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As empresas interagem em um mercado competitivo, no qual a disputa pela preferência dos clientes está cada vez mais acirrada. Trabalhar na redução de custos operacionais, investir em campanhas publicitárias, estabelecer estratégias de fidelização de clientes e implantação de programas de qualidade tem sido algumas das medidas adotadas pelas empresas para se manterem competitivas no mercado. Uma alternativa, que se mostra eficaz para a sustentabilidade das organizações no longo prazo, é o desenvolvimento de novos produtos. Nesse contexto, o Processo de Desenvolvimento de Produtos (PDP) é uma opção viável que busca facilitar o lançamento no mercado de produtos de qualidade no menor tempo possível. Dessa forma, foi realizado um ensaio que aplicasse uma metodologia no desenvolvimento de um produto inovador e de baixa complexidade tecnológica. O produto desenvolvido consistiu em um Equipamento de Proteção Individual (EPI) que sugere permitir o reencape de agulhas de seringas descartáveis de forma segura e prática. Tal produto possui caráter inovador e apresentou eficiência na resolução do problema ao qual foi proposto.

Purpose: Quantitative multi-parameter mapping (MPM) has been shown to provide good longitudinal and cross-sectional reproducibility for clinical research. Unfortunately, acquisition times are typically infeasible for routine scanning at high resolutions. Methods: A fast whole-brain MPM protocol based on interleaved multi-shot 3D-EPI with controlled aliasing (SC-EPI) at 3T and 7T is proposed and compared with MPM using a standard spoiled gradient echo (FLASH) sequence. Four parameters (R1, PD, R2 *, and MTsat) were measured in less than 3 minutes at 1mm isotropic resolution. Five subjects went through the same scanning sessions twice at each scanner. The intra-subject coefficient of variation (scanrescan) (CoV) was estimated for each protocol and scanner to assess the longitudinal reproducibility. Results: At 3T, the CoV of SC-EPI ranged between 1.2-4.8% for PD and R1, 2.8-10.6% for R2 * and MTsat, which was comparable with FLASH (0.6-4.9% for PD and R1, 2.6-11.3% for R2 * and MTsat). At 7T, where the SC-EPI acquisition time was reduced to ~2 minutes, the CoV of SCEPI (1.4-10.6% for PD, R1 and R2 * ) was 1.2-2.4 times larger than the CoV of FLASH (1.0-15%) and MTsat showed much higher variability across subjects. The SC-EPI-MPM protocol at 3T showed high reproducibility and yielded stable quantitative maps at a clinically feasible resolution and scan time, whereas at 7T, MT saturation homogeneity needs to be improved. Conclusion: SC-EPI-based MPM is feasible as an additional MRI modality in clinical or population studies where the parameters offer great potential as biomarkers.

High-Performance Computing can be accelerated using long-vector architectures. However, creating efficient coding implementations for these architectures can be challenging. This Master's thesis focuses on implementing four well-known and widely-used graph processing algorithms using the RISC-V Vector Extension, leveraging an experimental system in an FPGA. I present a graph storage format that benefits from long vectors and describe how these four algorithms can be rewritten to utilize it. This thesis also introduces an instrumentation tool for FPGA that I developed to link the output of electrical engineering software with performance analysis tools for HPC. This tool allows users to visualize information coming from the logic analyzer internal to the FPGA with powerful visualization tools, permitting fine-grain analysis of the FPGA signals correlated with the code running on it. This tool has been integrated into the experimental performance analysis tools of BSC. In this thesis I leverage this tool to analyze and improve my implementations of graph algorithms for long-vector architectures, collecting the process and thoughts behind each optimization. Finally, I compare the performance of my vector implementations with other machines, such as the NEC SX-Aurora, a commercial RISC-V board, and an Intel chip.

Os equipamentos de proteção individual (EPI), Coletiva (EPC) e as ferramentas dos eletricistas precisam passar por inspeções para saber se o equipamento esta viável para uso, sem perfurações ou com a rigidez dielétrica comprometida, ressaltando que as empresas são obrigadas por lei a seguirem normas como NR-10. A norma regulamentadora 10 tem o objetivo de minimizar os riscos existentes, protegendo a saúde e a integridade física dos colaboradores e a NR-6 norma especial que regulamenta a execução do trabalho com uso de equipamento de proteção individual (EPI), informa sobre a comercialização e utilização. O presente trabalho utiliza como metodologia um estudo de caso em um laboratório de EPI, acreditado pelo Inmetro, localizado em Manaus, residente do bairro distrito II, para a realização dos ensaios seguimos um padrão de normas brasileiras regulamentadoras (NBR`s), onde explica como se deve realizar o ensaio, mostrando o resultado satisfatório.

According to the World Economic Forum, the building sector is responsible for 40% of global energy consumption and 33% of greenhouse gas (GHG) emissions, and this is expected to increase due to population growth and the subsequent impact on the environment, economy and health. To tackle the problem, countries have set new construction codes, policies and regulations for the construction of new buildings in an effort to make them greener. However, there is a need to enhance the status of the existing buildings, especially mosques, as they are the main contributors to energy usage and water consumption in the United Arab Emirates (UAE). Therefore, this research seeks to fill this gap, aiming to evaluate the energy usage and water consumption practices employed in the existing mosque buildings within the UAE and to provide recommendations for improving the sustainability of mosques, with a focus on the environmental and economic pillars. The methodology relies mainly on data collected from 146 existing mosque buildings that have undergone energy saving audits across the UAE. Descriptive statistical analysis is performed to analyze the data from the period of 2018–2019 in order to determine the most significant factors related to energy inefficiency in existing mosque buildings in the UAE and to determine the most cost-effective and energy-saving corrective measures for energy and water conservation. The findings further enhance the standard of experience for mosque visitors (social aspect); reduce energy bill expenses, providing an acceptable return on investment from the proposed energy conservation measures for stakeholders (economic); and reduce the overall energy consumption, which can reduce the total CO2 emissions from mosque buildings (environmental).

