Plenária Virtual Permanente: em busca da interlocução entre os conselhos de saúde

A Plenária Virtual Permanente é um sistema de áudio e vídeo para redes digitais desenvolvido para conselhos de saúde do Brasil. O artigo aborda as discussões que subsidiaram a criação do dispositivo, a descrição do mesmo e os desafios para a inclusão digital no âmbito dessas instâncias de participação.

FY2011 Annual Report Research, Intelligent Transportation Systems, and Technology Transfer Activities

Transportation research makes a difference for Iowans and the nation. Implementation of cost-effective research projects contributes to a transportation network that is safer, more efficient, and longer lasting. Working in cooperation with our partners from universities, industry, other states, and FHWA, as well as participation in the Transportation Research Board (TRB), provides benefits for every facet of the DOT. This allows us to serve our communities and the traveling public more effectively. Pooled fund projects allow leveraging of funds for higher returns on investments. In 2011, Iowa led thirteen active pooled fund studies, participated in twenty-one others, and was wrapping-up, reconciling, and closing out an additional 6 Iowa Led pooled fund studies. In addition, non-pooled fund SPR projects included approximately 8 continued, 9 new, and over a dozen reoccurring initiatives such as the technical transfer/training program. Additional research is managed and conducted by the Office of Traffic and Safety and other departments in the Iowa DOT.

FY2012 Annual Report Research, Intelligent Transportation Systems, and Technology Transfer Activities

Transportation research makes a difference for Iowans and the nation. Implementation of cost-effective research projects contributes to a transportation network that is safer, more efficient, and longer lasting. Working in cooperation with our partners from universities, industry, other states, and FHWA, as well as participation in the Transportation Research Board (TRB), provides benefits for every facet of the DOT. This allows us to serve our communities and the traveling public more effectively. Pooled fund projects allow leveraging of funds for higher returns on investments. In 2011, Iowa led thirteen active pooled fund studies, participated in twenty-one others, and was wrapping-up, reconciling, and closing out an additional 6 Iowa Led pooled fund studies. In addition, non-pooled fund SPR projects included approximately 8 continued, 9 new, and over a dozen reoccurring initiatives such as the technical transfer/training program. Additional research is managed and conducted by the Office of Traffic and Safety and other departments in the Iowa DOT.

Virtual screening and computational optimization for the discovery of covalent prolyl oligopeptidase inhibitors with activity in human cells.

Our docking program, Fitted, implemented in our computational platform, Forecaster, has been modified to carry out automated virtual screening of covalent inhibitors. With this modified version of the program, virtual screening and further docking-based optimization of a selected hit led to the identification of potential covalent reversible inhibitors of prolyl oligopeptidase activity. After visual inspection, a virtual hit molecule together with four analogues were selected for synthesis and made in one-five chemical steps. Biological evaluations on recombinant POP and FAPα enzymes, cell extracts, and living cells demonstrated high potency and selectivity for POP over FAPα and DPPIV. Three compounds even exhibited high nanomolar inhibitory activities in intact living human cells and acceptable metabolic stability. This small set of molecules also demonstrated that covalent binding and/or geometrical constraints to the ligand/protein complex may lead to an increase in bioactivity.

Effectiveness of Work Zone Intelligent Transportation Systems, TPF-5(081), 2013

In the last decade, Intelligent Transportation Systems (ITS) have increasingly been deployed in work zones by state departments of transportation. Also known as smart work zone systems they improve traffic operations and safety by providing real-time information to travelers, monitoring traffic conditions, and managing incidents. Although there have been numerous ITS deployments in work zones, a framework for evaluating the effectiveness of these deployments does not exist. To justify the continued development and implementation of smart work zone systems, this study developed a framework to determine ITS effectiveness for specific work zone projects. The framework recommends using one or more of five performance measures: diversion rate, delay time, queue length, crash frequency, and speed. The monetary benefits and costs of ITS deployment in a work zone can then be computed using the performance measure values. Such ITS computations include additional considerations that are typically not present in standard benefit-cost computations. The proposed framework will allow for consistency in performance measures across different ITS studies thus allowing for comparisons across studies or for meta analysis. In addition, guidance on the circumstances under which ITS deployment is recommended for a work zone is provided. The framework was illustrated using two case studies: one urban work zone on I-70 and one rural work zone on I-44, in Missouri. The goals of the two ITS deployments were different – the I-70 ITS deployment was targeted at improving mobility whereas the I-44 deployment was targeted at improving safety. For the I-70 site, only permanent ITS equipment that was already in place was used for the project and no temporary ITS equipment was deployed. The permanent DMS equipment serves multiple purposes, and it is arguable whether that cost should be attributed to the work zone project. The data collection effort for the I-70 site was very significant as portable surveillance captured the actual diversion flows to alternative routes. The benefit-cost ratio for the I-70 site was 2.1 to 1 if adjusted equipment costs were included and 6.9 to 1 without equipment costs. The safety-focused I-44 ITS deployment had an estimated benefit-cost ratio of 3.2 to 1.

