OER in Portugal as agent of curriculum innovation and technological change. Inducing practices of "new" teaching standards

This research project aimed the following goal: promote the creation, use and disclosure of OER in a Group of Schools, involving schools and teachers from different learning levels, expecting to test and validate the use of OER, in a learning-teaching model towards curricular innovation. Defining as a starting point different subjects and teachers from distinct academic areas, we have implemented a set of activities leading to the creation of OER supported, when possible, in FLOSS tools. We adopted an action research methodology with a dual purpose: to act within a community of teachers and students, while increasing at the same time their knowledge, as well as the researcher's. The activity was developed cooperatively in order to process a certain reality of the teaching-learning process, through practical/reflective action towards it and inducing its implementation by others in the Portuguese School System, based on the production and sharing OER.

Consensus statement of the European guidelines on clinical management of HIV-1 tropism testing

Introduction: Testing for HIV tropism is recommended before prescribing a chemokine receptor blocker. To date, in most European countries HIV tropism is determined using a phenotypic test. Recently, new data have emerged supporting the use of a genotypic HIV V3-loop sequence analysis as the basis for tropism determination. The European guidelines group on clinical management of HIV-1 tropism testing was established to make recommendations to clinicians and virologists. Methods: We searched online databases for articles from Jan 2006 until March 2010 with the terms: tropism or CCR5-antagonist or CCR5 antagonist or maraviroc or vicriviroc. Additional articles and/or conference abstracts were identified by hand searching. This strategy identified 712 potential articles and 1240 abstracts. All were reviewed and finally 57 papers and 42 abstracts were included and used by the panel to reach a consensus statement. Results: The panel recommends HIV-tropism testing for the following indications: i) drug-naïve patients in whom toxicity or limited therapeutic options are foreseen; ii) patients experiencing therapy failure whenever a treatment change is considered. Both the phenotypic Enhanced Trofile assay (ESTA) and genotypic population sequencing of the V3-loop are recommended for use in clinical practice. Although the panel does not recommend one methodology over another it is anticipated that genotypic testing will be used more frequently because of its greater accessibility, lower cost and shorter turnaround time. The panel also provides guidance on technical aspects and interpretation issues. If using genotypic methods, triplicate PCR amplification and sequencing testing is advised using the G2P interpretation tool (clonal model) with an FPR of 10%. If the viral load is below the level of reliable amplification, proviral DNA can be used, and the panel recommends performing triplicate testing and use of an FPR of 10%. If genotypic DNA testing is not performed in triplicate the FPR should be increased to 20%. Conclusions: The European guidelines on clinical management of HIV-1 tropism testing provide an overview of current literature, evidence-based recommendations for the clinical use of tropism testing and expert guidance on unresolved issues and current developments. Current data support both the use of genotypic population sequencing and ESTA for co-receptor tropism determination. For practical reasons genotypic population sequencing is the preferred method in Europe.

A Change in the Epidemiology of Infections Due to Extended-Spectrum b-Lactamase–Producing Organisms

Extended-spectrum β-lactamases (ESBLs) form a heterogeneous group that share the property of hydrolytic activity against the oxyimino-β-lactams while remaining susceptible to inhibition by β-lactamase inhibitors, such as clavulanic acid. From a clinical point of view, they are important because they confer resistance to penicillins, aztreonam, and cephalosporins, and ESBL-producing organisms are typically also resistant to aminoglycosides, trimethoprim-sulfamethoxazole, and quinolones [1]. Until recently, the main problem posed by ESBLs was related to nosocomial outbreaks caused by ESBL-producing Klebsiella species. These outbreaks are usually clonal, the strains are mainly spread through cross-transmission, and the risk factors are similar to those found for other multidrug-resistant nosocomial pathogens [2]. In Europe and the United States, most ESBL-producing Klebsiella isolates harbored enzymes belonging to the TEM and SHV families [3]. Detection of colonized patients by performing surveillance cultures within affected units, isolation precautions for colonized patients, and restriction of oxyimino-β-lactam use are frequently useful for the control of these outbreaks [1]. There is no evidence that hospital-acquired ESBL-producing klebsiellae are decreasing in importance—in fact, data from the Centers for Disease Control and Prevention show that 20.6% of Klebsiella pneumoniae isolates from United States intensive care units in 2003 were probable producers of ESBL [4]. This represented a 47% increase, compared with the preceding 5 years. However, during the last few years, an impressive increase in the number of ESBL-producing Escherichia coli (and, less frequently, other Enterobacteriaceae) is being described in several parts of the world [5–8]. This emergent phenomenon shows some differences from the problem posed by Klebsiella species; many of these ESBL-producing E. coli are isolated …

