Utilidade dos estudos de condução nervosa e respostas-F do nervo peronial na radiculopatia de L5 e a sua correlação com o grau de gravidade avaliada eletromiograficamente

As radiculopatias lombares referem-se a um processo patológico envolvendo as raízes nervosas espinais, causando sintomas radiculares ao nível dos membros inferiores. As respostas-F são ondas tardias que advêm de descargas recorrentes de neurónios motores despolarizados antidromicamente, que podem ser úteis na avaliação de lesões radiculares. Com o objetivo de avaliar a utilidade dos estudos de condução nervosa e respostas- F do nervo peronial no diagnóstico de radiculopatia de L5 e a sua correlação com o seu grau de gravidade, foram estudados 47 sujeitos que padeciam de radiculopatia de L5 e foram comparados com um grupo de controlo, constituído por 28 sujeitos saudáveis. Foram estudadas as amplitudes do PAMC do nervo peronial profundo, do PANS do peronial superficial, bem como as latências mínima, média e máxima, cronodispersão e persistência das Respostas-F. Foi realizada ainda uma avaliação eletromiográfica, com o intuito de classificar o acometimento da raiz em termos de gravidade. Registaram-se diferenças significativas entre os dois grupos na amplitude do PAMC do peronial profundo (p<0,0001), na F-mínima, F-média, F-máxima e cronodispersão (p<0,0001), e ainda na persistência (p 0,014). Todos estes parâmetros também se correlacionaram significativamente com o grau de gravidade da radiculopatia, sendo as latências das ondas-F e a cronodispersão progressivamente maiores nos sujeitos com um grau de afeção mais grave, e a persistência e a amplitude dos estudos de condução motora mais baixas. O fator que se evidenciou mais sensível no diagnóstico desta patologia foi a latência-máxima das ondas-F, 31,25%, e o menos sensível a persistência, apenas alterada em 9,34% dos indivíduos. Tendo em consideração todos os parâmetros avaliados nas respostas-F atingiu-se uma sensibilidade global desta técnica de 42,19%. Com esta investigação concluímos que os estudos de condução nervosa e as respostas-F poderão ser úteis como complemento na avaliação das radiculopatias lombares, apresentando uma sensibilidade considerável para esta patologia. Não se deve limitar o estudo desta técnica à avaliação das latências mínima das ondas-F, mas incluir sempre todos os outros parâmetros, aumentando assim a sua sensibilidade. Estas técnicas deverão ser incluídas no estudo das radiculopatias de L5.

Clinical and genetic factors predicting response to therapy in patients with Crohn’s disease

Aim - To identify clinical and/or genetic predictors of response to several therapies in Crohn’s disease (CD) patients. Methods - We included 242 patients with CD (133 females) aged (mean ± standard deviation) 39 ± 12 years and a disease duration of 12 ± 8 years. The single-nucleotide polymorphisms (SNPs) studied were ABCB1 C3435T and G2677T/A, IL23R G1142A, C2370A, and G9T, CASP9 C93T, Fas G670A and LgC844T, and ATG16L1 A898G. Genotyping was performed with real-time PCR with Taqman probes. Results - Older patients responded better to 5-aminosalicylic acid (5-ASA) and to azathioprine (OR 1.07, p = 0.003 and OR 1.03, p = 0.01, respectively) while younger ones responded better to biologicals (OR 0.95, p = 0.06). Previous surgery negatively influenced response to 5-ASA compounds (OR 0.25, p = 0.05), but favoured response to azathioprine (OR 2.1, p = 0.04). In respect to genetic predictors, we observed that heterozygotes for ATGL16L1 SNP had a significantly higher chance of responding to corticosteroids (OR 2.51, p = 0.04), while homozygotes for Casp9 C93T SNP had a lower chance of responding both to corticosteroids and to azathioprine (OR 0.23, p = 0.03 and OR 0.08, p = 0.02,). TT carriers of ABCB1 C3435T SNP had a higher chance of responding to azathioprine (OR 2.38, p = 0.01), while carriers of ABCB1 G2677T/A SNP, as well as responding better to azathioprine (OR 1.89, p = 0.07), had a lower chance of responding to biologicals (OR 0.31, p = 0.07), which became significant after adjusting for gender (OR 0.75, p = 0.005). Conclusions - In the present study, we were able to identify a number of clinical and genetic predictors of response to several therapies which may become of potential utility in clinical practice. These are preliminary results that need to be replicated in future pharmacogenomic studies.

