Evaluation of cases of pemphigus vulgaris and pemphigus foliaceus from a reference service in Pará state, Brazil

BACKGROUND: Pemphigusis a bullous, rare and chronic autoimmune disease. There are two major forms of pemphigus: vulgaris and foliaceus. Epidemiological data and clinical outcome in patients diagnosed in the Brazilian Amazon states are still rare. OBJECTIVES: To study the occurrence of the disease during the study period and analyze the epidemiological profile of patients, the most common subtype of pemphigus, and the clinical evolution of patients. METHODS: Retrospective analysis of medical records of hospitalized patients with pemphigus foliaceus and pemphigus vulgaris in the period from 2003 to 2010 in Dermatology Service of Hospital Fundação Santa Casa de Misericórdia do Pará, Belém, Northern Brazil. RESULTS: We found a total of 20 cases of pemphigus during the study period, 8 of which were of foliaceus pemphigus and 12 of vulgaris pemphigus. Pemphigus foliaceus had the predominance of male patients (75%), showed satisfactory clinical evolution, and was characterized by absence of pediatric cases. Pemphigus vulgaris affected more women (66.7%), showed mean hospital stay of 1 to 3 months (50%), and there were three cases of death (25%). The prescribed immunosuppressive drugs included prednisone with or without combination of azathioprine and/or dapsone. Sepsis was associated with 100% of the deaths. CONCLUSIONS: The occurrence of the disease is rare, there are no familiar/endemic outbreaks in the sample. Evolution is usually favorable, but secondary infection is associated with worse prognosis. The choice of best drugs to treat pemphigus remains controversial.

DNA human identification for the family rights: one year of agreement between UNESP/laboratory of paternity and public defender service in São Paulo State

The universities have realized the importance of extending their knowledge to the population through the provision of services. Thus, this paper presents the data obtained in an agreement between UNESP/Laboratory of Paternity and Public Defender Service in São Paulo State to make DNA paternity tests.

Complex mixed state of the Pauli-limited superconductor CeCoIn5

Magnetization measurements were performed on CeCoIn5 at temperatures down to 20 mK and magnetic fields up to 17 T applied along different crystallographic orientations. For field configurations nearly parallel to the ab plane (theta less than or similar to 40 degrees and T <= 50 mK), we have found an intriguing vortex dynamics regime revealed by a hysteretic and metastable anomalous peak effect (APE), which gives evidence of surface barrier effects enhanced by antiferromagnetic fluctuations in the mixed state of CeCoIn5. Furthermore, we have observed crossover features in the torque and magnetization traces at fields below H-c2, which are consistent with vortices lattice phase transitions and with the anomalies speculated to be the Fulde-Ferrel-Larkin-Ovchinnikov (FFLO) superconducting state in CeCoIn5. All of the above features were found to be dramatically perturbed in Ce0.98Gd0.02CoIn5.

Service Innovation: the state of the art and a proposal of a research agenda

The service sector has acquired a growing importance in every country economy, which has stimulated research in the field of service innovation, a new field in management studies. This text aimed to state a research agenda upon service innovation, based on an articulated discussion of the results of several articles that compose the state of the art of this concept. 73 empirical articles were analyzed, 33% of them exploring the innovation strategies and technology; 18% of the articles describe research on economic performance and enterprise productivity; 16% are related to antecedents and determinants of innovation; another 16% about network capacity development, alliances and collaboration among organizations; 9% of the articles explore service quality, innovation taxonomy, flexible systems and regional systems of innovation; and another 8% are related to themes such as intensive knowledge, research and development. The researches were concentrated in the Engineering & Technology and Hospitality Industries, which accounted for 31% and 24% of the texts, respectively. The remaining 45% of the articles referred to sectors such as Telecommunications, Health, Retail, Financial & Insurance and Public Services. The main gaps identified in these texts refer to the difficulties on measuring service innovation, besides the small number of researches on the public sector. At the end, a research agenda in the subject is presented, including the development of a scale for orientating the innovation and identifying the determining factors of the innovation in the public environment.

On the modeling of drug induced respiratory depression in the non-steady-state

The ability of anesthetic agents to provide adequate analgesia and sedation is limited by the ventilatory depression associated with overdosing in spontaneously breathing patients. Therefore, quantitation of drug induced ventilatory depression is a pharmacokinetic-pharmacodynamic problem relevant to the practice of anesthesia. Although several studies describe the effect of respiratory depressant drugs on isolated endpoints, an integrated description of drug induced respiratory depression with parameters identifiable from clinically available data is not available. This study proposes a physiological model of CO2 disposition, ventilatory regulation, and the effects of anesthetic agents on the control of breathing. The predictive performance of the model is evaluated through simulations aimed at reproducing experimental observations of drug induced hypercarbia and hypoventilation associated with intravenous administration of a fast-onset, highly potent anesthetic mu agonist (including previously unpublished experimental data determined after administration of 1 mg alfentanil bolus). The proposed model structure has substantial descriptive capability and can provide clinically relevant predictions of respiratory inhibition in the non-steady-state to enhance safety of drug delivery in the anesthetic practice.

