LATERAL FLOW ASSAY FOR CRYPTOCOCCAL ANTIGEN: AN IMPORTANT ADVANCE TO IMPROVE THE CONTINUUM OF HIV CARE AND REDUCE CRYPTOCOCCAL MENINGITIS-RELATED MORTALITY

SUMMARYAIDS-related cryptococcal meningitis continues to cause a substantial burden of death in low and middle income countries. The diagnostic use for detection of cryptococcal capsular polysaccharide antigen (CrAg) in serum and cerebrospinal fluid by latex agglutination test (CrAg-latex) or enzyme-linked immunoassay (EIA) has been available for over decades. Better diagnostics in asymptomatic and symptomatic phases of cryptococcosis are key components to reduce mortality. Recently, the cryptococcal antigen lateral flow assay (CrAg LFA) was included in the armamentarium for diagnosis. Unlike the other tests, the CrAg LFA is a dipstick immunochromatographic assay, in a format similar to the home pregnancy test, and requires little or no lab infrastructure. This test meets all of the World Health Organization ASSURED criteria (Affordable, Sensitive, Specific, User friendly, Rapid/robust, Equipment-free, and Delivered). CrAg LFA in serum, plasma, whole blood, or cerebrospinal fluid is useful for the diagnosis of disease caused by Cryptococcusspecies. The CrAg LFA has better analytical sensitivity for C. gattii than CrAg-latex or EIA. Prevention of cryptococcal disease is new application of CrAg LFA via screening of blood for subclinical infection in asymptomatic HIV-infected persons with CD4 counts < 100 cells/mL who are not receiving effective antiretroviral therapy. CrAg screening of leftover plasma specimens after CD4 testing can identify persons with asymptomatic infection who urgently require pre-emptive fluconazole, who will otherwise progress to symptomatic infection and/or die.

Coherence and phase locking disruption in electromyograms of patients with amyotrophic lateral sclerosis

Dissertação para obtenção do Grau de Mestre em Engenharia Biomédica

Revision based total semantics for extended normal logic programs

Dissertação para obtenção do Grau de Doutor em Matemática - Lógica e Fundamentos da Matemática

Encurvadura lateral em vigas de alumínio

Dissertação para obtenção do Grau de Mestre em Engenharia Civil – Perfil de Estruturas

Encurvadura lateral em vigas de alumínio

A presente dissertação tem como objetivo o estudo do fenómeno de encurvadura lateral em vigas de alumínio com secção em I, simplesmente apoiadas e sujeitas a flexão pura (momento uniforme ao longo da viga). Em particular, estuda-se uma abordagem alternativa à do Eurocódigo 9 (EC9), que consiste em utilizar esbeltezas normalizadas que são função da carga crítica elastoplástica da viga. Para o efeito, é desenvolvido um programa de cálculo automático em MATLAB. A abordagem é aplicada (i) à curva de dimensionamento do EC9, (ii) a resultados numéricos, utilizando um programa de elementos finitos, e (iii) aos resultados experimentais obtidos por Y.Q. Wang, H.X. Yuan, Y.J. Shi e M. Cheng [1]. Mostra-se que se obtém uma significativa dispersão com a curva do EC9 mas, por oposição, uma reduzida dispersão com os resultados numéricos e experimentais. Por fim, mostra-se que os resultados numéricos para esbeltezas reduzidas (elevadas) conduzem a valores da resistência à encurvadura significativamente inferiores (superiores) aos do EC9.

Amyotrophic Lateral Sclerosis:Mammalian Cell Models,Copper-Zinc Superoxide Dismutaseand Biological Characteristics

"Amyotrophic Lateral Sclerosis (ALS) is the most severe and common adult onset disorder that affects motor neurons in the spinal cord, brainstem and cortex, resulting in progressive weakness and death from respiratory failure within two to five years of symptoms onset(...)

Study of the electromyographic signal dynamic behavior in Amyotrophic Lateral Sclerosis (ALS)

Amyotrophic Lateral Sclerosis (ALS) is a neurodegenerative disease characterized by motor neurons degeneration, which reduces muscular force, being very difficult to diagnose. Mathematical methods are used in order to analyze the surface electromiographic signal’s dynamic behavior (Fractal Dimension (FD) and Multiscale Entropy (MSE)), evaluate different muscle group’s synchronization (Coherence and Phase Locking Factor (PLF)) and to evaluate the signal’s complexity (Lempel-Ziv (LZ) techniques and Detrended Fluctuation Analysis (DFA)). Surface electromiographic signal acquisitions were performed in upper limb muscles, being the analysis executed for instants of contraction for ipsilateral acquisitions for patients and control groups. Results from LZ, DFA and MSE analysis present capability to distinguish between the patient group and the control group, whereas coherence, PLF and FD algorithms present results very similar for both groups. LZ, DFA and MSE algorithms appear then to be a good measure of corticospinal pathways integrity. A classification algorithm was applied to the results in combination with extracted features from the surface electromiographic signal, with an accuracy percentage higher than 70% for 118 combinations for at least one classifier. The classification results demonstrate capability to distinguish members between patients and control groups. These results can demonstrate a major importance in the disease diagnose, once surface electromyography (sEMG) may be used as an auxiliary diagnose method.