Sistema de aquisição de dados em tempo real

Neste trabalho propus-me realizar um Sistema de Aquisição de Dados em Tempo Real via Porta Paralela. Para atingir com sucesso este objectivo, foi realizado um levantamento bibliográfico sobre sistemas operativos de tempo real, salientando e exemplificando quais foram marcos mais importantes ao longo da sua evolução. Este levantamento permitiu perceber o porquê da proliferação destes sistemas face aos custos que envolvem, em função da sua aplicação, bem como as dificuldades, científicas e tecnológicas, que os investigadores foram tendo, e que foram ultrapassando com sucesso. Para que Linux se comporte como um sistema de tempo real, é necessário configura-lo e adicionar um patch, como por exemplo o RTAI ou ADEOS. Como existem vários tipos de soluções que permitem aplicar as características inerentes aos sistemas de tempo real ao Linux, foi realizado um estudo, acompanhado de exemplos, sobre o tipo de arquitecturas de kernel mais utilizadas para o fazer. Nos sistemas operativos de tempo real existem determinados serviços, funcionalidades e restrições que os distinguem dos sistemas operativos de uso comum. Tendo em conta o objectivo do trabalho, e apoiado em exemplos, fizemos um pequeno estudo onde descrevemos, entre outros, o funcionamento escalonador, e os conceitos de latência e tempo de resposta. Mostramos que há apenas dois tipos de sistemas de tempo real o ‘hard’ que tem restrições temporais rígidas e o ‘soft’ que engloba as restrições temporais firmes e suaves. As tarefas foram classificadas em função dos tipos de eventos que as despoletam, e evidenciando as suas principais características. O sistema de tempo real eleito para criar o sistema de aquisição de dados via porta paralela foi o RTAI/Linux. Para melhor percebermos o seu comportamento, estudamos os serviços e funções do RTAI. Foi dada especial atenção, aos serviços de comunicação entre tarefas e processos (memória partilhada e FIFOs), aos serviços de escalonamento (tipos de escalonadores e tarefas) e atendimento de interrupções (serviço de rotina de interrupção - ISR). O estudo destes serviços levou às opções tomadas quanto ao método de comunicação entre tarefas e serviços, bem como ao tipo de tarefa a utilizar (esporádica ou periódica). Como neste trabalho, o meio físico de comunicação entre o meio ambiente externo e o hardware utilizado é a porta paralela, também tivemos necessidade de perceber como funciona este interface. Nomeadamente os registos de configuração da porta paralela. Assim, foi possível configura-lo ao nível de hardware (BIOS) e software (módulo do kernel) atendendo aos objectivos do presente trabalho, e optimizando a utilização da porta paralela, nomeadamente, aumentando o número de bits disponíveis para a leitura de dados. No desenvolvimento da tarefa de hard real-time, foram tidas em atenção as várias considerações atrás referenciadas. Foi desenvolvida uma tarefa do tipo esporádica, pois era pretendido, ler dados pela porta paralela apenas quando houvesse necessidade (interrupção), ou seja, quando houvesse dados disponíveis para ler. Desenvolvemos também uma aplicação para permitir visualizar os dados recolhidos via porta paralela. A comunicação entre a tarefa e a aplicação é assegurada através de memória partilhada, pois garantindo a consistência de dados, a comunicação entre processos do Linux e as tarefas de tempo real (RTAI) que correm ao nível do kernel torna-se muito simples. Para puder avaliar o desempenho do sistema desenvolvido, foi criada uma tarefa de soft real-time cujos tempos de resposta foram comparados com os da tarefa de hard real-time. As respostas temporais obtidas através do analisador lógico em conjunto com gráficos elaborados a partir destes dados, mostram e comprovam, os benefícios do sistema de aquisição de dados em tempo real via porta paralela, usando uma tarefa de hard real-time.

