Synthesis and computer-assisted design of mitochondrial electron transport-chain inhibitors as antimalarial agents

Tese de doutoramento, Farmácia (Química Farmacêutica e Terapêutica), Universidade de Lisboa, Faculdade de Farmácia, 2014

Results of computer assisted navigation in Total Knee Arthroplasty (TKA): comparison with the conventional method

The aim of this retrospective study was to compare the clinical and radiographic results after TKA (PFC, DePuy), performed either by computer assisted navigation (CAS, Brainlab, Johnson&Johnson) or by conventional means. Material and methods: Between May and December 2006 we reviewed 36 conventional TKA performed between 2002 and 2003 (group A) and 37 navigated TKA performed between 2005 and 2006 (group B) by the same experienced surgeon. The mean age in group A was 74 years (range 62-90) and 73 (range 58-85) in group B with a similar age distribution. The preoperative mechanical axes in group A ranged from -13° varus to +13° valgus (mean absolute deviation 6.83°, SD 3.86), in group B from -13° to +16° (mean absolute deviation 5.35, SD 4.29). Patients with a previous tibial osteotomy or revision arthroplasty were excluded from the study. Examination was done by an experienced orthopedic resident independent of the surgeon. All patients had pre- and postoperative long standing radiographs. The IKSS and the WOMAC were utilized to determine the clinical outcome. Patient's degree of satisfaction was assessed on a visual analogous scale (VAS). Results: 32 of the 37 navigated TKAs (86,5%) showed a postoperative mechanical axis within the limits of 3 degrees of valgus or varus deviation compared to only 24 (66%) of the 36 standard TKAs. This difference was significant (p = 0.045). The mean absolute deviation from neutral axis was 3.00° (range -5° to +9°, SD: 1.75) in group A in comparison to 1.54° (range -5° to +4°, SD: 1.41) in group B with a highly significant difference (p = 0.000). Furthermore, both groups showed a significant postoperative improvement of their mean IKSS-values (group A: 89 preoperative to 169 postoperative, group B 88 to 176) without a significant difference between the two groups. Neither the WOMAC nor the patient's degree of satisfaction - as assessed by VAS - showed significant differences. Operation time was significantly higher in group B (mean 119.9 min.) than in group A (mean 99.6 min., p <0.000). Conclusion: Our study showed consistent significant improvement of postoperative frontal alignment in TKA by computer assisted navigation (CAS) compared to standard methods, even in the hands of a surgeon well experienced in standard TKA implantation. However, the follow-up time of this study was not long enough to judge differences in clinical outcome. Thus, the relevance of computer navigation for clinical outcome and survival of TKA remains to be proved in long term studies to justify the longer operation time. References 1 Stulberg SD. Clin Orth Rel Res. 2003;(416):177-84. 2 Chauhan SK. JBJS Br. 2004;86(3):372-7. 3 Bäthis H, et al. Orthopäde. 2006;35(10):1056-65.

Variability of ascending aorta diameter measurements as assessed with electrocardiography-gated multidetector computerized tomography and computer assisted diagnosis software.

Recently, morphometric measurements of the ascending aorta have been done with ECG-gated multidector computerized tomography (MDCT) to help the development of future novel transcatheter therapies (TCT); nevertheless, the variability of such measurements remains unknown. Thirty patients referred for ECG-gated CT thoracic angiography were evaluated. Continuous reformations of the ascending aorta, perpendicular to the centerline, were obtained automatically with a commercially available computer aided diagnosis (CAD). Then measurements of the maximal diameter were done with the CAD and manually by two observers (separately). Measurements were repeated one month later. The Bland-Altman method, Spearman coefficients, and a Wilcoxon signed-rank test were used to evaluate the variability, the correlation, and the differences between observers. The interobserver variability for maximal diameter between the two observers was up to 1.2 mm with limits of agreement [-1.5, +0.9] mm; whereas the intraobserver limits were [-1.2, +1.0] mm for the first observer and [-0.8, +0.8] mm for the second observer. The intraobserver CAD variability was 0.8 mm. The correlation was good between observers and the CAD (0.980-0.986); however, significant differences do exist (P<0.001). The maximum variability observed was 1.2 mm and should be considered in reports of measurements of the ascending aorta. The CAD is as reproducible as an experienced reader.

