Methodologies for the Development of the Management of Cough: CHEST Guideline and Expert Panel Report

BACKGROUND: This series of guidance documents on cough, which will be published over time, is a hybrid of two processes: (1) evidence-based guidelines and (2) trustworthy consensus statements based on a robust and transparent process.

METHODS: The CHEST Guidelines Oversight Committee selected a nonconflicted Panel Chair and jointly assembled an international panel of experts in each clinical area with few, if any, conflicts of interest. PICO (population, intervention, comparator, outcome)-based key questions and parameters of eligibility were developed for each clinical topic to inform the comprehensive literature search. Existing guidelines, systematic reviews, and primary studies were assessed for relevance and quality. Data elements were extracted into evidence tables and synthesized to provide summary statistics. These, in turn, are presented to support the evidence-based graded recommendations. A highly structured consensus-based Delphi approach was used to provide expert advice on all guidance statements. Transparency of process was documented.

RESULTS: Evidence-based guideline recommendations and consensus-based suggestions were carefully crafted to provide direction to health-care providers and investigators who treat and/or study patients with cough. Manuscripts and tables summarize the evidence in each clinical area supporting the recommendations and suggestions.

CONCLUSIONS: The resulting guidance statements are based on a rigorous methodology and transparency of process. Unless otherwise stated, the recommendations and suggestions meet the guidelines for trustworthiness developed by the Institute of Medicine and can be applied with confidence by physicians, nurses, other health-care providers, investigators, and patients.

Appointment keeping for medical review among patients with selected chronic diseases in an urban area of Uganda

Introduction: proper management of chronic diseases is important for prevention of disease complications and yet some patients miss appointments for medical review thereby missing the opportunity for proper monitoring of their disease conditions. There is limited information on missed appointments among chronic disease patients in resource limited settings. This study aimed to determine the prevalence of missed appointments for medical review and associated factors among chronic disease patients in an urban area of Uganda.

Methods: patients or caregivers of children with chronic diseases were identified as they bought medicines from a community pharmacy. They were visited at home to access their medical documents and those whose chronic disease status was ascertained were enrolled. The data was collected using: questionnaires, review of medical documents, and in-depth interviews with chronic disease patients.

Results: the prevalence of missed appointments was 42% (95%CI=35-49%). The factors associated with missed appointments were: monthly income ?30US Dollars (OR=2.56, CI=1.25–5.26), affording less than half of prescribed drugs (OR=3.92, CI=1.64–9.40), not experiencing adverse events (OR=2.66, CI=1.26–5.61), not sure if treatment helps (OR=2.84, CI=1.047.77), not having a medicines administration schedule (OR=6.77, CI=2.11–21.68), and increasing number of drugs (OR=0.72, CI=0.53–0.98). Conclusion: patients missed appointments mainly due to: financial and health system barriers, conflicting commitments with appointments, and perceptions of the disease condition. Patients should be supported with accessible and affordable health services.

Interpretable and Reconfigurable Clustering of Document Datasets by Deriving Word-based Rules

Clusters of text documents output by clustering algorithms are often hard to interpret. We describe motivating real-world scenarios that necessitate reconfigurability and high interpretability of clusters and outline the problem of generating clusterings with interpretable and reconfigurable cluster models. We develop two clustering algorithms toward the outlined goal of building interpretable and reconfigurable cluster models. They generate clusters with associated rules that are composed of conditions on word occurrences or nonoccurrences. The proposed approaches vary in the complexity of the format of the rules; RGC employs disjunctions and conjunctions in rule generation whereas RGC-D rules are simple disjunctions of conditions signifying presence of various words. In both the cases, each cluster is comprised of precisely the set of documents that satisfy the corresponding rule. Rules of the latter kind are easy to interpret, whereas the former leads to more accurate clustering. We show that our approaches outperform the unsupervised decision tree approach for rule-generating clustering and also an approach we provide for generating interpretable models for general clusterings, both by significant margins. We empirically show that the purity and f-measure losses to achieve interpretability can be as little as 3 and 5%, respectively using the algorithms presented herein.

