Calcifications vasculaires et déficit en vitamine K: un facteur de risque modifiable dans l'insuffisance rénale chronique [Vascular calcifications and vitamin K deficiency: a modifiable risk factor in chronic kidney disease].

The mechanisms of vascular calcifications in chronic renal failure are complex. Apart for clotting factors, vitamin K-dependent proteins include matrix Gla protein. Glutamic acid residues in matrix Gla protein are carboxylated by vitamin K-dependent gamma-carboxylase, which enables it to inhibit calcification. The purpose of this review is to discuss available evidence implicating vitamin K as a modifiable risk factor in the pathogenesis of vascular calcification in renal diseases.

A Gestão de Stock: O Fornecimento de OutPut como factor de redução de custo

O presente trabalho tem como objectivo mostrar a importância que a Gestão económica de Stock tem no processo de redução de custo, por via da implementação de um modelo. E para isso far-se-á um estudo de caso numa empresa inserida no ramo de transformação de pescado – FRESCOMAR. A metodologia adoptada para alcançar os objectivos propostos passou pela pesquisa bibliográfica, recolha de dados e de informação relevante junto da empresa e tratamento dos dados numa folha de Excel. O modelo de gestão de Stock a ser implementado depende essencialmente da componente procura, onde que para uma empresa com procura constante utiliza-se os modelos determinísticos e para uma com procura aleatória utiliza-se os modelos estocásticos (Nível de Encomenda e Revisão Cíclica). Nos modelos determinísticos temos 4 modelos diferenciados pela forma de reposição e a admissibilidade da procura. Com as informações recolhidas junto da empresa em estudo escolhemos implementar o modelo de reposição não instantânea com ruptura não permitida e obtivemos a optimização do Stock com níveis reduzidos de produção e consequentemente houve uma diminuição do custo. Com resultados obtiveram-se ainda valores da Quantidade Óptima a ser Produzida, do Stock Máximo e do Custo Total Óptimo por unidade de tempo. Devido a diversidade de produtos propomos à empresa a utilização da análise ABC para classificar os produtos reagrupando-os em classes A, B e C, conforme o peso no consumo de Stock.

Leaf-litter amount as a factor in the structure of a ponerine ants community (Hymenoptera, Formicidae, Ponerinae) in an eastern Amazonian rainforest, Brazil

Leaf-litter amount as a factor in the structure of a ponerine ants community (Hymenoptera, Formicidae, Ponerinae) in an eastern Amazonian rainforest, Brazil. Leaf-litter may be an important factor in structuring ponerine ant communities (Hymenoptera, Formicidae, Ponerinae) in tropical rainforests. We specifically examined how leaf-litter affects the structure of a ponerine ant community in primary Amazonian rainforest sites at the Ferreira Penna Scientific Station, Pará, Brazil. A total of 53 species belonging to eight genera of three ponerine tribes were collected with mini-Winkler extractors. The amount of leaf-litter positively affected the abundance and richness of the ponerine ant community, and also influenced species composition. Nearby samples often had low species similarity, especially when adjacent samples differed in the amount of leaf-litter. Leaf-litter availability in Amazonian primary forests is a key factor for distribution of ground-dwelling ponerine species, even at small scales.

The social value of health programs: Is age a relevant factor?

In cost-effectiveness analysis (CEA) it is usually assumed that a QALY is of equal value to everybody, irrespective of the patient's age. However, it is possible that society assigns different social values to a QALY according to who gets it. In this paper we discuss the possibility of weighting health benefits for age in CEA. We also examinethe possibility that age-related preferences depend on the size of the health gain. An experiment was performedto test these hypotheses. The results assessing suggest that the patient's age is a relevant factor when assessing health gains.

A liderança como factor de sucesso empresarial O caso da empresa Anjos Mundilar

O desempenho da empresa é influenciado pelas competências dos seus funcionários. A competência humana aliada a outros recursos empresariais dá origem e sustentação à competência empresarial. A participação dos funcionários no processo de gestão de competências expondo as suas expectativas, motivações e também, percepções a respeito do seu superior e da estratégia de negócios da empresa é fundamental para o sucesso empresarial.

