Evaluation of the reference value for the Montenegro skin test

Abstract:INTRODUCTION:The Montenegro skin test (MST) has good clinical applicability and low cost for the diagnosis of American tegumentary leishmaniasis (ATL). However, no studies have validated the reference value (5mm) typically used to discriminate positive and negative results. We investigated MST results and evaluated its performance using different cut-off points.METHODS:The results of laboratory tests for 4,256 patients with suspected ATL were analyzed, and 1,182 individuals were found to fulfill the established criteria. Two groups were formed. The positive cutaneous leishmaniasis (PCL) group included patients with skin lesions and positive direct search for parasites (DS) results. The negative cutaneous leishmaniasis (NCL) group included patients with skin lesions with evolution up to 2 months, negative DS results, and negative indirect immunofluorescence assay results who were residents of urban areas that were reported to be probable sites of infection at domiciles and peridomiciles.RESULTS:The PCL and NCL groups included 769 and 413 individuals, respectively. The mean ± standard deviation MST in the PCL group was 12.62 ± 5.91mm [95% confidence interval (CI): 12.20-13.04], and that in the NCL group was 1.43 ± 2.17mm (95% CI: 1.23-1.63). Receiver-operating characteristic curve analysis indicated 97.4% sensitivity and 93.9% specificity for a cut-off of 5mm and 95.8% sensitivity and 97.1% specificity for a cut-off of 6mm.CONCLUSIONS:Either 5mm or 6mm could be used as the cut-off value for diagnosing ATL, as both values had high sensitivity and specificity.

Future lending income and security value

I test the Duffie, Gârleanu, and Pedersen hypothesis that security prices incorporate expected future securities lending income. To determine whether institutional investors anticipate gains from future lending of securities, I examine their trading behavior around loan-fee increases. The evidence suggests that institutions buy shares in response to an increase in lending fees, and that this could explain the premium associated with high- lending-fee stocks. Expected future lending income affects stock prices, although the effect seems to be attenuated by the negative information that arises from short selling.

Two decades of tuberculosis in a city in Northeastern Brazil: advances and challenges in time and space

Abstract: INTRODUCTION This study presents two decades of epidemiological data on tuberculosis (TB), in order to understanding the disease profile and its spatiotemporal dynamics. METHODS This descriptive study was performed in the City of Olinda/Pernambuco, Brazil, from 1991-2010, and it analyzed new patients with TB living in the city. We used the χ²-test with a p-value <0.05 to identify differences in trends. Incidence and cluster distribution were identified using spatial scan statistics. RESULTS In total, 6202 new cases were recorded during the two decades. The highest incidence occurred in 1995 (110 cases/100,000 inhabitants), and the lowest occurred in 2009 (65 cases/100,000 inhabitants) (β=-1.44; R²=0.43; p=0.0018). The highest mortality occurred in 1998 (16 deaths/100,000 inhabitants), and the lowest occurred in 2008 (5 deaths/100,000 inhabitants) (β=-0.19; R²=0.17; p=0.07). There was a male predominance (65%), and ages ranged from 20-49 years (65%). There was a substantial increase in the number of patients that were cured after treatment (60% to 67%; p<0.001) as well as those tested for HIV (1.9% to 58.5%; p<0.001). During the first decade, clusters with p-values <0.05 included 29% of the total notified cases, and in the second decade, that percentage was 12%. CONCLUSIONS We observed a decreasing trend in incidence, which was significant, and mortality rates, which was not significant. The increased number of laboratory tests performed reflects advances in surveillance, and a reduction in the proportion of cases in primary clusters suggests, among other things, that the disease is spreading across the region.

