984 resultados para adapting open content
Resumo:
Objective: The vascular access steal syndrome is a complication occurring in 1-6% after native arterio-venous (AV) fistulas, often due to huge diameter of the vein. This results in very high flow, which could also be responsible for cardiac overload. The aim of this study is to evaluate the efficiency of a new approach in the treatment of this pathology using open-pore external scaffolding prosthesis.Methods: This a retrospective review of all patients presenting symptomatic high flow after native AV fistula between January 2007 and December 2009 in 3 vascular centers. Pre-operative duplex exam confirmed the diagnosis of high flow. The operation consisted in preparation of the whole fistula, measurement of the flow and section on the venous side. The vein was wrapped with this 6 to 8 mm open-pore external scaffolding prosthesis (ProVena, BBraun, Germany) according to its diameter and to the flow and then sutured. Measurement of the flow was repeated. Patients were followed by duplex exam at 1 week and at 1, 3, 6 and 12 months. Procedural success was defined as complete implantation of the prosthesis and reduction of the flow. Primary outcomes were reduction of the flow and recovery of the symptoms and secondary endpoint was patency of the fistula.Results: During the study period, 14 patients, with a mean age of 65・8 years old, have been operated with this technique.There were 2 native forearmfistulas and 12 on the armwith a mean pre-operative flow of 2600 ml/min (1800-3800). The mode of presentation was pain in 6 patients, neurological disorders in 10 and necrosis in 4. Moreover, 3 patients had cardiac insufficiency due to high flow in the fistula. The procedure was technically successful in 100% of cases. Re-intervention was necessary in 2 patients due to hematoma. Recovery of the initial symptoms occurred in 13 patients (93%). The mean flow reduction was 1200 ml/min (600-2000). In 1 patient, a persistent steal syndrome despite flow reduction to 1400 ml/min resulted in fistula closure 2 months later. At a mean follow-up of 22 months (4-35), all remaining patients (13/14) presented a patent fistula without recurrence.Conclusion: This new approach seems to be safe and effective in the treatment of symptomatic high flow native AV fistulas by significantly reducing the flow and avoiding closure of the vascular access. Longer follow-up with more patients are necessary to evaluate the risk of recurrence.
Resumo:
A gestão de infra-estruturas é um processo de coordenação, avaliação sistemática e manutenção efectiva das infra-estruturas relacionadas com os serviços básicos. A gestão eficaz de infra-estruturas exige que a disposição dos equipamentos no meio urbano seja conhecida, bem como sua relação com o uso do solo. Sendo a gestão de infra-estruturas uma questão de natureza espacial, é natural pensar na utilização de um Sistema de Informação Geográfica como ferramenta com potencial de grande utilidade, pois permite a georreferenciação de dados espaciais e sua interligação com atributos alfanuméricos, para além da realização de análises complexas e a possibilidade de simular diversos cenários de modo a propiciar uma tomada de decisão eficaz. O elevado custo das licenças e a especificidade de utilização a nível técnico, tornam-se obstáculos na criação e manutenção de dados geográficos. Contudo os recentes desenvolvimentos em tecnologias da Internet têm contribuído para o acesso, publicação, exploração e distribuição da Informação Geográfica. A utilização de SIG distribuídos na Internet (WebGIS), nomeadamente na vertente livre, pode ser uma solução adequada visto que coloca funcionalidades de SIG ao alcance de utilizadores, através de um simples browser, sem necessidade de investimentos em relação a software ou mesmo em formação técnica especializada. Assim, com este projecto pretende-se a criação de um sistema de Informação geográfico na Internet, utilizando softwares livres, que disponibiliza toda a informação geográfica e alfanumérica das infra-estruturas construídas e sob a responsabilidade do Ministério das Infra-estruturas e Economia Marítima, permitindo a visualização e a realização de pesquisas e operações de análise.
