Conception and first results of a cross-sectional national study on the demography, disease characteristics and socioeconomics status of the Portuguese patients with multiple sclerosis : the PORT-MS study

RESUMO: Introdução e objetivos: Não existia um estudo multicêntrico que descrevesse as características dos doentes com EM, da doença em si, ou do seu tratamento, em Portugal.Métodos: Doentes McDonald 2010 positivos foram sequencialmente recrutados em 7 centros entre Maio e Novembro 2014. Aplicou-se um Caderno de Recolha de Dados incidindo na demografia, doença, educação e emprego (estudo PORT-MS). Resultados: 561 doentes incluídos. Primeiros sintomas aos 30,2±10,5 anos (RRMS 29,2±10, PPMS 39,4±11,7, p<0,001); diagnóstico 3,2±5,3 anos depois (RRMS 3,0±5,1, PPMS 4,9±2,5, p=0,002); tempo de doença após diagnóstico 9,4±7,2 anos (semelhante RRMS no diagnóstico e PPMS); idade atual 42,9±12,4 anos (grupo RRMS no diagnóstico 42,0±12,1, PPMS 52,5±11,3, p<0,001); EDSS atual 2,5 (RRMS 2.0, PPMS 6.0); proporção feminino:masculino é 2,5:1 (RRMS semelhante, PPMS 1,1:1, p<0,05); no diagnóstico RRMS 90,6%, SPMS 0,9%, PPMS 8,6%; 9,5% dos RRMS encontravam-se em SP na inclusão (nomeadamente os com mais idade no diagnóstico e/ou atualidade ou tempo de doença mais prolongado). PPMS mais frequente em doentes diagnosticados mais tardiamente (p<0,001), onde aumenta também ligeiramente a proporção de mulheres na PPMS. Nas últimas décadas: novos casos mostram estabilidade na proporção de géneros e tipos de doença; idade nos primeiros sintomas e no diagnóstico aumentou ligeiramente, tempo entre eles diminuiu ligeiramente. Proporção sob DMT (Maio 2014): global 84,5%; atualmente RRMS 90,4%; SPMS 70,8%; PPMS 36,8%; progressivas agregadas 48%. Tipo de DMT, amostra global: interferões 56,5%, GA 18,4%, Natalizumab 11,6%, Fingolimod 9,7%. Global: economicamente ativos 61,5%, desemprego 13,5%, 74,1% dos não activos estão reformados por doença. Gravidezes após diagnóstico em 15% mulheres. Casos com história familiar positiva 7,8%. Discussão e conclusões: Incluída cerca de 10% da população portuguesa. Resultados congruentes com dados internacionais. Elevada proporção sob DMT, mesmo EDSS alto e formas progressivas. Terapêuticas de segunda linha sub representadas. Doentes jovens e com doença ligeira com vida económica ativa; restantes essencialmente reformados por doença.---------------- ABSTRACT : Background/aims: In Portugal, there wasn’t a multicentric study on the general characteristics (demography, disease milestones, DMT, socioeconomic status) of Multiple Sclerosis patients. Methods: Patients fulfilling McDonald 2010 criteria were sequentially recruited from May to November 2014 in 7 centers and data was systematically collected. Results: 561 patients included. First symptoms occurred at 30,2±10,5 years-old (RRMS 29,2±10, PPMS 39,4±11,7, p<0,001); diagnosis 3,2±5,3 years later (RRMS 3,0±5,1, PPMS 4,9±2,5, p=0,002); 9,4±7,2 years elapsed since diagnosis (similar for those is RRMS at diagnosis and PPMS); current age 42,9±12,4 years-old (group RRMS at diagnosis 42,0±12,1, PPMS 52,5±11,3, p<0,001); current EDSS 2,5 (RRMS 2.0, PPMS 6.0); females to males 2,5:1 (RRMS similar, PPMS 1,1:1, p<0,05); at diagnosis RRMS 90,6%, SPMS 0,9%, PPMS 8,6%; 9,5% of RRMS reached SP at inclusion (those older at diagnosis, in actuality, or with longer follow-up). PPMS more frequente in patients diagnosed at older ages (p<0,001), also slight increase in females. Along the last decades: new cases have showed stable proportions of gender and disease types; age at first symptoms and diagnosis slightly increased, time between them slightly decreased. Proportion on DMT (May 2014): 84,5% of all; 90,4% of currently in RRMS; 70,8% of SPMS; 36,8% of PPMS; 48% of progressive forms together. Type of DMT, all patients: interferons 56,5%, Glatiramer Acetate 18,4%, Natalizumab 11,6%, Fingolimod 9,7%. Economically active 61,5% of all, unemployment 13,5%, 74,1% of non-active are retired due to disease. Females pregnant after diagnosis 15%. Positive family cases in 7,8%. Discussion/Conclusions: 10% of the national MS population collected. Data generally consistente with international reports. Proportion under DMT relatively high in all disease types, but second line therapies underrepresented. Young patients with mild disease have an active economic life. Those not active are essentially retired due to disease.

