Amiloidose AL : revisão teórica a propósito de um caso clínico

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Performance accountability in the federal-state transportation program: Factors affecting successful implementation

Governmental accountability is the requirement of government entities to be accountable to the citizenry in order to justify the raising and expenditure of public resources. The concept of service efforts and accomplishments measurement for government programs was introduced by the Governmental Accounting Standards Board (GASB) in Service Efforts and Accomplishments Reporting: Its Time Has Come (1990). This research tested the feasibility of implementing the concept for the Federal-aid highway construction program and identified factors affecting implementation with a case study of the District of Columbia. Changes in condition and performance ratings for specific highway segments in 15 projects, before and after construction expenditures, were evaluated using data provided by the Federal Highway Administration. The results of the evaluation indicated difficulty in drawing conclusions on the state program performance, as a whole. The state program reflects problems within the Federally administered program that severely limit implementation of outcome-oriented performance measurement. Major problems identified with data acquisition are: data reliability, availability, compatibility and consistency among states. Other significant factors affecting implementation are institutional barriers and political barriers. Institutional issues in the Federal Highway Administration include the lack of integration of the fiscal project specific database with the Highway Performance Monitoring System database. The Federal Highway Administration has the ability to resolve both of the data problems, however interviews with key Federal informants indicate this will not occur without external directives and changes to the Federal “stewardship” approach to program administration. ^ The findings indicate many issues must be resolved for successful implementation of outcome-oriented performance measures in the Federal-aid construction program. The issues are organizational and political in nature, however in the current environment resolution is possible. Additional research is desirable and would be useful in overcoming the obstacles to successful implementation. ^

Meniere’s, Migraine & Motion Sickness

CONCLUSION Elevated MSS in MD is likely to be a consequence of the onset of MD and not migraine per se. OBJECTIVES Pathologies of the vestibular system influence motion sickness susceptibility (MSS). Bilateral vestibular deficits lower MSS, vestibular neuritis or benign paroxysmal positional vertigo have little overall effect, whereas vestibular migraine elevates MSS. However, less is known about MSS in Meniere’s disease (MD), a condition in which many patients experience vestibular loss and migraine symptoms. METHODS We conducted an online survey that posed diagnostic and disease questions before addressing frequency of headaches, migraines, visual display dizziness (VDD), syncope, social life and work impact of dizziness (SWID4) and motion sickness susceptibility (MSSQ). The two groups were: diagnosed MD individuals with hearing loss (n=751) and non-MD individuals in the control group (n=400). RESULTS The MD group showed significantly elevated MSS, more headache and migraine, increased VDD, higher SWID4 scores, and increased syncope. MSS was higher in MD than controls only after the development of MD but not before, nor in childhood. Although elevated in MD compared with controls, MSS was lower than migraine patients from past data. Multivariate analysis revealed VDD, SWID4 and MSS in adulthood as the strongest predictors of MD, but not headache nor migraine.

Futures Shock: Are Greedy Brokers Ruining The Economy?

[Excerpt] In a recent public relations document, the New York Stock Exchange defines its mission statement as to: “Support the capital-raising and asset management process by providing the highest quality and most cost-effective, self-regulated marketplace for the trading of financial instruments.” The common thread that runs through this and similar statements made by organized financial markets from Frankfurt to Tokyo is that they hold as their primary goals to help companies raise capital and to provide a liquid and efficient aftermarket for those securities.

Qualidade física e matéria orgânica do solo em sistema de integração lavoura - pecuária submetido a doses de nitrogênio

