Self-diagnosis of active head lice infestation by individuals from an impoverished community: high sensitivity and specificity

To compare sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of self-diagnosis for head lice infestation with visual inspection, we conducted a study in an urban slum in Brazil. Individuals were asked about active head lice infestation (self-diagnosis); we performed visual inspection and thereafter wet combing (gold standard). Of the 175 individuals included, 77 (44%) had an active head lice infestation. For self-diagnosis, sensitivity (80.5%), specificity (91.8%), PPV (88.6%) and NPV (85.7%) were high. Sensitivity of visual inspection was 35.1%. Public health professionals can use self-diagnosis as a diagnostic tool, to estimate accurately prevalence of pediculosis in a community, and to monitor ongoing intervention strategies.

An integration bridge for heterogeneous e-service environments

Dissertação para obtenção do Grau de Mestre em Engenharia Electrotécnica e de Computadores

Quality-of-service aware routing for static and mobile IPv6-based low-power and lossy sensor networks using RPL

The Internet of Things (IoT) has emerged as a paradigm over the last few years as a result of the tight integration of the computing and the physical world. The requirement of remote sensing makes low-power wireless sensor networks one of the key enabling technologies of IoT. These networks encompass several challenges, especially in communication and networking, due to their inherent constraints of low-power features, deployment in harsh and lossy environments, and limited computing and storage resources. The IPv6 Routing Protocol for Low Power and Lossy Networks (RPL) [1] was proposed by the IETF ROLL (Routing Over Low-power Lossy links) working group and is currently adopted as an IETF standard in the RFC 6550 since March 2012. Although RPL greatly satisfied the requirements of low-power and lossy sensor networks, several issues remain open for improvement and specification, in particular with respect to Quality of Service (QoS) guarantees and support for mobility. In this paper, we focus mainly on the RPL routing protocol. We propose some enhancements to the standard specification in order to provide QoS guarantees for static as well as mobile LLNs. For this purpose, we propose OF-FL (Objective Function based on Fuzzy Logic), a new objective function that overcomes the limitations of the standardized objective functions that were designed for RPL by considering important link and node metrics, namely end-to-end delay, number of hops, ETX (Expected transmission count) and LQL (Link Quality Level). In addition, we present the design of Co-RPL, an extension to RPL based on the corona mechanism that supports mobility in order to overcome the problem of slow reactivity to frequent topology changes and thus providing a better quality of service mainly in dynamic networks application. Performance evaluation results show that both OF-FL and Co-RPL allow a great improvement when compared to the standard specification, mainly in terms of packet loss ratio and average network latency. 2015 Elsevier B.V. Al

Effects of self-administered exercises based on Tuina techniques on musculoskeletal disorders of professional orchestra musicians: a randomized controlled trial

Background Musicians are frequently affected by playing-related musculoskeletal disorders (PRMD). Common solutions used by Western medicine to treat musculoskeletal pain include rehabilitation programs and drugs, but their results are sometimes disappointing. Objective To study the effects of self-administered exercises based on Tuina techniques on the pain intensity caused by PRMD of professional orchestra musicians, using numeric visual scale (NVS). Design, setting, participants and interventions We performed a prospective, controlled, single-blinded, randomized study with musicians suffering from PRMD. Participating musicians were randomly distributed into the experimental (n = 39) and the control (n = 30) groups. After an individual diagnostic assessment, specific Tuina self-administered exercises were developed and taught to the participants. Musicians were instructed to repeat the exercises every day for 3 weeks. Main outcome measures Pain intensity was measured by NVS before the intervention and after 1, 3, 5, 10, 15 and 20 d of treatment. The procedure was the same for the control group, however the Tuina exercises were executed in points away from the commonly-used acupuncture points. Results In the treatment group, but not the control group, pain intensity was significantly reduced on days 1, 3, 5, 10, 15 and 20. Conclusion The results obtained are consistent with the hypothesis that self-administered exercises based on Tuina techniques could help professional musicians controlling the pain caused by PRMD. Although our results are very promising, further studies are needed employing a larger sample size and double blinding designs.

SHõWA: A Self-healing Framework for Web-based Applications

The complexity of systems is considered an obstacle to the progress of the IT industry. Autonomic computing is presented as the alternative to cope with the growing complexity. It is a holistic approach, in which the systems are able to configure, heal, optimize, and protect by themselves. Web-based applications are an example of systems where the complexity is high. The number of components, their interoperability, and workload variations are factors that may lead to performance failures or unavailability scenarios. The occurrence of these scenarios affects the revenue and reputation of businesses that rely on these types of applications. In this article, we present a self-healing framework for Web-based applications (SHõWA). SHõWA is composed by several modules, which monitor the application, analyze the data to detect and pinpoint anomalies, and execute recovery actions autonomously. The monitoring is done by a small aspect-oriented programming agent. This agent does not require changes to the application source code and includes adaptive and selective algorithms to regulate the level of monitoring. The anomalies are detected and pinpointed by means of statistical correlation. The data analysis detects changes in the server response time and analyzes if those changes are correlated with the workload or are due to a performance anomaly. In the presence of per- formance anomalies, the data analysis pinpoints the anomaly. Upon the pinpointing of anomalies, SHõWA executes a recovery procedure. We also present a study about the detection and localization of anomalies, the accuracy of the data analysis, and the performance impact induced by SHõWA. Two benchmarking applications, exercised through dynamic workloads, and different types of anomaly were considered in the study. The results reveal that (1) the capacity of SHõWA to detect and pinpoint anomalies while the number of end users affected is low; (2) SHõWA was able to detect anomalies without raising any false alarm; and (3) SHõWA does not induce a significant performance overhead (throughput was affected in less than 1%, and the response time delay was no more than 2 milliseconds).