Turbines Plans - General Arrangement of Shaft & Cross Section of Turbine, 1903

Two photographs of turbine drawings from the year 1903. The first drawing is titled "10000HP Turbines. Canadian Niagara Power Company. General Arrangement of Shaft." It was last revised 18 May, 1903. The second drawing is titled "10000HP Turbines Canadian Niagara Power Company. Cross Section of Turbine" This drawing revised 6 May, 1903 and 26 June, 1903.

The foot of the cross; or the sorrows of Mary

UANL

Reduction of radar cross section of targets using periodic strip grating technique

The- classic: experiment of Heinrich Hertz verified the theoretical predict him of Maxwell that kxnfli radio and light waves are physical phenomena governed by the same physical laws. This has started a.rnnJ era of interest in interaction of electromagnetic energy with matter. The scattering of electromagnetic waves from a target is cleverly utilized im1 RADAR. This electronic system used tx> detect and locate objects under unfavourable conditions or obscuration that would render the unaided eye useless. It also provides a means for measuring precisely the range, or distance of an object and the speed of a moving object. when an obstacle is illuminated by electromagnetic waves, energy is dispersed in all directions. The dispersed energy depends on the size, shape and composition of the obstacle and frequency and nature of the incident wave. This distribution of energy’ is known as ‘scattering’ and the obstacle as ‘scatterer’ or 'target'.

Mechanisms of midlatitude cross-tropopause transport using a potential vorticity budget approach

[ 1] A potential vorticity (PV) budget method has been used to attribute vertical transport across the near-tropopause ( 1 PVU surface) in extratropical weather systems to radiative, latent heating and cooling, and mixing processes. Sources and sinks of PV due to nonconservative processes are calculated online and advected as passive tracers. There is reasonable agreement between the spatial distribution of transport determined from the PV budget method and the transport across the 1 - 2 PVU zone from a passive tracer and trajectories, but different aspects of exchange can be diagnosed with each method. Stratosphere-to-troposphere transport occurred in the broad upper level PV anomalies and was attributed mainly to latent heating and cooling processes; troposphere-to-stratosphere transport occurred toward the tail of a PV filament and in a ridge region and was attributed mainly to radiative processes. The contribution of mixing processes to transport was comparatively small. Using the PV budget method, the domain integrated exchange across the 1 PVU surface was from stratosphere to troposphere, and the magnitude of 1 x 10(15) kg over a 2 day winter integration in a large North Atlantic domain is consistent with stratosphere-troposphere exchange calculations from other studies. This exchange arises from an approximate balance between the dominant stratosphere-to-troposphere transport due to latent heating and cooling processes and troposphere-to-stratosphere transport due to radiative processes. The direction of transport across the tropopause in a fold was found to be critically dependent on the PV surface considered to represent the tropopause.