Quantification of the genetic change in the transition of Rhodnius pallescens Barber, 1932 (Hemiptera: Reduviidae) from field to laboratory

Previous studies have reported genetic differences between wild-caught sylvatic, domestic and laboratory pop-ulations of several Triatominae species. The differences between sylvatic and laboratory colonies parallel are similar to the differences observed between sylvatic and domestic populations. Laboratory colonies are frequently used as references for field populations, but the consequences of founder events on the genetic makeup of laboratory or domestic populations are rarely quantified. Our goal was to quantify the genetic change in Rhodnius pallescens populations artificially submitted to founder effects via laboratory colonization. We compared the genetic makeup of two sylvatic populations and their laboratory descendants using a panel of 10 microsatellite markers. Both sylvatic populations were initially collected from palm trees, but the colonies differed in the number of founder insects and amount of time kept in the laboratory. We evaluated allelic polymorphism, differences between expected and observed heterozygosity, estimates of population differentiation (Fst) and inbreeding (Fis, Fit) and cluster analyses based on Nei's distances. We found a unique genetic structure for each sample population, with significant differentiation between the field insects and each of the laboratory generations. These analyses showed strong founder effects and showed that genetic drift had led to a genetic equilibrium over several generations of isolation. Our results suggest that laboratory colonies of R. pallescens have a different genetic structure than their wild relatives and similar processes likely affect other Triatominae laboratory stocks.

IVA in addition to BMD can change the osteoporosis management in 25% of clinical routine patients

Introduction: Vertebral fracture is one of the major osteoporotic fractures which are unfortunately very often undetected. In addition, it is well known that prevalent vertebral fracture increases dramatically the risk of future additional fracture. Instant Vertebral Assessment (IVA) has been introduced in DXA device couple years ago to ease the detection of such fracture when routine DXA are performed. To correctly use such tool, ISCD provided clinical recommendation on when and how to use it. The aim of our study was to evaluate the ISCD guidelines in clinical routine patients and see how often it may change of patient management. Methods: During two months (March and April 2010), a medical questionnaire was systematically given to our clinical routine patient to check the validity of ISCD IVA recommendations in our population. In addition, all women had BMD measurement at AP spine, Femur and 1/3 radius using a Discovery A System (Hologic, Waltham, USA). When appropriate, IVA measurement had been performed on the same DXA system and had been centrally evaluated by two trained Doctors for fracture status according to the semi-quantitative method of Genant. The reading had been performed when possible between L5 and T4. Results: Out of 210 women seen in the consultation, 109 (52%) of them (mean age 68.2 ± 11.5 years) fulfilled the necessary criteria to have an IVA measurement. Out of these 109 women, 43 (incidence 39.4%) had osteoporosis at one of the three skeletal sites and 31 (incidence 28.4%) had at least one vertebral fracture. 14.7% of women had both osteoporosis and at least one vertebral fracture classifying them as "severe osteoporosis" while 46.8% did not have osteoporosis nor vertebral fracture. 24.8% of the women had osteoporosis but no vertebral fracture while 13.8% of women did have osteoporosis and vertebral fracture (clinical osteoporosis). Conclusion: In conclusion, in 52% of our patients, IVA was needed according to ISCD criteria. In half of them the IVA test influenced of patient management either by changing the type of treatment of simply by classifying patient as "clinical osteoporosis". IVA appears to be an important tool in clinical routine but unfortunately is not yet very often used in most of the centers.

'Greek' and 'Roman' in Latin Medical Texts. Studies in Cultural Change and Exchange in Ancient Medicine : [Proceedings of the 10th International Conference "Ancient Latin Medical Texts", Lausanne, 2010, November 3rd-6th November]

Latin medical texts transmit medical theories and practices that originated mainly in Greece. This interaction took place through juxtaposition, assimilation and transformation of ideas. 'Greek' and 'Roman' in Latin Medical Texts studies the ways in which this cultural interaction influenced the development of the medical profession and the growth of knowledge of human and animal bodies, and especially how it provided the foundations for innovations in the areas of anatomy, pathology and pharmacology, from the earliest Latin medical texts until well into the medieval world.

Beyond the Transatlantic Divide: The Multiple Authorities of Standards in the Global Political Economy of Services

This paper explores the plurality of institutional environments in which standards for the service sector are expected to support the rise of a global knowledge-based economy. Despite the careful wording of the World Trade Organization (WTO), a whole range of international bodies still have the capacity to define technical specifications affecting how services are expected to be traded on worldwide basis. The analysis relies on global political economy approaches to extend to the area of service standards the assumption that the process of globalization is not opposing states and markets, but a joint expression of both of them including new patterns and agents of structural change through formal and informal power and regulatory practices. It analyses on a cross-institutional basis patterns of authority in the institutional setting of service standards in the context of the International Organisation for Standardisation (ISO), the European Union, and the United States. In contrast to conventional views opposing the American system to the ISO/European framework, the paper questions the robustness of this opposition by showing that institutional developments of service standards are likely to face trade-offs and compromises across those systems and between two opposing models of standardisation.