Urinary tract infection in full-term newborn infants: value of urine culture by bag specimen collection

OBJETIVE: to evaluate the efficacy of urine culture by bag specimen for the detection of neonatal urinary tract infection in full-term newborn infants. Retrospective study (1997) including full-term newborn infants having a positive urine culture (>100,000 CFU/ml) by bag specimen collection. The urinary tract infection diagnosis was confirmed by positive urine culture (suprapubic bladder aspiration method). The select cases were divided into three groups, according to newborn infant age at the bag specimen collection: GI (< 48 h, n = 17), GII (48 h to 7 d, n = 35) and GIII (> 7 d, n = 9). Sixty one full-term newborn infants were studied (5.1 % of total infants). The diagnosis was confirmed on 19/61 (31.1 %) of full-term infants born alive. Distribution among the groups was: GI = 2/17 (11.8 %), GII = 10//35 (28.6 %), and GIII = 7/9 (77.7 %). The most relevant clinical symptoms were: fever (GI - 100 %, GII - 91.4 %) and weight loss (GI - 35.3 %, GII - 45.7 %). Urine culture results for specimens collected by suprapubic aspiration were: E. coli GI (100 %), GII (40 %) and GIII (28.6 %), E. faecalis GI (30%), Staphylococcus coagulase-negative GII (20 %) and GIII (42.8 %), and Staphylococcus aureus GII (10 %). Correlation between positive urine culture collection (bag specimen method) and urinary tract infection diagnosis, using relative risk analysis, produced the following results: GI=0.30 (CI95% 0.08-1.15), GII=0.51 (CI 95% 0.25-1.06) and GIII=3.31 (CI95% 1.8-6.06) The most frequent urinary tract infection clinical signs in the first week were fever and weight loss, while non-specific symptomatology occurred later. E. coli was most frequent infectious agent, although from the 7th day of life, staphylococcus was noted. The urine culture (bag specimen method) was effective in detecting urinary tract infection only after the 7th day of life.

Predictive value of the ankle-brachial index in the evaluation of intermittent claudication

The purpose of this study was to determine whether the ankle-brachial index (ABI) could be used to predict the prognosis for a patient with intermittent claudication (IC). We studied 611 patients prospectively during 28 months of follow-up. We analyzed the predictive power of using various levels of ABI - 0.30 to 0.70 at 0.05 increments - in terms of the measure's specificity (association with a favorable outcome after exercise rehabilitation therapy) and sensitivity (association with a poor outcome after exercise rehabilitation therapy). We found that using an ABI of 0.30 as a cut-off value produced the lowest margin of error overall, but the predictive power was still low with respect to identifying the patients with a poor prognosis after non-aggressive therapeutic treatment. Further study is needed to perhaps identify a second factor that could increase the sensitivity of the test.

Estudo de implementação da NP EN ISO 22000:2005 na Cooperativa de Olivicultores de Fátima, C. R.L.

O conceito de “Segurança Alimentar” faz sentido no momento em que o ser humano tem consciência de que o que ingere deve ser inócuo para a sua saúde e bem-estar. Para dar resposta a esta preocupação global, a indústria alimentar teve necessidade de adotar diretrizes orientadoras para a produção de alimentos seguros. Em consequência disso, surgiram as normas para os Sistemas de Gestão da Segurança Alimentar (SGSA) e a sua implementação é hoje em dia um elemento fundamental para a competitividade da empresa e dos produtos que comercializa. O trabalho desenvolvido na presente dissertação visa o estudo da implementação de um Sistema de Gestão da Segurança Alimentar com base no referencial de certificação NP EN ISO 22000:2005, na Cooperativa de Olivicultores de Fátima C. R. L.. A implementação de um sistema de gestão e a sua posterior certificação, é uma mais-valia para uma empresa. Ao obter a certificação, obtêm-se reconhecimento e satisfação dos clientes e outras partes interessadas, melhoria da imagem e prestigio, acesso a novos mercados, redução de custos de funcionamento através da melhoria do desempenho operacional e uma nova cultura com a sensibilização e motivação dos colaboradores, orientada para a melhoria continua e para a satisfação dos clientes e outras partes interessadas. Tendo por base os Códigos de Boas-práticas e HACCP existentes, fez-se a revisão e atualização de todo o sistema. Reapreciou-se o processo de fabrico e reavaliaram-se os pontos críticos. Reviram-se os Programas Pré-requisitos e melhorou-se o sistema HACCP. Os SGSA têm uma elevada relevância nas organizações associadas ao sector alimentar também nas indústrias produtoras de azeite, uma vez que estas devem implementar metodologias capazes de assegurar que os perigos para a saúde dos consumidores são eliminados ou reduzidos a níveis aceitáveis. Os principais perigos na indústria do azeite numa fase inicial são a presença de microrganismos patogénicos e parasitas da azeitona (Ex.: Bactrocera oleae) que se podem desenvolver devido ao excessivo tempo de espera até à operação ou por temperaturas inadequadas, podendo este perigo ser resolvido através do controlo na receção, de fornecedores, e do tempo de operação; boas práticas de fabrico e formação do pessoal. A presença de folhas, terra, pedras e metais diversos é outro dos perigos mais frequentes que são contornados através do controlo na receção; inspeção visual; avaliação dos fornecedores, limpeza e lavagem das azeitonas. Ao longo da produção e embalamento os principais perigos são os resíduos de produtos de higienização, incorporação de partículas estranhas ou restos de sujidade e a contaminação química por resíduos de massas e óleos de lubrificação, perigos estes que são colmatados através de boas práticas de fabrico; plano de higiene e de manutenção dos equipamentos e do uso de lubrificantes homologados para a indústria alimentar.

