Comparative study of the in-hospital case-fatality rate of leptospirosis between pediatric and adult patients of different age groups

The main objective was to compare the in-hospital case-fatality rate of leptospirosis between pediatric (< 19 years) and adult (>19 years) patients, taking into account gender, renal function, duration of symptoms and jaundice. Medical records of 1016 patients were reviewed. Comparative analysis was restricted to 840 patients (100 pediatric, 740 adults) with recorded information on the variables included in the analysis. Among these patients 81.7% were male and 91.5% were icteric. The case-fatality rate of leptospirosis was 14.4%. The odds of death adjusted for gender, jaundice, duration of symptoms, serum urea and serum creatinine were almost four times higher for the adult than for the pediatric group (odds ratio (OR) = 3.94; 95% confidence interval = 1.19-13.03, p = 0.029). Among adults, increased age was also significantly and independently associated with increased risk of death (p < 0.01). Older patients were also more often treated by dialysis. In conclusion, the data suggest that the in-hospital case fatality rate of leptospirosis is higher for adults than for children and adolescents, even after taking into account the effects of several potential risk factors of death. Among adults, older age was also strongly and independently associated with higher risk of death.

Treatment with mebendazole is not associated with distal migration of adult Angiostrongylus costaricensis in the murine experimental infection

Abdominal angiostrongyliasis is a zoonotic infection produced by a metastrongylid intra-arterial nematode, Angiostrongylus costaricensis. Human accidental infection may result in abdominal lesions and treatment with anti-helminthics is contra-indicated because of potential higher morbidity with excitement or death of worms inside vessels. To evaluate the effect of mebendazole on localization of the worms, male Swiss mice, 5 week-old, were infected with 10 third stage larvae per animal. Twelve infected mice were treated with oral mebendazol, at 5 mg/kg/day, for 5 consecutive days, begining 22 days after inoculation. As control groups, 12 infected but non-treated mice and other 12 non-infected and non-treated mice were studied. The findings at necropsy were, respectively for the treated (T) and control (C) groups: 92% and 80% of the worms were inside the cecal mesenteric arterial branch; 8% and 10% were located inside the aorta. Only in the group C some worms (10%) were found inside the portal vein or splenic artery. These data indicate that treatment with mebendazole does not lead to distal or ectopic migration of A. costaricensis worms.

Immunogenicity of three recombinant hepatitis B vaccines administered to students in three doses containing half the antigen amount routinely used for adult vaccination

We evaluated the immunogenicity of three recombinant hepatitis B vaccines, one Brazilian (Butang, Instituto Butantan) and two Korean vaccines (Euvax-B, LG Chemical Ltd. and Hepavax-Gene, Greencross Vaccine Corp.), administered intramuscularly to students aged 17 to 19 years in three 10-µg doses (corresponding to half the amount of antigen routinely used for adult vaccination) at intervals of one month between the first and second dose, and of four months between the second and third dose. A total of 316 students non-reactive for any serological marker of hepatitis B virus infection were vaccinated: 77 (24.4%) with the Butang vaccine, 71 (22.5%) with Euvax-B, 85 (26.9%) with Hepavax-Gene and, for comparison, 83 (26.2%) with Engerix-B (GlaxoSmithKline), whose efficacy in young adults at the dose used here has been confirmed in previous studies. Similar seroconversion rates (anti-HBs > 10 mIU/mL about one month after application of the third dose) were obtained for the Butang, Euvax-B, Hepavax-Gene and Engerix-B vaccines (96.2%, 98.6%, 96.5% and 97.6%, respectively). The frequency of good responders (anti-HBs > 100 mIU/mL) was also similar among students receiving the four vaccines (85.8%, 91.6%, 89.4% and 89.2%, respectively). The geometric mean titers (GMT) of anti-HBs about one month after the third dose obtained with these vaccines were 727.78 ± 6.46 mIU/mL, 2009.09 ± 7.16 mIU/mL, 1729.82 ± 8.85 mIU/mL and 2070.14 ± 11.69 mIU/mL, respectively. The GMT of anti-HBs induced by the Euvax-B and Engerix-B vaccines were higher than those obtained with the Butang vaccine (p < 0.05); this difference was not significant when comparing the other vaccines two-by-two. No spontaneous adverse effects attributable to the application of any dose of the four vaccines were reported.

