CRYPTOSPORIDIUM RELATED TO MEASLES DIARRHOEA IN RWANDA

SCOPUS: le.j

Contact Force in Atrial Fibrillation: Role of Atrial Rhythm and Ventricular Contractions: Co-Force Atrial Fibrillation Study

In an experimental model, variable and intermittent contact force (CF) resulted in a significant decrease in lesion volume. In humans, variability of CF during pulmonary vein isolation has not been characterized. Methods and Results-In 20 consecutive patients undergoing CF-guided circumferential pulmonary vein isolation, 914 radiofrequency applications (530 in sinus rhythm and 384 in atrial fibrillation) were analyzed. The variability of the 60% CF range (CF60%) was 17 ± 9.6 g. Hundred seventy-one (19%) applications were delivered with constant, 717 (78%) with variable, and 26 (3%) with intermittent CF. The mean CF and force-time integral were significantly higher during applications with variable than with intermittent or constant CF. There was no significant difference in CF variability, CF60% variability, and force-time integral between applications delivered in sinus rhythm and atrial fibrillation. The main reasons for CF variability were systolo-diastolic heart movement (29%) and respiration (27%). In 10 additional patients, during adenosine-induced atrioventricular block, the minimum CF significantly increased at 19 sites (5.3 ± 4.4 versus 13.4 ± 5.9 g; P < 0.001) and at 16 sites intermittent or variable CF became constant. At only 1 site systolo-diastolic movement remained the main reason for variable CF. Conclusions-CF during pulmonary vein isolation remains highly variable despite efforts to optimize contact. CF and CF parameters were similar during sinus rhythm and atrial fibrillation. The main reasons for CF variability are systolodiastolic heart movement and respiration. The systolo-diastolic peaks and nadirs of CF are because of ventricular contractions at the large majority of pulmonary vein isolation sites.

Clinical practice guideline on diagnosis and treatment of hyponatraemia

Hyponatraemia, defined as a serum sodium concentration <135 mmol/l, is the most common disorder of body fuid and electrolyte balance encountered in clinical practice. It can lead to a wide spectrum of clinical symptoms, from subtle to severe or even life threatening, and is associated with increased mortality, morbidity and length of hospital stay in patients presenting with a range of conditions. Despite this, the management of patients remains problematic. The prevalence of hyponatraemia in widely different conditions and the fact that hyponatraemia is managed by clinicians with a broad variety of backgrounds have fostered diverse institution-and speciality-based approaches to diagnosis and treatment. To obtain a common and holistic view, the European Society of Intensive Care Medicine (ESICM), the European Society of Endocrinology (ESE) and the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA), represented by European Renal Best Practice (ERBP), have developed the Clinical Practice Guideline on the diagnostic approach and treatment of hyponatraemia as a joint venture of three societies representing specialists with a natural interest in hyponatraemia. In addition to a rigorous approach to methodology and evaluation, we were keen to ensure that the document focused on patient-important outcomes and included utility for clinicians involved in everyday practice.

effects of weight and injected dose in the liver’s Signal-to-Noise Ratio in patients submitted to PET/CT scans

The quality of the image of 18F-FDG PET/CT scans in overweight patients is commonly degraded. This study evaluates, retrospectively, the relation between SNR, weight and dose injected in 65 patients, with a range of weights from 35 to 120 kg, with scans performed using the Biograph mCT using a standardized protocol in the Nuclear Medicine Department at Radboud University Medical Centre in Nijmegen, The Netherlands. Five ROI’s were made in the liver, assumed to be an organ of homogenous metabolism, at the same location, in five consecutive slices of the PET/CT scans to obtain the mean uptake (signal) values and its standard deviation (noise). The ratio of both gave us the Signal-to- Noise Ratio in the liver. With the help of a spreadsheet, weight, height, SNR and Body Mass Index were calculated and graphs were designed in order to obtain the relation between these factors. The graphs showed that SNR decreases as the body weight and/or BMI increased and also showed that, even though the dose injected increased, the SNR also decreased. This is due to the fact that heavier patients receive higher dose and, as reported, heavier patients have less SNR. These findings suggest that the quality of the images, measured by SNR, that were acquired in heavier patients are worst than thinner patients, even though higher FDG doses are given. With all this taken in consideration, it was necessary to make a new formula to calculate a new dose to give to patients and having a good and constant SNR in every patient. Through mathematic calculations, it was possible to reach to two new equations (power and exponential), which would lead to a SNR from a scan made with a specific reference weight (86 kg was the considered one) which was independent of body mass. The study implies that with these new formulas, patients heavier than the reference weight will receive higher doses and lighter patients will receive less doses. With the median being 86 kg, the new dose and new SNR was calculated and concluded that the quality of the image remains almost constant as the weight increases and the quantity of the necessary FDG remains almost the same, without increasing the costs for the total amount of FDG used in all these patients.

