Avaliação ecocardiográfica da insuficiência mitral concomitante, na substituição valvular aórtica isolada: é possível prevê-la?

Mestrado em Tecnologia de Diagnóstico e Intervenção Cardiovascular - Ramo de especialização: Ultrassonografia Cardiovascular

Patterns of deliveries in a Brazilian birth cohort: almost universal cesarean sections for the better-off

OBJECTIVE: To describe the patterns of deliveries in a birth cohort and to compare vaginal and cesarean section deliveries. METHODS: All children born to mothers from the urban area of Pelotas, Brazil, in 2004, were recruited for a birth cohort study. Mothers were contacted and interviewed during their hospital stay when extensive information on the gestation, the birth and the newborn, along with maternal health history and family characteristics was collected. Maternal characteristics and childbirth care financing - either private or public healthcare (SUS) patients - were the main factors investigated along with a description of C-sections distribution according to day of the week and delivery time. Standard descriptive techniques, Χ² tests for comparing proportions and Poisson regression to explore the independent effect of C-section predictors were the methods used. RESULTS: The overall C-section rate was 45%, 36% among SUS and 81% among private patients, where 35% of C-sections were reported elective. C-sections were more frequent on Tuesdays and Wednesdays, reducing by about a third on Sundays, while normal deliveries had a uniform distribution along the week. Delivery time for C-sections was markedly different among public and private patients. Maternal schooling was positively associated with C-section among SUS patients, but not among private patients. CONCLUSIONS: C-sections were almost universal among the wealthier mothers, and strongly related to maternal education among SUS patients. The patterns we describe are compatible with the idea that C-sections are largely done to suit the doctor's schedule. Drastic action is called for to change the current situation.

A influência dos horários de trabalho (horário normal e horário por turnos) na qualidade de vida no trabalho e engagement profissional

Dissertação apresentada ao Instituto Politécnico do Porto para obtenção do Grau de Mestre em Gestão das Organizações, Ramo de Gestão de Empresas Orientada por Prof. Doutora Maria Alexandra Pacheco Ribeiro da Costa Esta dissertação inclui as críticas e sugestões feitas pelo júri.

Caracterização das cesarianas em centro de parto normal

OBJETIVO: Estimar a prevalência de cesarianas em um centro de parto normal intra-hospitalar e identificar fatores associados. MÉTODOS: Estudo transversal com análise de prontuários de 2.441 partos assistidos em março e abril de 2005 em um centro de parto normal intra-hospitalar de São Paulo, SP. A variável dependente (tipo de parto) foi classificada como parto normal e operação cesariana. As variáveis independentes foram categorizadas em quatro grupos: demográficas; história obstétrica pregressa e atual; assistência intraparto; e resultados perinatais. A razão de prevalência e o intervalo de 95% de confiança (IC95%) foram calculados para identificar associação entre tipo de parto e variáveis maternas e do recém-nascido. RESULTADOS: Do total de partos, 14,9% foram operações cesarianas. Ter sido submetida a cesariana na gestação atual esteve associado a cesariana em gestação anterior (RP = 3,19; IC95%: 2,64;3,84), idade gestacional > 40 semanas (RP = 1,32; IC95%: 1,09;1,61), ser admitida com cervicodilatação até 4 cm (RP = 3,22; IC95%: 2,31;4,50), líquido amniótico meconial (RP = 2,5; IC95%: 2,05;3,06). Quanto ao recém-nascido, a cesariana associou-se a peso > 4kg (RP = 1,86; IC95%: 1,29;2,66). Entre as mulheres com cesariana em gestação anterior, ter também parto normal prévio foi fator de proteção para cesariana na gestação atual (RP = 0,46; IC95% 0,30;0,71). Fatores relacionados à condição fetal, como estresse fetal, líquido amniótico meconial, apresentação pélvica e macrossomia corresponderam a 47,8% (175) das indicações para a realização da cesariana; condições ligadas ao mecanismo do parto, como parada de progressão, distócia funcional e distócia de rotação totalizaram 31,3% (115) das indicações. CONCLUSÕES: A prevalência de cesariana mostrou-se dentro dos limites propostos pela Organização Mundial da Saúde. Mulheres com cesariana em gestação anterior, admitidas com até 4 cm de dilatação, idade gestacional > 40 semanas, com líquido amniótico meconial e recém-nascido > 4 kg tiveram maior risco para cesariana.

