Diagnostic value of surgical lung biopsy: comparison with clinical and radiological diagnosis

OBJECTIVE: To determine overall and disease-related accuracy of the clinical/imagiological evaluation for pulmonary infiltrates of unknown aetiology, compared with the pathological result of the surgical lung biopsy (SLB) and to evaluate the need for the latter in this setting. METHODS: We conducted a retrospective review of the experiences of SLB in 366 consecutive patients during the past 5 years. The presumptive diagnosis was based on clinical, imagiological and non-invasive or minimally invasive diagnostic procedures and compared with the gold standard of histological diagnosis by SLB. We considered five major pathological groups: diffuse parenchymal lung disease (DPLD), primitive neoplasms, metastases, infectious disease and other lesions. Patients with previous histological diagnosis were excluded. RESULTS: In 56.0% of patients (n=205) clinical evaluation reached a correct diagnosis, in 42.6% a new diagnosis was established (n=156) by the SLB, which was inconclusive in 1.4% (n=5). The pre-test probability for each disease was 85% for DPLD, 75% for infectious disease, 64% for primitive neoplasms and 60% for metastases. Overall sensitivity, specificity, positive and negative predictive values for the clinical/radiological diagnosis were 70%, 90%, 62% and 92%, respectively. For DPLD: 67%, 90%, 76% and 85%; primitive neoplasms: 47%, 90%, 46% and 90%; metastases: 99%, 79%, 60% and 99%; infectious disease 38%, 98%, 53% and 96%. CONCLUSIONS: Despite a high sensitivity and specificity of the clinical and imagiological diagnosis, the positive predictive value was low, particularly in the malignancy group. SLB should be performed in pulmonary infiltrates of unknown aetiology because the clinical/imagiological assessment missed and/or misdiagnosed an important number of patients.

Bullying nas escolas: prevenção e intervenção

A temática da violência (e do bullying) nas escolas em Portugal tem vindo, nos anos mais recentes, a assumir uma crescente visibilidade fruto de variados fatores, entre os quais podemos destacar o aparente aumento no número de incidentes reportados envolvendo alunos, professores e pessoal não docente ou, ainda, como resultado da maior atenção dispensada ao(s) fenómeno(s) pela comunicação social. Na relação que se estabelece entre alunos, o bullying (e ultimamente o cyberbullying) tem igualmente ocupado um maior espaço de discussão no contexto português pela elevada complexidade que o carateriza e pelas diversas consequências negativas e irreversíveis que acarreta para vítimas, agressores, famílias e escolas. Para que sejam encontradas estratégias e soluções eficazes na abordagem ao(s) fenómeno(s), torna-se necessário aprofundar – e partilhar – o(s) conhecimento(s) em torno dos fatores e das dinâmicas que caraterizam o fenómeno e que contribuem para a sua (re)ocorrência. Procurámos, portanto, refletir sobre o papel que a escola, enquanto organização com uma missão muito própria ‒ e todos os demais elementos que a integram (diretores, docentes, assistentes operacionais, alunos e respetivas famílias) ‒ devem efetivamente desempenhar no sentido de serem promovidas e implementadas políticas e medidas que possam acautelar e solucionar quaisquer manifestações de violência, com especial incidência nos episódios de bullying. Sobressai, em primeira instância, a necessidade de sensibilizar e de mobilizar toda a comunidade escolar, prestando especial atenção ao papel vital que cada sujeito desempenha. Destaque-se, por outro lado, a aposta que deve ser feita na vertente da (in)formação de professores, não docentes, alunos e pais com o claro propósito de serem criados climas de escola positivos e seguros. Dividimos o trabalho empírico da nossa investigação em dois momentos. Do estudo comparativo (resultante da recolha de informação baseada na pesquisa e análise documental) que levámos a cabo na primeira parte a um conjunto de doze programas de prevenção e de intervenção de bullying implementados (e igualmente avaliados) em países anglo-saxónicos, procurámos identificar os seus componentes fundamentais (princípios teóricos subjacentes às intervenções, objetivos pretendidos, destinatários, níveis/fases de ação, componentes/estratégias de atuação e materiais de apoio disponibilizados). Pudemos verificar que essas iniciativas assentaram numa perspetiva sistémica da problemática do bullying que sublinha a necessidade de mudanças persistentes e contibuadas ao nível da sensibilização, da consciencialização e de transformações nas atitudes da população escolar no seu todo. Este exercício possibilitou, por outro lado, a identificação e a assimiliação de algumas das boas práticas experimentadas com esses programas. Na segunda parte, desenvolvemos um projeto-piloto numa escola Secundária com o 3.º Ciclo do Ensino Básico ao longo do ano letivo de 2010/2011 (envolvendo diretamente na iniciativa duas turmas ‒ uma do 7.º e outra do 10.º ano ‒ e os respetivos professores), sendo de destacar que a temática se tornou mais familiar para a maior parte dos participantes (por via da mobilização, da sensibilização e da formação desses atores). Na sequência da aplicação de dois questionários a 190 alunos no âmbito do projeto-piloto, foi ainda possível apurar que as percentagens de vitimação de bullying presencial moderado se situam abaixo dos 10%, sendo que para as ofensas sofridas de modo mais intenso esses níveis não ultrapassam os 5% para qualquer uma das formas de agressão apresentadas. Os dados indicaram igualmente as ofensas diretas verbais e indiretas como sendo as mais frequentes entre os inquiridos, surgindo em terceiro lugar as de pendor direto físico. Os índices de vitimação apresentam valores superiores junto dos alunos mais novos, independentemente do seu género. Perto de 45% dos sujeitos objeto de agressão admitiu não ter reportado o sucedido a uma terceira pessoa. Cerca de 27% dos jovens confessou assumir uma atitude passiva ou de indiferença perante uma agressão testemunhada. Foi, por outro lado, possível constatar que um conjunto significativo de jovens admitiu conhecer um colega da escola que tenha sido já gozado ou ameaçado no ciberespaço.