Contracts for the Sale of Land: Understanding the Impecuniosity Defence

Where either the seller or buyer of landed property fails to complete a contract to sell land the non-breaching party has a right to seek specific performance of the contract. This remedy would compel the party in default to perform the contract on pain of being held in contempt of court if the court's order is not obeyed. The defaulting party would not be able to satisfy its obligations under the law by paying a sum of money as damages for breach of contract. This paper considers the impecuniosity defence to specific performance as recognised by courts in Northern Ireland, the Republic of Ireland, Australia and New Zealand. Where the buyer demonstrates that he or she simply cannot raise the funds to buy the property specific performance will not be decreed and the court will make an award of damages for breach of contract measured by the difference between the contract price and the market price of the property at the time of default. The paper considers the nature and parameters of this defence and how it differs (if at all) from the alternative defence of extreme hardship. The paper addresses the question of whether it might be better to move to a position where sellers of land in all cases no longer enjoy a presumption of specific performance but have to demonstrate that the alternative remedy of damages is clearly inadequate. If this should be so the paper goes on to consider whether abolition of the presumption in favour of specific performance for sellers should lead to abolition of the presumption of specific performance for buyers, as is the position in Canada following the Supreme Court's decision in Semelhago v Paramadevan [1996] 2 SCR 415.

Diversity and biology of polychaeta of Diopatra Genus

Os anelídeos poliquetas são elementos importantes em ambientes estuarinos e costeiros, pela sua elevada biodiversidade e abundância e pelo papel que têm nas cadeias tróficas. Algumas espécies são intensivamente exploradas para serem utilizadas como isco na pesca desportiva e profissional, como é o caso de Diopatra neapolitana. Apesar da importância económica, existem poucos estudos sobre a sua biologia e ecologia. No decorrer deste estudo foram identificadas duas outras espécies do género Diopatra em Portugal: D. marocensis, inicialmente descrita para a costa de Marrocos e cuja distribuição actual se sabe estender-se a toda a costa Portuguesa e Norte de Espanha e, D. micrura, espécie nova para a ciência. O presente estudo tem como objectivos principais estudar a diversidade e reprodução do género Diopatra, bem como a capacidade de regeneração da espécie D. neapolitana. Este trabalho aborda a distribuição espacial de D. marocensis ao longo da costa Portuguesa e descreve a espécie D. micrura, uma nova espécie do género Diopatra Audouin and Milne Edwards, 1833. As três espécies coabitam em águas transicionais, onde as espécies D. micrura e D. marocensis facilmente se confundem com juvenis de D. neapolitana. Foi realizada uma comparação morfológica e genética entre as três espécies. A espécie D. neapolitana coexiste em algumas áreas da Ria de Aveiro com a D. marocensis. Apesar destas duas espécies apresentarem padrões reprodutivos muito diferentes, Maio a Agosto é o período principal para a reprodução de ambas as espécies. D. neapolitana apresenta um desenvolvimento larvar planctónico, e os óocitos presentes na cavidade celómica são esverdeados e apresentam um diâmetro de 40-240 μm (média = 164.39±40.79 μm) e as fêmeas contêm no celoma milhares de óocitos. Contrariamente, a espécie D. marocensis reproduz-se por desenvolvimento directo no interior do tubo parental. Os óocitos observados no celoma são amarelos com um diâmetro entre 180 e 740 μm (média = 497.65 ± 31.38 μm) e o seu número varia entre 44 e 624 (276.85 ± 161.54). Por seu turno, o número de ovos observados no interior dos tubos varia entre 75 e 298, com um diâmetro entre 600 e 660 μm, e o número de larvas entre 60 e 194. A proporção machos: fêmeas foi de 1:1 para a população de D. neapolitana e entre 1:2 e 1:4 para a população de D. marocensis, em que as fêmeas dominam a população durante todo o ano. O estudo da capacidade de regeneração da espécie D. neapolitana, avaliada a partir de experiências de laboratório, revelou que esta espécie é capaz de sobreviver à perda de alguns setígeros. Durante a captura de D. neapolitana para vender como isco são normalmente cortados mais de 20 setígeros e de acordo com os nossos resultados a extremidade posterior que fica no tubo não é capaz de regenerar a extremidade anterior; a espécie consegue no entanto recuperar de ataques por predadores.