Perceptions of some teachers about the similarities and/or differences in teaching online versus in a classroom environment /

The introduction of computer and communications technology, and particularly the internet, into education has opened up some new possibilities for teaching and learning. Courses designed and delivered in an online environment offer the possibility of highly interactive and individually focussed teaching and learning experiences. However, online courses also present new challenges for both teachers and students. A qualitative study was conducted to explore teachers' perceptions about the similarities and differences in teaching in the online and face-to-face (F2F) environments. Focus group discussions were held with 5 teachers; 2 teachers were interviewed in depth. The participants, 3 female and 2 male, were full-time teachers from a large College of Applied Arts & Technology in southern Ontario. Each of them had over 10 years of F2F teaching experience and each had been involved in the development and teaching of at least one online course. i - -; The study focussed on how teaching in the online environment compares with teaching in the F2F environment, what roles teachers and students adopt in each setting, what learning communities mean online and F2F and how they are developed, and how institutional policies, procedures, and infrastructure affect teaching and learning F2F and online. This study was emic in nature, that is the teachers' words determine the themes identified throughout the study. The factors identified as affecting teaching in an online environment included teacher issues such as course design, motivation to teach online, teaching style, role, characteristics or skills, and strategies. Student issues as perceived by the teachers included learning styles, role, and characteristics or skills. As well, technology issues such as a reliable infrastructure, clear role and responsibilities for maintaining the infrastructure, support, and multimedia capability affected teaching online. Finally, administrative policies and procedures, including teacher selection and training, registration and scheduling procedures, intellectual property and workload policies, and the development and communication of a comprehensive strategic plan were found to impact on teaching online. The teachers shared some of the benefits they perceived about teaching online as well as some of the challenges they had faced and challenges they perceived students had faced online. Overall, the teachers feh that there were more similarities than differences in teaching between the two environments, with the main differences being the change from F2F verbal interactions involving body language to online written interactions without body language cues, and the fundamental reliance on technology in the online environment. These findings support previous research in online teaching and learning, and add teachers' perspectives on the factors that stay the same and the factors that change when moving from a F2F environment to an online environment.

Introducing e-learning in a large multisite academic health sciences centre: a case study of e-curriculum planning and educator support /

This qualitative study investigated how a team of 7 hospital educators collaborated to develop e-curriculum units to pilot for a newly acquired learning -r management system at a large, multisite academic health sciences centre. A case study approach was used to examine how the e-Curriculum Team was structured, how the educators worked together to develop strategies to better utilize e-leaming in their ovwi practice, what e-curriculum they chose to develop, and how they determined their priorities for e-curriculum development. It also inquired into how they planned to involve other educators in using e-leaming. One set of semistructured interviews with the 6 hospital educators involved in the project, as well as minutes of team meetings and the researcher's journal, were analyzed (the researcher was also a hospital educator on the team). Project management structure, educator support, and organizational pressures on the implementation project feature prominently in the case study. This study suggests that implementation of e-leaming will be more successful if (a) educators involved in the development of e-leaming curriculum are supported in their role as change agents, (b) the pain of vmleaming current educational practice is considered, (c) the limitations of the software being implemented are recognized, (d) time is spent leaming about best practice, and (e) the project is protected as much as possible from organizational pressures and distractions.

A narrative journey of teacher reflexivity and authenticity in technological environments /