Auditoria interna como factor de promoção da qualidade do serviço educativo – sua aplicação no controlo dos sumários na Universidade Jean Piaget de Cabo Verde

Este trabalho aborda a auditoria como um meio para a promoção da qualidade de ensino praticado na Universidade Jean Piaget de Cabo Verde, tendo como referências os resultados das análises efectuadas aos sumários. De referir que, para esse efeito, tivemos que partir de extracto amostral de 25% dos 16 cursos de graduação que vêm sendo ministrados, procurando fazer jus à metodologia inicialmente escolhida que, para além da pesquisa bibliográfica, inclui, igualmente, o tratamento estatístico dos dados recolhidos. No tocante à recolha, ao tratamento e à análise dos dados, recorremos a duas abordagens, isto é, a abordagem quantitativa e a abordagem qualitativa. Na verdade, a abordagem quantitativa aparece já no momento do extracto da amostra; todavia, passa a estar mais evidenciada depois de termos elaborado grelhas que, com efeito, nos permitiram recolher e, consequentemente, fazer o tratamento dos dados relacionados com o cumprimento da carga horária e dos itens apontados nos programas pelo docente de cada disciplina, bem como no que toca ao cumprimento das exigências formais exigidas pela UniPiaget, com auxílio dos programas Excel e SPSS versão 11.0 for Windows.

Human immunodeficiency virus type 1 fitness is a determining factor in viral rebound and set point in chronic infection.

Human immunodeficiency virus type 1 (HIV-1) isolates from 20 chronically infected patients who participated in a structured treatment interruption (STI) trial were studied to determine whether viral fitness influences reestablishment of viremia. Viruses derived from individuals who spontaneously controlled viremia had significantly lower in vitro replication capacities than viruses derived from individuals that did not control viremia after interruption of antiretroviral therapy (ART), and replication capacities correlated with pre-ART and post-STI viral set points. Of note, no clinically relevant improvement of viral loads upon STI occurred. Virus isolates from controlling and noncontrolling patients were indistinguishable in terms of coreceptor usage, genetic subtype, and sensitivity to neutralizing antibodies. In contrast, viruses from controlling patients exhibited increased sensitivity to inhibition by chemokines. Sensitivity to inhibition by RANTES correlated strongly with slower replication kinetics of the virus isolates, suggesting a marked dependency of these virus isolates on high coreceptor densities on the target cells. In summary, our data indicate that viral fitness is a driving factor in determining the magnitude of viral rebound and viral set point in chronic HIV-1 infection, and thus fitness should be considered as a parameter influencing the outcome of therapeutic intervention in chronic infection.

Can the trabecular bone score (TBS) be considered as a major clinical risk factor (CRF) of osteoporotic fractures? A meta-like analysis

Abstract: To have an added value over BMD, a CRF of osteoporotic fracture must be predictable of the fracture, independent of BMD, reversible and quantifiable. Many major recognized CRF exist.Out of these factorsmany of themare indirect factor of bone quality. TBS predicts fracture independently of BMD as demonstrated from previous studies. The aim of the study is to verify if TBS can be considered as a major CRF of osteoporotic fracture. Existing validated datasets of Caucasian women were analyzed. These datasets stem from different studies performed by the authors of this report or provided to our group. However, the level of evidence of these studies will vary. Thus, the different datasets were weighted differently according to their design. This meta-like analysis involves more than 32000 women (≥50 years) with 2000 osteoporotic fractures from two prospective studies (OFELY&MANITOBA) and 7 crosssectional studies. Weighted relative risk (RR) for TBS was expressed for each decrease of one standard deviation as well as per tertile difference (TBS=1.300 and 1.200) and compared with those obtained for the major CRF included in FRAX®. Overall TBS RR obtained (adjusted for age) was 1.79 [95%CI-1.37-2.37]. For all women combined, RR for fracture for the lowest comparedwith themiddle TBS tertilewas 1.55[1.46- 1.68] and for the lowest compared with the highest TBS tertile was 2.8[2.70-3.00]. TBS is comparable to most of the major CRF (Fig 1) and thus could be used as one of them. Further studies have to be conducted to confirm these first findings.

Liderança como factor de sucesso na gestão escolar O caso da Escola Secundária “Amor de Deus”

O presente trabalho de investigação destina-se a obtenção do grau de licenciatura em ciências de educação e praxis educativa, variante administração escolar na Universidade Jean Piaget de Cabo Verde, O trabalho de investigação intitula-se liderança como factor de sucesso na gestão escolar: O caso da escola secundária ―Amor de Deus‖ (cidade da praia), local de incidência de estudo. A metodologia utilizada permitiu-nos fazer consulta bibliográfica e sitografica sobre o tema. No que refere ao inquérito por questionário, uma amostra de 20 professores deram os seus contributos no universo de 43 docentes efectivo da escola, e a entrevista foi feita à directora da escola. Constatamos que a gestão das instituições do ensino secundário Amor de Deus que consideramos que uma escola nova está a atingir o nível alto de democratização uma vez que com os dirigentes aceitam as opiniões (quando relevante) dos diferentes elementos das organizações dando-lhes a autonomia e conferindo um vasto leque de competências aos seus diversos órgãos de gestão, nos planos administrativos, pedagógicos e disciplinar. O presente trabalho estudou o ciclo de gestão escolar das escolas secundárias a luz de do Decreto-Lei n° 20/2002 de 19 de Agosto, com vista a compreender os modelos de gestão escolar e a autonomia da escola como condição indispensável à prestação de um serviço educativo de qualidade. Muito são os problemas que se tem colocado às escolas secundárias de Cabo Verde nesse momento, como por exemplo os objectivos da escola, sua forma de actuação perante os dilemas gerado nessa sociedade em transformação e a sua forma de gestão. Neste sentido o tema em estudo é sem dúvida, polémico e de grande importância para as organizações educativas em geral, e em particular para a escola secundária em estudo.