This study compares the diagnostic performance and image quality of single-shot turbo spin-echo DWI (tseDWI), standard readout-segmented DWI (rsDWI), and a modified rsDWI version (topupDWI) for cholesteatoma diagnostics. Thirty-four patients with newly suspected unilateral cholesteatoma were examined on a 1.5 Tesla MRI scanner. Diagnostic performance was evaluated by calculating and comparing the sensitivity and specificity using histopathological results as the standard of reference. Image quality was independently reviewed by two readers using a 5-point Likert scale evaluating image distortions, susceptibility artifacts, image resolution, lesion conspicuity, and diagnostic confidence. Twenty-five cholesteatomas were histologically confirmed after surgery and originated in the study group. TseDWI showed the highest sensitivity with 96% (95% confidence interval (CI): 88–100%), followed by topupDWI with 92% (95% CI: 81–100%) for both readers. The sensitivity for rsDWI was 76% (95% CI: 59–93%) for reader 1 and 84% (95% CI: 70–98%) for reader 2, respectively. Both tseDWI and topupDWI revealed a specificity of 100% (95% CI: 66–100%) and rsDWI of 89% (95% CI: 52–100%). Both tseDWI and topupDWI showed fewer image distortions and susceptibility artifacts compared to rsDWI. Image resolution was consistently rated best for topupDWI, followed by rsDWI, which both outperformed tseDWI. TopupDWI and tseDWI showed comparable results for lesions’ conspicuity and diagnostic confidence, both outperforming rsDWI. Modified readout-segmented DWI using the topup-correction method is preferable to standard rsDWI and may be regarded as an accurate alternative to single-shot turbo spin-echo DWI in cholesteatoma diagnostics.

Functional MRI (fMRI) data acquired using echo-planar imaging (EPI) are highly distorted by magnetic field inhomogeneities. Distortion and differences in image contrast between EPI and T1-weighted and T2-weighted (T1w/T2w) images makes their alignment a challenge. Typically, field map data are used to correct EPI distortions. Alignments achieved with field maps can vary greatly and depends on the quality of field map data. However, many public datasets lack field map data entirely. Additionally, reliable field map data is often difficult to acquire in high-motion pediatric or developmental cohorts. To address this, we developed Synth, a software package for distortion correction and cross-modal image registration that does not require field map data. Synth combines information from T1w and T2w anatomical images to construct an idealized undistorted synthetic image with similar contrast properties to EPI data. This synthetic image acts as an effective reference for individual-specific distortion correction. Using pediatric (ABCD: Adolescent Brain Cognitive Development) and adult (MSC: Midnight Scan Club; HCP: Human Connectome Project) data, we demonstrate that Synth performs comparably to field map distortion correction approaches, and often outperforms them. Field map-less distortion correction with Synth allows accurate and precise registration of fMRI data with missing or corrupted field map information.

It is well known that a Lagrangian (usually kinetic energy - potential) may be extremized (subject to constraints) to obtain Newton’s laws. In (1) it is argued that the Lagrangian is linked to Fisher’s information and that there exists a general extremization process of Fisher’s extremization subject to constraints i.e. Extreme Physical Information (EPI) which accounts for the Lagrangian process. Here we note that special relativity yields EE= pp + momo (c=1) for a free particle and (E-V)(E-V) = pp +momo for one with a potential V(x). From this follows Newton’s conservation of energy equation E= pp/2m + V. We thus ask: Does special relativity guarantee the existence of a function L (called a Lagrangian) such that its extremization leads to a dynamical equation of motion? We argue that it does. In particular, we argue that special relativity ensures p= dL/dv if one defines L using the standard variable switch approach (used in thermodynamics) i.e. E = -L+pv. This, together with v=dx/dt, guarantees that the function L, when extremized, yields the equation of motion. Thus we argue that special relativity is behind the extremization/variational approaches of the Lagrangian and EPI.

The notion of extremizing Shannon’s entropy subject to constraints is well known in classical statistical mechanics (e.g. in the case of a Maxwell-Boltzmann gas). There, however, the maximization of the number of arrangements is the key physical idea. Alternatively, in dynamics there exists the extremization of Extreme Physical Information (EPI) (which makes use of Fisher’s information) (1). This may be used to derive Newton’s equations (from the Lagrangia ) and the time-independent Schrodinger equation. We suggest there exists a unifying idea, namely the extremization of pressure subject to constraints, which accounts for both the extremization of entropy and (EPI). We argue that this is the key idea behind the two seemingly different extremization approaches.

A área da gestão de stocks assume grande importância para o setor da saúde, dada a sua função de decisão dos bens necessários para o público alvo, a sua quantidade e onde estes se devem encontrar. Uma adequada gestão de stocks não só aumenta a capacidade de resposta da organização face à procura, como também, do ponto de vista financeiro, imobiliza capital para a mesma, sendo desejável que se diminua a despesa em stocks sem prejudicar o nível e qualidade de serviço prestado. O presente relatório, intitulado “Gestão de Stocks e Melhoria Contínua do Armazém de EPI do ACeS Algarve I – Central”, surge no âmbito da realização do Mestrado em Gestão de Unidades de Saúde na Faculdade de Economia da Universidade Do Algarve e apresenta as atividades desenvolvidas no decorrer do estágio curricular realizado no ACeS Algarve I – Central, nomeadamente no armazém de Equipamento de proteção individual (EPI), durante o período de 26 de outubro de 2021 a 18 de fevereiro de 2022. No decorrer do estágio, procedeu-se ao enquadramento dos processos e procedimentos de gestão de stocks do armazém e, posteriormente, à implementação de uma ferramenta de melhoria contínua da qualidade. Neste relatório constam as atividades desenvolvidas no âmbito do Armazém de EPI que incidiram sobre toda a cadeia logística, desde o pedido de material e recebimento, seguindo-se da sua armazenagem, distribuição, gestão e controlo de stocks. A partir de uma análise SWOT realizada ao armazém de EPI, foram detetadas fraquezas ao nível dos protocolos correspondentes aos processos de funcionamento e ao espaço e movimentação de stocks. No sentido de superar e solucionar estas fraquezas, foi proposta como medida de gestão o uso da Auditoria, enquanto ferramenta de gestão da qualidade e melhoria contínua do armazém de EPI. Por fim, como conclusão do estágio realizado salienta-se a importância do mesmo por permitir o contacto direto com o mundo profissional, assim como as diversas áreas da gestão em saúde como: a gestão de stocks e aprovisionamento e a gestão da melhoria contínua e qualidade. The field of stock management is of great importance for the health sector, given its role in deciding the supplies needed by the target audience, their quantity and where they should be found. An Adequate stock management not only increases the organization's ability to respond to demand, but also, from a financial point of view, immobilizes capital, making it desirable to reduce the expense of stocks without harming the quality of service provided. This report, entitled “Gestão de Stocks e Melhoria Contínua do Armazém de EPI do ACeS Algarve I – Central”, arises within the scope of the Master's in Health Units Management at the Universidade do Algarve and presents the activities carried out during the curricular internship held at ACeS Algarve I – Central, specifically in the Personal Protective Equipment (PPE) warehouse, during the period from October 26th of 2021 to February 18th of 2022. During the internship, the warehouse stock management processes and procedures were formulated and later, a continuous quality improvement tool was implemented. This report includes the activities carried out in the PPE Warehouse and focuses on the entire logistics chain, from the request of material and its delivery to its storage, distribution, management, and stock control. Based on a SWOT analysis carried out in the PPE warehouse, weaknesses were detected in the protocols specifically in the operating processes, the lack of warehouse space and movement of stocks. In order to overcome and solve these weaknesses, the use of an Audit was proposed as a management measure to improve quality and continuous improvement of the PPE warehouse. Finally, as a reflection of the internship carried out, its importance is highlighted for allowing direct contact with the professional world, as well as the various areas of health management such as: stock and supply management and management of continuous improvement and quality.

