor of Statistics and Information Management

Distribution of the entodiniomorphid ciliate Troglocorys cava Tokiwa, Modrý, Ito, Pomajbíková, Petrželková, & Imai, , (Entodiniomorphida: Blepharocorythidae) in wild and captive chimpanzees.

Trophozoites of Troglocorys cava were detected in all but one of the wild chimpanzee populations from Rubondo Island (Tanzania), with a prevalence ranging between 20% and 78%. However, the ciliate was absent in all captive groups. Prevalence appeared to increase with the number of sequential samples taken from a particular individual and reached 95.5% in wild individuals sampled at least 4 times.

Studying urban space and literary representations using GIS: Lisbon, Portugal, 1852-2009

This article proposes a methodology to address the urban evolutionary process, demonstrating how it is reflected in literature. It focuses on “literary space,” presented as a territory defined by the period setting or as evoked by the characters, which can be georeferenced and drawn on a map. It identifies the different locations of literary space in relation to urban development and the economic, political, and social context of the city. We suggest a new approach for mapping a relatively comprehensive body of literature by combining literary criticism, urban history, and geographic information systems (GIS). The home-range concept, used in animal ecology, has been adapted to reveal the size and location of literary space. This interdisciplinary methodology is applied in a case study to nineteenth- and twentieth-century novels involving the city of Lisbon. The developing concepts of cumulative literary space and common literary space introduce size calculations in addition to location and structure, previously developed by other researchers. Sequential and overlapping analyses of literary space throughout time have the advantage of presenting comparable and repeatable results for other researchers using a different body of literary works or studying another city. Results show how city changes shaped perceptions of the urban space as it was lived and experienced. A small core area, correspondent to a part of the city center, persists as literary space in all the novels analyzed. Furthermore, the literary space does not match the urban evolution. There is a time lag for embedding new urbanized areas in the imagined literary scenario.

Validação e aplicação clínica de uma escala de cognição social na esquizofrenia = Validation and clinical use of a measure of social cognition in schizophrenia

RESUMO: A cognição social encontra-se frequentemente alterada na esquizofrenia. Esta alteração relaciona-se com a diminuição do funcionamento social,caracterizando-se quer por défices quer por vieses cognitivos sociais. No entanto, existem poucos instrumentos fiáveis e válidos para avaliar a cognição social na esquizofrenia, nomeadamente capazes de medir os vieses cognitivos sociais e a cognição social auto-relevante. Adicionalmente, as bases biológicas da disfunção social não estão totalmente esclarecidas. Evidências recentes sugerem que o peptídeo oxitocina (OXT) influencia o funcionamento social, e que esta relação poderá ser mediada pela cognição social. Este Trabalho de Projecto descreve a contribuição do autor para o desenvolvimento e avaliação psicométrica inicial de um novo instrumento de avaliação da cognição social, e a utilidade desta escala na investigação das associações entre a OXT e a capacidade e vieses cognitivos sociais. A Waiting Room Task (WRT), uma escala constituída por 26 vídeos sequenciais que simulam a experiência de observar outra pessoa numa sala de espera, foi administrada num estudo transversal com 61 doentes com esquizofrenia e 20 controlos saudáveis. Observou-se uma menor capacidade cognitiva social e um aumento dos vieses cognitivos sociais nos doentes com esquizofrenia, comparativamente aos controlos. Nos controlos e doentes com delírios, o desempenho na WRT correlacionou-se significativamente com os níveis de OXT. Esta correlação não se observou nos doentes sem delírios, sugerindo que o papel da OXT na cognição social poderá encontrar-se atenuado neste grupo. Estes achados fornecem suporte inicial para a adequação da WRT como instrumento de avaliação da cognição social na esquizofrenia, podendo ainda ser útil na investigação da sua base biológica. ------------ ABSTRACT: Social cognition is often impaired in schizophrenia. This impairment is related to poor social functioning and is characterized by both social cognitive deficits and biases. However, there are few reliable and valid measures of social cognition in schizophrenia, particularly measures of social cognitive bias and of self-relevant social cognition. Also, the biological bases of social dysfunction are not well understood. Emerging evidence suggests that the peptide oxytocin (OXT) influences social functioning, and that this relationship may be mediated by social cognition. This Research Project describes the author’s contribution to the development and initial psychometric testing of a new measure of social cognition, and the utility of this instrument to examine associations between OXT and social cognitive capacity and bias. The Waiting Room Task WRT), a video-based test comprising 26 sequential videos simulating the experience of facing another person in a waiting room, was administered in a cross-sectional study involving 61 patients with schizophrenia and 20 healthy controls. Social cognitive capacity was lower and social cognitive bias was increased in patients with schizophrenia compared with controls. Among controls and patients with delusions, performance on the WRT was significantly correlated with OXT level. This correlation was not found in patients without delusions suggesting that OXT’s role in social cognition may be blunted in this group. These findings provide initial support for the adequacy of the WRT as a measure for assessing social cognition in schizophrenia that may also be useful in understanding its biological underpinnings.