Composição de Flores Masculinas de Pupunha (Bactris gasipaes H. B. K., Palmae)

Composition of the male flowers of peach palm(Bactris gasipaes H.E.K., Palmae). Male flowers of, peach palm ore occasionally consumed as a vegetable 0r, mixed with other ingredients, as a condiment. Three sample were analysed to discover their nutritional values. These flowers contain law levels of protein (1.2% and fats (2.8%)and reasonable levels of able levels of carboidrates (15%); nutritional value is low.

Estudo anatômico das madeiras dos gêneros Anisophyllea R. Brow ex. sabine e Polygonanthus Ducke. (Rhizophoraceae)

Neste trabalho, é feito o estudo dos caracteres anatômicos de 1 (uma) espécie do gênero Anlsophylleae de 2 (duas) espécies do gênero Polygonanthus(Rhizophoraceae) e para cada espécie são apresentadas: características gerais, descrição macro e microscópía, macro e microfotografias dos cortes transversal, tangencial e radial, histogramas da variação de freqüência de fibras e elementos vasculares, um quadro slinóptico com as principais características de cada espécie e uma ficha biométrlca dos elementos anatômicos, para cada espécie. As espécies estudadas foram: Anlisophylea manausensisPires & Rodrigues, Polygonanthus amazonicusDucke e P. punctulatusKuhlmann.

A type system for value-dependent information flow analysis

Information systems are widespread and used by anyone with computing devices as well as corporations and governments. It is often the case that security leaks are introduced during the development of an application. Reasons for these security bugs are multiple but among them one can easily identify that it is very hard to define and enforce relevant security policies in modern software. This is because modern applications often rely on container sharing and multi-tenancy where, for instance, data can be stored in the same physical space but is logically mapped into different security compartments or data structures. In turn, these security compartments, to which data is classified into in security policies, can also be dynamic and depend on runtime data. In this thesis we introduce and develop the novel notion of dependent information flow types, and focus on the problem of ensuring data confidentiality in data-centric software. Dependent information flow types fit within the standard framework of dependent type theory, but, unlike usual dependent types, crucially allow the security level of a type, rather than just the structural data type itself, to depend on runtime values. Our dependent function and dependent sum information flow types provide a direct, natural and elegant way to express and enforce fine grained security policies on programs. Namely programs that manipulate structured data types in which the security level of a structure field may depend on values dynamically stored in other fields The main contribution of this work is an efficient analysis that allows programmers to verify, during the development phase, whether programs have information leaks, that is, it verifies whether programs protect the confidentiality of the information they manipulate. As such, we also implemented a prototype typechecker that can be found at http://ctp.di.fct.unl.pt/DIFTprototype/.