This paper will analyze the economic performance of six Western Balkan countries. The intention is to utilize the index of economic performance for each country in this region. The analysis will look at the data for the past decade (2010-2022). In addition, secondary data available from publically available databases have been included in this analysis. EPI is constructed by using important macroeconomic indexes such as unemployment, inflation, budget deficit, and annual growth. Also, this paper will analyze the impact that the war in Ukraine has had in affecting the economic performance of Western Balkans countries. To do this, graphs, descriptive statistics, and regression models have been used. In line with conventional wisdom, the results show that countries with lower unemployment have performed better than the countries with higher unemployment rates. Contrary to expectations, higher growth rates have not translated to better performance, as well as increased public borrowing has not correlated to better performance.

An earlier version of this paper is available as a Department of Economics and Finance Working Paper at https://www.brunel.ac.uk/economics-and-finance/research/pdf/2216-Oct-GMC-SMEs-and-EEMs.pdf . This paper investigates the factors (such as different sources of financing, energy audits and internal monitoring activities) affecting the propensity of European small and medium sized enterprises (SMEs) to adopt energy saving measures (ES). For this purpose, a Probit model is estimated using data from the 2017 Flash Eurobarometer survey covering a large sample of European firms. The analysis is carried out for the full sample as well as for clusters based on an environmental performance index (EPI) and on the level of economic development in turn. The results indicate that internal financing always has a positive effect on a firm’s propensity to adopt ES. Private external sources of financing appear to be more important for Western European firms as well as for those located in countries with a greater level of environmental awareness; in the latter, when firms combine private financing with energy audits or internal monitoring activities the propensity to adopt ES increases further. By contrast, in the Eastern Countries this occurs when firms simultaneously rely on public funds and monitoring activities.

Adenosine deaminases acting on RNA 1 (ADAR1) are enzymes involved in editing adenosine to inosine in the dsRNAs of cells associated with cancer development. The p150 isoform of ADAR1 is the only isoform containing the Zα domain that binds to both Z-DNA and Z-RNA. The Zα domain is suggested to modulate the immune response and could be a suitable target for antiviral treatment and cancer immunotherapy. In this study, we aimed to identify potential inhibitors for ADAR1 protein that bind the Zα domain using molecular docking and simulation tools. Virtual docking and molecular dynamics simulation approaches were used to screen the potential activity of 2115 FDA-approved compounds on the Zα domain of ADAR1 and filtered for to obtain the top-scoring hits. The top three compounds with the best XP Gscore—namely alendronate (−7.045), etidronate (−6.923), and zoledronate (−6.77)—were subjected to 50 ns simulations to characterize complex stability and identify the fundamental interactions that contribute to inhibition of the ADAR1 Zα domain. The three compounds were shown to interact with Lys169, Lys170, Asn173, and Tyr177 of the Zα domain-like helical backbone of Z-RNA. The study provides a comprehensive and novel insights of repurposes drugs for the inhibition of ADAR1 function.

Background Awareness of exocrine pancreatic insufficiency (EPI) in cats has increased since the development of an assay for feline trypsin-like immunoreactivity (fTLI). Ultrasound findings in cats with EPI have only been reported rarely and described as nonspecific. Hypothesis/objectives To describe the ultrasonographic findings, clinical signs, and concurrent diseases in cats with EPI. Animals Twenty-two client-owned cats with EPI. Methods Multicenter retrospective descriptive study including cats with serum fTLI concentration ≤8 μg/L and an abdominal ultrasound examination performed within 6 weeks of fTLI measurement. Sonographic measurements of maximal pancreatic thickness and maximal pancreatic duct diameter as well as ratios of pancreatic duct diameter to pancreatic thickness were obtained. Additional sonographic findings, concurrent conditions, and clinical signs were recorded. Results The most common clinical sign was weight loss (15/22 cats). Chronic enteropathy was the most common concurrent disease (13/22 cats). In 39% of cats, the pancreas had minimal or no sonographic alterations. Pancreatic duct dilatation (>2.5 mm), pancreatic duct tortuosity with variable diameter, or both were seen in 6/13 cats. The pancreatic parenchyma was subjectively thin in 6 cats. A significant relationship was found between subjectively thin pancreatic parenchyma and increased pancreatic duct size : pancreatic thickness ratio (P = .004). Diffuse gastrointestinal dilatation with echogenic content was observed in 8/22 cats. Conclusion Exocrine pancreatic insufficiency often causes minimal to no sonographic pancreatic changes. Nonetheless, the findings of thin pancreatic parenchyma, pancreatic duct dilatation, or diffuse small intestinal dilatation with echogenic contents in cats with unexplained weight loss or unformed feces should raise clinical suspicion for EPI.

Immunization is among the most cost-effective public health interventions available and is estimated to have averted at least 37 million deaths between 2000 and 2019. Since the establishment of the Expanded Programme on Immunization in 1974, global vaccination coverage increased and the coverage gap between rich and poor countries decreased. Creation of Gavi, the Vaccine Alliance, in 2000 allowed the poorest countries in the world to benefit from new, life-saving vaccines and expand the breadth of protection against an increasing number of vaccine-preventable diseases. Despite this progress, inequities in access to and uptake of vaccines persist. Opportunities to realize the full potential of vaccines are within reach but require focused, tailored and committed action by Governments and immunization stakeholders. The Immunization Agenda 2030 provides a framework for action during the next decade to attain a world where everyone, everywhere, at every age fully benefits from vaccines for good health and well-being.