The animal trampling favors the soil compaction process in sheep raising and crop production integrated systems. This compression has negative effects, hindering the development of roots, the availability of nutrients, water and aeration, causing production losses, making it essential for the assessment of soil physical attributes for monitoring soil quality. Soil organic matter can be used to assess the quality of the soil, due to its relationship with the chemical, physical and biological soil properties. Conservation management system with tillage, along with systems integration between crops and livestock are being used to maintain and even increase the levels of soil organic matter. For that, a field experiment was carried out over a Oxisol clayey Alic in Guarapuava, PR, from de 2006 one. experiment sheep raising and crop production integrated systems The climate classified as Cfb .. The study was to evaluate the soil physical properties and quantify the stock of soil organic carbon and its compartmentalization in system integration crop - livestock with sheep under four nitrogen rates (0, 75, 150 and 225 kg ha-1) in the winter pasture, formed by the consortium oat (Avena strigosa) and ryegrass (Lolium multiflorum) and the effect of grazing (with and without). The soil samples blades density evaluations, total porosity, macro and micro, aggregation and carbon stocks were held in two phases: Phase livestock (after removal of the animals of the area) and phase crop (after maize cultivation). The collection of soil samples were carried out in layers of 0-0.5, 0.05-0.10, 0.10-0.20 and m. Data were subjected to analysis of variance and the hypotheses tested by the F test (p <0.05). For the quantitative effect data regression and the qualitative effect used the test medium. In non-significant regressions used the average and standard deviation treatments. The animal trampling caused an increase in bulk density in the 0.10-0.20 m layer. The dose of 225 kg N ha-1 in winter pasture increased total soil porosity at 8% compared to dose 0 kg N ha-1 in the crop stage. The grazing had no effect on soil macroporosity. GMD of aggregates in the phase after grazing the surface layer was damaged by grazing. Nitrogen rates used in the winter pasture and grazing not influence the total organic carbon stocks. The TOC is not influenced by nitrogen fertilization on grassland. The grazing increases the stock of POC in the 0.10-0.20 m layer livestock phase and cause the stock of POC in the 0-0.5 m layer in the crop stage. The MAC is not influenced by N rates applied in the pasture or by grazing.

Spiritual guides: supporting adults who nurture the spirituality of children

This research considers the role of those who support voluntary youth leaders in their responsibility to nurture spiritual development in children and young people. It discusses particularly those who work in organisations with an ethos of supporting such spiritual development and at the same time of welcoming members of many faiths and encouraging their full participation in their various faith traditions. The specific context of the research is the work of the Guide Movement and, in particular, of Girlguiding in the United Kingdom. The research addresses the current challenges but also the enormous value of providing for young people a multi-faith space in which it is genuinely ‘OK to do God’. It discusses the issues which leaders are raising and some suggestions which trainers have made for addressing these.

Qualidade e responsabilidade social: implementação de um sistema integrado na cooperativa terras de felgueiras

Dissertação de Mestrado em Gestão Integrada da Qualidade, Ambiente e Segurança

Estrategias de logística inversa que permitan la reutilización de llantas usadas

Esta investigación busca desde la logística inversa, mostrar como un producto tan implementado y desechado por la sociedad, puede generar un nuevo uso, e incluso la reintegración total de sus materias primas a la cadena de suministro, mostrando la estrecha relación que existe entre la logística inversa y la reutilización de productos fuera de uso. Para esto se analizara el manejo actual que tienen las llantas en Bogotá, planteando su flujo y dando a conocer el principal punto de falencia, que es la recolección y los diferentes sitios de acopio de estas. Los neumáticos o llantas son desechados anualmente en Bogotá sin medir las consecuencias ambientales que esto trae consigo, pues las quemas a cielo abierto de estos materiales y su almacenamiento inadecuado generan altos riesgos para su entorno y el medio ambiente. Además, el manejo inapropiado de llantas es una de las principales razones por la cual pasan a ser obsoletas al poco tiempo de uso. El proceso de fabricación de llantas es muy similar al proceso de cualquier producto, pues en resumen este cuenta con la implementación de sus materias primas, proceso de manufactura, una inspección final y como resultado un producto terminado, que al ser vendido muchas compañías se libran de la disposición final de las llantas. Pero ahí radica un punto a favor para la logística inversa, donde esta buscara la manera de darle un nuevo ciclo de vida a este producto, a través del reciclaje y la reutilización. Mediante esta investigación, se busca captar los principales lugares de acopio de llantas usadas en Bogotá, de manera que estos serán nuestros principales puntos de información para el proyecto, que permita plantear y definir de manera clara estrategias y conclusiones cualitativas.

Evaluation of Speaker Normalization Methods for Vowel Recognition Using Fuzzy ARTMAP and K-NN

A procedure that uses fuzzy ARTMAP and K-Nearest Neighbor (K-NN) categorizers to evaluate intrinsic and extrinsic speaker normalization methods is described. Each classifier is trained on preprocessed, or normalized, vowel tokens from about 30% of the speakers of the Peterson-Barney database, then tested on data from the remaining speakers. Intrinsic normalization methods included one nonscaled, four psychophysical scales (bark, bark with end-correction, mel, ERB), and three log scales, each tested on four different combinations of the fundamental (Fo) and the formants (F1 , F2, F3). For each scale and frequency combination, four extrinsic speaker adaptation schemes were tested: centroid subtraction across all frequencies (CS), centroid subtraction for each frequency (CSi), linear scale (LS), and linear transformation (LT). A total of 32 intrinsic and 128 extrinsic methods were thus compared. Fuzzy ARTMAP and K-NN showed similar trends, with K-NN performing somewhat better and fuzzy ARTMAP requiring about 1/10 as much memory. The optimal intrinsic normalization method was bark scale, or bark with end-correction, using the differences between all frequencies (Diff All). The order of performance for the extrinsic methods was LT, CSi, LS, and CS, with fuzzy AHTMAP performing best using bark scale with Diff All; and K-NN choosing psychophysical measures for all except CSi.