Socioeconomic inequities in the health and nutrition of children in low/middle income countries

OBJECTIVE: To describe the effects of social inequities on the health and nutrition of children in low and middle income countries. METHODS: We reviewed existing data on socioeconomic disparities within-countries relative to the use of services, nutritional status, morbidity, and mortality. A conceptual framework including five major hierarchical categories affecting inequities was adopted: socioeconomic context and position, differential exposure, differential vulnerability, differential health outcomes, and differential consequences. The search of the PubMed database since 1990 identified 244 articles related to the theme. Results were also analyzed from almost 100 recent national surveys, including Demographic Health Surveys and the UNICEF Multiple Indicator Cluster Surveys. RESULTS: Children from poor families are more likely, relative to those from better-off families, to be exposed to pathogenic agents; once they are exposed, they are more likely to become ill because of their lower resistance and lower coverage with preventive interventions. Once they become ill, they are less likely to have access to health services and the quality of these services is likely to be lower, with less access to life-saving treatments. As a consequence, children from poor family have higher mortality rates and are more likely to be undernourished. CONCLUSIONS: Except for child obesity and inadequate breastfeeding practices, all the other adverse conditions analyzed were more prevalent in children from less well-off families. Careful documentation of the multiple levels of determination of socioeconomic inequities in child health is essential for understanding the nature of this problem and for establishing interventions that can reduce these differences.

The influence of experience and training in a group of novice observers: a jackknife alternative free-response receiver operating characteristic analysis

Purpose - The study evaluates the pre- and post-training lesion localisation ability of a group of novice observers. Parallels are drawn with the performance of inexperienced radiographers taking part in preliminary clinical evaluation (PCE) and ‘red-dot’ systems, operating within radiography practice. Materials and methods - Thirty-four novice observers searched 92 images for simulated lesions. Pre-training and post-training evaluations were completed following the free-response the receiver operating characteristic (FROC) method. Training consisted of observer performance methodology, the characteristics of the simulated lesions and information on lesion frequency. Jackknife alternative FROC (JAFROC) and highest rating inferred ROC analyses were performed to evaluate performance difference on lesion-based and case-based decisions. The significance level of the test was set at 0.05 to control the probability of Type I error. Results - JAFROC analysis (F(3,33) = 26.34, p < 0.0001) and highest-rating inferred ROC analysis (F(3,33) = 10.65, p = 0.0026) revealed a statistically significant difference in lesion detection performance. The JAFROC figure-of-merit was 0.563 (95% CI 0.512,0.614) pre-training and 0.677 (95% CI 0.639,0.715) post-training. Highest rating inferred ROC figure-of-merit was 0.728 (95% CI 0.701,0.755) pre-training and 0.772 (95% CI 0.750,0.793) post-training. Conclusions - This study has demonstrated that novice observer performance can improve significantly. This study design may have relevance in the assessment of inexperienced radiographers taking part in PCE or commenting scheme for trauma.

Agar extraction from integrated multitrophic aquacultured Gracilaria vermiculophylla: Evaluation of a microwave-assisted process using response surface methodology

Microwave-assisted extraction (MAE) of agar from Gracilaria vermiculophylla, produced in an integrated multitrophic aquaculture (IMTA) system, from Ria de Aveiro (northwestern Portugal), was tested and optimized using response surface methodology. The influence of the MAE operational parameters (extraction time, temperature, solvent volume and stirring speed) on the physical and chemical properties of agar (yield, gel strength, gelling and melting temperatures, as well as, sulphate and 3,6-anhydro-Lgalactose contents) was evaluated in a 2^4 orthogonal composite design. The quality of the extracted agar compared favorably with the attained using traditional extraction (2 h at 85ºC) while reducing drastically extraction time, solvent consumption and waste disposal requirements. Agar MAE optimum results were: an yield of 14.4 ± 0.4%, a gel strength of 1331 ± 51 g/cm2, 40.7 ± 0.2 _C gelling temperature, 93.1 ± 0.5ºC melting temperature, 1.73 ± 0.13% sulfate content and 39.4 ± 0.3% 3,6-anhydro-L-galactose content. Furthermore, this study suggests the feasibility of the exploitation of G. vermiculophylla grew in IMTA systems for agar production.