Development and validation of an instrument for evaluating the ludicity of games in health education
Resumo:
Abstract OBJECTIVE Developing and validating an instrument to evaluate the playfulness of games in health education contexts. METHODOLOGY A methodological, exploratory and descriptive research, developed in two stages: 1. Application of an open questionnaire to 50 graduate students, with content analysis of the answers and calculation of Kappa coefficient for defining items; 2. Procedures for construction of scales, with content validation by judges and analysis of the consensus estimate byContent Validity Index(CVI). RESULTS 53 items regarding the restless character of the games in the dimensions of playfulness, the formative components of learning and the profiles of the players. CONCLUSION Ludicity can be assessed by validated items related to the degree of involvement, immersion and reinvention of the subjects in the game along with the dynamics and playability of the game.
Resumo:
Connexin36 (Cx36), a trans-membrane protein that forms gap junctions between insulin-secreting beta-cells in the Langerhans islets, contributes to the proper control of insulin secretion and beta-cell survival. Hypercholesterolemia and pro-atherogenic low density lipoproteins (LDL) contribute to beta-cell dysfunction and apoptosis in the context of Type 2 diabetes. We investigated the impact of LDL-cholesterol on Cx36 levels in beta-cells. As compared to WT mice, the Cx36 content was reduced in islets from hypercholesterolemic ApoE-/- mice. Prolonged exposure to human native (nLDL) or oxidized LDL (oxLDL) particles decreased the expression of Cx36 in insulin secreting cell-lines and isolated rodent islets. Cx36 down-regulation was associated with overexpression of the inducible cAMP early repressor (ICER-1) and the selective disruption of ICER-1 prevented the effects of oxLDL on Cx36 expression. Oil red O staining and Plin1 expression levels suggested that oxLDL were less stored as neutral lipid droplets than nLDL in INS-1E cells. The lipid beta-oxidation inhibitor etomoxir enhanced oxLDL-induced apoptosis whereas the ceramide synthesis inhibitor myriocin partially protected INS-1E cells, suggesting that oxLDL toxicity was due to impaired metabolism of the lipids. ICER-1 and Cx36 expressions were closely correlated with oxLDL toxicity. Cx36 knock-down in INS-1E cells or knock-out in primary islets sensitized beta-cells to oxLDL-induced apoptosis. In contrast, overexpression of Cx36 partially protected INS-1E cells against apoptosis. These data demonstrate that the reduction of Cx36 content in beta-cells by oxLDL particles is mediated by ICER-1 and contributes to oxLDL-induced beta-cell apoptosis.
Resumo:
Recombinant strains of the oleaginous yeast Yarrowia lipolytica expressing the PHA synthase gene (PhaC) from Pseudomonas aeruginosa in the peroxisome were found able to produce polyhydroxyalkanoates (PHA). PHA production yield, but not the monomer composition, was dependent on POX genotype (POX genes encoding acyl-CoA oxidases) (Haddouche et al. FEMS Yeast Res 10:917-927, 2010). In this study of variants of the Y. lipolytica β-oxidation multifunctional enzyme, with deletions or inactivations of the R-3-hydroxyacyl-CoA dehydrogenase domain, we were able to produce hetero-polymers (functional MFE enzyme) or homo-polymers (with no 3-hydroxyacyl-CoA dehydrogenase activity) of PHA consisting principally of 3-hydroxyacid monomers (>80%) of the same length as the external fatty acid used for growth. The redirection of fatty acid flux towards β-oxidation, by deletion of the neutral lipid synthesis pathway (mutant strain Q4 devoid of the acyltransferases encoded by the LRO1, DGA1, DGA2 and ARE1 genes), in combination with variant expressing only the enoyl-CoA hydratase 2 domain, led to a significant increase in PHA levels, to 7.3% of cell dry weight. Finally, the presence of shorter monomers (up to 20% of the monomers) in a mutant strain lacking the peroxisomal 3-hydroxyacyl-CoA dehydrogenase domain provided evidence for the occurrence of partial mitochondrial β-oxidation in Y. lipolytica.