Analysis, modeling, design and optimization of future communications systems: from theory to practice

Esta tese descreve uma framework de trabalho assente no paradigma multi-camada para analisar, modelar, projectar e optimizar sistemas de comunicação. Nela se explora uma nova perspectiva acerca da camada física que nasce das relações entre a teoria de informação, estimação, métodos probabilísticos, teoria da comunicação e codificação. Esta framework conduz a métodos de projecto para a próxima geração de sistemas de comunicação de alto débito. Além disso, a tese explora várias técnicas de camada de acesso com base na relação entre atraso e débito para o projeto de redes sem fio tolerantes a atrasos. Alguns resultados fundamentais sobre a interação entre a teoria da informação e teoria da estimação conduzem a propostas de um paradigma alternativo para a análise, projecto e optimização de sistemas de comunicação. Com base em estudos sobre a relação entre a informação recíproca e MMSE, a abordagem descrita na tese permite ultrapassar, de forma inovadora, as dificuldades inerentes à optimização das taxas de transmissão de informação confiáveis em sistemas de comunicação, e permite a exploração da atribuição óptima de potência e estruturas óptimas de pre-codificação para diferentes modelos de canal: com fios, sem fios e ópticos. A tese aborda também o problema do atraso, numa tentativa de responder a questões levantadas pela enorme procura de débitos elevados em sistemas de comunicação. Isso é feito através da proposta de novos modelos para sistemas com codificação de rede (network coding) em camadas acima da sua camada física. Em particular, aborda-se a utilização de sistemas de codificação em rede para canais que variam no tempo e são sensíveis a atrasos. Isso foi demonstrado através da proposta de um novo modelo e esquema adaptativo, cujos algoritmos foram aplicados a sistemas sem fios com desvanecimento (fading) complexo, de que são exemplos os sistemas de comunicação via satélite. A tese aborda ainda o uso de sistemas de codificação de rede em cenários de transferência (handover) exigentes. Isso é feito através da proposta de novos modelos de transmissão WiFi IEEE 801.11 MAC, que são comparados com codificação de rede, e que se demonstram possibilitar transferência sem descontinuidades. Pode assim dizer-se que esta tese, através de trabalho de análise e de propostas suportadas por simulações, defende que na concepção de sistemas de comunicação se devem considerar estratégias de transmissão e codificação que sejam não só próximas da capacidade dos canais, mas também tolerantes a atrasos, e que tais estratégias têm de ser concebidas tendo em vista características do canal e a camada física.

Acute electronic cigarette use: nicotine delivery and subjective effects in regular users

Rationale Electronic cigarettes are becoming increasingly popular among smokers worldwide. Commonly reported reasons for use include the following: to quit smoking, to avoid relapse, to reduce urge to smoke, or as a perceived lower-risk alternative to smoking. Few studies, however, have explored whether electronic cigarettes (e-cigarettes) deliver measurable levels of nicotine to the blood. Objective This study aims to explore in experienced users the effect of using an 18-mg/ml nicotine first-generation e-cigarette on blood nicotine, tobacco withdrawal symptoms, and urge to smoke. Methods Fourteen regular e-cigarette users (three females), who are abstinent from smoking and e-cigarette use for 12 h, each completed a 2.5 h testing session. Blood was sampled, and questionnaires were completed (tobacco-related withdrawal symptoms, urge to smoke, positive and negative subjective effects) at four stages: baseline, 10 puffs, 60 min of ad lib use and a 60-min rest period. Results Complete sets of blood were obtained from seven participants. Plasma nicotine concentration rose significantly from a mean of 0.74 ng/ml at baseline to 6.77 ng/ml 10 min after 10 puffs, reaching a mean maximum of 13.91 ng/ml by the end of the ad lib puffing period. Tobacco-related withdrawal symptoms and urge to smoke were significantly reduced; direct positive effects were strongly endorsed, and there was very low reporting of adverse effects. Conclusions These findings demonstrate reliable blood nicotine delivery after the acute use of this brand/model of e-cigarette in a sample of regular users. Future studies might usefully quantify nicotine delivery in relation to inhalation technique and the relationship with successful smoking cessation/harm reduction.