How to increase brand value expanding the category and brand presence to the main meal occasion for Sumol- Compal

Having registered negative retail value growth of 4% in Portugal in 2014, the juice category is set to decline further by 5,5% until 2019. Manufacturers of juices and nectars are therefore increasingly looking for new categories in order to balance this negative forecast in their home territory. One apparent growth opportunity for Compal, the leading producer of juices and nectars, is to expand its commercial reach to new occasions of consumption. This report carefully analyzes the opportunities related to an expansion to the main meal occasion and introduces a complete marketing and communications plan for a possible new main meal juice, Compal à Mesa. The product concept represents a rather premium positioning for the main meal occasion, including new flavor mixes that are targeted at different occasions of meals. The justification of the introduced concept includes a discussion of the primary and secondary research that was performed

The mixed impact of design thinking on business collaborations

The present work project investigates the implications of design thinking on an interbusiness collaborative project, unveiling both the benefits and fragilities that derive from the use of such methodology within the mentioned context. The study is organized in two parts. The first one starts with a literature review on the two relevant frames of reference – design thinking and business collaboration. It proceeds to the creation of a conceptual framework to assess the potential value of the design-based approach. The second part focuses on the practical application of to the newly developed instrument to the inTRAIN project – R&D for railway interiors.

The value creation radar applied to the space engineering sector

This case study illustrates the application of the Value Creation Radar (VCR) to SenSyF, an Earth Observation (EO) system which was developed by Deimos Engenharia S.A. (DME), the Portuguese affiliate of Elecnor Deimos. It describes how a team of consultants adopted the VCR in order to find new market applications for SenSyF, selected the one with the highest potential, and defined a path to guarantee a sustainable market launch. This case study highlights the main challenges of bringing a technology-driven company closer to the market in the pursuit of long-term sustainability, while not compromising its technological capabilities

Return on assets in the Tobacco Industry analysis of the four main Tobacco Manufacturers

This paper studies operating profitability drivers in the Four Main Tobacco Manufacturers for the period 2004-2014. The operating profitability is analyzed as return on assets (ROA) based on the DuPont Extended Model breakdown in degree of operational risk, gross sales margin and assets turnover. The sources of ROA are market share and price strategies appraised through the drivers: firm-size, global value and strategic choices. Using consolidated data, results suggest that firm-size and global value holds a positive relationship with ROA. Also innovation through less harmful tobacco products can lead to better ROA despite no correlation between R&D and ROA.

Developing a gamification system to increase customer lifetime value at MyGon

There have never been so many touch points between companies and consumers as there are today, which paradoxically makes it very challenging for companies to be able to retain and engage customers. Gamification is a strategy used by a large number of companies to increase customer engagement and customer lifetime value. This work aims at developing a gamification system for MyGon, a Portuguese startup working in the market of discounts and experiences. In addition to examining the literature concerning gamification, its elements and characteristics, recommendations were developed for addressing MyGon’s business goals of increasing conversion and customer engagement. The gamification mechanisms suggested include badges, missions, points, leaderboards and levels.

On-board electric vehicle battery charger with enhanced V2H operation mode

This paper proposes an on-board Electric Vehicle (EV) battery charger with enhanced Vehicle-to-Home (V2H) operation mode. For such purpose was adapted an on-board bidirectional battery charger prototype to allow the Grid-to-Vehicle (G2V), Vehicle-to-Grid (V2G) and V2H operation modes. Along the paper are presented the hardware topology and the control algorithms of this battery charger. The idea underlying to this paper is the operation of the on-board bidirectional battery charger as an energy backup system when occurs a power outages. For detecting the power outage were compared two strategies, one based on the half-cycle rms calculation of the power grid voltage, and another in the determination of the rms value based in a Kalman filter. The experimental results were obtained considering the on-board EV battery charger under the G2V, V2G, and V2H operation modes. The results show that the power outage detection is faster using a Kalman filter, up to 90% than the other strategy. This also enables a faster transition between operation modes when a power outage occurs.