Differences in Mismatch Negativity (MMN) response to Pure-tone and Speech sounds in normal subjects: an additional explanation

The relation of automatic auditory discrimination, measured with MMN, with the type of stimuli has not been well established in the literature, despite its importance as an electrophysiological measure of central sound representation. In this study, MMN response was elicited by pure-tone and speech binaurally passive auditory oddball paradigm in a group of 8 normal young adult subjects at the same intensity level (75 dB SPL). The frequency difference in pure-tone oddball was 100 Hz (standard = 1 000 Hz; deviant = 1 100 Hz; same duration = 100 ms), in speech oddball (standard /ba/; deviant /pa/; same duration = 175 ms) the Portuguese phonemes are both plosive bi-labial in order to maintain a narrow frequency band. Differences were found across electrode location between speech and pure-tone stimuli. Larger MMN amplitude, duration and higher latency to speech were verified compared to pure-tone in Cz and Fz as well as significance differences in latency and amplitude between mastoids. Results suggest that speech may be processed differently than non-speech; also it may occur in a later stage due to overlapping processes since more neural resources are required to speech processing.

Resultados maternos e neonatais em centro de parto normal peri-hospitalar e hospital

OBJETIVO: Comparar os resultados maternos e neonatais em mulheres de baixo risco atendidas em centro de parto normal peri-hospitalar e hospital. MÉTODOS: Estudo transversal com amostra representativa de mulheres de baixo risco atendidas em São Paulo, SP, de 2003 a 2006. Foram incluídas 991 mulheres que tiveram o parto no centro de parto normal e 325 que deram à luz no hospital. Os dados foram obtidos dos prontuários. A análise comparativa foi realizada para o total de mulheres e estratificada segundo a paridade. Foram aplicados os testes qui-quadrado e exato de Fisher. RESULTADOS: Houve distribuição homogênea das mulheres segundo a paridade (45,4% nulíparas e 54,6% mulheres com um ou mais partos anteriores). Foram encontradas diferenças estatisticamente significantes em relação às seguintes intervenções: amniotomia (mais freqüente entre nulíparas do hospital); utilização de ocitocina no trabalho de parto e utilização de analgésico no pós-parto (mais freqüentes no hospital entre as mulheres de todas as paridades). A taxa de episiotomia foi maior entre as nulíparas, tanto no centro de parto como no hospital. Houve maior freqüência de intervenções com o neonato no hospital: aspiração das vias aéreas superiores, aspiração gástrica, lavagem gástrica, oxigênio por máscara aberta. Também ocorreram com mais freqüência no hospital bossa serossanguínea, desconforto respiratório e internação na unidade neonatal. Não houve diferença nos valores de Apgar no quinto minuto nem casos de morte materna ou perinatal. CONCLUSÕES: A assistência no centro de parto normal foi realizada com menos intervenções e com resultados maternos e neonatais semelhantes aos do hospital.

Antioxidant properties of hydroxycinnamic acids: a review of structure- activity relationships

Hydroxycinnamic acids (HCAs) are important phytochemicals possessing significant biological properties. Several investigators have studied in vitro antioxidant activity of HCAs in detail. In this review, we have gathered the studies focused on the structure-activity relationships (SARs) of these compounds that have used medicinal chemistry to generate more potent antioxidant molecules. Most of the reports indicated that the presence of an unsaturated bond on the side chain of HCAs is vital to their activity. The structural features that were reported to be of importance to the antioxidant activity were categorized as follows: modifications of the aromatic ring, which include alterations in the number and position of hydroxy groups and insertion of electron donating or withdrawing moieties as well as modifications of the carboxylic function that include esterification and amidation process. Furthermore, reports that have addressed the influence of physicochemical properties including redox potential, lipid solubility and dissociation constant on the antioxidant activity were also summarized. Finally, the pro-oxidant effect of HCAs in some test systems was addressed. Most of the investigations concluded that the presence of ortho-dihydroxy phenyl group (catechol moiety) is of significant importance to the antioxidant activity, while, the presence of three hydroxy groups does not necessarily improve the activity. Optimization of the structure of molecular leads is an important task of modern medicinal chemistry and its accomplishment relies on the careful assessment of SARs. SAR studies on HCAs can identify the most successful antioxidants that could be useful for management of oxidative stress-related diseases.

Tipificação de fundações de torres eólicas em parques industriais, para diversos tipos de solos

Dissertação para obtenção do grau de Mestre em Engenharia Civil na Área de Especialização de Edificações

Fatores maternos e neonatais associados ao mecônio no líquido amniótico em um centro de parto normal