Model of access to natural language sources in electronic government

For the actual existence of e-government it is necessary and crucial to provide public information and documentation, making its access simple to citizens. A portion, not necessarily small, of these documents is in an unstructured form and in natural language, and consequently outside of which the current search systems are generally able to cope and effectively handle. Thus, in thesis, it is possible to improve access to these contents using systems that process natural language and create structured information, particularly if supported in semantics. In order to put this thesis to test, this work was developed in three major phases: (1) design of a conceptual model integrating the creation of structured information and making it available to various actors, in line with the vision of e-government 2.0; (2) definition and development of a prototype instantiating the key modules of this conceptual model, including ontology based information extraction supported by examples of relevant information, knowledge management and access based on natural language; (3) assessment of the usability and acceptability of querying information as made possible by the prototype - and in consequence of the conceptual model - by users in a realistic scenario, that included comparison with existing forms of access. In addition to this evaluation, at another level more related to technology assessment and not to the model, evaluations were made on the performance of the subsystem responsible for information extraction. The evaluation results show that the proposed model was perceived as more effective and useful than the alternatives. Associated with the performance of the prototype to extract information from documents, comparable to the state of the art, results demonstrate the feasibility and advantages, with current technology, of using natural language processing and integration of semantic information to improve access to unstructured contents in natural language. The conceptual model and the prototype demonstrator intend to contribute to the future existence of more sophisticated search systems that are also more suitable for e-government. To have transparency in governance, active citizenship, greater agility in the interaction with the public administration, among others, it is necessary that citizens and businesses have quick and easy access to official information, even if it was originally created in natural language.

Heritability and The Units of Selection: A defense of Genic Selectionism

Tesina elaborada para obtener el MPhil en la Universidad de Cambridge, Inglaterra, 1987

Germination requirements of Plantago algarbiensis seeds, an endangered species endemic to the Algarve region (South of Portugal)

The ecdysteroid, 20-hydroxyecdysone or beta-ecdysone, is a steroid hormone which plays a crucial role in molting, metamor- phosis and reproduction of arthropods. This ecdysteroid and its analogues have high potential to be used as insecticides. Previous studies in our laboratory have demonstrated that Vitex glabrata R.Br. (commonly known as Khai-Nao), an indigenous herbaceous plant of Thailand, synthesized and accumulated high quantity of 20-hydroxyecdysone. Therefore, the aim of this study was to investigate the effect of precursor and elicitors feeding on cell growth and 20-hydroxyecdysone production of V. glabrata suspension cultures. Plant cells were cultured in half strength MS medium containing 30 g/l glucose and supplemented with 2.0 mg/l 6- benzylaminopurine (BAP) and 1.0 mg/l 2,4-dichlorophenoxyacetic acid (2,4-D). Cells were incubated on a rotary shaker at 120 rpm under continuous light of 2000 lux at 25 °C. Sterilized cholesterol (5 and 10 mg/l) as precursor was added to the cell cultures on the day of inoculation, while chitosan (50, 100 and 200 mg/l) and methyl jusmonate (100 and 200 mM) as elicitors were added to the cell cultures on day 6 after cultivation.

Framework for the characterization of hotel websites

Nowadays the importance of websites to the tourism and hospitality industries is fundamental. Hotels, for instance, spend a huge amount of money improving their websites to show all the activities and amenities that they can provide. There are studies to evaluate website performance based on functionality, usability and other factors; nevertheless, they are not exhaustive. This paper presents a framework for the characterization of hotel and resort websites, that was applied as a case study to the websites of 5-star hotels and resorts that operate in the tourism region of the Algarve, Portugal. This framework allows us to identify a set of features for the hotel and resort websites characterization. From these features, we propose a set of comprehensive indicators, grouping them into ten fundamental information dimensions, as well as the application of these indicators and information dimensions, which allows obtaining quantitative and qualitative results.