Although hyperpolarization (HP) greatly increases the sensitivity of 13C MR, the usefulness of HP in vivo is limited by the short lifetime of HP agents. To address this limitation, we developed an echo-planar (EPI) sequence with spectral-spatial radiofrequency (SSRF) pulses for fast and efficient metabolite-specific imaging of HP [1-13C]pyruvate and [1-13C]lactate at 4.7 T. The spatial and spectral selectivity of each SSRF pulse was verified using simulations and phantom testing. EPI and CSI imaging of the rat abdomen were compared in the same rat after injecting HP [1-13C]pyruvate. A procedure was also developed to automatically set the SSRF excitation pulse frequencies based on real-time scanner feedback. The most significant results of this study are the demonstration that a greater spatial and temporal resolution is attainable by metabolite-specific EPI as compared with CSI, and the enhanced lifetime of the HP signal in EPI, which is attributable to the independent flip angle control between metabolites. Real-time center frequency adjustment was also highly effective for minimizing off-resonance effects. To the best of our knowledge, this is the first demonstration of metabolite-specific HP 13C EPI at 4.7 T. In conclusion, metabolite-specific EPI using SSRF pulses is an effective way to image HP [1-13C]pyruvate and [1-13C]lactate at 4.7 T.

There is an urgent need to find novel treatments for combating multidrug-resistant bacteria. Multidrug efflux pumps that expel antibiotics out of cells are major contributors to this problem. Therefore, using efflux pump inhibitors (EPIs) is a promising strategy to increase antibiotic efficacy. However, there are no EPIs currently approved for clinical use especially because of their toxicity. This study investigates sodium malonate, a natural, non-hazardous, small molecule, for its use as a novel EPI of AcrAB-TolC, the main multidrug efflux pump of the Enterobacteriaceae family. Using ethidium bromide accumulation experiments, we found that 25 mM sodium malonate inhibited efflux by the AcrAB-TolC and other MDR pumps of Escherichia coli to a similar degree than 50 μΜ phenylalanine-arginine-β-naphthylamide, a well-known EPI. Using minimum inhibitory concentration assays and molecular docking to study AcrB-ligand interactions, we found that sodium malonate increased the efficacy of ethidium bromide and the antibiotics minocycline, chloramphenicol, and ciprofloxacin, possibly via binding to multiple AcrB locations, including the AcrB proximal binding pocket. In conclusion, sodium malonate is a newly discovered EPI that increases antibiotic efficacy. Our findings support the development of malonic acid/sodium malonate and its derivatives as promising EPIs for augmenting antibiotic efficacy when treating multidrug-resistant bacterial infections.

Functional Magnetic Resonance Imaging (fMRI) at ultra-high field benefits from a boosted signal to noise ratio enabling an increase in the spatiotemporal resolution of the human cortex. This technique consists of measuring the signal change induced by neuronal activity through neurovascular coupling. Therefore, a 11.7T MRI has been installed in order to push resolution and sensitivity in the acquisitions and gain detailed knowledge about the human brain. However, ultra-high field comes with more severe radiofrequency (RF) field inhomogeneity resulting in dark region and loss of contrast in the image. RF transmission solutions have been successfully developed at NeuroSpin to tackle this problem. The main goal of this thesis consists in developing in this context dedicated solutions to fMRI (RF pulses, sequences, reconstruction). Universal RF pulses were specifically designed for slab-selective excitations in order to benefit from the reduced RF field inhomogeneity and a shorter acquisition time. The pulses were then successfully implemented into a 3D-EPI with a simple gradient delay measurement and artifact correction tool employing gradient trim blips. Finally, different RF coil combination strategies optimizing signal stability were explored. A data-based and analytical solution optimal in temporal signal to noise ratio was derived but had a tendency to erode activation spikes shading light on the limits of this widely used quality metric.; L'imagerie par résonance magnétique fonctionnelle (IRMf) à ultra-haut champ bénéficie d'un rapport signal sur bruit renforcé permettant d'augmenter la résolution spatio-temporelle des images cérébrales. Cette technique consiste à mesurer le changement en amplitude du signal grâce au couplage neurovasculaire induit par l'activité neuronale. Ainsi, une IRM à 11.7T fut installé à NeuroSpin afin de pousser la résolution et sensibilité des acquisitions et approfondir notre connaissance du cerveau humain. Cependant, l'ultra-haut champ s'accompagne d'une plus grande inhomogénéité du champ radiofréquence (RF), générant des zones sombres et une perte de contraste sur l'image. Des solutions de transmission RF ont été développées à NeuroSpin avec succès pour résoudre ce problème. L'objectif principal de cette thèse consiste à développer dans ce contexte des solutions dédiées à l'IRMf (impulsions RF, séquences, reconstruction). Des impulsions RF universelles ont été spécifiquement conçues pour les excitations sélectives afin de bénéficier d'une inhomogénéité de champ RF réduite avec un temps d'acquisition plus court. Les impulsions ont ensuite été implémentées avec succès sur une séquence EPI-3D avec un outil simple de mesure et de correction des artefacts de délais de gradient utilisant des blips de gradient. Enfin, différentes combinaisons de canaux de réception RF optimisant la stabilité du signal ont été explorées. Une solution analytique basée sur les données et optimale pour le rapport signal sur bruit temporel a été proposée, mais celle-ci avait tendance à éroder les pics d'activation, mettant en lumière les limites de cette métrique pourtant largement utilisée.