Macrophages as biomarkers in BCG treatment response in bladder cancer

Bladder cancer is a common urologic cancer and the majority has origin in the urothelium. Patients with intermediate and high risk of recurrence/progression bladder cancer are treated with intravesical instillation with Bacillus Calmette-Guérin, however, approximately 30% of patients do not respond to treatment. At the moment, there are no accepted biomarkers do predict treatment outcome and an early identification of patients better served by alternative therapeutics. The treatment initiates a cascade of cytokines responsible by recruiting macrophages to the tumor site that have been shown to influence treatment outcome. Effective BCG therapy needs precise activation of the Th1 immune pathway associated with M1 polarized macrophages. However, tumor-associated macrophages (TAMs) often assume an immunoregulatory M2 phenotype, either immunosuppressive or angiogenic, that interfere in different ways with the BCG induced antitumor immune response. The M2 macrophage is influenced by different microenvironments in the stroma and the tumor. In particular, the degree of hypoxia in the tumors is responsible by the recruitment and differentiation of macrophages into the M2 angiogenic phenotype, suggested to be associated with the response to treatment. Nevertheless, neither the macrophage phenotypes present nor the influence of localization and hypoxia have been addressed in previous studies. Therefore, this work devoted to study the influence of TAMs, in particular of the M2 phenotype taking into account their localization (stroma or tumor) and the degree of hypoxia in the tumor (low or high) in BCG treatment outcome. The study included 99 bladder cancer patients treated with BCG. Tumors resected prior to treatment were evaluated using immunohistochemistry for CD68 and CD163 antigens, which identify a lineage macrophage marker and a M2-polarized specific cell surface receptor, respectively. Tumor hypoxia was evaluated based on HIF-1α expression. As a main finding it was observed that a high predominance of CD163+ macrophage counts in the stroma of tumors under low hypoxia was associated with BCG immunotherapy failure, possibly due to its immunosuppressive phenotype. This study further reinforces the importance the tumor microenvironment in the modulation of BCG responses.

How many low birthweight babies in low- and middle-income countries are preterm?

OBJECTIVE: To assess the prevalence of preterm birth among low birthweight babies in low and middle-income countries. METHODS: Major databases (PubMed, LILACS, Google Scholar) were searched for studies on the prevalence of term and preterm LBW babies with field work carried out after 1990 in low- and middle-income countries. Regression methods were used to model this proportion according to LBW prevalence levels. RESULTS: According to 47 studies from 27 low- and middle-income countries, approximately half of all LBW babies are preterm rather than one in three as assumed in studies previous to the 1990s. CONCLUSIONS: The estimate of a substantially higher number of LBW preterm babies has important policy implications in view of special health care needs of these infants. As for earlier projections, our findings are limited by the relative lack of population-based studies.

Response of high-risk of recurrence/progression bladder tumours expressing sialyl-Tn and sialyl-6-T to BCG immunotherapy

High risk of recurrence/progression bladder tumours is treated with Bacillus Calmette-Guérin (BCG) immunotherapy after complete resection of the tumour. Approximately 75% of these tumours express the uncommon carbohydrate antigen sialyl-Tn (Tn), a surrogate biomarker of tumour aggressiveness. Such changes in the glycosylation of cell-surface proteins influence tumour microenvironment and immune responses that may modulate treatment outcome and the course of disease. The aim of this work is to determine the efficiency of BCG immunotherapy against tumours expressing sTn and sTn-related antigen sialyl-6-T (s6T). METHODS: In a retrospective design, 94 tumours from patients treated with BCG were screened for sTn and s6T expression. In vitro studies were conducted to determine the interaction of BCG with high-grade bladder cancer cell line overexpressing sTn. RESULTS: From the 94 cases evaluated, 36 had recurrence after BCG treatment (38.3%). Treatment outcome was influenced by age over 65 years (HR=2.668; (1.344-5.254); P=0.005), maintenance schedule (HR=0.480; (0.246-0.936); P=0.031) and multifocality (HR=2.065; (1.033-4.126); P=0.040). sTn or s6T expression was associated with BCG response (P=0.024; P<0.0001) and with increased recurrence-free survival (P=0.001). Multivariate analyses showed that sTn and/or s6T were independent predictive markers of recurrence after BCG immunotherapy (HR=0.296; (0.148-0.594); P=0.001). In vitro studies demonstrated higher adhesion and internalisation of the bacillus to cells expressing sTn, promoting cell death. CONCLUSION: s6T is described for the first time in bladder tumours. Our data strongly suggest that BCG immunotherapy is efficient against sTn- and s6T-positive tumours. Furthermore, sTn and s6T expression are independent predictive markers of BCG treatment response and may be useful in the identification of patients who could benefit more from this immunotherapy.