Compositional hypotheses of subcompositional stability and specific perturbation change and their testing

In standard multivariate statistical analysis common hypotheses of interest concern changes in mean vectors and subvectors. In compositional data analysis it is now well established that compositional change is most readily described in terms of the simplicial operation of perturbation and that subcompositions replace the marginal concept of subvectors. To motivate the statistical developments of this paper we present two challenging compositional problems from food production processes.Against this background the relevance of perturbations and subcompositions can beclearly seen. Moreover we can identify a number of hypotheses of interest involvingthe specification of particular perturbations or differences between perturbations and also hypotheses of subcompositional stability. We identify the two problems as being the counterpart of the analysis of paired comparison or split plot experiments and of separate sample comparative experiments in the jargon of standard multivariate analysis. We then develop appropriate estimation and testing procedures for a complete lattice of relevant compositional hypotheses

Tests for sex-biased dispersal using bi-parentally inherited genetic markers.

Understanding why dispersal is sex-biased in many taxa is still a major concern in evolutionary ecology. Dispersal tends to be male-biased in mammals and female-biased in birds, but counter-examples exist and little is known about sex bias in other taxa. Obtaining accurate measures of dispersal in the field remains a problem. Here we describe and compare several methods for detecting sex-biased dispersal using bi-parentally inherited, codominant genetic markers. If gene flow is restricted among populations, then the genotype of an individual tells something about its origin. Provided that dispersal occurs at the juvenile stage and that sampling is carried out on adults, genotypes sampled from the dispersing sex should on average be less likely (compared to genotypes from the philopatric sex) in the population in which they were sampled. The dispersing sex should be less genetically structured and should present a larger heterozygote deficit. In this study we use computer simulations and a permutation test on four statistics to investigate the conditions under which sex-biased dispersal can be detected. Two tests emerge as fairly powerful. We present results concerning the optimal sampling strategy (varying number of samples, individuals, loci per individual and level of polymorphism) under different amounts of dispersal for each sex. These tests for biases in dispersal are also appropriate for any attribute (e.g. size, colour, status) suspected to influence the probability of dispersal. A windows program carrying out these tests can be freely downloaded from http://www.unil.ch/izea/softwares/fstat.html

Alternative ways to estimate change points in multinomial sequences. An application to an authorship attribution problem

The statistical analysis of literary style is the part of stylometry that compares measurable characteristicsin a text that are rarely controlled by the author, with those in other texts. When thegoal is to settle authorship questions, these characteristics should relate to the author’s style andnot to the genre, epoch or editor, and they should be such that their variation between authors islarger than the variation within comparable texts from the same author.For an overview of the literature on stylometry and some of the techniques involved, see for exampleMosteller and Wallace (1964, 82), Herdan (1964), Morton (1978), Holmes (1985), Oakes (1998) orLebart, Salem and Berry (1998).Tirant lo Blanc, a chivalry book, is the main work in catalan literature and it was hailed to be“the best book of its kind in the world” by Cervantes in Don Quixote. Considered by writterslike Vargas Llosa or Damaso Alonso to be the first modern novel in Europe, it has been translatedseveral times into Spanish, Italian and French, with modern English translations by Rosenthal(1996) and La Fontaine (1993). The main body of this book was written between 1460 and 1465,but it was not printed until 1490.There is an intense and long lasting debate around its authorship sprouting from its first edition,where its introduction states that the whole book is the work of Martorell (1413?-1468), while atthe end it is stated that the last one fourth of the book is by Galba (?-1490), after the death ofMartorell. Some of the authors that support the theory of single authorship are Riquer (1990),Chiner (1993) and Badia (1993), while some of those supporting the double authorship are Riquer(1947), Coromines (1956) and Ferrando (1995). For an overview of this debate, see Riquer (1990).Neither of the two candidate authors left any text comparable to the one under study, and thereforediscriminant analysis can not be used to help classify chapters by author. By using sample textsencompassing about ten percent of the book, and looking at word length and at the use of 44conjunctions, prepositions and articles, Ginebra and Cabos (1998) detect heterogeneities that mightindicate the existence of two authors. By analyzing the diversity of the vocabulary, Riba andGinebra (2000) estimates that stylistic boundary to be near chapter 383.Following the lead of the extensive literature, this paper looks into word length, the use of the mostfrequent words and into the use of vowels in each chapter of the book. Given that the featuresselected are categorical, that leads to three contingency tables of ordered rows and therefore tothree sequences of multinomial observations.Section 2 explores these sequences graphically, observing a clear shift in their distribution. Section 3describes the problem of the estimation of a suden change-point in those sequences, in the followingsections we propose various ways to estimate change-points in multinomial sequences; the methodin section 4 involves fitting models for polytomous data, the one in Section 5 fits gamma modelsonto the sequence of Chi-square distances between each row profiles and the average profile, theone in Section 6 fits models onto the sequence of values taken by the first component of thecorrespondence analysis as well as onto sequences of other summary measures like the averageword length. In Section 7 we fit models onto the marginal binomial sequences to identify thefeatures that distinguish the chapters before and after that boundary. Most methods rely heavilyon the use of generalized linear models