Caracterização da adesão terapêutica dos doentes seguidos no Centro Hospitalar Lisboa Norte, EPE, no decurso do tratamento da, Esclerose Múltipla, Esclerose Lateral Amiotrófica, Artrite Reumatóide, Espondilite Anquilosante, Artrite Psoriática, Artrite Idiopática Juvenil Poliarticular, Psoríase em Placas, Polineuropatia Amiloidótica Familiar (Paramiloidose) e HIV/Sida : análise retrospetiva

RESUMO - Objetivos: Caracterizar a adesão à terapêutica nos doentes do CHLN, na área do VIH/SIDA, Esclerose, Artrite Reumatóide, Psoríase e Paramiloidose e avaliar a hipótese de ser possível prever o risco de um doente se tornar, num doente sem adesão. Metodologia: Estudo retrospetivo, observacional e longitudinal, realizado entre Janeiro de 2010 a 31 de Dezembro de 2013, a 4.761 doentes, em que a adesão à terapêutica foi calculada com base nos registos informáticos das dispensas de medicação, efectuados pelos Serviços Farmacêuticos, com recurso à Compliance Rate (CR) e utilizada como variável dependente. A estatística descritiva foi utilizada para caracterizar os doentes e os seus levantamentos e a regressão logística para avaliar o efeito das variáveis (idade, sexo, distrito de residência, período de observação, número de interrupções superiores a trinta dias e tempo até à primeira interrupção) sobre a adesão à terapêutica. Resultados e Conclusões: A percentagem de doentes com adesão foi de 64%, no entanto no HIV/Sida e na Artrite Reumatóide e Psoríase esta percentagem foi significativamente mais baixa, 42% dos doentes interromperam a terapêutica por períodos superiores a 30 dias, ocorrendo essa interrupção maioritariamente entre o primeiro e segundo ano de terapêutica. O modelo de regressão logística permitiu verificar que só com as variáveis sociodemográficas não é possível prever o risco de um doente se tornar num doente sem adesão, sendo para tal necessário adicionar ao modelo a variável número de interrupções superiores a 30 dias que foi identificada como importante factor preditivo da não adesão (OR=15,9, p=0,000).

Machine ethics via logic programming

Machine ethics is an interdisciplinary field of inquiry that emerges from the need of imbuing autonomous agents with the capacity of moral decision-making. While some approaches provide implementations in Logic Programming (LP) systems, they have not exploited LP-based reasoning features that appear essential for moral reasoning. This PhD thesis aims at investigating further the appropriateness of LP, notably a combination of LP-based reasoning features, including techniques available in LP systems, to machine ethics. Moral facets, as studied in moral philosophy and psychology, that are amenable to computational modeling are identified, and mapped to appropriate LP concepts for representing and reasoning about them. The main contributions of the thesis are twofold. First, novel approaches are proposed for employing tabling in contextual abduction and updating – individually and combined – plus a LP approach of counterfactual reasoning; the latter being implemented on top of the aforementioned combined abduction and updating technique with tabling. They are all important to model various issues of the aforementioned moral facets. Second, a variety of LP-based reasoning features are applied to model the identified moral facets, through moral examples taken off-the-shelf from the morality literature. These applications include: (1) Modeling moral permissibility according to the Doctrines of Double Effect (DDE) and Triple Effect (DTE), demonstrating deontological and utilitarian judgments via integrity constraints (in abduction) and preferences over abductive scenarios; (2) Modeling moral reasoning under uncertainty of actions, via abduction and probabilistic LP; (3) Modeling moral updating (that allows other – possibly overriding – moral rules to be adopted by an agent, on top of those it currently follows) via the integration of tabling in contextual abduction and updating; and (4) Modeling moral permissibility and its justification via counterfactuals, where counterfactuals are used for formulating DDE.

Persistence of the embryonic lateral marginal vein: report of two cases

PURPOSE: Congenital venous malformations of the lower limbs represent a particular challenge for the vascular surgeon. Persistence of fetal veins is a rare malformation, and the most common is the persistence of the lateral marginal vein usually observed in patients with Klippel-Trenaunnay Syndrome. The persistence of this embryonic vein as an isolated venous malformation without the other characteristics of the Klippel-Trenaunnay Syndrome has not yet been reported. This paper describes two cases. METHODS: Two patients, a 17-year-old male patient and a 16-year-old female, have had since their birth a large venous trunk in the lateral aspect of the right leg and thigh. The limbs underwent duplex scanning and phlebography. The surgical removal of the lateral marginal vein was performed. RESULTS: Surgical treatment resulted in very good functional and aesthetic results. Follow-up at 26 months showed no evidence of varicose vein recurrence. CONCLUSIONS: To achieve good results, surgical intervention may be indicated in cases of orthopedic deformity, hemorrhage, symptomatic, and unaesthetic lesions.