Determination of ochratoxin A in bread: evaluation of microwave-assisted extraction using an orthogonal composite design coupled with response surface methodology

An analytical method using microwave-assisted extraction (MAE) and liquid chromatography (LC) with fluorescence detection (FD) for the determination of ochratoxin A (OTA) in bread samples is described. A 24 orthogonal composite design coupled with response surface methodology was used to study the influence of MAE parameters (extraction time, temperature, solvent volume, and stirring speed) in order to maximize OTA recovery. The optimized MAE conditions were the following: 25 mL of acetonitrile, 10 min of extraction, at 80 °C, and maximum stirring speed. Validation of the overall methodology was performed by spiking assays at five levels (0.1–3.00 ng/g). The quantification limit was 0.005 ng/g. The established method was then applied to 64 bread samples (wheat, maize, and wheat/maize bread) collected in Oporto region (Northern Portugal). OTAwas detected in 84 % of the samples with a maximum value of 2.87 ng/g below the European maximum limit established for OTA in cereal products of 3 ng/g.

Response surface methodology applied to SPE for the determination of ibuprofen in various types of water samples

Over the last few years, there has been a growing concern about the presence of pharmaceuticals in the environment. The main objective of this study was to develop and validate an SPE method using surface response methodology for the determination of ibuprofen in different types of water samples. The influence of sample pH and sample volume on the ibuprofen recovery was studied. The effect of each studied independent variable is pronounced on the dependent variable (ibuprofen recovery). Good selectivity, extraction efficiency, and precision were achieved using 600 mL of sample volume with the pH adjusted to 2.2. LC with fluorescence detection was employed. The optimized method was applied to 20 water samples from the North and South of Portugal.

Demand response management in power systems using a particle swarm optimization approach

Competitive electricity markets have arisen as a result of power-sector restructuration and power-system deregulation. The players participating in competitive electricity markets must define strategies and make decisions using all the available information and business opportunities.

The influence of inter-domain mobility on message stream response time in wired/wireless PROFIBUS-based networks

In previous works we have proposed a hybrid wired/wireless PROFIBUS solution where the interconnection between the heterogeneous media was accomplished through bridge-like devices with wireless stations being able to move between different wireless cells. Additionally, we had also proposed a worst-case timing analysis assuming that stations were stationary. In this paper we advance these previous works by proposing a worst-case timing analysis for the system’s message streams considering the effect of inter-cell mobility.

Distributed active traction control system applied to the RoboCup middle size league

This work addresses the problem of traction control in mobile wheeled robots in the particular case of the RoboCup Middle Size League (MSL). The slip control problem is formulated using simple friction models for ISePorto Team robots with a differential wheel configuration. Traction was also characterized experimentally in the MSL scenario for relevant game events. This work proposes a hierarchical traction control architecture which relies in local slip detection and control at each wheel, with relevant information being relayed to a higher level responsible for global robot motion control. A dedicated one axis control embedded hardware subsystem allowing complex local control, high frequency current sensing and odometric information procession was developed. This local axis control board is integrated in a distributed system using CAN bus communications. The slipping observer was implemented in the axis control hardware nodes integrated in the ISePorto robots and was used to control and detect loss of for traction. %and to detect the ball in the kicking device. An external vision system was used to perform a qualitative analysis of the slip detection and observer performance results are presented.

Evaluating P-NET message's response time with fixed priority queuing at application process level

P-NET is a multi-master fieldbus standard based on a virtual token passing scheme. In P-NET each master is allowed to transmit only one message per token visit. In the worst-case, the communication response time can be derived considering that, in each token cycle, all stations use the token to transmit a message. In this paper, we define a more sophisticated P-NET model, which considers the actual token utilisation. We then analyse the possibility of implementing a local priority-based scheduling policy to improve the real-time behaviour of P-NET.