Association of hypertension and hypokalemia with Cushing's syndrome caused by ectopic ACTH secretion: a series of 58 cases.

Cushing's syndrome is associated with hypertension in approximately 80% of cases. Hypertension contributes to the marked increased mortality risk of past or current Cushing's syndrome, largely because of increased cardiovascular risk. Observation of the pathophysiological effect of chronically elevated ACTH and cortisol values in patients with ectopic ACTH secretion complements the available data from acute studies of the effects of ACTH and glucocorticoid infusions in normal volunteers. In a retrospective case review, we identified 58 patients with Cushing's syndrome caused by ectopic ACTH secretion, who were treated at the National Institutes of Health between 1983-1997. The diagnosis of an ectopic ACTH cause was confirmed by inferior petrosal sinus sampling and/or pathologic examination of tumor. The commonest causes were bronchial carcinoid (40%) and thymic carcinoid (10%), but 18 of 58 (31%) patients had an unknown source of ectopic ACTH. Hypertension (systolic blood pressure >140 mmHg and/or diastolic blood pressure >90 mmHg in adults) was noted in 45 of 58 (78%) ectopic Cushing's patients, a prevalence similar to that noted in other endogenous Cushing's syndrome etiologies. Hypertension was severe, deemed to require 3 or more drugs by the treating physicians, in 26 of 58 (45%) patients. Hypokalemia was much more prevalent than in patients with other causes of Cushing's syndrome, affecting 33 of 58 (57%) patients. The range of plasma ACTH (17-1557 pg/mL, normal

Speleothem U-series dating of semi-synchronous climate oscillations during the last deglaciation

Evidence for nearly synchronous climate oscillations during the last deglaciation has been found throughout the Northern Hemisphere but few records are based on independent time scales of calendar years. We present a rare uranium-series dated oxygen-carbon isotope record for a speleothem from Tangshan Cave, China, which demonstrates that abrupt deglacial climatic oscillations from 16 800 to 10 500 yr BP are semi-synchronous with those found in Greenland ice core records. Relatively rapid shifts in speleothem oxygen isotope ratios demonstrate that the intensity of the East Asian monsoon switched in parallel with the abrupt transitions separating the Bolling-Allerod, Younger Dryas, and pre-Boreal climatic reversals. However, the dated isotopic transitions appear to have lasted longer. Our results demonstrate the dominant role of atmospheric teleconnections in the rapid propagation of deglacial climatic signals on a hemispheric scale, and highlight the importance of U-series dated speleothems in the timing and characterization of abrupt climate change. (C) 2003 Elsevier B.V. All rights reserved.

As estatais e as PPPs: o project finance como estrat??gia de garantia de investimentos em infra-estrutura

Este trabalho discute o papel das estatais nas PPPs, de modo a garantir investimentos em infraestrutura pelo financiamento via project finance. Partindo de um contexto de privatiza????es desse setor, que, no Brasil, efetivou-se na d??cada de 1990, buscou-se mostrar como surgiu espa??o para o estabelecimento de PPPs, advindas de novas institui????es resultantes do processo de reforma do Estado. O project finance ?? colocado como uma forma de garantir o financiamento desses investimentos. Sua estrutura financeira, baseada na cria????o de uma pessoa jur??dica para a gest??o do empreendimento, busca dirimir os riscos pela eleva????o do n??mero de participantes e pela securitiza????o de receitas futuras, tornando-as l??quidas em curto prazo. A discuss??o sobre o papel do project finance revela que essa ?? uma estrat??gia vi??vel para a garantia de investimentos por parte das estatais, em parceria com o governo e com outras empresas, que levem ao desenvolvimento socioecon??mico sustent??vel do Pa??s.