Second Wave Positive Psychology: Exploring the Positive–Negative Dialectics of Wellbeing

Positive psychology has tended to be defined in terms of a concern with ‘positive’ psychological qualities and states. However, critics of the field have highlighted various problems inherent in classifying phenomena as either ‘positive’ or ‘negative.’ For instance, ostensibly positive qualities (e.g., optimism) can sometimes be detrimental to wellbeing, whereas apparently negative processes (like anxiety) may at times be conducive to it. As such, over recent years, a more nuanced ‘second wave’ of positive psychology has been germinating, which explores the philosophical and conceptual complexities of the very idea of the ‘positive.’ The current paper introduces this emergent second wave by examining the ways in which the field is developing a more subtle understanding of the ‘dialectical’ nature of flourishing (i.e., involving a complex and dynamic interplay of positive and negative experiences). The paper does so by problematizing the notions of positive and negative through seven case studies, including five salient dichotomies (such as optimism versus pessimism) and two complex processes (posttraumatic growth and love). These case studies serve to highlight the type of critical, dialectical thinking that characterises this second wave, thereby outlining the contours of the evolving field.

Looking behaviour and preference for artworks: The role of emotional valence and location

The position of an item influences its evaluation, with research consistently finding that items occupying central locations are preferred and have a higher subjective value. The current study investigated whether this centre-stage effect (CSE) is a result of bottom-up gaze allocation to the central item, and whether it is affected by item valence. Participants (n=50) were presented with three images of artistic paintings in a row and asked to choose the image they preferred. Eye movements were recorded for a subset of participants (n=22). On each trial the three artworks were either similar but different, or were identical and with positive valence, or were identical and with negative valence. The results showed a centre-stage effect, with artworks in the centre of the row preferred, but only when they were identical and of positive valence. Significantly greater gaze allocation to the central and left artwork was not mirrored by equivalent increases in preference choices. Regression analyses showed that when the artworks were positive and identical the participants’ last fixation predicted preference for the central art-work, whereas the fixation duration predicted preference if the images were different. Overall the result showed that item valence, rather than level of gaze allocation, influences the CSE, which is incompatible with the bottom-up gaze explanation. We propose that the centre stage heuristic, which specifies that the best items are in the middle, is able to explain these findings and the centre-stage effect.

Towards a positive cross-cultural lexicography: Enriching our emotional landscape through 216 ‘untranslatable’ words pertaining to well-being

Although much attention has been paid to culture-specific psychopathologies, there have been no comparable attempts to chart positive mental states that may be particular to certain cultures. This paper outlines the beginnings of a positive cross-cultural lexicography of ‘untranslatable’ words pertaining to wellbeing, culled from across the world’s languages. A quasi-systematic search uncovered 216 such terms. Using grounded theory, these words were organised into three categories: feelings (comprising positive and complex feelings); relationships (comprising intimacy and pro-sociality); and character (comprising personal resources and spirituality). The paper has two main aims. First, it aims to provide a window onto cultural differences in constructions of wellbeing, thereby enriching our understanding of wellbeing. Second, a more ambitious aim is that this lexicon may help expand the emotional vocabulary of English speakers (and indeed speakers of all languages), and consequently enrich their experiences of wellbeing. The paper concludes by setting out a research agenda to pursue these aims further.

Non-linear analysis of composite structures with integrated piezoelectric sensors and actuators

This paper deals with the geometrically non linear analysis of thin plate/shell laminated structures with embedded integrated piezoelectric actuors or sensors layers and/or patches.The model is based on the Kirchhoff classical laminated theory and can be applied to plate and shell adaptive structures with arbitrary shape, general mechanical and electrical loadings. the finite element model is a nonconforming single layer triangular plate/shell element with 18 degrees of fredom for the generalized displacements and one eçlectrical potential degree of freedom for each piezoelectric layer or patch. An updated Lagrangian formulation associated to Newton-Raphson technique is used to solve incrementally and iteratively the equilibrium equation.The model is applied in the solution of four illustrative cases, and the results are compared and discussedwith alternative solutions when available.