Peer reviewed: True, BACKGROUND: Immunizations are one of the most effective tools a community can use to increase overall health and decrease the burden of vaccine-preventable diseases. Nevertheless, socioeconomic status, geographical location, education, and a child's sex have been identified as contributing to inequities in vaccine uptake in low- and middle-income countries (LMICs). Madagascar follows the World Health Organization's Extended Programme on Immunization (EPI) schedule, yet vaccine distribution remains highly inequitable throughout the country. This systematic review sought to understand the differences in EPI vaccine uptake between boys and girls in Madagascar. METHODS: A systematic literature search was conducted in August 2021 through MEDLINE, the Cochrane Library, Global Index Medicus, and Google Scholar to identify articles reporting sex-disaggregated vaccination rates in Malagasy children. Gray literature was also searched for relevant data. All peer-reviewed articles reporting sex-disaggregated data on childhood immunizations in Madagascar were eligible for inclusion. Risk of bias was assessed using a tool designed for use in systematic reviews. Data extraction was conducted with a pre-defined data extraction tool. Sex-disaggregated data were synthesized to understand the impact of a child's sex on vaccination status. FINDINGS: The systematic search identified 585 articles of which a total of three studies were included in the final data synthesis. One additional publication was included from the gray literature search. Data from included articles were heterogeneous and, overall, indicated similar vaccination rates in boys and girls. Three of the four articles reported slightly higher vaccination rates in girls than in boys. A meta-analysis was not conducted due to the heterogeneity of included data. Six additional barriers to immunization were identified: socioeconomic status, mother's education, geographic location, supply chain issues, father's education, number of children in the household, and media access. INTERPRETATION: The systematic review revealed the scarcity of available sex-stratified immunization data for Malagasy children. The evidence available was limited and heterogeneous, preventing researchers from conclusively confirming or denying differences in vaccine uptake based on sex. The low vaccination rates and additional barriers identified here indicate a need for increased focus on addressing the specific obstacles to vaccination in Madagascar. A more comprehensive assessment of sex-disaggregated vaccination status of Malagasy children and its relationship with such additional obstacles is recommended. Further investigation of potential differences in vaccination status will allow for the effective implementation of strategies to expand vaccine coverage in Madagascar equitably. FUNDING AND REGISTRATION: AH, BT, FM, GN, and RR are supported by a grant from the Bill and Melinda Gates Foundation (grant number: OPP1205877). The review protocol is registered in the Prospective Register of Systematic Reviews (PROSPERO ID: CRD42021265000).

Estratégia Nacional para a Qualidade em Saúde O Plano nacional de segurança dos doentes (PNSD) 2021 -2026 tem por objetivo: - consolidar e promover a segurança na prestação de cuidados de saúde no SNS, incluindo outros contextos, como o domicílio e a telessaúde, sem negligenciar os princípios que sustentam a área da segurança do doente, como a cultura de segurança, a comunicação e a implementação continuada de práticas seguras em ambientes cada vez mais complexos. - contribuir para o reforço da equidade e condições adequadas às necessidades dos stakeholders, impondo aos serviços prestadores de cuidados, a incorporação, num quadro de melhoria contínua da qualidade e da segurança, as ações de promoção da saúde e de prevenção das doenças. N/A

Segurança na preparação de medicamentos “ERRAR É HUMANO”- Todos sabemos Desde que se fale em preparação/manipulação o “Fator” humano está sempre presente. Necessidade de aplicar sistemas seguros contra as falhas para EVITAR que ERROS provoquem danos - RISCO N/A

Highlights • After implementing optimized model, we observed 34% reduction in supply chain costs. • Costs increased for Provincial store but decreased for Zones and health facilities. • Streamlined distribution practices supported cost reductions for transportation. • After implementing optimized model, costs increased in control Zones and facilities., Objective In 2017, an optimized immunization supply chain (iSC) model was implemented in Equateur Province, Democratic Republic of the Congo. The optimized model aimed to address iSC challenges and featured direct deliveries to service delivery points (SDPs), longer replenishment intervals and increased cold chain capacity. This assessment examines iSC costs before and 5 months after implementing the optimized model. Materials & Methods We used a nonexperimental pre-post study design to compare iSC costs before and after implementation. We applied an activity-based costing approach with a comparison arm to assess procurement, management, storage and transportation costs for three iSC tiers: Province (n = 1); Zone (n = 4) and SDP (n = 15). We included data from 3 treatment Zones and 11 treatment SDPs; 1 control Zone and 4 control SDPs. We used sample and population data to estimate iSC costs for the entirety of Equateur Province. Results In the period immediately before implementing the optimized model, estimated annual iSC costs were $974,237. Following implementation, estimated annual iSC costs were $642,627—a 34% ($331,610) reduction. This change in costs was influenced by a 43% ($180,313) reduction in SDP costs, a 67% ($198,092) reduction in Zonal costs and an 18% ($46,795) increase in Provincial costs. After implementing the optimized model, average iSC costs for treatment Zones was $6,895 (SD: $6,072); for the control Zone was $21,738; for treatment SDPs was $989 (SD: $969); and for control SDPs was $1,356 (SD: $1,062). Conclusions We observed an absolute reduction in iSC costs in treatment Zones while control Zone post-implementation iSC costs remained the same or increased. The greatest cost reductions were for storage and transport at Zones and SDPs. Although cost implications of this model must continue to be evaluated over time, these findings are promising and will inform decisions around project expansion.

Resume Au regard des diverses menaces sanitaires observees ou suspectees, la protection des personnels de sante (que ce soit en hospitalier, extrahospitalier ou mission exterieure et humanitaire) est toujours une problematique essentielle a laquelle les equipes sont confrontees. Dans le domaine du biologique, meme si l’agent est identifie, la connaissance des voies de contamination (aeriennes, cutanees, etc.) est limitee dans le cas d’agents emergents (type SARS-CoV-2). De ce fait, les moyens de protection sont souvent sur- ou sous-dimensionnes au depart, soit par meconnaissance du risque, soit par meconnaissance des capacites du moyen de protection lui-meme. La plupart des professions, associees a un risque particulier, sont dotees d’equipements de protection individuelle (EPI) specifiques (militaires, sapeurs-pompiers, industrie, agriculture, etc.) adaptes a leurs contraintes propres. Dans le domaine de la sante, l’offre d’EPI est souvent, a quelques exceptions pres, derivee directement de l’industrie ou des equipements militaires (tenues de protection contre le risque chimique par exemple) mais les contraintes specifiques « sante » sont rarement envisagees, entrainant souvent une inadaptation de ceux-ci. La legislation en matiere d’EPI est complexe nous en resumerons les grands principes. Deux concepts s’affrontent et parfois se completent entre les tenues de type etanches et filtrantes. Au regard d’experiences hospitalieres et humanitaires, nous tenterons de faire ressortir les caracteristiques essentielles qui pourraient definir nos tenues de demain.