Key-CRDT stores

Dissertação para obtenção do Grau de Mestre em Engenharia Informática

P2P service exposer

Dissertação para obtenção do Grau de Mestre em Engenharia Electrotécnica e de Computadores

The Risks of Self - Medication: Case Report of Familial Misuse of AM3 (Immunoferon®)

Over the last decades extended medical knowledge has been an important health care benefit in terms of disease prevention and management. However, probably with no exception, most pharmaceutical products are not devoid of adverse consequences. Immunomodulators are commonly considered a “benign” drug whose advantages bypass consequences. The immunomodulator AM3 (Immunoferon®) is a clinically used, orally administered compound whose active principle is stabilised in an inorganic matrix of calcium. We report the misuse of AM3 in three members of a family; father and two children. The drug was prescribed to the father who subsequently administered it to the children without seeking medical advice. Two months later, all subjects developed abdominal and/or flank colicky pain. Hypercalciuria was diagnosed in the children with different degrees of severity. It is likely that the calcium content of the inorganic matrix played an important role in the onset of symptoms. No adverse side effects related to the inorganic matrix of calcium of immunoferon® have been documented so far. This family case report calls attention to the risks of self -medication in a susceptible family. Paediatric patients are vulnerable as they rely on adults for the supply of medications. Concerning the use of drugs in family, especially nonprescription drugs, the quality of health care provided to the children depends on the health literacy of their parents.

Tuberculosis among HIV-1-infected subjects in a tertiary out-patient service in São Paulo city, Brazil

TB is currently considered to be the most important infectious disease among HIV-1-infected subjects in developing countries, such as Brazil. A retrospective analysis of TB cases was performed, occurring from January 1995 to December 2010 in our cohort of 599 HIV positive patients. The primary outcome was the occurrence of active TB. Forty-one TB cases were diagnosed over this period of 16 years, among 599 HIV positive patients in an open cohort setting in the city of Sao Paulo, Brazil. All-time lowest mean CD4 T cell count at the time of TB diagnosis was 146 and 186 cells/mm³, respectively. The mean HIV viral load was 5.19 log10 copies/mL, and 59% of the patients were on HAART. TB incidence was 1.47 per 100 person-years, for a total follow-up time of 2775 person-years. The probability of surviving up to 10 years after diagnosis was 75% for TB patients as opposed to 96% for patients with other, non-TB opportunistic diseases (p = 0.03). TB can be considered a public health problem among people living with HIV in Brazil despite of the widespread use of antiretrovirals for the treatment of HIV infection/AIDS.

Skew(er)ing Identities: the assertion of self in Gish Jen’s Mona in the promised land and Colson Whitehead’s Sag Harbor

Dissertação apresentada para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Línguas Literatura e Cultura

Toxocariasis in children attending a Public Health Service Pneumology Unit in Paraná State, Brazil

The enzyme-linked immunosorbent assay (ELISA) is the most widely used tool to detect anti-Toxocara IgG antibodies for both serodiagnostic and seroepidemiological surveys on human toxocariasis. In the last eight years a high prevalence of toxocariasis (32.2-56.0%) has been reported in children attending public health units from municipalities in the state of Paraná, Brazil. Therefore, the aim of this work was to compare the frequency found among the general child population with that of children attending a public pneumology service in Maringá, Paraná, Brazil and describe the laboratorial, clinical and epidemiological findings. The research was conducted at the Consórcio Público Intermunicipal de Saúde do Setentrião Paranaense (CISAMUSEP) from July 2009 to July 2010 among children aged between one and 15 years. From a total of 167 children studied, only 4.2% (7/167) tested positive for anti-Toxocara spp. IgG antibodies and presented mild eosinophilia (2/7), increased serum IgE levels (6/7) and a positive allergy test for mites (5/7). The presence of pets (dogs or cats) at home did not correlate with the seroprevalence. In conclusion, cases of toxocariasis involving the respiratory tract are rare in children attending a public health pneumology unit in the northwestern region of Paraná State, despite the high prevalence of this type of toxocariasis among the infantile population attending Basic Health Units in the same geographical area.