Portal ACFEL. Actividades Comuns de Formação e Educação e-Learning

Trabalho de Projecto apresentado para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Gestão de Sistemas e-Learning

A arte de envelhecer dançando: recordar o passado e preparar o futuro no Centro Social da Paróquia de Santa Eulália de Nespereira

Com a realização do trabalho, que agora se apresenta, tem-se como finalidade refletir sobre a maneira como se pode envelhecer dançando. Sustentados na metodologia de projeto, o esforço recaiu numa análise sobre as conexões das necessidades emergentes dos participantes, no que concerne desejos e motivações dos idosos1 (bem como as diferentes implicações subjacentes e latentes), com a possibilidade de as concretizar pela dança. Intentou-se, assim depreender de que forma numa sociedade global, onde o acesso a informações e conhecimentos atualizados é fundamental, a motivação para a aquisição de novas competências, adaptadas a novos desafios e situações, é considerada crucial e possível na idade adulta, e mais concretamente no período de reforma e, particularmente neste caso, na melhoria da ocupação dos tempos livres, desenvolvendo novas competências e estímulos. Tendo em conta os interesses e a implicação dos idosos, direcionou-se o trabalho no sentido de se construir um projeto com e para os idosos, através da metodologia de investigação ação participativa, mostrando como não há idade para aprender nem para ensinar, de forma a potenciar melhorias na qualidade de vida dos participantes, nos tempos livres ocupando-os e implicando-os, suplantando as habituais atividade comummente designadas de “entreter velhinhos”.

Risk of Surgery for Congenital Heart Disease in the Adult: a Multicentered European Study

BACKGROUND: Surgery for congenital heart disease (CHD) has changed considerably during the last three decades. The results of primary repair have steadily improved, to allow treating almost all patients within the pediatric age; nonetheless an increasing population of adult patients requires surgical treatment. The objective of this study is to present the early surgical results of patients who require surgery for CHD in the adult population within a multicentered European study population. METHODS: Data relative to the hospital course of 2,012 adult patients (age > or = 18 years) who required surgical treatment for CHD from January 1, 1997 through December 31, 2004 were reviewed. Nineteen cardiothoracic centers from 13 European countries contributed to the data collection. RESULTS: Mean age at surgery was 34.4 +/- 14.53 years. Most of the operations were corrective procedures (1,509 patients, 75%), followed by reoperations (464 patients, 23.1%) and palliative procedures (39 patients, 1.9%). Six hundred forty-nine patients (32.2%) required surgical closure of an isolated ostium secundum atrial septal defect. Overall hospital mortality was 2%. Preoperative cyanosis, arrhythmias, and NYHA class III-IV, proved significant risk factors for hospital mortality. Follow-up data were available in 1,342 of 1,972 patients (68%) who were discharged home. Late deaths occurred in 6 patients (0.5%). Overall survival probability was 97% at 60 months, which is higher for corrective procedures (98.2%) if compared with reoperations (94.1%) and palliations (86.1%). CONCLUSIONS: Surgical treatment of CHD in adult patients, in specialized cardiac units, proved quite safe, beneficial, and low-risk.