Levofloxacin is considered an alternative treatment option of Stenotrophomonas maltophilia infections to trimethoprim/sulfamethoxazole. The fluoroquinolone resistance in S. maltophilia is usually caused by an overproduction of efflux pumps. In this study, the contribution of efflux systems to levofloxacin resistance in S. maltophilia clinical isolates was demonstrated using phenotypic (minimal inhibitory concentrations, MICs, of antibiotics determination ± efflux pump inhibitors, EPIs) and molecular (real-time polymerase-chain-reaction and sequencing) methods. Previously, the occurrence of genes encoding ten efflux pumps was shown in 94 studied isolates. Additionally, 44/94 isolates demonstrated reduction in susceptibility to levofloxacin. Only 5 of 13 isolates (with ≥4-fold reduction in levofloxacin MIC) in the presence of EPIs showed an increased susceptibility to levofloxacin and other antibiotics. The overexpression of smeD and smeV genes (in five and one isolate, respectively) of 5 tested efflux pump operons was demonstrated. Sequencing analysis revealed 20–35 nucleotide mutations in local regulatory genes such as smeT and smeRv. However, mutations leading to an amino acid change were shown only in smeT (Arg123Lys, Asp182Glu, Asp204Glu) for one isolate and in smeRv (Gly266Ser) for the other isolate. Our data indicate that the overproduction of the SmeVWX efflux system, unlike SmeDEF, plays a significant role in the levofloxacin resistance.

Purpose Very high gradient amplitudes played out over extended time intervals as required for second-order motion-compensated cardiac DTI may violate the assumption of a linear time-invariant gradient system model. The aim of this work was to characterize diffusion gradient-related system nonlinearity and propose a correction approach for echo-planar and spiral spin-echo motion-compensated cardiac DTI. Methods Diffusion gradient-induced eddy currents of 9 diffusion directions were characterized at b values of 150 s/mm2 and 450 s/mm2 for a 1.5 Tesla system and used to correct phantom, ex vivo, and in vivo motion-compensated cardiac DTI data acquired with echo-planar and spiral trajectories. Predicted trajectories were calculated using gradient impulse response function and diffusion gradient strength- and direction-dependent zeroth- and first-order eddy current responses. A reconstruction method was implemented using the predicted -space trajectories to additionally include off-resonances and concomitant fields. Resulting images were compared to a reference reconstruction omitting diffusion gradient-induced eddy current correction. Results Diffusion gradient-induced eddy currents exhibited nonlinear effects when scaling up the gradient amplitude and could not be described by a 3D basis alone. This indicates that a gradient impulse response function does not suffice to describe diffusion gradient-induced eddy currents. Zeroth- and first-order diffusion gradient-induced eddy current effects of up to −1.7 rad and −16 to +12 rad/m, respectively, were identified. Zeroth- and first-order diffusion gradient-induced eddy current correction yielded improved image quality upon image reconstruction. Conclusion The proposed approach offers correction of diffusion gradient-induced zeroth- and first-order eddy currents, reducing image distortions to promote improvements of second-order motion-compensated spin-echo cardiac DTI., Magnetic Resonance in Medicine, 88 (6), ISSN:0740-3194, ISSN:1522-2594

Traballo Fin de Grao en Enfermaría. Curso 2021-2022 Introducción: el COVID es una enfermedad con numerosos factores de riesgo y complicaciones. La pandemia generada por esta enfermedad tuvo repercusiones en el ámbito de la Enfermería, tanto física como mentalmente. Objetivos: comparar las diferencias entre los protocolos de manejo de pacientes infectados por la enfermedad del COVID, y valorar la importancia y la responsabilidad del papel de la Enfermería en estos protocolos. Métodos: se realizó una revisión bibliográfica con los protocolos disponibles en las páginas web de los servicios sanitarios de las distintas Comunidades Autónomas (CCAA) y los protocolos de los 3 principales ámbitos sanitarios del Ministerio de Sanidad. Resultados: se han descrito 4 ítems para diferenciar dichos protocolos: el triaje, los test, el aislamiento y seguimiento, y los EPI (Equipo de Protección Individual) utilizados. Los resultados más llamativos encontrados con respecto a los protocolos de los ámbitos sanitarios son la falta de triaje en las plantas de hospitalización y el control del aislamiento y seguimiento que siempre es realizado por el MAP (Médico de Atención Primaria). En cuanto a los protocolos de las CCAA lo más llamativo está en los protocolos de Andalucía, Aragón, Canarias, Navarra y Valencia, en los que todavía se realiza control del seguimiento y aislamiento, aunque esto probablemente se deba a la antigüedad de los protocolos. Conclusión: no se observan grandes diferencias entre los protocolos de las Comunidades Autónomas, mientras que sí existen diferencias apreciables entre los 3 ámbitos sanitarios que planteamos. Podemos observar que el papel de Enfermería es muy importante y la responsabilidad muy grande dado que los ítems de triaje, realización de las pruebas diagnósticas es tarea de Enfermería y el control del aislamiento y del seguimiento también, junto con el MAP. Introdución: o COVID é unha enfermidade con numerosos factores de risco e complicacións. A pandemia xerada por esta enfermidade tivo repercusións no ámbito da Enfermería, tanto física como mentalmente. Obxectivos: comparar as diferenzas entre os protocolos de manexo de pacientes infectados pola enfermidade do COVID, e valorar a importancia e a responsabilidade do papel da Enfermería nestes protocolos. Métodos: realizouse unha revisión bibliográfica cos protocolos dispoñibles nas páxinas web dos servizos sanitarios das distintas Comunidades Autónomas (CCAA) e os protocolos dos 3 principais ámbitos sanitarios do Ministerio de Sanidade. Resultados: describíronse 4 ítems para diferenciar os devanditos protocolos: o triaxe, os test, o illamento e seguimento, e os EPI (Equipo de Protección Individual) utilizados. Os resultados máis rechamantes atopados con respecto aos protocolos dos ámbitos sanitarios son a falta de triaxe nas plantas de hospitalización e o control do illamento e seguimento que sempre é realizado polo MAP (Médico de Atención Primaria). En canto aos protocolos das CCAA (Comunidades Autónomas), o máis rechamante está nos protocolos de Andalucía, Aragón, Canarias, Navarra e Valencia, nos que aínda se realiza control do seguimento e illamento, aínda que isto probablemente se deba á antigüidade dos protocolos. Conclusión: non se observan grandes diferenzas entre os protocolos das Comunidades Autónomas, mentres que si existen diferenzas apreciables entre os 3 ámbitos sanitarios expostos. Podemos observar que o papel de Enfermería e a responsabilidade é moi importante dado que os ítems de triaxe, realización das probas diagnósticas é tarefa de Enfermería e o control do illamento e do seguimento tamén, xunto co MAP Introduction: COVID is a disease with numerous risk factors and complications. The pandemic generated by this disease had repercussions in the field of Nursing, both physically and mentally. Objectives: to compare the differences between the management protocols of patients infected with COVID disease, and to assess the importance and responsibility of the role of nursing in these protocols. Methods: a bibliographic review was carried out with the protocols available on the websites of the health services of the different Autonomous Communities (AC) and the protocols of the 3 main health areas of the Ministry of Health. Results: 4 items have been described to differentiate these protocols: triage, tests, isolation and follow-up, and PPE (personal protective equipment) used. The most striking results found with respect to the protocols of the health areas are the lack of triage in the hospitalization plants and the control of isolation and follow-up that is always performed by the primary care physician. As for the protocols of the autonomous communities (autonomous communities), the most striking thing is in the protocols of Andalucía, Aragon, the Canary Islands, Navarra and Valencia, where monitoring and isolation are still carried out, although this is probably due to the age of the protocols. Conclusion: there are no major differences between the protocols of the Autonomous Communities, while there are appreciable differences between the 3 health areas we propose. We can observe that the role of Nursing and responsibility is very important given that the items of triage, carrying out diagnostic tests is the task of Nursing and the control of isolation and follow-up also, along with the primary care physician.