Análise da Qualidade de Energia em Instalações Eléctricas com MiniProdução

Com a alteração da legislação energética em Portugal, nomeadamente a implementação da legislação de Micro e Minigeração, a produção distribuída cresceu de forma exponencial na rede elétrica nacional, diminuindo por um lado as perdas no transporte e distribuição, e por outro aumentando a complexidade na gestão do trânsito de potência ao Distribuidor. No entanto a motivação desta dissertação prende-se com o facto de que as centrais de produção distribuída, em particular as de tecnologia fotovoltaica, pela sua dimensão, serem instaladas nos pontos de consumo, em paralelo com a instalação elétrica de utilização do cliente e como tal, têm sido verificadas diversas anomalias no funcionamento e exploração das mesmas, por influência da má qualidade de energia resultante das más condições de funcionamento e exploração em que se encontram as instalações de consumo. A presente dissertação pretende apresentar uma descrição das anomalias mais frequentes verificadas nas centrais fotovoltaicas de minigeração com origem na qualidade da energia que transita das instalações elétricas de consumo ligadas ao mesmo ponto de interligação com a rede elétrica nacional. Como base de fundamento, foram demonstradas através de três casos práticos reais, algumas das mais frequentes e prejudiciais anomalias descritas na presente dissertação. Foram escolhidos 3 casos reais com diferentes tipos de instalação de consumo sendo que um deles não apresenta qualquer anomalia de forma a comprovar o bom funcionamento em condições normais de ambas as instalações. Foram encontradas e demonstradas várias soluções paras os diferentes tipos de anomalias, no entanto esta dissertação vai permitir não só a resolução deste tipo de anomalias em centrais fotovoltaicas em exploração e já com prejuízos avultados mas também introduzir em futuras instalações a análise da qualidade da energia nas instalações de consumo em fase preliminar de estudo de implementação de centrais fotovoltaicas de minigeração e de autoconsumo, precavendo futuros problemas de rentabilidade técnico-económica. Este estudo, irá certamente servir de motor de impulsão para a preocupação com a Qualidade da Energia essencialmente dentro das instalações elétricas de consumo sensibilizando os seus gestores energéticos. Poderá ainda impulsionar a reformulação do Regulamento de Qualidade de Serviço para exigências ainda mais apertadas de forma a incorporar algumas das anomalias aqui descritas, sendo por isso um elemento de alerta para todos os “Players” do Sistema Elétrico Nacional tendo como limite a melhoria continua da Segurança e da Qualidade da energia na rede elétrica beneficiando da sensibilização de todos os intervenientes.

Sobre a representação linguística da subjectividade: Representação do self num texto "esquizofrénico"

No âmbito de uma reflexão geral sobre o modo como a subjectividade pode ser expressa através da linguagem (entendendo-se por subjectividade essa experiência individual de continuidade - ou descontinuidade em casos patológicos - do self através do tempo), procurarei colocar em destaque alguns dispositivos linguísticos que permitem ao sujeito exprimir a percepção que tem de si próprio e o conceito que devido a isso forma de si. A escolha de alguns desses dispositivos em detrimento de outros está condicionada pela análise dum texto de um paciente diagnosticado como esquizofrénico, texto esse que me foi facultado já há alguns anos na Casa de Saúde do Telhai e que fazia parte do dossier clínico do mesmo doente. De entre as várias expressões que em Linguística agrupamos sob a designação de referência deictica indiciai, isto é, de entre as diversas expressões cujo referente depende e varia de acordo com a situação comunicativa em que são empregues, os pronomes pessoais são, tal como pôde destacar Emile Benveni ste na sua apresentação do quadro formal da enunciação (1974), excelentes candidatos à expressão da subjectividade.

ASSOCIATION BETWEEN SMOKING, CRACK COCAINE ABUSE AND THE DISCONTINUATION OF COMBINATION ANTIRETROVIRAL THERAPY IN RECIFE, PERNAMBUCO, BRAZIL

Despite the effectiveness of combination antiretroviral therapy in the treatment of people living with HIV/AIDS (PLWHA), nonadherence to medication has become a major threat to its effectiveness. This study aimed to estimate the prevalence of self-reported irregular use of antiretroviral therapy and the factors associated with such an irregularity in PLWHA. A cross-sectional study of PLWHA who attended two referral centers in the city of Recife, in Northeastern Brazil, between June 2007 and October 2009 was carried out. The study analyzed socioeconomic factors, social service support and personal habits associated with nonadherence to antiretroviral therapy, adjusted by multivariable logistic regression analysis. The prevalence of PLWHA who reported irregular use of combination antiretroviral therapy (cART) was 25.7%. In the final multivariate model, the irregular use of cART was associated with the following variables: being aged less than 40 years (OR = 1.66, 95%-CI: 1.29-2.13), current smokers (OR = 1.76, 95%-CI: 1.31-2.37) or former smokers (OR = 1.43, 95%-CI: 1.05-1.95), and crack cocaine users (OR = 2.79, 95%-CI: 1.24-6.32). Special measures should be directed towards each of the following groups: individuals aged less than 40 years, smokers, former smokers and crack cocaine users. Measures for giving up smoking and crack cocaine should be incorporated into HIV-control programs in order to promote greater adherence to antiretroviral drugs and thus improve the quality of life and prolong life expectancy.