Preventing atomicity violations with contracts

Concurrent programming is a difficult and error-prone task because the programmer must reason about multiple threads of execution and their possible interleavings. A concurrent program must synchronize the concurrent accesses to shared memory regions, but this is not enough to prevent all anomalies that can arise in a concurrent setting. The programmer can misidentify the scope of the regions of code that need to be atomic, resulting in atomicity violations and failing to ensure the correct behavior of the program. Executing a sequence of atomic operations may lead to incorrect results when these operations are co-related. In this case, the programmer may be required to enforce the sequential execution of those operations as a whole to avoid atomicity violations. This situation is specially common when the developer makes use of services from third-party packages or modules. This thesis proposes a methodology, based on the design by contract methodology, to specify which sequences of operations must be executed atomically. We developed an analysis that statically verifies that a client of a module is respecting its contract, allowing the programmer to identify the source of possible atomicity violations.

Low sensitivity of polymerase chain reaction for diagnosis of tuberculous meningitis in southeastern Brazil

Two polymerase chain reaction (PCR) protocols showed low sensitivity (36% and 53% for TB AMPLICOR and MPB64 nested PCR, respectively), when compared with classic microbiological methods (73% and 54% for Ziehl-Neelsen staining and culture, respectively), in the diagnosis of tuberculous meningitis in 91 patients in southeastern Brazil. Only three PCR-positive, microbiologically negative patients were found. Analysis of sequential cerebrospinal fluid samples by nested PCR detected Mycobacterium tuberculosis DNA up to 29 days after the introduction of antituberculosis chemotherapy.

Tbx1 and Bmp2 in the development of the ear, neural crest and pharyngeal system in mice

Dissertation presented to obtain the Ph.D degree in Biology

Aplicação da dramatização em aula como instrumento para o aperfeiçoamento da oralidade no ensino da língua materna (Português) e da língua estrangeira (Espanhol)

O tema do presente relatório é a dramatização como um procedimento didático nas aulas de língua – dramatização, enquanto método baseado no teatro (drama), como um processo de ensino-aprendizagem que articula os conteúdos de estudo escolar com técnicas e conceitos teatrais. O objetivo principal da aplicação desta metodologia é conseguir que o estudo das matérias da aula de língua seja interessante e motivador para os intervenientes, alunos e professor, procurando-se proporcionar aulas dinâmicas, com momentos de recreação que possibilitem a identificação do estudo com o prazer. Na organização das aulas usa-se um procedimento didático baseado no enfoque por tarefas, método educativo aplicado ao ensino-aprendizagem das línguas estrangeiras, particularmente na conceção de Ellis (2003) para um processo sequencial de ensino orientado, onde são considerados três momentos: as atividades anteriores à tarefa, a tarefa e as atividades posteriores à tarefa. No caso do presente estudo, consideram-se tarefas as atividades de natureza dramática que apresentam duas expressões diferentes: simulações de situações comunicativas reais, e leituras em voz alta, individualmente ou em diálogo, feitas para um público. A expressão oral manifesta-se através de vários modos: prática de diferentes formas de leitura em voz alta, atuação em simulações comunicativas e a interação oral entre alunos e professora na execução de muitas atividades. A relevância destas práticas orais prende-se com o seu potencial para desenvolverem as destrezas requeridas nos processos comunicativos da língua oral: a cognitiva, a linguística e a fonética. Ainda que o enfoque por tarefas seja um método para a didática das línguas estrangeiras, a sua aplicabilidade no ensino da língua materna é possível, seguindo a mesma sequenciação de operações num e noutro caso pois focalizar o estudo das línguas na sua funcionalidade comunicativa é o propósito das pedagogias atuais para as línguas, maternas ou estrangeiras.

Barriers preventing the successful integration of mental health services into Primary Health Care in Nigeria : a mixed methods approach