Formation of dityrosine cross-links during breadmaking

To establish its significance during commercial breadmaking, dityrosine formation was quantified in flours and doughs of six commercial wheat types at various stages of the Chorleywood Bread Process. Dityrosine was formed mainly during mixing and baking, at the levels of nmol/g dry weight. Good breadmaking flours tended to exhibit higher dityrosine content in the final bread than low quality ones, but no relationship was found for dityrosine as a proportion of flour protein content, indicating that the latter was still a dominant factor in the analysis. There was no correlation between gluten yield of the six wheat types and their typical dityrosine concentrations, suggesting that dityrosine crosslinks were not a determinant factor for gluten formation. Ascorbic acid was found to inhibit dityrosine formation during mixing and proving, and have no significant effect on dityrosine in the final bread. Hydrogen peroxide promoted dityrosine formation, which suggests a radical mechanism involving endogenous peroxidases might be the responsible for dityrosine formation during breadmaking.

Establishment of a Cross-European Field Site Network in the ALARM Project for Assessing Large-Scale Changes in Biodiversity

The field site network (FSN) plays a central role in conducting joint research within all Assessing Large-scale Risks for biodiversity with tested Methods (ALARM) modules and provides a mechanism for integrating research on different topics in ALARM on the same site for measuring multiple impacts on biodiversity. The network covers most European climates and biogeographic regions, from Mediterranean through central European and boreal to subarctic. The project links databases with the European-wide field site network FSN, including geographic information system (GIS)-based information to characterise the test location for ALARM researchers for joint on-site research. Maps are provided in a standardised way and merged with other site-specific information. The application of GIS for these field sites and the information management promotes the use of the FSN for research and to disseminate the results. We conclude that ALARM FSN sites together with other research sites in Europe jointly could be used as a future backbone for research proposals

An efficient shock capturing algorithm for compressible flows in a duct of variable cross-section

A numerical scheme is presented for the solution of the Euler equations of compressible flow of a gas in a single spatial co-ordinate. This includes flow in a duct of variable cross-section as well as flow with slab, cylindrical or spherical symmetry and can prove useful when testing codes for the two-dimensional equations governing compressible flow of a gas. The resulting scheme requires an average of the flow variables across the interface between cells and for computational efficiency this average is chosen to be the arithmetic mean, which is in contrast to the usual ‘square root’ averages found in this type of scheme. The scheme is applied with success to five problems with either slab or cylindrical symmetry and a comparison is made in the cylindrical case with results from a two-dimensional problem with no sources.

Farm animal welfare, consumer willingness to pay, and trust: results of a cross-national survey

Higher animal welfare standards increase costs along the supply chain of certified animal-friendly products (AFP). Since the market outcome of certified AFP depends on consumer confidence toward supply chain operators complying with these standards, the role of trust in consumer willingness-to-pay (WTP) for AFP is paramount. Results from a contingent valuation survey administered in five European Union countries show that WTP estimates were sensitive to robust measures of consumer trust for certified AFP. Deriving the WTP effect of a single food category on total food expenditure is difficult for survey respondents; hence, a budget approach was employed to facilitate this process.

The ecology of crusading: investigating the environmental impact of holy war and colonisation at the frontiers of medieval Europe

The Crusades in the Near East, eastern Baltic and Iberian Peninsula (in the context of the Reconquest/reconquista) were accompanied by processes of colonisation, characterising the expansion of medieval Europe and resulting in the creation of frontier societies at the fringes of Christendom. Colonisation was closely associated with — indeed, depended on — the exploitation of local environments, but this dimension is largely missing from studies of the crusading frontiers. This paper, the product of a European Science Foundation Exploratory Workshop on 'The Ecology of Crusading' in 2009, surveys the potential for investigating the environmental impact of the crusading movement in all three frontier regions. It considers a diverse range of archaeological, palaeoenvironmental and written sources, with the aim of situating the societies created by the Crusades within the context of medieval colonisation and human ecological niche construction. It demonstrates that an abundant range of data exists for developing this largely neglected and disparately studied aspect of medieval frontier societies into a significant research programme.