A learning environment for robotic production line simulation

This paper presents a framework for a robotic production line simulation learning environment using Autonomous Ground Vehicles (AGV). An eLearning platform is used as interface with the simulator. The objective is to introduce students to the production robotics area using a familiar tool, an eLearning platform, and a framework that simulates a production line using AGVs. This framework allows students to learn about robotics but also about several areas of industrial management engineering without requiring an extensive prior knowledge on the robotics area. The robotic production line simulation learning environment simulates a production environment using AGVs to transport materials to and from the production line. The simulator allows students to validate the AGV dynamics and provides information about the whole materials supplying system which includes: supply times, route optimization and inventory management. The students are required to address several topics such as: sensors, actuators, controllers and an high level management and optimization software. This simulator was developed with a known open source tool from robotics community: Player/Stage. This tool was extended with several add-ons so that students can be able to interact with a complex simulation environment. These add-ons include an abstraction communication layer that performs events provided by the database server which is programmed by the students. An eLearning platform is used as interface between the students and the simulator. The students can visualize the effects of their instructions/programming in the simulator that they can access via the eLearning platform. The proposed framework aims to allow students from different backgrounds to fully experience robotics in practice by suppressing the huge gap between theory and practice that exists in robotics. Using an eLearning platform eliminates installation problems that can occur from different computers software distribution and makes the simulator accessible by all students at school and at home.

Innovations in technology: a friendly math project and the learning analytics “challenge”

Currently the world around us "reboots" every minute and “staying at the forefront” seems to be a very arduous task. The continuous and “speeded” progress of society requires, from all the actors, a dynamic and efficient attitude both in terms progress monitoring and moving adaptation. With regard to education, no matter how updated we are in relation to the contents, the didactic strategies and technological resources, we are inevitably compelled to adapt to new paradigms and rethink the traditional teaching methods. It is in this context that the contribution of e-learning platforms arises. Here teachers and students have at their disposal new ways to enhance the teaching and learning process, and these platforms are seen, at the present time, as significant virtual teaching and learning supporting environments. This paper presents a Project and attempts to illustrate the potential that new technologies present as a “backing” tool in different stages of teaching and learning at different levels and areas of knowledge, particularly in Mathematics. We intend to promote a constructive discussion moment, exposing our actual perception - that the use of the Learning Management System Moodle, by Higher Education teachers, as supplementary teaching-learning environment for virtual classroom sessions can contribute for greater efficiency and effectiveness of teaching practice and to improve student achievement. Regarding the Learning analytics experience we will present a few results obtained with some assessment Learning Analytics tools, where we profoundly felt that the assessment of students’ performance in online learning environments is a challenging and demanding task.

Design a computer programming learning environment for Massive Open Online Courses

Teaching and learning computer programming is as challenging as difficult. Assessing the work of students and providing individualised feedback to all is time-consuming and error prone for teachers and frequently involves a time delay. The existent tools and specifications prove to be insufficient in complex evaluation domains where there is a greater need to practice. At the same time Massive Open Online Courses (MOOC) are appearing revealing a new way of learning, more dynamic and more accessible. However this new paradigm raises serious questions regarding the monitoring of student progress and its timely feedback. This paper provides a conceptual design model for a computer programming learning environment. This environment uses the portal interface design model gathering information from a network of services such as repositories and program evaluators. The design model includes also the integration with learning management systems, a central piece in the MOOC realm, endowing the model with characteristics such as scalability, collaboration and interoperability. This model is not limited to the domain of computer programming and can be adapted to any complex area that requires systematic evaluation with immediate feedback.

Odin: a service for gamification of learning activities

Existing gamification services have features that preclude their use by e-learning tools. Odin is a gamification service that mimics the API of state-of-the-art services without these limitations. This paper describes Odin, its role in an e-learning system architecture requiring gamification, and details its implementation. The validation of Odin involved the creation of a small e-learning game, integrated in a Learning Management System (LMS) using the Learning Tools Interoperability (LTI) specification.

Integrating rich learning applications in LMS

Currently, a learning management system (LMS) plays a central role in any e-learning environment. These environments include systems to handle the pedagogic aspects of the teaching–learning process (e.g. specialized tutors, simulation games) and the academic aspects (e.g. academic management systems). Thus, the potential for interoperability is an important, although over looked, aspect of an LMS. In this paper, we make a comparative study of the interoperability level of the most relevant LMS. We start by defining an application and a specification model. For the application model, we create a basic application that acts as a tool provider for LMS integration. The specification model acts as the API that the LMS should implement to communicate with the tool provider. Based on researches, we select the Learning Tools Interoperability (LTI) from IMS. Finally, we compare the LMS interoperability level defined as the effort made to integrate the application on the study LMS.