This qualitative narrative inquiry was driven by my desire to further explore my personal discovery that my utilization of educational technologies in teaching and learning environments seemed to heighten a sense of creativity, which in turn increased reflective practice and authenticity in my teaching. A narrative inquiry approach was used as it offered the opportunity to uncover the deeper meanings of authenticity and reflection as participants' personal experiences were coconstructed and reconstructed in relationship with me and in relationship to a social milieu. To gain further insight into this potential phenomenon, I engaged in 2 conversational interviews with 2 other teachers from an Ontario College in a large urban centre who have utilized educational technologies in their teaching and learning communities and I maintained a research journal, constructed during the interview process, to record my own emerging narrative accounts, reflections, insights and further questions. The field texts consisted of transcriptions of the interviews and my reflective journal. Research texts were developed as field texts were listened to multiple times and texts were examined for meanings and themes. The educational technologies that both women focused on in the interview were digital video of children as they play, learn and develop and the use of an audible teacher voice in online courses. The invitation given to students to explore and discover meaning in videos of children as they watched them with the teacher seemed to be a catalyst for authenticity and a sense of synergy in the classroom. The power of the audible teacher voice came through as an essential component in online learning environments to offer students a sense of humanness and connection with the teacher. Relationships in both online and face to face classrooms emerged as a necessary and central component to all teaching and learning communities. The theme of paradox also emerged as participants recognized that educational technologies can be used in ways that enhance creativity, authenticity, reflection and relationships or in ways that hinder these qualities in the teaching and learning community. Knowledge of the common experiences of college educators who utilize educational technologies, specifically digital video of children to educate early childhood educators, might give meaning and insight to inform the practice of other teachers who seek authentic, reflexive practice in the classroom and in on line environments.

The Impact of a Text-Reader Support Program on Intermediate Students' Reading Comprehension

This study examined the efficacy of providing four Grade 7 and 8 students with reading difficulties with explicit instruction in the use of reading comprehension strategies while using text-reader software. Specifically, the study explored participants' combined use of a text-reader and question-answering comprehension strategy during a 6-week instructional program. Using a qualitative case study methodology approach, participants' experiences using text-reader software, with the presence of explicit instruction in evidence-based reading comprehension strategies, were examined. The study involved three phases: (a) the first phase consisted of individual interviews with the participants and their parents; (b) the second phase consisted of a nine session course; and (c) the third phase consisted of individual exit interviews and a focus group discussion. After the data collection phases were completed, data were analyzed and coded for emerging themes, with-quantitativ,e measures of participants' reading performance used as descriptive data. The data suggested that assistive technology can serve as an instructional "hook", motivating students to engage actively in the reading processes, especially when accompanied by explicit strategy instruction. Participants' experiences also reflected development of strategy use and use of text-reader software and the importance of social interactions in developing reading comprehension skills. The findings of this study support the view that the integration of instruction using evidence-based practices are important and vital components in the inclusion oftext-reader software as part of students' educational programming. Also, the findings from this study can be extended to develop in-class programming for students using text-reader software.

Video Object Tracking And Analysis For Computer Assisted Surgery

Pedicle screw insertion technique has made revolution in the surgical treatment of spinal fractures and spinal disorders. Although X- ray fluoroscopy based navigation is popular, there is risk of prolonged exposure to X- ray radiation. Systems that have lower radiation risk are generally quite expensive. The position and orientation of the drill is clinically very important in pedicle screw fixation. In this paper, the position and orientation of the marker on the drill is determined using pattern recognition based methods, using geometric features, obtained from the input video sequence taken from CCD camera. A search is then performed on the video frames after preprocessing, to obtain the exact position and orientation of the drill. An animated graphics, showing the instantaneous position and orientation of the drill is then overlaid on the processed video for real time drill control and navigation

Evaluation Of A Novel Method Of Real Time Computer Assisted Spine Surgery

In this paper the effectiveness of a novel method of computer assisted pedicle screw insertion was studied using testing of hypothesis procedure with a sample size of 48. Pattern recognition based on geometric features of markers on the drill has been performed on real time optical video obtained from orthogonally placed CCD cameras. The study reveals the exactness of the calculated position of the drill using navigation based on CT image of the vertebra and real time optical video of the drill. The significance value is 0.424 at 95% confidence level which indicates good precision with a standard mean error of only 0.00724. The virtual vision method is less hazardous to both patient and the surgeon