Evaluation and Application of Environmental Flows in Running Waters in Slovenia

Water use invariably results in major impacts on river flows. Environmental Flows (EF) are defined as the quantity and quality of water that is needed to preserve the structure and the function of the river and riparian zone ecosystem and sufficient quantity of water to enable the survival and reproduction of aquatic organisms in different hydraulic habitats. This paper describes the criteria and methods used to determine EF and experiences with their application in Slovenia. The diversity of running waters of Slovenia demand special treatment and determination of EF for each individual section of the river system. Using hydrological, morphological and ecological criteria, two different approaches are used for the determination of EF in Slovenia, a rapid assessment method and a detailed assessment method. For both methods, data are then analyzed by an expert panel in order to determine an EF. Since 1994, more than 180 study sites have been examined for research and application of EF in Slovenia. Determination of EF for existing users has prioritized their water requirements so they can remain economically viable. Where new schemes are proposed, there has been much greater scope to prioritize ecosystem requirements. EF determination is receiving growing attention and will continue to increase in importance, driven by research that aids our understanding of flow-biota relationships and recent environmental policy and legislation at both the national and European level.

The Impact of Uncertainty Shocks under Measurement Error: A Proxy SVAR approach

A growing literature considers the impact of uncertainty using SVAR models that include proxies for uncertainty shocks as endogenous variables. In this paper we consider the impact of measurement error in these proxies on the estimated impulse responses. We show via a Monte-Carlo experiment that measurement error can result in attenuation bias in impulse responses. In contrast, the proxy SVAR that uses the uncertainty shock proxy as an instrument does not su¤er from this bias. Applying this latter method to the Bloom (2009) data-set results in impulse responses to uncertainty shocks that are larger in magnitude and more persistent than those obtained from a recursive SVAR.

The Greatest lover: a post-colonial rewriting of My Fair Lady

INTRODUCTION The popular Hong Kong comedy, The Greatest Lover, re-incarnates one of the most popular western musicals, My Fair Lady. OBJECTIVES 1. To find out in what major ways My Fair Lady was rewritten as the Hong Kong Cantonese movie, Gungzi Docing (The Greatest Lover). 2. To find out the socio-political, socio-linguistic, and gender ideology behind the rewriting. METHODOLOGY 1. To note the similarity of the themes for both works – a creator falling in love with his/her creation, and class prejudice and cross-class romance. 2. To note how the times of The Greatest Lover differ from that of My Fair Lady. 3. To note how the main characters in The Greatest Lover differ from My Fair Lady in terms of profession, gender, etc. 4. To note how the plot of The Greatest Lover differs from that of My Fair Lady. 5. To note how focus on language in The Greatest Lover compares with that in My Fair Lady. 6. To discuss the ideological implications of the differences noted above, e.g. women in Hong Kong today have much higher status than women in Victorian England; the conflict between local Hong Kong people and both legal and illegal immigrants from Mainland China is even more serious than that between the British upper middle class and the lower class during the Victorian period. 7. Andre Lefevere (1992) argues that translation and adaptation are rewriting informed and influenced by the rewriter’s ideology, among other things. 8. Both Aline Remael (1995) and Patrick Cattrysse (1992) think that film adaptation is a kind of translation. 9. Sirkkus Aaltonen (2000) argues that drama translation mirrors the ideologies of the target society. CONCLUSION 1. The Greatest Lover projects local cultural significance onto My Fair Lady by helping us to appreciate an important Western work of art through the Hong Kong Cantonese perspective. 2. Broader issues in translation and intercultural studies are also considered.

Effect of temperature and prey in the biology of Scymnus subvillosus (Goeze) (Coleoptera: Coccinellidae)

Dissertação de Mestrado, Biotecnologia em Controlo Biológico, 18 de Dezembro de 2013, Universidade dos Açores.

Digital serious games and simulation games - comparison of two approaches to lean training

In an increasingly competitive and globalized world, companies need effective training methodologies and tools for their employees. However, selecting the most suitable ones is not an easy task. It depends on the requirements of the target group (namely time restrictions), on the specificities of the contents, etc. This is typically the case for training in Lean, the waste elimination manufacturing philosophy. This paper presents and compares two different approaches to lean training methodologies and tools: a simulation game based on a single realistic manufacturing platform, involving production and assembly operations that allows learning by playing; and a digital game that helps understand lean tools. This paper shows that both tools have advantages in terms of trainee motivation and knowledge acquisition. Furthermore, they can be used in a complementary way, reinforcing the acquired knowledge.

Low-cost vibration sensors: tendencies and applications in condition monitoring of machines and structures

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Mecânica