THE EFFECTS OF COST-SHARING ON USE OF SERVICES AND CONSUMER CHARACTERISTICS IN A STATE'S CRIPPLED CHILDREN'S DIVISION

The present study analyzed some of the effects of imposing a cost-sharing requirement on users of a state's health service program. The study population consisted of people who were in diagnosed medical need and included, but was not limited to, people in financial need.^ The purpose of the study was to determine if the cost-sharing requirement had any detrimental effects on the service population. Changes in the characteristics of service consumers and in utilization patterns were analyzed using time-series techniques and pre-post policy comparisons.^ The study hypotheses stated that the distribution of service provided, diagnoses serviced, and consumer income levels would change following the cost-sharing policy.^ Analysis of data revealed that neither the characteristics of service users (income, race, sex, etc.) nor services provided by the program changed significantly following the policy. The results were explainable in part by the fact that all of the program participants were in diagnosed medical need. Therefore, their use of "discretionary" or "less necessary" services was limited.^ The study's findings supported the work of Joseph Newhouse, Charles Phelps, and others who have contended that necessary service use would not be detrimentally affected by reasonable cost-sharing provisions. These contentions raise the prospect of incorporating cost-sharing into programs such as Medicaid, which, at this writing, do not demand any consumer payment for services.^ The study concluded with a discussion of the cost-containment problem in health services. The efficacy of cost-sharing was considered relative to other financing and reimbursement strategies such as HMO's, self-funding, and reimbursement for less costly services and places of service. ^

REST service testing based on inferred XML schemas

The concept of service oriented architecture has been extensively explored in software engineering, due to the fact that it produces architectures made up of several interconnected modules, easy to reuse when building new systems. This approach to design would be impossible without interconnection mechanisms such as REST (Representationa State Transfer) services, which allow module communication while minimizing coupling. . However, this low coupling brings disadvantages, such as the lack of transparency, which makes it difficult to sistematically create tests without knowledge of the inner working of a system. In this article, we present an automatic error detection system for REST services, based on a statistical analysis over responses produced at multiple service invocations. Thus, a service can be systematically tested without knowing its full specification. The method can find errors in REST services which could not be identified by means of traditional testing methods, and provides limited testing coverage for services whose response format is unknown. It can be also useful as a complement to other testing mechanisms.

Working to Form a More Perfect Union: Honoring Women in Public Service in the State of Missouri

https://bluetigercommons.lincolnu.edu/pli/1010/thumbnail.jpg

Working to Form a More Perfect Union: Honoring Women in Public Service in the State of Missouri

https://bluetigercommons.lincolnu.edu/pli/1009/thumbnail.jpg

Limited internal friction in the rate-limiting step of a two-state protein folding reaction

Small, single-domain proteins typically fold via a compact transition-state ensemble in a process well fitted by a simple, two-state model. To characterize the rate-limiting conformational changes that underlie two-state folding, we have investigated experimentally the effects of changing solvent viscosity on the refolding of the IgG binding domain of protein L. In conjunction with numerical simulations, our results indicate that the rate-limiting conformational changes of the folding of this domain are strongly coupled to solvent viscosity and lack any significant “internal friction” arising from intrachain collisions. When compared with the previously determined solvent viscosity dependencies of other, more restricted conformational changes, our results suggest that the rate-limiting folding transition involves conformational fluctuations that displace considerable amounts of solvent. Reconciling evidence that the folding transition state ensemble is comprised of highly collapsed species with these and similar, previously reported results should provide a significant constraint for theoretical models of the folding process.

EC leaders to discuss the state of the Community. European Community Information Service, Background Note No. 16/1976, 31 March 1976

Includes discussion of Tindemans report.

State Aid and Public Service Broadcasting How Future-proof is the Remit of Public Broadcasting Organisations? IES WORKING PAPER 1/2009

The European Commission’s interference through state aid rules with the Member States’ support for public service broadcasting is not undisputed. Member States, public broadcasters and numerous academics fear that State aid control might limit the public service remit and, hence, the multi-platform and holistic role of public broadcasters in the converging media industries. This paper assesses to what extent the fear for Commission intervention is, indeed, justified. It starts with the assumption that the transformation from public service broadcasting to public service media is vital for the European democratic society. The paper leads to the observation that, in fact, European State aid policy might contribute to such a necessary and urgent transformation, instead of threatening it. The paper consists of three main parts. Firstly, the legal constraints and margins of the Community’s State aid framework are discussed. Secondly, the application of the rules to a selection of public broadcasting cases is analyzed. Finally, some conclusions are drawn from the analysis.

Shlaudeman nomination : hearings before the Committee on Foreign Relations, United States Senate, Ninety-fourth Congress, second session, on the nomination of Harry W. Shlaudeman, of California, a Foreign Service officer of class 1, to be Assistant Secretary of State for Inter-American Affairs, May 25, and June 10 and 11, 1976.

Includes bibliographical references.