Objective: To compare seroprotection of children at 5 and 6 year of age after receiving Hepatitis B vaccination according to Expanded Programme on Immunization (EPI). Study Design: Cross sectional study. Place and Duration of Study: The study was conducted in the Department of Paediatric Medicine, Pak Emirates Military Hospital, Rawalpindi, from Oct 2015 to Apr 2016. Methodology: After the approval of ethics committee, informed consent of participants was obtained. Total 85 children, both male and female, aging 5 and 6 years were included in study fulfilling inclusion criteria. 3.5 ml blood samples were obtained ensuring antiseptic precautions using disposable syringes. Samples were taken in vaccutainers, labeled with patient’s demographic information and were immediately transported to the Armed Forces Institute of Pathology (AFIP) for analysis. Hepatitis B surface antibody titers of >10 IU/ L was taken as protective and

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was responsible for the outbreak of the 2019 coronavirus disease (COVID-19), which is now considered as a pandemic. The prevention strategies adopted have included social distancing measures and the modification, reduction or interruption of a large proportion of routine healthcare activity. This has had a significant impact on the care provided in Gastrointestinal Motility Units. Having passed the peak, in terms of mortality and infections, a gradual reduction in transmission figures has been observed in Spain and other European countries. The risk of reactivation, however, remains high, so it is necessary to have a plan in place that allows healthcare centres to safely resume, for their patients and professionals, instrumental examinations linked to the management of motor pathology. Based on the available scientific evidence and the consensus of a panel of experts, the Spanish Association of Neurogastroenterology and Motility (ASENEM) has drawn up a series of practical recommendations, which have been adapted to the risks inherent in each activity. These include individual protection proposals, as well as organisational and structural measures, which are conceived to allow for the gradual resumption of examinations while minimising the possibility of contagion. (C) 2020 Elsevier Espana, S.L.U. All rights reserved.

The study aims to analyse managerial and operational hindrances to polio eradication process in Tehsil Katlang, District Mardan using quantitative research method i.e. questionnaire and statistical analysis. A sample size of 200 respondents i.e. polio workers of health department, staff of WHO and UNICEF are selected through proportionate stratified random technique. Bi-variate analyses are conducted with the help of Chi-square test. The study results concludes a significant association between polio eradication process and maintenance of cold chain, lack of transportation facility to polio staff, accessibility with reference to locality, training opportunities of polio workers, lack of trained public health professionals, workers dissatisfaction from salaries, timely payment of NIDs remuneration, unnecessary bureaucratic interventions and influences in Expended Program on Immunisation (EPI), lack of proper evaluation of National Immunisation Days (NIDs) campaign and security threats to polio workers. Further, a non-significant association is ascertained between polio eradication and timely availability of vaccines to EPI workers, effects of load shedding on maintenance of cold chain and proper monitoring of NIDs campaign. The findings state that the program needs proper management process for cold chain and transportation facilities. Salaries of the workers need to be increased and NIDs remuneration needs to pay on time. Various training programs should be initiated for workers and shortage of staff should be removed. Security arrangements for polio workers may be enhanced.

Fundamentos y objetivos: Estudio del grado de competencias sobre intubación orotraqueal en enfermo COVID-19 en estudiantes de 6º de Medicina de la UCV mediante simulación clínica. Material y métodos: Se evalúan 41 alumnos, antes y después de realizar un taller teórico-práctico con un simulador de tareas tipo busto, mediante un checklist y una encuesta de control de calidad anónima. Se elabora una estadística descriptiva e inferencial y su posterior análisis. Se aplica la metodología de aprendizaje basado en problemas. Resultados: En la evaluación pre-taller, la media de puntuación obtenida fue de 3,71 sobre 10 antes, contra el 9,12 sobre 10 después del taller de simulación. La media de número de intentos empleados fue de 1,87 antes, contra el 1,28 después del taller de simulación. La media de tiempo empleado, para realizar una IOT fue de 103,90 segundos antes, contra 47,43 segundos después del taller de simulación. La opinión favorable de los alumnos sobre el taller es muy alta, con una puntuación de 4 a 5 sobre 5. Conclusiones: El grado de adquisición de competencias de los estudiantes de 6º de Medicina de la UCV es alto, más del doble en total, después de realizar simulación clínica en comparación con las competencias iniciales insuficientes para realizar una IOT. El grado de satisfacción de los alumnos después de realizar un taller con un simulador de tareas tipo busto, con gran realismo es alto. Fundamentals and objectives: Study of the degree of competence in orotracheal intubation in COVID-19 patients in 6th year medical students at the UCV by means of clinical simulation. Material and methods: 41 students were evaluated before and after a theoreticalpractical workshop with a bust-type task simulator, using a checklist and an anonymous quality control survey. Descriptive and inferential statistics and subsequent analysis. The problem-based learning methodology is applied. Results: In the pre-workshop evaluation, the mean score obtained was 3.71 out of 10 before, against 9.12 out of 10 after the simulation workshop. The average number of attempts used was 1.87 before, against 1.28 after the simulation workshop. The average time taken to perform an OTI was 103.90 seconds before, against 47.43 seconds after the simulation workshop. The students opinion of the workshop is very high, with a score of 4 to 5 out of 5. Conclusions: The degree of competence acquisition of the 6th year medical students at UCV is high, more than double in total, after performing clinical simulation compared to the initial insufficient competences to perform an OTI. The degree of satisfaction of the students after a workshop with a bust-type task simulator with high realism is high. Medicina