Corrector d’autòmats per la plataforma ACME : mòdul pertanyent al Projecte ACME

Fa uns anys un grup de professors del departament d’Informàtica i Matemàtica Aplicada de la Universitat de Girona va decidir endinsar-se al món de l’ensenyament a través d’Internet (e-learning). D’aquí va néixer el projecte ACME (Avaluació Continuada i Millora de l’Ensenyament). Inicialment l’ACME anava dirigit a reduir l’elevat fracàs dels alumnes a les assignatures de matemàtiques. El resultat va ser tan bo que es va ampliar a altres camps d’estudi com la química o la informàtica, amb tot i això encara hi ha moltes matèries a les quals no dóna suport. Aquest Projecte Final de Carrera neix per donar suport a un nou tipus de problemes dins de la plataforma ACME, els autòmats finits. Aquest nou mòdul inclourà les eines necessàries per poder generar diferents tipus de problemes sobre autòmats finits i la seva posterior correcció, donant suport a les assignatures de LGA (Llenguatges, Gramàtiques i Autòmats) i TALLF (Teoria d’Autòmats i Llenguatges Formals)

Designing context-aware adaptive units of learning based on IMS-LD standard

Learning contents adaptation has been a subject of interest in the research area of the adaptive hypermedia systems. Defining which variables and which standards can be considered to model adaptive content delivery processes is one of the main challenges in pedagogical design over e-learning environments. In this paper some specifications, architectures and technologies that can be used in contents adaptation processes considering characteristics of the context are described and a proposal to integrate some of these characteristics in the design of units of learning using adaptation conditions in a structure of IMS-Learning Design (IMS-LD) is presented. The key contribution of this work is the generation of instructional designs considering the context, which can be used in Learning Management Systems (LMSs) and diverse mobile devices

Adaption of Courses and Learning Environment to the User Context in dotLRN

The explosive growth of Internet during the last years has been reflected in the ever-increasing amount of the diversity and heterogeneity of user preferences, types and features of devices and access networks. Usually the heterogeneity in the context of the users which request Web contents is not taken into account by the servers that deliver them implying that these contents will not always suit their needs. In the particular case of e-learning platforms this issue is especially critical due to the fact that it puts at stake the knowledge acquired by their users. In the following paper we present a system that aims to provide the dotLRN e-learning platform with the capability to adapt to its users context. By integrating dotLRN with a multi-agent hypermedia system, online courses being undertaken by students as well as their learning environment are adapted in real time

Microcalcification evaluation in computer assisted diagnosis for digital mammography

In order to develop applications for z;isual interpretation of medical images, the early detection and evaluation of microcalcifications in digital mammograms is verg important since their presence is often associated with a high incidence of breast cancers. Accurate classification into benign and malignant groups would help improve diagnostic sensitivity as well as reduce the number of unnecessa y biopsies. The challenge here is the selection of the useful features to distinguish benign from malignant micro calcifications. Our purpose in this work is to analyse a microcalcification evaluation method based on a set of shapebased features extracted from the digitised mammography. The segmentation of the microcalcifications is performed using a fixed-tolerance region growing method to extract boundaries of calcifications with manually selected seed pixels. Taking into account that shapes and sizes of clustered microcalcifications have been associated with a high risk of carcinoma based on digerent subjective measures, such as whether or not the calcifications are irregular, linear, vermiform, branched, rounded or ring like, our efforts were addressed to obtain a feature set related to the shape. The identification of the pammeters concerning the malignant character of the microcalcifications was performed on a set of 146 mammograms with their real diagnosis known in advance from biopsies. This allowed identifying the following shape-based parameters as the relevant ones: Number of clusters, Number of holes, Area, Feret elongation, Roughness, and Elongation. Further experiments on a set of 70 new mammogmms showed that the performance of the classification scheme is close to the mean performance of three expert radiologists, which allows to consider the proposed method for assisting the diagnosis and encourages to continue the investigation in the sense of adding new features not only related to the shape

Curriculum sequencing for an e-learning system based on learning styles

This work shows the use of adaptation techniques involved in an e-learning system that considers students' learning styles and students' knowledge states. The mentioned e-learning system is built on a multiagent framework designed to examine opportunities to improve the teaching and to motivate the students to learn what they want in a user-friendly and assisted environment

Computer Assisted Assessement

Introduction for UG course on TEL