O recurso da propaganda na valorização do produto imobiliário nos municípios de Vitória e Serra a partir da segunda metade do século XX

Este trabalho analisa a importância da propaganda no setor da construção imobiliária nos municípios de Vitória e Serra no Espírito Santo, localizados na Região Metropolitana da Grande Vitória (RMGV). Esse setor tem produzido uma série de transformações no espaço urbano da RMGV, onde a propaganda situa-se como parte destas estratégias, constituindo-se numa importante ferramenta. A partir de informações oriundas de entrevistas e de pesquisa bibliográfica e documental, investigamos por que a propaganda vai modificando-se com as formas diferenciadas de produção imobiliária e ganhando importância nos lançamentos de empreendimentos entre as décadas de 1950 a 2010, nos municípios de Vitória e Serra. Ao longo da pesquisa foi possível constatar que os mecanismos institucionais criados pelo Estado trouxeram modificações ao referido setor, o que acarretou na elaboração de estratégias de produção e criação de novos produtos. Tais modificações manifestaram-se na propaganda imobiliária, que atualmente ocupa um lugar de destaque na gestão de marketing implantada nas construtoras e incorporadoras capixabas. Os resultados mostram que ao longo das décadas o setor da construção imobiliária vem elaborando estratégias para criação de novas formas de distinção de seus produtos com intuito de apropriação do espaço urbano nos municípios estudados.

The influence of nationalism in Mercosur and in South America: can the regional integration project survive?

The article discusses if nationalism is getting in the way of regional integration through a Brazilian prism due to Brazil’s pivotal role in regional integration in Mercosur and South America.

A Digital Game Development Education Project

The success of the digital game industry is spawning several undergraduate degrees aiming at the training of digital game developers. Building adequate new courses curricula is not a trivial task and demands a profound analysis of the scientific areas to introduce as well as the dependencies throughout the entire degree. Another important aspect of every academic educational plan are the satellite projects that promote entrepreneurship and provide practical professional experiences to students. This paper presents the main guidelines adopted in the creation of the first digital game development undergraduate degree created in Portugal.

Mechanical Behavior of the Lamellar Structure in Semi-Crystalline Polymers

We have employed molecular dynamics simulations to study the behavior of virtual polymeric materials under an applied uniaxial tensile load. Through computer simulations, one can obtain experimentally inaccessible information about phenomena taking place at the molecular and microscopic levels. Not only can the global material response be monitored and characterized along time, but the response of macromolecular chains can be followed independently if desired. The computer-generated materials were created by emulating the step-wise polymerization, resulting in self-avoiding chains in 3D with controlled degree of orientation along a certain axis. These materials represent a simplified model of the lamellar structure of semi-crystalline polymers,being comprised of an amorphous region surrounded by two crystalline lamellar regions. For the simulations, a series of materials were created, varying i) the lamella thickness, ii) the amorphous region thickness, iii) the preferential chain orientation, and iv) the degree of packing of the amorphous region. Simulation results indicate that the lamella thickness has the strongest influence on the mechanical properties of the lamella-amorphous structure, which is in agreement with experimental data. The other morphological parameters also affect the mechanical response, but to a smaller degree. This research follows previous simulation work on the crack formation and propagation phenomena, deformation mechanisms at the nanoscale, and the influence of the loading conditions on the material response. Computer simulations can improve the fundamental understanding about the phenomena responsible for the behavior of polymeric materials, and will eventually lead to the design of knowledge-based materials with improved properties.

Espectador Activo: Comunicação audiovisual institucional num mundo de redes participativas

Once delighted by the moving image advent as a new method of realistically presenting reality, the viewer has been reposition himself towards the audiovisual contents he consumes, as he is given the opportunity to create and share his own perspective of that reality. We are living in a new technological setting, governed mainly by factors of interactivity, digital systems and technological convergence. The research project that we will present in this paper focuses on the subject of participatory media and the way cultural institutions are increasingly facing the inevitability of a profound revision of their traditional parameters of unidirectional communication, given the increasing availability of tools for audiovisual production as well as the diversity of networked communication contexts. The Serralves Foundation with its Museum of Contemporary Art, in Porto, Portugal, was the subject of a fi rst study of an empirical nature: a series of audiovisual objects were developed, in order to generate material for analysis and proposition. In this new stage of the project, our aim is to identify new procedures and practices that may be effectively implemented within the institutional universe. We intend to propose effi cient audiovisual communication contexts, including the maximizing of the relationship between institutions and audiences regarding dimensions that are traditionally outside the institutional radar: identity, narrative and affection. The project is currently in the process of surveying and categorization, with the aim of producing a map of different vocations and positions of the various institutions in regards to the aforementioned issues, which require participatory communication.