Matrizes da linguagem e a organização virtual do conhecimento

Os signos e as linguagens foram investigados para a organização virtual do conhecimento por meio dos mecanismos de busca. Fundamentou-se na teoria das matrizes da linguagem-pensamento, postuladas por Santaella (2005), na qual se perscrutou as linguagens sonora, visual e verbal. O objetivo da investigação foi estabelecer uma categorização dos mecanismos de busca a partir da correspondência dessas matrizes da linguagem com a indexação virtual e o modus análogo de busca. Os resultados da investigação indicam ser adequada a categorização dos mecanismos de busca sob o critério dos paradigmas semiótico da linguagem em três matrizes, dado o seu modo de ser e sua operacionalidade, sendo eles baseados em conteúdos sonoros, visuais e verbais. Sinteticamente, a sintaxe é a representação do sonoro, a forma é a representação do visível e o discurso é a representação do conhecimento verbal.

Fixed-dose combinations as initial therapy for hypertension : a review of approved agents and a guide to patient selection.

Recent guidelines recommend initiation of antihypertensive therapy with fixed-dose combinations in high-risk patients because such patients usually need two or more blood pressure (BP)-lowering agents in order to normalize their BP. Agents that block the renin-angiotensin system (ACE inhibitors or angiotensin II receptor antagonists [angiotensin receptor blockers; ARBs]) are preferred for the management of hypertension in most patients exhibiting subclinical target organ damage, or established cardiovascular or renal diseases. Unless contraindicated they should be one of the components of fixed-dose combinations, whereas the other component may be either a calcium channel antagonist or a thiazide diuretic. Fixed-dose combinations containing an ACE inhibitor or ARB plus a calcium channel antagonist appear particularly effective in preventing complications of coronary heart disease.

A LC-tandem MS assay for the simultaneous measurement of new antiretroviral agents: Raltegravir, maraviroc, darunavir, and etravirine.

Raltegravir (RAL), maraviroc (MVC), darunavir (DRV), and etravirine (ETV) are new antiretroviral agents with significant potential for drug interactions. This work describes a sensitive and accurate liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the determination of plasma drug levels. Single-step extraction of RAL, MVC, DRV, ETV and RTV from plasma (100 microl) is performed by protein precipitation using 600 microl of acetonitrile, after the addition of 100 microl darunavir-d(9) (DRV-d(9)) at 1000 ng/ml in MeOH/H(2)O 50/50 as internal standard (I.S.). The mixture is vortexed, sonicated for 10 min, vortex-mixed again and centrifuged. An aliquot of supernatant (150 microl) is diluted 1:1 with a mixture of 20 mM ammonium acetate/MeOH 40/60 and 10 microl is injected onto a 2.1 x 50 mm Waters Atlantis-dC18 3 microm analytical column. Chromatographic separations are performed using a gradient program with 2 mM ammonium acetate containing 0.1% formic acid and acetonitrile with 0.1% formic acid. Analytes quantification is performed by electrospray ionisation-triple quadrupole mass spectrometry using the selected reaction monitoring detection in the positive mode. The method has been validated over the clinically relevant concentrations ranging from 12.5 to 5000 ng/ml, 2.5 to 1000 ng/ml, 25 to 10,000 ng/ml, 10 to 4000 ng/ml, and 5 to 2000 ng/ml for RAL, MRV, DRV, ETV and RTV, respectively. The extraction recovery for all antiretroviral drugs is always above 91%. The method is precise, with mean inter-day CV% within 5.1-9.8%, and accurate (range of inter-day deviation from nominal values -3.3 to +5.1%). In addition our method enables the simultaneous assessment of raltegravir-glucuronide. This is the first analytical method allowing the simultaneous assay of antiretroviral agents targeted to four different steps of HIV replication. The proposed method is suitable for the Therapeutic Drug Monitoring Service of these new regimen combinations administered as salvage therapy to patients having experienced treatment failure, and for whom exposure, tolerance and adherence assessments are critical.

Fusarium oxysporum strains as biocontrol agents against Fusarium wilt: effects on soil microbial biomass and activity

Before planning the large-scale use of nonpathogenic strains of Fusarium oxysporum as biocontrol agents of Fusarium wilt, their behaviour and potential impact on soil ecosystems should be carefully studied as part of risk assessment. The aim of this work was to evaluate the effects of antagonistic F. oxysporum strains, genetically manipulated (T26/6) or not (233/1), on soil microbial biomass and activity. The effects were evaluated, in North-western Italy, in two soils from different sites at Albenga, one natural and the other previously solarized, and in a third soil obtained from a 10-year-old poplar stand (Popolus sp.), near Carignano. There were no detectable effects on ATP, fluorescein diacetate hydrolysis, and biomass P that could be attributed to the introduction of the antagonists. A transient increase of carbon dioxide evolution and biomass C was observed in response to the added inoculum. Although the results showed only some transient alterations, further studies are required to evaluate effects on specific microorganism populations.