A liderança como Factor de Motivação para o Trabalho em Equipa

A liderança constitui, hoje, um tema muito debatido pela sua importância no seio das organizações. Este factor é considerado por todas as organizações que têm objectivos e metas a alcançar. Quando falamos no alcance dos objectivos e metas, torna-se necessário mencionar a equipa que vai trabalhar para este fim. Daí a importância de referirmos a “Liderança como Factor de Motivação para o Trabalho em Equipa”. Visando contribuir para análise desta temática e a obtenção do grau de licenciatura, escolhemos o contexto da instituição Centro de Emprego e Formação Profissional da Praia (CEFPP), para fazer o nosso estudo. Ela que é uma organização que promove a formação, orientação e inserção na vida profissional, e tal como outras organizações necessita do exercício da liderança para motivação de sua equipa, á obtenção de resultados satisfatórios. O objectivo principal do nosso estudo é saber se o estilo de liderança predominantemente adoptado no CEFP da Praia incentiva o trabalho em equipa. Para atingir esse objectivo, apoiamos teoricamente, em autores que têm trabalhado a temática em questão e empiricamente, no estudo de caso realizado no “Centro de Emprego e Formação Profissional da Praia”, situado em Chão de Areia, Cidade da Praia. De referir que a recolha de dados foi efectuada mediante a aplicação de um questionário aos colaboradores e realização de uma entrevista ao Director do Centro. Quanto ao tratamento dos dados recolhidos através do questionário, recorremos ao Método Estatístico e dos dados da entrevista o Método Descritivo. Dos dados obtidos concluímos que o estilo de liderança predominante é o estilo Democrático e este incentiva os colaboradores a trabalharem em equipa.

Achievement of at least very good partial response is a simple and robust prognostic factor in patients with multiple myeloma treated with high-dose therapy: long-term analysis of the IFM 99-02 and 99-04 Trials.

PURPOSE: The prognostic impact of complete response (CR) achievement in multiple myeloma (MM) has been shown mostly in the context of autologous stem-cell transplantation. Other levels of response have been defined because, even with high-dose therapy, CR is a relatively rare event. The purpose of this study was to analyze the prognostic impact of very good partial response (VGPR) in patients treated with high-dose therapy. PATIENTS AND METHODS: All patients were included in the Intergroupe Francophone du Myelome 99-02 and 99-04 trials and treated with vincristine, doxorubicin, and dexamethasone (VAD) induction therapy followed by double autologous stem-cell transplantation (ASCT). Best post-ASCT response assessment was available for 802 patients. RESULTS: With a median follow-up of 67 months, median event-free survival (EFS) and 5-year EFS were 42 months and 34%, respectively, for 405 patients who achieved at least VGPR after ASCT versus 32 months and 26% in 288 patients who achieved only partial remission (P = .005). Five-year overall survival (OS) was significantly superior in patients achieving at least VGPR (74% v 61% P = .0017). In multivariate analysis, achievement of less than VGPR was an independent factor predicting shorter EFS and OS. Response to VAD had no impact on EFS and OS. The impact of VGPR achievement on EFS and OS was significant in patients with International Staging System stages 2 to 3 and for patients with poor-risk cytogenetics t(4;14) or del(17p). CONCLUSION: In the context of ASCT, achievement of at least VGPR is a simple prognostic factor that has importance in intermediate and high-risk MM and can be informative in more patients than CR.

Transcriptional activation of the GLUT2 gene by the IPF-1/STF-1/IDX-1 homeobox factor.