UNA ECONOMÍA EN FUNCIÓN DE LA VIDA: UTOPÍA Y SUJETO

Hablar de la utopía no es soñar, sino anticipar como lograr una sociedad de seres humanos libres e iguales que como sujetos construyen su futuro. No se trata de una mera ilusión sino de unproyecto movilizador. Es imaginar y luchar por una sociedad donde el ser humano ya no está dominado, explotado ni rebajado a ser un mero recurso o medio en función de la acumulación misma (ver Houtart, 2002:26). Es poner laeconomía en función de la vida misma y no sacrificar la vida en función de la economía de mercado. Desde el punto de vista del mercado, como sistema totalizador, las exigencias de la vidahumana son percibidas como distorsiones. La propia economía de mercado y su funcionamiento como sistema constituyen la finalidad y la vida humana y natural apenas un recurso para estesistema. Desde el punto de vista de los seres humanos  afectados, sin embargo, la totalización de la economía de mercado aparece como distorsión de la vida humana y natural que experimentamos como vulnerabilidad ascendente. La ética del bien común se deriva del sufrimiento que experimentamos por esas distorsiones crecientes. La ética del bien común surge como consecuencia de la experiencia de sufrimiento por los afectados debido a las distorsiones cada vez más grandes que el mercado totalizado produce en la vida humana y natural. Si la economía de mercado no produjera tales distorsiones y conllevara como tendencia a un equilibrio (como suelen afirmar los economistas neoclásicos), no nos sentiríamos cada vez más vulnerables y no surgiría la ética del bien común. Bastaría la ética de mercado (ver, Hinkelammert, 2002:97-98).

FLUJOS INTERNACIONALES DE CAPITAL PRIVADO EN COSTA RICA

Las crisis financieras sufridas por varios países de economías emergentes durante el segundo semestre de 1997, la crisis de Rusia en 1998, la crisis de Brasil de inicios de 1999 y la crisis de Argentina de finales del 2000, son las más recientes e importantes trastornos financieros que han puesto a prueba teorías ampliamente aceptadas de la economía internacional y que han servido para desarrollar nuevos enfoques financieros.La esencia de muchas crisis financieras en un país cualquiera es una enorme y repentina salida de capitales motivada por elementos de desconfianza basada en hechos reales o ficticiamente especulativos. La crisis en Asia, por ejemplo, pudo ocurrir porque una parte substancial de la deuda internacional estaba estructurada a muy cortos plazos de vencimiento.

El Enfoque de la cadena global de mercancías como herramienta analítica en las economías en vías de desarrollo

Los países en vías de desarrollo han venido aplicando estrategias de ajuste estructural con el fin de reorientar sus economías desde el mercado interno hacia un desarrollo orientado al exterior. Este proceso conlleva a la necesidad de convertir sus industrias en unas de mayor competitividad internacional, y esto de una manera sistémica y sostenible. Sin embargo, en la fase actual de globalización, estas economías se ven confrontadas con tendencias de fragmentación y descentralización progresivas de los procesos de producción; y las fronteras nacionales llegan a ser menos importantes económicamente, a raíz de la liberalización de los flujos de mercancías y de capital internacionales, así como a la reducción gradual del papel de los Estados.El objetivo de este artículo es mostrar la utilidad del enfoque de la cadena global de mercancías para el diseño de estrategias de desarrollo, ya que éste permite incluir en el análisis la nuevas dinámicas de la organización internacional de las industrias globales. Las teorías del comercio internacional predominantes que se basan en las ventajas absolutas, comparativas o competitivas, resultan incompletas o inadecuadas como marco teórico para el diseño de políticas orientadas a fortalecer la competitividad dentro del contexto actual de globalización. Una deficiencia importante de estas teorías es su imposibilidad de integrar coherentemente en la valoración de las políticas, la existencia o la generación de externalidades. Varios estudios recientes demuestran que las políticas que simplemente generan un crecimiento en las exportaciones, no pueden garantizar la transición hacia el desarrollo sostenible de la economía, y uno de los mayores méritos del enfoque de la cadena consiste en la posibilidad de incluir en el análisis los importantes y significativos cambios que están ocurriendo en las fronteras territoriales y de producción. Además, este enfoque puede aportar criterios que permiten completar el marco de análisis de la economía del desarrollo.

Comparison between benzyladenine and metamitron as chemical thinning agents in Gala, Kanzi, Pink Lady and Red Delicious apple cultivars

Mestrado em Engenharia Agronómica - Instituto Superior de Agronomia - UL

Sales–marketing encroachment effects on innovation

The role of sales has changed dramatically during the last two decades, with sales becoming increasingly strategic and encroaching on domains that traditionally belong to marketing. Many studies address the role of marketing in new product development (NPD) success, but research on the increasing importance of sales, its changing role and changing dynamics with marketing is scarce. This empirical study of 296 Hungarian firms addresses this gap and shows that the extent to which sales encroaches on marketing's tasks is influenced by interface relations, exchange processes and sales' capabilities. The effect of sales–marketing encroachment on NPD financial success is partially mediated by customer involvement, while its effect on market success is fully mediated by customer involvement. These findings suggest that firms may improve their NPD financial performance by letting sales encroach on marketing tasks, but need to establish customer co-creation initiatives to benefit from sales–marketing encroachment in terms of superior NPD performance compared with competitors.