Resumo:
This paper studies monetary and fiscal policy interactions in a two country model, where taxes on firms sales are optimally chosen and the monetary policy is set cooperatively.It turns out that in a two country setting non-cooperative fiscal policy makers have an incentive to change taxes on sales depending on shocks realizations in order to reduce output production. Therefore whether the fiscal policy is set cooperatively or not matters for optimal monetary policy decisions. Indeed, as already shown in the literature, the cooperative monetary policy maker implements the flexible price allocation only when special conditions on the value of the distortions underlying the economy are met. However, if non-cooperative fiscal policy makers set the taxes on firms sales depending on shocks realizations, these conditions cannot be satisfied; conversely, when fiscal policy is cooperative, these conditions are fulfilled. We conclude that whether implementing the flexible price allocation is optimal or not depends on the fiscal policy regime.
Resumo:
Monetary policy is conducted in an environment of uncertainty. This paper sets upa model where the central bank uses real-time data from the bond market togetherwith standard macroeconomic indicators to estimate the current state of theeconomy more efficiently, while taking into account that its own actions influencewhat it observes. The timeliness of bond market data allows for quicker responsesof monetary policy to disturbances compared to the case when the central bankhas to rely solely on collected aggregate data. The information content of theterm structure creates a link between the bond market and the macroeconomythat is novel to the literature. To quantify the importance of the bond market asa source of information, the model is estimated on data for the United Statesand Australia using Bayesian methods. The empirical exercise suggests that thereis some information in the US term structure that helps the Federal Reserve toidentify shocks to the economy on a timely basis. Australian bond prices seemto be less informative than their US counterparts, perhaps because Australia is arelatively small and open economy.
Resumo:
Content outline used during the Improving Transition Outcomes Resource Mapping Workshops
Resumo:
As required in Iowa Code section 307.21, this is a summary of purchasing activity for soy-based inks and recycled content trash bags. The figures are for fiscal year 2007.
Resumo:
We have identified new malaria vaccine candidates through the combination of bioinformatics prediction of stable protein domains in the Plasmodium falciparum genome, chemical synthesis of polypeptides, in vitro biological functional assays, and association of an antigen-specific antibody response with protection against clinical malaria. Within the predicted open reading frame of P. falciparum hypothetical protein PFF0165c, several segments with low hydrophobic amino acid content, which are likely to be intrinsically unstructured, were identified. The synthetic peptide corresponding to one such segment (P27A) was well recognized by sera and peripheral blood mononuclear cells of adults living in different regions where malaria is endemic. High antibody titers were induced in different strains of mice and in rabbits immunized with the polypeptide formulated with different adjuvants. These antibodies recognized native epitopes in P. falciparum-infected erythrocytes, formed distinct bands in Western blots, and were inhibitory in an in vitro antibody-dependent cellular inhibition parasite-growth assay. The immunological properties of P27A, together with its low polymorphism and association with clinical protection from malaria in humans, warrant its further development as a malaria vaccine candidate.
Resumo:
Résumé Introduction: La plupart des études disponibles sur la chirurgie colorectale par laparoscopie concernent des patients hautement sélectionnés. Le but de cette étude est d'analyser les résultats à court et à long terme de l'ensemble des patients traités dans un service de chirurgie générale. Méthodes: Il s'agit d'une analyse rétrospective d'un registre prospectif interne au service, dans lequel tous les patients consécutifs opérés pour la première fois du colon et du rectum entre mars 1993 et décembre 1997 ont été enregistrés. Les informations concernant le suivi ont été collectées par questionnaire. Résultats: Un total de 187 patients ont été opérés par laparoscopie et 215 patients par chirurgie ouverte durant la période d'étude. Les informations concernant le suivi ont pu être collectées dans 95% des cas avec une évolution de 1-107 mois (médiane 59 mois), respectivement de 1-104 mois (médiane 53 mois). Une conversion fut nécessaire dans 28 cas (15%) mais ceux-ci restent inclus dans le groupe laparoscopie pour l'analyse par intention de traitement. Dans le groupe laparoscopie, les opérations ont duré plus longtemps (205 vs 150 min, p<0.001) mais l'hospitalisation a été plus courte (8 vs 13 jours, p<0.001). La reprise du transit a été plus rapide après laparoscopie, mais uniquement après intervention sur le colon gauche (3 vs 4 jours, p<0.01). Cependant, la sélection préopératoire (nombre plus élevé d'urgences et de patients avec un risque anesthésiologique élevé dans le groupe de la chirurgie ouverte) a été favorable à la laparoscopie. Le taux de complications (global ainsi que pour chaque complication chirurgicale) a été similaire dans les deux groupes, avec un taux global de 20% environ. Conclusions: Malgré une sélection favorable des cas, uniquement très peu d'avantages à la laparoscopie sur la chirurgie ouverte ont pu être observés. Abstract Background: Most studies available on laparoscopic colorectal surgery focus on highly selected patient groups. The aim of the present study was to review short- and long-term outcome of everyday patients treated in a general surgery department. Methods: Retrospective review was carried out of a prospective database of all consecutive patients having undergone primary laparoscopic (LAP) or open colorectal surgery between March 1993 and December 1997. Follow-up data were completed via questionnaire. Results: A total of 187 patients underwent LAP resection and 215 patients underwent open surgery. Follow up was complete in 95% with a median of 59 months (range, 1-107 months) and 53 months (range, 1-104 months), respectively. There were 28 conversions (15%) in the LAP group and these remained in the LAP group in an intention-to-treat analysis. The LAP operations lasted significantly longer for all types of resections (205 vs 150 min, P<0.001) and hospital stay was shorter (8 vs 13 days, P<0.001). Recovery of intestinal function was faster in the LAP group, but only after left-sided procedures (3 vs 4days, P<0.01). However, preoperative patient selection (more emergency operations and patients with higher American Society of Anesthesiologists (ASA) score in the open group) had a major influence on these elements and favours the LAP group. Surprisingly, the overall surgical complication rate (including long-term complications such as wound hernia) was 20% in both groups with rates of individual complications also being comparable in both groups. Conclusion: Despite a patient selection favourable to the laparoscopy group, only little advantage in postoperative outcome could be shown for the minimally invasive over the open approach in the everyday patient.
Resumo:
O propósito da Web Semântica é conseguir uma Web de dados totalmente ligada, isto é, numa perspetiva Linked Open Data. A Web Semântica deve garantir (estabelecendo padrões tecnológicos, vocabulários, linguagens lógicas, etc.) que os conteúdos publicados na Websejam inteligíveis quer por agentes humanos, quer por agentes máquina. Esta dissertação tem como objetivo responder à um problema delimitado, propondo uma solução no quadro da Web Semântica e suas tecnologias. Partindo-se de uma lista de termos em linguagem natural utilizados no Website da ANACOM (Autoridade Nacional de Comunicações), propomos uma organização de acordo com metodologias de construção de ontologias e vocabulários. Inspirámo-nos em duas metodologias, o Ontology Development 101 e o Process and Methodology for Core Vocabularies. O vocabulário controlado resultante, tem como base tecnológica o modelo de organização de conhecimento, recomendado pelo W3C (World Wide Web Consortium), o SKOS (Simple Knowledge Organization System). Trata-sede uma tecnologia standard da W3C desde 2009, utilizada na criação de tesauros,esquemas de classificação, taxonomias, glossários e outros tipos de vocabulários controlados. Como resultado da nossa intervenção, conseguimos organizar e codificar em SKOS, cerca de cinco centenas de termos identificados no Website da ANACOM. Para além da proposta do vocabulário controlado, passámos em revista às tecnologias e teorias que sustentam a temática da Web Semântica.