IMRT credentialing for prospective trials using institutional virtual phantoms: results of a joint European Organization for the Research and Treatment of Cancer and Radiological Physics Center project.

BACKGROUND AND PURPOSE: Intensity-modulated radiotherapy (IMRT) credentialing for a EORTC study was performed using an anthropomorphic head phantom from the Radiological Physics Center (RPC; RPCPH). Institutions were retrospectively requested to irradiate their institutional phantom (INSTPH) using the same treatment plan in the framework of a Virtual Phantom Project (VPP) for IMRT credentialing. MATERIALS AND METHODS: CT data set of the institutional phantom and measured 2D dose matrices were requested from centers and sent to a dedicated secure EORTC uploader. Data from the RPCPH and INSTPH were thereafter centrally analyzed and inter-compared by the QA team using commercially available software (RIT; ver.5.2; Colorado Springs, USA). RESULTS: Eighteen institutions participated to the VPP. The measurements of 6 (33%) institutions could not be analyzed centrally. All other centers passed both the VPP and the RPC ±7%/4 mm credentialing criteria. At the 5%/5 mm gamma criteria (90% of pixels passing), 11(92%) as compared to 12 (100%) centers pass the credentialing process with RPCPH and INSTPH (p = 0.29), respectively. The corresponding pass rate for the 3%/3 mm gamma criteria (90% of pixels passing) was 2 (17%) and 9 (75%; p = 0.01), respectively. CONCLUSIONS: IMRT dosimetry gamma evaluations in a single plane for a H&N prospective trial using the INSTPH measurements showed agreement at the gamma index criteria of ±5%/5 mm (90% of pixels passing) for a small number of VPP measurements. Using more stringent, criteria, the RPCPH and INSTPH comparison showed disagreement. More data is warranted and urgently required within the framework of prospective studies.

Indications and limitations of chemotherapy and targeted agents in non-small cell lung cancer brain metastases.

Lung cancer is characterized by the highest incidence of solid tumor-related brain metastases, which are reported with a growing incidence during the last decade. Prognostic assessment may help to identify subgroups of patients that could benefit from more aggressive therapy of metastatic disease, in particular when central nervous system is involved. The recent sub-classification of non-small cell lung cancer (NSCLC) into molecularly-defined "oncogene-addicted" tumors, the emergence of effective targeted treatments in molecularly defined patient subsets, global improvement of advanced NSCLC survival as well as the availability of refined new radiotherapy techniques are likely to impact on outcomes of patients with brain dissemination. The present review focuses on key evidence and research strategies for systemic treatment of patients with central nervous system involvement in non-small cell lung cancer.

Assessment of emotional reactivity produced by exposure to virtual environments in patients with eating disorders

The aim of this study was to assess the usefulness of virtual environments representing situations that are emotionally significant to subjects with eating disorders (ED). These environments may be applied with both evaluative and therapeutic aims and in simulation procedures to carry out a range of experimental studies. This paper is part of a wider research project analyzing the influence of the situation to which subjects are exposed on their performance on body image estimation tasks. Thirty female patients with eating disorders were exposed to six virtual environments: a living-room (neutral situation), a kitchen with highcalorie food, a kitchen with low-calorie food, a restaurant with high-calorie food, a restaurant with low-calorie food, and a swimming-pool. After exposure to each environment the STAI-S (a measurement of state anxiety) and the CDB (a measurement of depression) were administered to all subjects. The results show that virtual reality instruments are particularly useful for simulating everyday situations that may provoke emotional reactions such as anxiety and depression, in patients with ED. Virtual environments in which subjects are obliged to ingest high-calorie food provoke the highest levels of state anxiety and depression.

The future of patient safety: Surgical trainees accept virtual reality as a new training tool.

BACKGROUND: The use of virtual reality (VR) has gained increasing interest to acquire laparoscopic skills outside the operating theatre and thus increasing patients' safety. The aim of this study was to evaluate trainees' acceptance of VR for assessment and training during a skills course and at their institution. METHODS: All 735 surgical trainees of the International Gastrointestinal Surgery Workshop 2006-2008, held in Davos, Switzerland, were given a minimum of 45 minutes for VR training during the course. Participants' opinion on VR was analyzed with a standardized questionnaire. RESULTS: Fivehundred-twenty-seven participants (72%) from 28 countries attended the VR sessions and answered the questionnaires. The possibility of using VR at the course was estimated as excellent or good in 68%, useful in 21%, reasonable in 9% and unsuitable or useless in 2%. If such VR simulators were available at their institution, most course participants would train at least one hour per week (46%), two or more hours (42%) and only 12% wouldn't use VR. Similarly, 63% of the participants would accept to operate on patients only after VR training and 55% to have VR as part of their assessment. CONCLUSION: Residents accept and appreciate VR simulation for surgical assessment and training. The majority of the trainees are motivated to regularly spend time for VR training if accessible.