Reconfigurable photonic logic architecture

The amorphous silicon photo-sensor studied in this thesis, is a double pin structure (p(a-SiC:H)-i’(a-SiC:H)-n(a-SiC:H)-p(a-SiC:H)-i(a-Si:H)-n(a-Si:H)) sandwiched between two transparent contacts deposited over transparent glass thus with the possibility of illumination on both sides, responding to wave-lengths from the ultra-violet, visible to the near infrared range. The frontal il-lumination surface, glass side, is used for light signal inputs. Both surfaces are used for optical bias, which changes the dynamic characteristics of the photo-sensor resulting in different outputs for the same input. Experimental studies were made with the photo-sensor to evaluate its applicability in multiplexing and demultiplexing several data communication channels. The digital light sig-nal was defined to implement simple logical operations like the NOT, AND, OR, and complex like the XOR, MAJ, full-adder and memory effect. A pro-grammable pattern emission system was built and also those for the validation and recovery of the obtained signals. This photo-sensor has applications in op-tical communications with several wavelengths, as a wavelength detector and to execute directly logical operations over digital light input signals.

Logic programming and artificial neural networks in breast cancer detection

About 90% of breast cancers do not cause or are capable of producing death if detected at an early stage and treated properly. Indeed, it is still not known a specific cause for the illness. It may be not only a beginning, but also a set of associations that will determine the onset of the disease. Undeniably, there are some factors that seem to be associated with the boosted risk of the malady. Pondering the present study, different breast cancer risk assessment models where considered. It is our intention to develop a hybrid decision support system under a formal framework based on Logic Programming for knowledge representation and reasoning, complemented with an approach to computing centered on Artificial Neural Networks, to evaluate the risk of developing breast cancer and the respective Degree-of-Confidence that one has on such a happening.

Evaluation of the determinism of the actuator sensor interface (ASI) on programmable logic controllers (PLC), personal computers (PC) and real-time operating systems (RTOS)

The purpose of this study was to evaluate the determinism of the AS-lnterface network and the 3 main families of control systems, which may use it, namely PLC, PC and RTOS. During the course of this study the PROFIBUS and Ethernet field level networks were also considered in order to ensure that they would not introduce unacceptable latencies into the overall control system. This research demonstrated that an incorrectly configured Ethernet network introduces unacceptable variable duration latencies into the control system, thus care must be exercised if the determinism of a control system is not to be compromised. This study introduces a new concept of using statistics and process capability metrics in the form of CPk values, to specify how suitable a control system is for a given control task. The PLC systems, which were tested, demonstrated extremely deterministic responses, but when a large number of iterations were introduced in the user program, the mean control system latency was much too great for an AS-I network. Thus the PLC was found to be unsuitable for an AS-I network if a large, complex user program Is required. The PC systems, which were tested were non-deterministic and had latencies of variable duration. These latencies became extremely exaggerated when a graphing ActiveX was included in the control application. These PC systems also exhibited a non-normal frequency distribution of control system latencies, and as such are unsuitable for implementation with an AS-I network. The RTOS system, which was tested, overcame the problems identified with the PLC systems and produced an extremely deterministic response, even when a large number of iterations were introduced in the user program. The RTOS system, which was tested, is capable of providing a suitable deterministic control system response, even when an extremely large, complex user program is required.

Efeitos da exposição à fumaça lateral do cigarro sobre o barorreflexo em ratos adultos

FUNDAMENTO: Tem sido demonstrado na literatura que a exposição à fumaça do cigarro causa hipertensão em ratos; entretanto, ainda não foi demonstrado se a função barorreflexa está prejudicada antes do animal se tornar hipertenso. OBJETIVO: Avaliamos os efeitos de curto prazo da exposição à fumaça lateral do cigarro (FLC) sobre a função barorreflexa em ratos Wistar normotensos. MÉTODOS: Os ratos foram expostos à FLC durante três semanas, 180 minutos, cinco dias por semana, a uma concentração de monóxido de carbono entre 100-300 ppm. A pressão arterial média (PAM) e a freqüência cardíaca (FC) foram avaliadas através de canulação da veia e artéria femoral. RESULTADOS: Não houve diferença significante entre os grupos controle e FLC em relação à MAP e FC, componentes simpáticos e parassimpáticos da função barorreflexa. CONCLUSÃO: Nossos dados sugerem que três semanas de exposição à FLC não são suficientes para causar dano significante aos parâmetros cardiovasculares e sensibilidade barorreflexa em ratos Wistar normotensos.