RESUMO: A Nigéria tem uma população estimada em cerca de 170 milhões de pessoas. O número de profissionais de saúde mental é muito diminuto, contando apenas com 150 psiquiatras o que perfaz aproximadamente um rácio de psiquiatra: população de mais de 1:1 milhão de pessoas. O Plano Nacional de Saúde Mental de 1991 reconheceu esta insuficiência e recomendou a integração dos serviços de saúde mental nos cuidados de saúde primários (CSP). Depois de mais de duas décadas, essa política não foi ainda implementada. Este estudo teve como objetivos mapear a estrutura organizacional dos serviços de saúde mental da Nigéria, e explorar os desafios e barreiras que impedem a integração bem-sucedida dos serviços de saúde mental nos cuidados de saúde primários, isto segundo a perspectiva dos profissionais dos cuidados de saúde primários. Com este objetivo, desenvolveu-se um estudo exploratório sequencial e utilizou-se um modelo misto para a recolha de dados. A aplicação em simultâneo de abordagens qualitativas e quantitativas permitiram compreender os problemas relacionados com a integração dos serviços de saúde mental nos CSP na Nigéria. No estudo qualitativo inicial, foram realizadas entrevistas com listagens abertas a 30 profissionais dos CSP, seguidas de dois grupos focais com profissionais dos CSP de duas zonas governamentais do estado de Oyo de forma a obter uma visão global das perspectivas destes profissionais locais sobre os desafios e barreiras que impedem uma integração bem-sucedida dos serviços de saúde mental nos CSP. Subsequentemente, foram realizadas entrevistas com quatro pessoas-chave, especificamente coordenadores e especialistas em saúde mental. Os resultados do estudo qualitativo foram utilizados para desenvolver um questionário para análise quantitativa das opiniões de uma amostra maior e mais representativa dos profissionais dos CSP do Estado de Oyo, bem como de duas zonas governamentais locais do Estado de Osun. As barreiras mais comummente identificadas a partir deste estudo incluem o estigma e os preconceitos sobre a doença mental, a formação inadequada dos profissionais dos CPS sobre saúde mental, a perceção pela equipa dos CSP de baixa prioridade de ação do Governo, o medo da agressão e violência pela equipa dos CSP, bem como a falta de disponibilidade de fármacos. As recomendações para superar estes desafios incluem a melhoria sustentada dos esforços da advocacia à saúde mental que vise uma maior valorização e apoio governamental, a formação e treino organizados dos profissionais dos cuidados primários, a criação de redes de referência e de apoio com instituições terciárias adjacentes, e o engajamento da comunidade para melhorar o acesso aos serviços e à reabilitação, pelas pessoas com doença mental. Estes resultados fornecem indicações úteis sobre a perceção das barreiras para a integração bem sucedida dos serviços de saúde mental nos CSP, enquanto se recomenda uma abordagem holística e abrangente. Esta informação pode orientar as futuras tentativas de implementação da integração dos serviços de saúde mental nos cuidados primários na Nigéria.------------ABSTRACT: Nigeria has an estimated population of about 170 million people but the number of mental health professionals is very small, with about 150 psychiatrists. This roughly translates to a psychiatrist:population ratio of more than 1:1 million people. The National Mental Health Policy of 1991 recognized this deficiency and recommended the integration of mental health into primary health care (PHC) delivery system. After more than two decades, this policy has yet to be implemented. This study aimed to map out the organizational structure of the mental health systems in Nigeria, and to explore the challenges and barriers preventing the successful integration of mental health into primary health care, from the perspective of the primary health care workers. A mixed methods exploratory sequential study design was employed, which entails the use of sequential timing in the combined methods of data collection. A combination of qualitative and uantitative approaches in sequence, were utilized to understand the problems of mental health services integration into PHC in Nigeria. The initial qualitative phase utilized free listing interviews with 30 PHC workers, followed by two focus group discussions with primary care workers from two Local Government Areas (LGA) of Oyo State to gain useful insight into the local perspectives of PHC workers about the challenges and barriers preventing successful integration of mental health care services into PHC. Subsequently, 4 key informant interviews with PHC co-ordinators and mental health experts were carried out. The findings from the qualitative study were utilized to develop a quantitative study questionnaire to understand the opinions of a larger and more representative sample of PHC staff in two more LGAs of Oyo State, as well as 2 LGAs from Osun State. The common barriers identified from this study include stigma and misconceptions about mental illness, inadequate training of PHC staff about mental health, low government priority, fear of aggression and violence by the PHC staff, as well as non-availability of medications. Recommendations for overcoming these challenges include improved and sustained efforts at mental health advocacy to gain governmental attention and support, organized training and retraining for primary care staff, establishment of referral and supportive networks with neighbouring tertiary facilities and community engagement to improve service utilization and rehabilitation of mentally ill persons. These findings provide useful insight into the barriers to the successful integration of mental health into PHC, while recommending a holistic and comprehensive approach. This information can guide future attempts to implement the integration of mental health into primary care in Nigeria.

Smart machines in day-to-day financial management:

Starting from Novabase’s challenge to launch in the UK Millennials a personal financial advisor mobile application, this work project aims to build a planning model to frame a business side of a launch strategy for mobile application in similar market and category. This study culminates on the design of SPOSTAC planning model. The created framework is intended to effectively and efficiently plan a launch strategy, being structured based on seven sequential elements: Situation, Product, Objectives, Strategy, Tactics, Action, and Control.