Noise propagation from a cutting of arbitrary cross-section and impedance

A boundary integral equation is described for the prediction of acoustic propagation from a monofrequency coherent line source in a cutting with impedance boundary conditions onto surrounding flat impedance ground. The problem is stated as a boundary value problem for the Helmholtz equation and is subsequently reformulated as a system of boundary integral equations via Green's theorem. It is shown that the integral equation formulation has a unique solution at all wavenumbers. The numerical solution of the coupled boundary integral equations by a simple boundary element method is then described. The convergence of the numerical scheme is demonstrated experimentally. Predictions of A-weighted excess attenuation for a traffic noise spectrum are made illustrating the effects of varying the depth of the cutting and the absorbency of the surrounding ground surface.

A case study to investigate the life cycle carbon emissions and carbon storage capacity of a cross laminated timber, multi-storey residential building

Forests are a store of carbon and an eco-system that continually removes carbon dioxide from the atmosphere. If they are sustainably managed, the carbon store can be maintained at a constant level, while the trees removed and converted to timber products can form an additional long term carbon store. The total carbon store in the forest and associated ‘wood chain’ therefore increases over time, given appropriate management. This increasing carbon store can be further enhanced with afforestation. The UK’s forest area has increased continually since the early 1900s, although the rate of increase has declined since its peak in the late 1980s, and it is a similar picture in the rest of Europe. The increased sustainable use of timber in construction is a key market incentive for afforestation, which can make a significant contribution to reducing carbon emissions. The case study presented in this paper demonstrates the carbon benefits of a Cross Laminated Timber (CLT) solution for a multi-storey residential building in comparison with a more conventional reinforced concrete solution. The embodied carbon of the building up to completion of construction is considered, together with the stored carbon during the life of the building and the impact of different end of life scenarios. The results of the study show that the total stored carbon in the CLT structural frame is 1215tCO2 (30tCO2 per housing unit). The choice of treatment at end of life has a significant effect on the whole life embodied carbon of the CLT frame, which ranges from -1017 tCO2e for re-use to +153tCO2e for incinerate without energy recovery. All end of life scenarios considered result in lower total CO2e emissions for the CLT frame building compared with the reinforced concrete frame solution.

Survival at the frontier of Holy War: political expansion, crusading, commerce and the medieval colonizing settlement at Biała Gora, North Poland

Between the eleventh and thirteenth centuries AD, the Lower Vistula valley represented a permeable and shifting frontier between Pomerelia (eastern Pomerania), which had been incorporated into the Polish Christian state by the end of the tenth century, and the territories of western Prussian tribes, who had resisted attempts at Christianization. Pomeranian colonization eventually began to falter in the latter decades of the twelfth and early thirteenth centuries, most likely as a result of Prussian incursions, which saw the abandonment of sites across the borderland. Subsequently, the Teutonic Order and its allies led a protracted holy war against the Prussian tribes, which resulted in the conquest of the region and its incorporation into a theocratic state by the end of the thirteenth century. This was accompanied by a second wave of colonization, which resulted in the settlement pattern that is still visible in the landscape of north-central Poland today. However, not all colonies were destroyed or abandoned in between the two phases of colonization. The recently excavated site of Biała Góra, situated on the western side of the Forest of Sztum overlooking the River Nogat, represents a unique example of a transitional settlement that included both Pomeranian and Teutonic Order phases. The aim of this paper is to situate the site within its broader landscape context which can be characterized as a militarized frontier, where, from the later twelfth century and throughout much of the thirteenth century, political and economic expansion was combined with the ideology of Christian holy war and missionary activity. This paper considers how the colonists provisioned and sustained themselves in comparison to other sites within the region, and how Biała Góra may be tentatively linked to a documented but otherwise lost outpost in this volatile borderland.