OBJETIVO: Analisar a frequência e os fatores maternos e neonatais associados ao mecônio no líquido amniótico no parto. MÉTODOS: Estudo transversal com 2.441 nascimentos em um centro de parto normal hospitalar em São Paulo, SP, em março e abril de 2005. A associação entre mecônio no líquido amniótico e as variáveis independentes (idade materna, paridade, ter ou não cesariana prévia, idade gestacional, antecedentes obstétricos, uso de ocitocina no trabalho de parto, dilatação cervical na admissão, tipo do parto atual, peso do RN, índice de Apgar de 1º e 5º minutos de vida) foi expressa como razão de prevalência. RESULTADOS: Verificou-se mecônio no líquido amniótico em 11,9% dos partos; 68,2% desses foram normais e 38,8%, cesarianas. O mecônio esteve associado a: primiparidade (RP = 1,49; IC95% 1,29;1,73), idade gestacional ≥ 41 semanas (RP = 5,05; IC95% 1,93;13,25), ocitocina no parto (RP = 1,83, IC95% 1,60;2,10), cesariana (RP = 2,65; IC95% 2,17;3,24) e índice de Apgar < 7 no 5º minuto (RP = 2,96, IC95% 2,94;2,99). A mortalidade neonatal foi 1,6/1.000 nascidos vivos; mecônio no líquido amniótico foi encontrado em 50% das mortes neonatais e associado a maiores taxas de partos cirúrgicos. CONCLUSÕES: Emprego de ocitocina, piores condições do recém-nascido logo após o parto e aumento de taxas de cesariana foram fatores associados ao mecônio. A utilização rotineira de ocitocina no intraparto poderia ser revista por sua associação com mecônio no líquido amniótico.

β-Lactams: chemical structure, mode of action and mechanisms of resistance

This synopsis summarizes the key chemical and bacteriological characteristics of β-lactams, penicillins, cephalosporins, carbanpenems, monobactams and others. Particular notice is given to first-generation to fifth-generation cephalosporins. This reviewalso summarizes the main resistancemechanism to antibiotics, focusing particular attention to those conferring resistance to broad-spectrum cephalosporins by means of production of emerging cephalosporinases (extended-spectrum β-lactamases and AmpC β-lactamases), target alteration (penicillin-binding proteins from methicillin-resistant Staphylococcus aureus) and membrane transporters that pump β-lactams out of the bacterial cell.

Mining protein structure data

The principal topic of this work is the application of data mining techniques, in particular of machine learning, to the discovery of knowledge in a protein database. In the first chapter a general background is presented. Namely, in section 1.1 we overview the methodology of a Data Mining project and its main algorithms. In section 1.2 an introduction to the proteins and its supporting file formats is outlined. This chapter is concluded with section 1.3 which defines that main problem we pretend to address with this work: determine if an amino acid is exposed or buried in a protein, in a discrete way (i.e.: not continuous), for five exposition levels: 2%, 10%, 20%, 25% and 30%. In the second chapter, following closely the CRISP-DM methodology, whole the process of construction the database that supported this work is presented. Namely, it is described the process of loading data from the Protein Data Bank, DSSP and SCOP. Then an initial data exploration is performed and a simple prediction model (baseline) of the relative solvent accessibility of an amino acid is introduced. It is also introduced the Data Mining Table Creator, a program developed to produce the data mining tables required for this problem. In the third chapter the results obtained are analyzed with statistical significance tests. Initially the several used classifiers (Neural Networks, C5.0, CART and Chaid) are compared and it is concluded that C5.0 is the most suitable for the problem at stake. It is also compared the influence of parameters like the amino acid information level, the amino acid window size and the SCOP class type in the accuracy of the predictive models. The fourth chapter starts with a brief revision of the literature about amino acid relative solvent accessibility. Then, we overview the main results achieved and finally discuss about possible future work. The fifth and last chapter consists of appendices. Appendix A has the schema of the database that supported this thesis. Appendix B has a set of tables with additional information. Appendix C describes the software provided in the DVD accompanying this thesis that allows the reconstruction of the present work.

Specification of software architecture reconfiguration

In the past years, Software Architecture has attracted increased attention by academia and industry as the unifying concept to structure the design of complex systems. One particular research area deals with the possibility of reconfiguring architectures to adapt the systems they describe to new requirements. Reconfiguration amounts to adding and removing components and connections, and may have to occur without stopping the execution of the system being reconfigured. This work contributes to the formal description of such a process. Taking as a premise that a single formalism hardly ever satisfies all requirements in every situation, we present three approaches, each one with its own assumptions about the systems it can be applied to and with different advantages and disadvantages. Each approach is based on work of other researchers and has the aesthetic concern of changing as little as possible the original formalism, keeping its spirit. The first approach shows how a given reconfiguration can be specified in the same manner as the system it is applied to and in a way to be efficiently executed. The second approach explores the Chemical Abstract Machine, a formalism for rewriting multisets of terms, to describe architectures, computations, and reconfigurations in a uniform way. The last approach uses a UNITY-like parallel programming design language to describe computations, represents architectures by diagrams in the sense of Category Theory, and specifies reconfigurations by graph transformation rules.