Speaker Normalization Methods for Vowel Cognition: Comparative Analysis Using Neural Network and Nearest Neighbor Classifiers

Intrinsic and extrinsic speaker normalization methods are systematically compared using a neural network (fuzzy ARTMAP) and L1 and L2 K-Nearest Neighbor (K-NN) categorizers trained and tested on disjoint sets of speakers of the Peterson-Barney vowel database. Intrinsic methods include one nonscaled, four psychophysical scales (bark, bark with endcorrection, mel, ERB), and three log scales, each tested on four combinations of F0 , F1, F2, F3. Extrinsic methods include four speaker adaptation schemes, each combined with the 32 intrinsic methods: centroid subtraction across all frequencies (CS), centroid subtraction for each frequency (CSi), linear scale (LS), and linear transformation (LT). ARTMAP and KNN show similar trends, with K-NN performing better, but requiring about ten times as much memory. The optimal intrinsic normalization method is bark scale, or bark with endcorrection, using the differences between all frequencies (Diff All). The order of performance for the extrinsic methods is LT, CSi, LS, and CS, with fuzzy ARTMAP performing best using bark scale with Diff All; and K-NN choosing psychophysical measures for all except CSi.

Pitch range and vowel duration in the speech of children with Williams syndrome

This paper reports the pitch range and vowel duration data from a group of children with Williams syndrome (WS) in comparison with a group of typically developing children matched for chronological age (CA) and a group matched for receptive language abilities (LA). It is found that the speech of the WS group has a greater pitch range and that vowels tend to be longer in duration than in the speech of the typically developing children. These findings are in line with the impressionistic results reported by Reilly, Klima and Bellugi [17].

Robust and fast vowel recognition using optimum-path forest

The applications of Automatic Vowel Recognition (AVR), which is a sub-part of fundamental importance in most of the speech processing systems, vary from automatic interpretation of spoken language to biometrics. State-of-the-art systems for AVR are based on traditional machine learning models such as Artificial Neural Networks (ANNs) and Support Vector Machines (SVMs), however, such classifiers can not deal with efficiency and effectiveness at the same time, existing a gap to be explored when real-time processing is required. In this work, we present an algorithm for AVR based on the Optimum-Path Forest (OPF), which is an emergent pattern recognition technique recently introduced in literature. Adopting a supervised training procedure and using speech tags from two public datasets, we observed that OPF has outperformed ANNs, SVMs, plus other classifiers, in terms of training time and accuracy. ©2010 IEEE.

Comparative Analysis of the Closed Quotient for Lip and Tongue Trills in Relation to the Sustained Vowel /epsilon/

Various types of trill exercises have been used for a long time as a tool in the treatment and preparation of the voice. Although they are reported to produce vocal benefits in most subjects, their physiology has not yet been studied in depth. The aim of this study was to compare the mean and standard deviation of the closed quotient in exercises of lip and tongue trills with the sustained vowel /epsilon/ in opera singers. Ten professional classical (operatic) singers, reportedly in perfect laryngeal health, served as subjects for this study and underwent electroglottography. During the examination, the subjects were instructed to deliver the sustained vowel /epsilon/ and lip and tongue trills in a same preestablished frequency and intensity. The mean values and standard deviation of the closed quotient were obtained using the software developed for this purpose. The comparison of the results was intrasubjects; maximum intensities were compared only among them and so were minimum intensities. The means of closed quotient were statistically significant only in the strong intensities, and the lip trill was different from the tongue trill and the sustained vowel /epsilon/. The standard deviation of the closed quotient distinguished the sustained vowel /epsilon/ from the lip and tongue trills in the two intensities. We concluded that there is oscillation of the closed quotient during the exercises of tongue and lip trills, and the closed quotient is higher during the performance of exercises of the lip trill, when compared with the two other utterances, only in the strong intensities.