Cognitive robotics: a new approach to simultaneous localisation and mapping

Most simultaneous localisation and mapping (SLAM) solutions were developed for navigation of non-cognitive robots. By using a variety of sensors, the distances to walls and other objects are determined, which are then used to generate a map of the environment and to update the robot’s position. When developing a cognitive robot, such a solution is not appropriate since it requires accurate sensors and precise odometry, also lacking fundamental features of cognition such as time and memory. In this paper we present a SLAM solution in which such features are taken into account and integrated. Moreover, this method does not require precise odometry nor accurate ranging sensors.

Detection of mineralized structures in very early stages of development of Marine Teleostei using a modified Alcian blue-Alizarin red double staining technique for bone and cartilage

We have developed a procedure for staining cartilage and bone in fish larvae as small as 2 mm (notochord length), for which standard alcian blue/alizarin red procedures did not give positive and/or consistent results. Small calcified structures only 100-200 pm in length can be clearly visualized. The method is suitable for both ontogenic studies during early stages of skeletal development in most marine fishes (e.g., Sparus aurata L., Solea senegalensis Kaup), whose larvae at hatching are often only a few millimeters long and for detecting skeletal abnormalities in small larvae. This procedure can also be used for specimens that have been preserved in 1000/0 ethanol for up to two years.

Complex Interplay Between Determinants of Pacing and Performance During 20 km Cycle Time Trials

Purpose This study examined the determinants of pacing strategy and performance during self paced maximal exercise. Methods Eight well trained cyclists completed two 20 km time trials. Power output, RPE, positive and negative affect, and iEMG activity of the active musculature were recorded every 0.5km, confidence in achieving pre-exercise goals was assessed every 5 km, and blood lactate and pH were measured post-exercise. Differences in all parameters were assessed between fastest (FAST) and slowest (SLOW) trials performed. Results Mean power output was significantly higher during the initial 90% of FAST, but not the final 10%, and blood lactate concentration was significantly higher and pH significantly lower following FAST. Mean iEMG activity was significantly higher throughout SLOW. RPE was similar throughout both trials, but participants had significantly more positive affect and less negative affect throughout FAST. Participants grew less confident in their ability to achieve their goals throughout SLOW. Conclusions The results suggest that affect may be the primary psychological regulator of pacing strategy and that higher levels of positivity and lower levels of negativity may have been associated with a more aggressive strategy during FAST. Although the exact mechanisms through which affect acts to influence performance are unclear, it may determine the degree of physiological disruption that can be tolerated, or be reflective of peripheral physiological status in relation to the still to be completed exercise task.

The Impact of School Leadership on Parental Engagement: a Study of Inclusion and Cohesion

This article focuses on the role played by principals in enhancing parental involvement in primary schools. The schools involved in this research were characterised by a high presence of ethnic minority children and were located in a neighbourhood of low social and economic status in the Midlands region of the United Kingdom. Qualitative methods were employed in order to explore the influence of strong leadership on engagement of the parents. The study spanned a period of four years, giving an opportunity to examine sustainability of the activities introduced by the principals and staff. The findings reported are based on data collected from an Infant and Junior School involved in a number of extra-curricular and curriculum-enhancing projects. It argues that strong leadership fosters engagement of parents in school activities and thus academic achievement of pupils improved over time. The findings bring evidence that the role of the school principal is crucial in the introduction, implementation and sustainability of solutions focused on parental involvement, as well as bringing benefits to the social cohesion of the local community. Full Text:

Our Past Betrays Us: Collective Memory, Homicide and Southern Lynching

Thesis (Master's)--University of Washington, 2013

The Impact of Thought Speed and Variability on Psychological State and Threat Perception: Further Exploration of the Theory of Mental Motion

Thought speed and variability are purportedly common features of specific psychological states, such as mania and anxiety. The present study explored the independent and combinational influence of these variables upon condition-specific symptoms and affective state, as proposed by Pronin and Jacobs’ (Perspect Psychol Sci, 3:461–485, 2008) theory of mental motion. A general population sample was recruited online (N = 263). Participants completed a thought speed and variability manipulation task, inducing a combination of fast/slow and varied/repetitive thought. Change in mania and anxiety symptoms was assessed through direct self-reported symptom levels and indirect, processing bias assessment (threat interpretation). Results indicated that fast and varied thought independently increased self-reported mania symptoms. Affect was significantly less positive and more negative during slow thought. No change in anxiety symptoms or threat interpretation was found between manipulation conditions. No evidence for the proposed combinational influence of speed and variability was found. Implications and avenues for therapeutic intervention are discussed.