Impact of carbon/nitrogen feeding strategy on polyhydroxyalkanoates production using mixed microbial cultures

Polyhydroxyalkanoates (PHA) production using mixed microbial cultures (MMC) requires a multi-stage process involving the microbial selection of PHA-storing microorganisms, typically operated in sequencing batch reactors (SBR), and an accumulation reactor. Since low-cost renewable feedstocks used as process feedstock are often nitrogen-deficient, nutrient supply in the selection stage is required to allow for microbial growth. In this context, the possibility to uncouple nitrogen supply from carbon feeding within the SBR cycle has been investigated in this study. Moreover, three different COD:N ratios (100:3.79, 100:3.03 and 100:2.43) were tested in three different runs which also allowed the study of COD:N ratio on the SBR performance. For each run, a synthetic mixture of acetic and propionic acids at an overall organic load rate of 8.5 gCOD L-1 d-1 was used as carbon feedstock, whereas ammonium sulfate was the nitrogen source in a lab-scale sequence batch reactor (SBR) with 1 L of working volume. Besides, a sludge retention time (SRT) of 1 d was used as well as a 6 h cycle length. The uncoupled feeding strategy significantly enhanced the selective pressure towards PHA-storing microorganisms, resulting in a two-fold increase in the PHA production (up to about 1.3 gCOD L-1). A high storage response was observed for the two runs with the COD:N ratios (gCOD:gN) of 100:3.79 and 100:3.03, whereas the lowest investigated nitrogen load resulted in very poor performance in terms of polymer production. In fact, strong nitrogen limitation caused fungi to grow and a very poor storage ability by microorganisms that thrived in those conditions. The COD:N ratio also affected the polymer composition, indeed the produced poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) showed a variable HV content (1-20 %, w/w) among the three runs, lessening as the COD:N increased. This clearly suggests the possibility to use the COD:N ratio as a tool for tuning polymer properties regardless the composition of the feedstock.

A public transport bus assignment problem: parallel metaheuristics assessment

Combinatorial Optimization Problems occur in a wide variety of contexts and generally are NP-hard problems. At a corporate level solving this problems is of great importance since they contribute to the optimization of operational costs. In this thesis we propose to solve the Public Transport Bus Assignment problem considering an heterogeneous fleet and line exchanges, a variant of the Multi-Depot Vehicle Scheduling Problem in which additional constraints are enforced to model a real life scenario. The number of constraints involved and the large number of variables makes impracticable solving to optimality using complete search techniques. Therefore, we explore metaheuristics, that sacrifice optimality to produce solutions in feasible time. More concretely, we focus on the development of algorithms based on a sophisticated metaheuristic, Ant-Colony Optimization (ACO), which is based on a stochastic learning mechanism. For complex problems with a considerable number of constraints, sophisticated metaheuristics may fail to produce quality solutions in a reasonable amount of time. Thus, we developed parallel shared-memory (SM) synchronous ACO algorithms, however, synchronism originates the straggler problem. Therefore, we proposed three SM asynchronous algorithms that break the original algorithm semantics and differ on the degree of concurrency allowed while manipulating the learned information. Our results show that our sequential ACO algorithms produced better solutions than a Restarts metaheuristic, the ACO algorithms were able to learn and better solutions were achieved by increasing the amount of cooperation (number of search agents). Regarding parallel algorithms, our asynchronous ACO algorithms outperformed synchronous ones in terms of speedup and solution quality, achieving speedups of 17.6x. The cooperation scheme imposed by asynchronism also achieved a better learning rate than the original one.

Pancreatic lesions in acute experimental Chagas' disease

BACKGROUND: Chagas' disease is an endemic tropical affliction found from southern United States to Argentina. The acute phase of this disease is difficult to study in man because the symptoms are non-specific and most cases require no medical assistance. Experimental models have been developed for sequential studies, and intense parasitism in all organs and tissues, including the pancreas, have been detected in the acute phase. PURPOSE: To evaluate the involvement of the pancreas in acute experimental Chagas' disease in a mouse model by histopathological characterization. CASUISTIC AND METHODS: Ten BALBc mice, about 20 g, injected i.p. with 100 000 forms of the Y strain of Trypanosoma cruzi were used. The animals were sacrificed after 14 days of infection. Fragments of pancreas were processed by conventional paraffin embedding and hematoxylin-eosin staining. RESULTS: Ruptured pseudocysts and release of parasites to the extracellular medium caused by necrosis of acinar and duct cells and foci of fat were the most striking histopathological features of acute Chagasic pancreatitis. CONCLUSION: Parasitism is the main cause of acute pancreatitis in Chagas' disease.