Pine processionary moth (Thaumetopoea pityocampa) and great tit (Parus major) in Portugal

In the present work, we studied a common outbreaking Lepidoptera species in Portuguese pine stands – Thaumetopoea pityocampa (Den. & Schiff.) - and one of its potential predators – Parus major (L.). The population dynamics of the immature stages of the Lepidoptera was studied in several types of Pinus pinaster (Aiton) plantations in three different areas: Setúbal Peninsula, Abrantes and National Pine Forest of Leiria. Location and plantation structure was the most important factors determining population density of T. pityocampa. Setubal and Abrantes was highly susceptible to attacks by the Lepidoptera, whereas Leiria had lower densities. Young and homogeneous pine stands was more susceptible to attacks than older and more heterogeneous pines stands. However, a desynchronized population of T. pityocampa, in which the larvae develops during summer instead of during winter, reached high densities also in Leiria. The impact of several mortality factors and climatic conditions on the immature stages of the insect (eggs and larvae), in normal and desynchronized populations are discussed, as well as possible evolutionary implications of the sudden appearance of the new version of T. pityocampa. The break of the pupa diapause and adult emergence times the annual life cycle of this insect. Adults from the desynchronized population emerged earlier than adults from the normal population, which in turn determined the change in the larvae development period. Different factors, potentially affecting the timing of adult emergence in both normal and abnormal populations are also discussed. To study P. Major, nest-boxes were placed in the areas of Setúbal and Leiria and they were monitored during three seasons. The nest-boxes increased the density of breeding and wintering birds in the studied pine plantations, indicating that a lack of natural holes are in fact a limiting factor for this populations. The earliest breeding start for this species was recorded in my study area, indicating that Portuguese coastal pines provide good breeding conditions earlier than in other areas of Europe and North Africa. This leads to an overlap between the end of the larvae stage of T. pityocampa and the beginning of the breeding season of P. major. Key-words: Thaumetopoea pityocampa, Parus major, Pinus pinaster, population dynamics, Portugal.

Real-time scheduling with resource sharing on uniform multiprocessors

Consider the problem of scheduling a set of implicit-deadline sporadic tasks to meet all deadlines on a uniform multiprocessor platform where each task may access at most one of |R| shared resources and at most once by each job of that task. The resources have to be accessed in a mutually exclusive manner. We propose an algorithm, GIS-vpr, which offers the guarantee that if a task set is schedulable to meet deadlines by an optimal task assignment scheme that allows a task to migrate only when it accesses or releases a resource, then our algorithm also meets the deadlines with the same restriction on the task migration, if given processors 4 + 6|R| times as fast. The proposed algorithm, by design, limits the number of migrations per job to at most two. To the best of our knowledge, this is the first result for resource sharing on uniform multiprocessors with proven performance guarantee.

Les Plus Anciens Mastodontes Tetralophodontes (Langhien inférieur Vb), évolution et remarques sur la Tetralophodontie

This study deals with mastodont teeth found near Lisbon in Lower Langhian (lower Middle Miocene) fluviatile, feldspathic sands (Vb division). Conclusions are as follows: 1. Tetralophodont molars (even if at a still primitive stade of the tetralophodont condition) do exist at least since lower Langhian times, and not only since late Middle Miocene as was previously known. 2. Tri- and tetralophodont structures may (and indeed do) coexist in the same individual: such examples do not correspond to transitional forms, but instead to a mosaic of juxtaposed characters (however this does not mean there are no transitional forms in other instances). 3. So these structures coexisted in a population not yet genetically separated beyond fertile cross-breeding, i.e. beyond species' level. 4. Origin of the tetralophodont molar was due to some mutation (s). but without crossing species, limits and even more genus'ones. 5. At this times probably soon after the first appearance of tetralophodont mutants, animals with such characters were a small but significant minority among the population (17% if account is taken on D4's: only 2% after M2's). 6. There was not then any direct and clear correlation between number of lophs (transversal crests) and tooth size, even if the increase of such number goes along with length's increase. 7. Dimensions (length in special) in tetralophodont teeth tend to exceed those in «normal» trilophodont teeth, this being particularly clear in D4, even if there is no clear distinction: the situation is quite the same, maybe less marked, with the M2. 8. According to the preceding conclusions there are no reasons to segregate different taxa among such mastodont population on the grounds of the presence in D4, M1 and M2 of 3 or 4 crests (this character being regarded as diagnostic of the genus Tetralophodon). 9. On the contrary, if any natural (in biological sense) classification is disregarded and a morphological parataxonomy is adopted there should be considered both Gomphotherium angustidens and Tetralophodon sp.: however this is absolutely not our opinion.