The homeodomain protein PDX-1, referred as IPF-1/STF-1/IDX-1, is a transcriptional factor that plays a critical role in the control of several genes expressed in the pancreatic islet. PDX-1 gene expression has been previously shown to be reduced in cultured beta-cell lines chronically exposed to high glucose concentrations. As the glucose transporter type 2 (GLUT2) gene expression is selectively decreased in the beta-pancreatic cells of experimental models of diabetes, we postulated that the loss of GLUT2 gene expression in the pancreatic islets of diabetic animals may be due to the loss of PDX-1 transacting function on the GLUT2 gene. We, therefore, investigated the potential role of PDX-1 in the transcriptional control of GLUT2. We have identified a repeat of a TAAT motif (5'-TAATA-ATAACA-3') conserved in the sequence of the human and murine GLUT2 promoters. Recombinant PDX-1 binds to this GLUT2TAAT motif in electrophoretic mobility shift experiments. PDX-1 antiserum detects the formation of the complex of PDX-1 with the GLUT2TAAT motif in nuclear extracts from the pancreatic insulin-secreting cell line, beta TC3. The GLUT2TAAT motif was mutated in the murine GLUT2 promoter (-1308/+49 bp) linked to a luciferase reporter gene and transfected into beta TC3 cells. Compared with the transcriptional activity of the wild type promoter, that of the mutated promoter decreases by 41%. Multiple copies of the GLUT2TAAT motif were ligated 5' to a heterologous promoter and transfected into a PDX-1-expressing cell line (beta TC3) and into cell lines lacking the homeobox factor (InR1-G9 and JEG-3). The GLUT2TAAT motif mediates the activation of the heterologous promoter in the PDX-1-expressing cell line but not in InR1-G9 or JEG-3 cell lines. Furthermore, cotransfection in a PDX-1-deficient cell line with the expression vector encoding PDX-1 transactivates specifically the heterologous promoter containing the multimerized GLUT2TAAT motif. These data demonstrate that the murine GLUT2 promoter is controlled by the PDX-1 homeobox factor through the identified GLUT2TAAT motif.

Loss of the BMP Antagonist, SMOC-1, Causes Ophthalmo-Acromelic (Waardenburg Anophthalmia) Syndrome in Humans and Mice.

Ophthalmo-acromelic syndrome (OAS), also known as Waardenburg Anophthalmia syndrome, is defined by the combination of eye malformations, most commonly bilateral anophthalmia, with post-axial oligosyndactyly. Homozygosity mapping and subsequent targeted mutation analysis of a locus on 14q24.2 identified homozygous mutations in SMOC1 (SPARC-related modular calcium binding 1) in eight unrelated families. Four of these mutations are nonsense, two frame-shift, and two missense. The missense mutations are both in the second Thyroglobulin Type-1 (Tg1) domain of the protein. The orthologous gene in the mouse, Smoc1, shows site- and stage-specific expression during eye, limb, craniofacial, and somite development. We also report a targeted pre-conditional gene-trap mutation of Smoc1 (Smoc1(tm1a)) that reduces mRNA to ∼10% of wild-type levels. This gene-trap results in highly penetrant hindlimb post-axial oligosyndactyly in homozygous mutant animals (Smoc1(tm1a/tm1a)). Eye malformations, most commonly coloboma, and cleft palate occur in a significant proportion of Smoc1(tm1a/tm1a) embryos and pups. Thus partial loss of Smoc-1 results in a convincing phenocopy of the human disease. SMOC-1 is one of the two mammalian paralogs of Drosophila Pentagone, an inhibitor of decapentaplegic. The orthologous gene in Xenopus laevis, Smoc-1, also functions as a Bone Morphogenic Protein (BMP) antagonist in early embryogenesis. Loss of BMP antagonism during mammalian development provides a plausible explanation for both the limb and eye phenotype in humans and mice.

Thiamine-auxotrophic mutants of Pseudomonas fluorescens CHA0 are defective in cell-cell signaling and biocontrol factor expression.

In the biocontrol strain Pseudomonas fluorescens CHA0, the Gac/Rsm signal transduction pathway positively controls the synthesis of antifungal secondary metabolites and exoenzymes. In this way, the GacS/GacA two-component system determines the expression of three small regulatory RNAs (RsmX, RsmY, and RsmZ) in a process activated by the strain's own signal molecules, which are not related to N-acyl-homoserine lactones. Transposon Tn5 was used to isolate P. fluorescens CHA0 insertion mutants that expressed an rsmZ-gfp fusion at reduced levels. Five of these mutants were gacS negative, and in them the gacS mutation could be complemented for exoproduct and signal synthesis by the gacS wild-type allele. Furthermore, two thiamine-auxotrophic (thiC) mutants that exhibited decreased signal synthesis in the presence of 5 x 10(-8) M thiamine were found. Under these conditions, a thiC mutant grew normally but showed reduced expression of the three small RNAs, the exoprotease AprA, and the antibiotic 2,4-diacetylphloroglucinol. In a gnotobiotic system, a thiC mutant was impaired for biological control of Pythium ultimum on cress. Addition of excess exogenous thiamine restored all deficiencies of the mutant. Thus, thiamine appears to be an important factor in the expression of biological control by P. fluorescens.