A digital game development education project

The success of the digital game industry is spawning several undergraduate degrees aiming at the training of digital game developers. Building adequate new courses curricula is not a trivial task and demands a profound analysis of the scientific areas to introduce as well as the dependencies throughout the entire degree. Another important aspect of every academic educational plan are the satellite projects that promote entrepreneurship and provide practical professional experiences to students. This paper presents the main guidelines adopted in the creation of the first digital game development undergraduate degree created in Portugal.

A Caregiver Support Platform within the Scope of an Ambient Assisted Living Ecosystem

The Ambient Assisted Living (AAL) area is in constant evolution, providing new technologies to users and enhancing the level of security and comfort that is ensured by house platforms. The Ambient Assisted Living for All (AAL4ALL) project aims to develop a new AAL concept, supported on a unified ecosystem and certification process that enables a heterogeneous environment. The concepts of Intelligent Environments, Ambient Intelligence, and the foundations of the Ambient Assisted Living are all presented in the framework of this project. In this work, we consider a specific platform developed in the scope of AAL4ALL, called UserAccess. The architecture of the platform and its role within the overall AAL4ALL concept, the implementation of the platform, and the available interfaces are presented. In addition, its feasibility is validated through a series of tests.

Protecção contra descargas atmosféricas: aplicação informática de identificação das vulnerabilidades das edificações e de apoio à concepção da protecção

A concepção de instalações eléctricas deve garantir condições de segurança para as pessoas e equipamentos. Para tal é exigida, quer por força de regulamentação ou de normalização, a instalação de dispositivos que garantam a detecção e a protecção contra os defeitos mais comuns nas instalações eléctricas como, por exemplo, as sobreintensidades e as sobretensões. Susceptíveis de criar sobretensões perigosas nas instalações eléctricas, as descargas atmosféricas podem ainda causar danos estruturais elevados, o que, em algumas actividades económicas, torna fundamental a implementação de medidas de protecção contra este fenómeno natural. A protecção contra descargas atmosféricas directas consiste em identificar as vulnerabilidades das estruturas e, nesses locais, implementar dispositivos de captura, direccionamento e escoamento da descarga atmosférica à terra, em condições de segurança. O presente trabalho, desenvolvido no âmbito da dissertação de Mestrado em Engenharia Electrotécnica, visa desenvolver e implementar uma ferramenta computacional, baseada em programas de desenho assistido por computador (CAD) de utilização corrente na área de projecto de arquitectura e de engenharia, que permita, no âmbito de normas internacionais, a análise e implementação de sistemas de protecção em edifícios contra descargas atmosféricas de uma forma rápida e expedita. Baseado num programa CAD 3D, que permite a modelização tridimensional das estruturas a proteger, a ferramenta desenvolvida tentará identificar as suas vulnerabilidades das estruturas às descargas atmosféricas directas, com o intuito de implementar as medidas de protecção mais adequadas do ponto de vista técnico económico. Prevê-se que a ferramenta resultante deste estudo, o Simulador do Modelo Electrogeométrico (SIMODEL), possibilite aos projectistas e particularmente aos alunos das unidades curriculares na área do projecto de instalações eléctricas da Área Departamental de Engenharia de Sistemas e Potencia e Automação (ADESPA) do ISEL, estudar e implementar sistemas de protecção contra descargas atmosféricas (SPDA) baseados na normalização internacional do CENELEC e da IEC, nomeadamente as normas da série 62305.

Improving the learning experience and learning environment of adults in Higher Education – Project LIHE: the Portuguese case

Project LIHE: the Portuguese Case. ESREA Fourth Access Network Conference – “Equity, Access and Participation: Research, Policy and Practice”. Edinburgh (Scotland), 11 – 13 December, 2003.