Immune Microenvironment in Colorectal Cancer: A New Hallmark to Change Old Paradigms

Impact of immune microenvironment in prognosis of solid tumors has been extensively studied in the last few years. Specifically in colorectal carcinoma, increased knowledge of the immune events around these tumors and their relation with clinical outcomes have led to consider immune microenvironment as one of the most important prognostic factors in this disease. In this review we will summarize and update the current knowledge with respect to this intriguing and complex new hallmark of cancer, paying special attention to infiltration by T-infiltrating lymphocytes and their subtypes in colorectal cancer, as well as its eventual clinical translation in terms of long-term prognosis. Finally, we suggest some possible investigational approaches based on combinatorial strategies to trigger and boost immune reaction against tumor cells.

IVA in addition to BMD can change the osteoporosis management in 25% of clinical routine patients.

Vertebral fracture is one of the major osteoporotic fractures which are unfortunately very often undetected. In addition, it is well known that prevalent vertebral fracture increases dramatically the risk of future additional fracture. Instant Vertebral Assessment (IVA) has been introduced in DXA device couple years ago to ease the detection of such fracture when routine DXA are performed. To correctly use such tool, ISCD provided clinical recommendation on when and how to use it. The aim of our study was to evaluate the ISCD guidelines in clinical routine patients and see how often it may change of patient management. During two months (March and April 2010), a medical questionnaire was systematically given to our clinical routine patient to check the validity of ISCD IVA recommendations in our population. In addition, all women had BMD measurement at AP spine, Femur and 1/3 radius using a Discovery A System (Hologic, Waltham, USA). When appropriate, IVA measurement had been performed on the same DXA system and had been centrally evaluated by two trained Doctors for fracture status according to the semi-quantitative method of Genant. The reading had been performed when possible between L5 and T4. Out of 210 women seen in the consultation, 109 (52%) of them (mean age 68.2±11.5 years) fulfilled the necessary criteria to have an IVA measurement. Out of these 109 women, 43 (incidence 39.4%) had osteoporosis at one of the three skeletal sites and 31 (incidence 28.4%) had at least one vertebral fracture. 14.7% of women had both osteoporosis and at least one vertebral fracture classifying them as "severe osteoporosis" while 46.8% did not have osteoporosis not vertebral fracture. 24.8% of the women had osteoporosis but no vertebral fracture while 13.8% of women did have osteoporosis but vertebral fracture (Clinical osteoporosis). In conclusion, in 52% of our patients, IVA was needed according to ISCD criteria. In half of them the IVA test influenced of patient management either my changing the type of treatment of simply by classifying patient as "clinical osteoporosis". IVA appears to be an important tool in clinical routine but unfortunately is not yet very often use in most of the centers.

Biased thinking assessed by external observers in borderline personality disorder

Objectives. Biased thinking (to some extent overlapping with the concepts of cognitive distortions and cognitive errors) is a key concept in cognitive therapy of Borderline Personality Disorder (BPD). Specific contents and cognitive processes related to BPD functioning are known. However, most studies are based on self-report measures which present a number of important limitations, in particular the difficulty in assessing non-conscious processes infused by affect. So far, no studies were conducted using valid observer-rated methodology addressing the question of biased thinking in BPD as it unfolds spontaneously in session. Design. This is a controlled interview study comparing two matched groups, BPD patients and healthy controls. Methods. A total of N= 25 clinical dynamic interviews with patients presenting with BPD were transcribed and rated using the Cognitive Errors Rating Scale (Drapeau, Perry, & Dunkley, 2008); their cognitive profiles were compared to those of N= 25 healthy controls who underwent the same procedure. Results. Overall, results indicated that no between-group difference in the frequency of specific biases was found. However, heightened levels of negative cognitive biases, in particular over-generalizing and fortune-telling, were associated with BPD. Furthermore, negative over-generalizing was associated with the number of BPD symptoms. Conclusions. These results have high levels of ecological validity and are promising for the refinement of cognitive theory of BPD. Clinical implications for assessment and intervention are discussed.