First evidence of Schmallenberg virus introduction in Portugal, 2014

Objectives: Serra da Estrela native (SEN) breed of sheep is one of the most important in Portugal, standing responsible for the production of one of the most internationally recognized cheeses in the world, "Queijo Serra da Estrela” (protected designation of origin). One of the major risks to the sustainability of SEN dairy flocks if footrot, an infectious diseases that causes lameness, decrease in milk production, weight loss and decrease in fertility. The aim of this work was to determine which parameters become decisive for the appearance of footrot in SEN dairy flocks, while establishing associations with environmental and nutritional variables. Materials and Methods: The present study was carried out by performing an especially designed 27 multiple choice questionnaire, based on the underlying causes of lameness in livestock and in the clinical diagnosis performed by the vet techinichian of the clinical cases evaluated at the moment of the inquiry. The survey was performed during the execution of the oficial veterinary health program between February and September of 2014 by a veterinarian team from the Association of SEN Sheep Breeders (ANCOSE). The ovine producers (N=30, with a total of 1270 animals) were randomly selected from the extense area of production of “Queijo Serra da Estrela”. The parameters evaluated in the study were: season and consequent weather changes during the period of the study, floor types, hygiene conditions, bed types, the existence and use of footbaths, location of footbaths, foot trimming and foot hygiene procedures. After the construction of the database and using the Statistical Package for Social Sciences version 16.0 the frequency response for each item was calculated. Results: All SEN livestock producers are proactive in the treatment of lameness (70%). About 99.7% of lameness was related with footroot and most appeared in winter (36.7%). In some occasions there was not a specific season distribution (56.7% rainiest years). From the analyzed farms, 70% use straw as a floor bed, followed by bush (21%). 45.6% of animals were clinically diagnosed with footrot and were sheltered in straw floor. Bed quality is good in 40%, however frequent changes in the floor bed in the preceding 15 days had a higher rate of footroot diagnosed cases (33,23%) compared to monthly changes. Regarding sheepfold animal number, the distribution is proper in 36.7%, elevated in 30%, overcrowded in 6.7% and low in 23.3%. Clinically ill diagnosed animals in last category were the lowest observed (3%). Concerning hoof trimming, 76.7% trims while 23.3% reported not to perform that task. From those that perform trimming, 73.9% do it only when necessary, 21.7% at the time of clipping and 4.4% when the animal is affected. One curious result was that animals who perform trimming at clipping had higher footrot cases (52.6%), unlike those who trim only when necessary (40.2%) or even when animals are clinically ill (0.91%). Mostly all in the presence of footrot choose a local treatment (95.2%) using antibiotic sprays, instead of parenteral antibiotic treatment. Footbath is rarely used in the prevention (13.3%) of this disease and when it is misconceived (25%) and incorrectly formulated (100%). Conclusions: This study was the first performed in Portugal focusing footrot caracterization in native SEN flocks.Economic impact in SEN dairy flocks is atributed to factors such as direct decrease in milk and meat production,early slaughter of affected animals due to non responsive treatment and medical expenses.The most effective eradication method combines first of all the ability to understand the problems of SEN producers and implementation of preventive measures and treatment of footrot.Often linked to lack of formation, the advance age of portuguese producers the mentality and social factors block the advance of veterinarian intervention itself.

Functional heterogeneity of medial posterior parietal cortex of macaque monkey

The posterior parietal cortex (PPC) of primates represents a remarkable platform that has evolved over time to solve some of the computational challenges that we face in the everyday life, such as sensorimotor integration, spatial attention, and motor planning. With the aim of further investigating the multifaceted functional characteristics of medial PPC, we conducted three studies to explore the visuomotor, somatic, visual, and attention-related properties of two PPC areas: V6A, a visuomotor area part of the dorsomedial visual stream, and PE, an area strongly dominated by somatomotor input, residing mainly on the exposed surface of the superior parietal lobule. In the first study, we tested the impact of visual feedback on V6A grasp-related activity during arm movements towards objects of different shapes. Our results demonstrate that V6A is modulated by both grip type and visual information during grasping preparation and execution, with a predominance of cells influenced by grip type. In the second study, we explored the influence of depth and direction information on reach-related activity of neurons in the so far largely neglected medial part of area PE. We observed a remarkable trend in medial PPC, going from the joint coding of depth and direction signals caudally, in area V6A, to a largely segregated processing of the two signals rostrally, in area PE. In the third study, we used a combined fMRI-electrophysiology experiment to investigate the neuronal mechanisms underlying covert shift of attention processes in area V6A. Our preliminary results reveal that half of the cells showed shift-selective activity when the monkey covertly shifted its attention towards the receptive field. All together these findings highlight the role of the medial PPC in integrating information coming from different sources (vision, somatosensory and motor) and emphasize the involvement of action-related regions of the dorsomedial visual stream in higher level cognitive functions.