Resumo:
The following main lithostratigraphic units have been distinguished in the Domes Area. The Kibaran basement complex composed of gneisses, migmatites with amphibolite bands and metagranites is exposed in dome structures; metamorphic features of Kibaran age have been almost completely obliterated by extensive Lufilian reactivation. The post-Kibaran cover sequence is subdivided into the Lower Roan Group consisting of well-preserved quartzites with high Mg content, talc-bearing, extremely foliated schists intercalated with pseudo-conglomerates of tectonic origin and the Upper Roan Group including dolomitic marbles with rare stromatolites, metapelites and a sequence of detrital metasediments, with local volcano-sedimentary components and interlayered banded ironstones. The sediments of the Lower Roan Group are interpreted as continental to lagoonal-evaporitic deposits partly converted into the talc-kyanite + garnet assemblage characteristic of ``white schists''. The dolomites and metapelites of the Upper Roan Group are attributed to a carbonate platform sequence progressively subsiding under terrigenous deposits, whilst the detrital metasediments and BIF may be interpreted as a basinal sequence, probably deposited on oceanic crust grading laterally into marbles. Metagabbros and metabasalts are considered as remnants of an ocean-floor-type crustal unit probably related to small basins. Alkaline stocks of Silurian age intruded the post-Kibaran cover. Significant ancestral tectonic discontinuities promoted the development of a nappe pile that underwent high-pressure metamorphism during the Lufilian orogeny and all lithostratigraphic units. Rb-Sr and K-Ar and U-Pb data indicate an age of 700 Ma for the highest grade metamorphism and 500 Ma for blocking of the K-Ar and Rb-Sr system in micas, corresponding to the time when the temperature dropped below 350-degrees-400-degrees-C and to an age of about 400 Ma for the emplacement of hypabyssal syenitic bodies. A first phase of crustal shortening by decoupling of basement and cover slices along shallow shear zones has been recognized. Fluid-rich tectonic slabs of cover sediments were thus able to transport fluids into the anhydrous metamorphic basement or mafic units. During the subsequent metamorphic re-equilibration stage of high pressure, pre-existing thrusts horizons were converted into recrystallized mylonites. Due to uplift, rocks were re-equilibrated into assemblages compatible with lower pressures and slightly lower temperatures. This stage occurs under a decompressional (nearly adiabatic) regime, with P(fluid) almost-equal-to P(lithostatic). It is accompanied by metasomatic development of minerals, activated by injection of hot fluids. New or reactivated shear zones and mylonitic belts were the preferred conduits of fluids. The most evident regional-scale effect of these processes is the intense metasomatic scapolitization of formerly plagioclase-rich lithologies. Uraninite mineralization can probably be assigned to the beginning of the decompressional stage. A third regional deformation phase characterized by open folds and local foliation is not accompanied by significant growth of new minerals. However, pitchblende mineralization can be ascribed to this phase as late-stage, short-range remobilization of previously existing deposits. Finally, shallow alkaline massifs were emplaced when the level of the Domes Area now exposed was already subjected to exchange with meteoric circuits, activated by residual geothermal gradients generally related to intrusions or rifting. Most of the superficial U-showings with U-oxidation products were probably generated during this relatively recent phase.
Resumo:
This paper sets up and estimates a structuralmodel of Australia as a small open economyusing Bayesian techniques. Unlike other recentstudies, the paper shows that a small microfoundedmodel can capture the open economydimensions quite well. Specifically, the modelattributes a substantial fraction of the volatilityof domestic output and inflation to foreigndisturbances, close to what is suggested by unrestrictedVAR studies. The paper also investigatesthe effects of various exogenous shockson the Australian economy.
Resumo:
A tese que ora findamos visa a obtenção do grau de doutora em Educação, na Especialidade de Desenvolvimento Curricular, pelo Departamento do Currículo e Tecnologia Educativa, do Instituto de Educação e Psicologia, da Universidade do Minho. Intitulado o dualismo cultural: os luso-caboverdianos entre a escola, a família e a comunidade, o presente estudo centra-se numa abordagem crítica da escolaridade básica obrigatória, no qual procurámos compreender e explicar as condições de realização deste nível de ensino pelos jovens de ascendência caboverdiana, nascidos em Portugal, na qualidade de sujeitos biculturais em consequência da simbiose das culturas caboverdeana e portuguesa. Isto para concluirmos se na oferta do serviço educativo e de formação estão acautelados os seus direitos de cidadania e de participação na sociedade em que se encontram inseridos e a que pertencem de facto. Nesta investigação foi