O desenvolvimento da competência intercultural através do Task-Based learning na aula de língua estrangeira

Relatório de Estágio apresentado para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Ensino de Inglês e de Língua Estrangeira (Francês) no 3.º Ciclo do Ensino Básico e no Ensino Secundário

Aplicação criativa do e-learning à arte floral

Trabalho de Projecto apresentado para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Gestão de Sistemas de E-learning

Interactional strategies between terminologist and domain specialist. Putting order into our universe: the concept of Blended Learning

A presente comunicação visa discutir as mais-valias de um desenho metodológico sustentado numa abordagem conceptual da Terminologia aplicado ao exercício de harmonização da definição do cenário educativo mais promissor do Ensino Superior actual: o blended learning. Sendo a Terminologia uma disciplina que se ocupa da representação, da descrição e da definição do conhecimento especializado através da língua a essência deste domínio do saber responde a uma necessidade fundamental da sociedade actual: putting order into our universe, nas palavras de Nuopponen (2011). No contexto descrito, os conceitos, enquanto elementos da estrutura do conhecimento (Sager, 1990) constituem um objecto de investigação de complexidade não despicienda, pois apesar do postulado de que a língua constitui uma ferramenta fundamental para descrever e organizar o conhecimento, o princípio isomórfico não pode ser tomado como adquirido. A abordagem conceptual em Terminologia propõe uma visão precisa do papel da língua no trabalho terminológico, sendo premissa basilar que não existe uma correspondência unívoca entre os elementos atomísticos do conhecimento e os elementos da expressão linguística. É pela razões enunciadas que as opções metodológicas circunscritas à análise do texto de especialidade serão consideradas imprecisas. Nesta reflexão perspectiva-se que o conceito-chave de uma abordagem conceptual do trabalho terminológico implica a combinação de um processo de elicitação do conhecimento tácito através de uma negociação discursiva orientada para o conceito e a análise de corpora textuais. Defende-se consequentemente que as estratégias de interacção entre terminólogo e especialista de domínio merecem atenção detalhada pelo facto de se reflectirem com expressividade na qualidade dos resultados obtidos. Na sequência do exposto, o modelo metodológico que propomos sustenta-se em três etapas que privilegiam um refinamento dessa interacção permitindo ao terminólogo afirmar-se como sujeito conceptualizador, decisor e interventor: (1) etapa exploratória do domínio-objecto de estudo; (2) etapa de análise onamasiológica de evidência textual e discursiva; (3) etapa de modelização e de validação de resultados. Defender-se-á a produtividade de uma sequência cíclica entre a análise textual e discursiva para fins onomasiológicos, a interacção colaborativa e a introspecção.

Preliminary antigenic characterisation of an adult worm vomit preparation of Fasciola hepatica by infected human sera

Fascioliasis is an emerging/re-emerging vector-borne disease with the widest known distribution. Approximately 17 million people are infected around the world, being the Andean region the most affected area. There is an important necessity to develop sensitive and specific diagnostic tools to treat patients early and to avoid complications. In this paper we evaluated the immune response of infected humans against two antigenic preparations: the total soluble extract (FhTSE) and the adult worm vomit (FhAWV) in order to identify antigenic fractions specific for Fasciola hepatica. Both preparations were processed by SDS-PAGE and Western blot with human sera with fascioliasis (F), other parasitosis and healthy individuals. In the immunoblot of FhTSE, sera F recognised 16 bands with MW between eight and 110 kDa, from which those of 8, 9, 10, 38, 45 and 57 kDa were specific. In the preparation FhAWV, sera F recognised nine bands with MW from eight to 85 kDa, from which those of 8, 12, 15 and 24 kDa were specific. Some bands of cross-reaction were evident with sera from patients with other parasitoses, more frequent with the FhTSE. Bands within the MW mentioned, particularly that of eight kDa, have been shown to be specific by others, and deserve additional characterisation for their potential use in immunodiagnosis.