fundamental analisar a oferta de educação básica, entender as representações de alunos lusocaboverdeanos acerca da sua identidade cultural e das suas percepções sobre a formação académica que recebem; reconhecer representações e percepções de professores acerca da realidade educativa portuguesa, o enquadramento da multiculturalidade e a docência em turmas com alunos luso-caboverdianos, e compreender as percepções de pais e encarregados da educação caboverdeanos acerca da realidade educativa portuguesa e do enquadramento dos seus filhos na escola, para perceber se o insucesso educativo dos luso-caboverdeanos está relacionado com a condição de aluno “culturalmente diferente” ou se tem a sua origem na escola e no currículo da escolaridade obrigatória e, assim, contribuir com subsídios teóricos e práticos para o aprofundamento da problemática da multiculturalidade em Portugal, com vista à sua potenciação e normalização no sistema educativo. Estando perante uma sociedade de formação multicultural reafirmada com a colonização, justifica-se, em Portugal, a preocupação com a temática da diversidade cultural nas políticas educativas, resultante da consciencialização da manifestação da diversidade cultural no contexto escolar, podendo a sua omissão constituir num factor de insucesso educativo. Por isso, integramos nesta investigação matérias como: uma conceptualização do multiculturalismo com vista a questionar e clarificar os conceitos e as perspectivas inerentes a este fenómeno. Uma tentativa de desocultar para perceber o conteúdo simbólico e os porquês das políticas de integração das minorias etnicoculturais que, ao que parece, nos tempos que correm, por quase toda a parte, se converteram numa prioridade absoluta e inadiável. Estabelecemos uma ponte entre a génese do campo curricular e a construção de um currículo multi e/ou intercultural, merecendo devida atenção as tendências que dominam as discussões e a produção científica actuais nestes domínios. Problematizámos o currículo e identidade na escolaridade obrigatória nas dimensões inserção sociocultural, promoção da igualdade de sucesso educativo e inclusão dos sujeitos e o currículo e a educação para o exercício da cidadania numa escola que se quer plural. Neste último debatemos o conteúdo político da educação para a cidadania, as políticas educativas e curriculares e a escolaridade básica obrigatória como uma proposta que continua em aberto, por isso, passível de adequação às necessidades de uma educação da e para a diversidade. Procurámos fazer uma análise das políticas de integração socioeducativa da diversidade cultural, com destaque para o quadro legal que regula a integração das minorias étnicas na escola básica portuguesa, com particular incidência sobre as crianças pertencentes à comunidade caboverdeana nascidas em território português, procurando concluir acerca da existência, ou não, de posições e opções de políticas educativas concretas face à necessidade de dar prosseguimento à educação multicultural neste contexto. Tratou-se de uma investigação qualitativa holística, que permitiu desenvolver compreensões profundas dos fenómenos a partir das evidências reunidas, do estudo das representações dos sujeitos sobre quem recaem os resultados da investigação, mas também de sujeitos que, assim como o meio envolvente, estabelecem uma relação indirecta com os mesmos resultados. Circunscrito a um estudo de caso, a reflexão e a partilha de conhecimento e informações possibilitou desenvolver uma compreensão sobre a problemática estudada. Dos resultados obtidos, destacámos aqui que, em Portugal, apesar da absorvência da diversidade cultural nas política educativa, não se concretizou, ainda, uma proposta que, na prática, crie a reciprocidade entre as questões etnicoculturais e o sucesso e/ou insucesso educativos das minorias em educação com ganhos decisivos no combate ao insucesso e ao abandono escolar. Continua-se a desenvolver uma educação igualitarista monocultural pela via da homogeneização curricular, assente na noção de que povos e grupos podem estar em condições de igualdade se reunidos numa cultura comum. Aparentemente sob pilares democráticos, esta educação multicultural segue a concepção liberal associando essencialismo, universalismo e igualitarismo, resultando num propósito civilizacional excludente das minorias etnicoculturais. As conclusões chegadas permitem-nos defender a dessacralização do currículo nacional comum e uniforme e a defesa de uma proposta curricular baseada numa cultura científica global e necessária, de acordo com as faixas etárias e níveis de ensino, com campos de integração obrigatória de conteúdos territorializados alicerçados no interculturalismo como estratégia promotora da interacção crítica e solidária entre diferentes sujeitos e grupos culturais, permissiva da construção de identidades próprias e da confissão da diferença cultural, associada ao intraculturalismo como uma via permeabilizadora da educação democrática como garante da cidadania plena a todos os indivíduos, como condição fundamental para o estabelecimento das condições de igualdade e de garantia de sucesso em educação.