Submitted by Jonathan Sousa de Almeida (jonathan.sousa@ufma.br) on 2022-05-12T15:48:22Z No. of bitstreams: 1 MAYANNECAMARASERRA.pdf: 5609669 bytes, checksum: bdfcb04d51925c62c332d19bf79dddec (MD5) Made available in DSpace on 2022-05-12T15:48:22Z (GMT). No. of bitstreams: 1 MAYANNECAMARASERRA.pdf: 5609669 bytes, checksum: bdfcb04d51925c62c332d19bf79dddec (MD5) Previous issue date: 2022-04-08 CAPES Most of the Personal Protective Equipments (PPEs) that women workers, construction technicians, engineers and architects use in construction sites are the same for men in the same functions. This occurs due to the occupational safety products have been historically projected and developed taking into account only the male gender, and there is the aggravating factor of the lack of updated official anthropometric information. It is emphasized that women have most of their anthropometric measurements smaller than those of men, which makes questionable the effective protection and adequacy of the PPEs that the workers women use. With this contextualization, this paper has the general objective to analyze the suitability of PPE, helmets, goggles and safety boots for use by female construction workers, considering the experiences of women at construction sites in São Luís - MA. To achieve this purpose, this research include the formation of a theoretical contribution based on literature and in normative aspects, the realization of four focus groups with construction workers women from São Luís - Maranhão and the description of copies of PPEs objects of study available in the markets local and national. From the results of the research, show up needs of improvements in the PPEs addressed with a focus on the anthropometric context of the female public, being that preliminary suggestions were elaborated as way to try attend the these needs. With the research fulfilled, emphasizes that the meeting of knowledges of the Design and of the Ergonomics can favor a positive change in toward the development of PPEs characterized as suitable to the use by women in civil construction. A maioria dos Equipamentos de Proteção Individual (EPIs) que operárias, técnicas da construção, engenheiras e arquitetas utilizam em canteiros de obras são os mesmos para homens nas mesmas funções. Isso ocorre devido aos produtos de segurança ocupacional terem sido historicamente projetados e desenvolvidos levando em conta apenas o gênero masculino, e há o agravante da falta de informações antropométricas oficiais atualizadas. Ressalta-se que as mulheres possuem a maioria de suas medidas antropométricas menor que as dos homens, o que torna questionável a efetiva proteção e adequação dos EPIs que as trabalhadoras utilizam. Com essa contextualização, este trabalho tem como objetivo geral analisar a adequação dos EPIs capacetes, óculos de proteção e botinas de segurança ao uso por trabalhadoras da construção civil, considerando experiências de mulheres em canteiros de obras de São Luís - MA. Para alcançar este propósito, esta pesquisa abrange a formação de um aporte teórico baseado na literatura e em aspectos normativos, a realização de quatro grupos focais com trabalhadoras da construção de São Luís – Maranhão e a descrição de exemplares dos EPIs objetos de estudo disponíveis nos mercados local e nacional. A partir dos resultados da pesquisa, evidenciam-se necessidades de melhorias nos EPIs abordados com enfoque no contexto antropométrico do público feminino, sendo que sugestões preliminares foram elaboradas como forma de tentar atender a essas necessidades. Com a pesquisa realizada, enfatiza-se que a reunião de conhecimentos do Design e da Ergonomia pode favorecer uma mudança positiva em direção ao desenvolvimento de EPIs caracterizados como adequados ao uso por mulheres na construção civil.

MRI is a non-invasive medical imaging modality that is sensitive to patient motion, which constitutes a major limitation in most clinical applications. Solutions may arise from the reduction of acquisition times or from motion-correction techniques, either prospective or retrospective. Benchmarking the latter methods requires labeled motion-corrupted datasets, which are uncommon. Up to our best knowledge, no protocol for generating labeled datasets of MRI images corrupted by controlled motion has yet been proposed. Hence, we present a methodology allowing the acquisition of reproducible motion-corrupted MRI images as well as validation of the system's performance by motion estimation through rigid-body volume registration of fast 3D echo-planar imaging (EPI) time series. A proof-of-concept is presented, to show how the protocol can be implemented to provide qualitative and quantitative results. An MRI-compatible video system displays a moving target that volunteers equipped with customized plastic glasses must follow to perform predefined head choreographies. Motion estimation using rigid-body EPI time series registration demonstrated that head position can be accurately determined (with an average standard deviation of about 0.39 degrees). A spatio-temporal upsampling and interpolation method to cope with fast motion is also proposed in order to improve motion estimation. The proposed protocol is versatile and straightforward. It is compatible with all MRI systems and may provide insights on the origins of specific motion artifacts. The MRI and artificial intelligence research communities could benefit from this work to build in-vivo labeled datasets of motion-corrupted MRI images suitable for training/testing any retrospective motion correction or machine learning algorithm.

The efflux pumps, beside the class D carbapenem-hydrolysing enzymes (CHLDs), are being increasingly investigated as a mechanism of carbapenem resistance in Acinetobacter baumannii. This study investigates the contribution of efflux mechanism to carbapenem resistance in 61 acquired blaCHDL-genes-carrying A. baumannii clinical strains isolated in Warsaw, Poland. Studies were conducted using phenotypic (susceptibility testing to carbapenems ± efflux pump inhibitors (EPIs)) and molecular (determining expression levels of efflux operon with regulatory-gene and whole genome sequencing (WGS)) methods. EPIs reduced carbapenem resistance of 14/61 isolates. Upregulation (5–67-fold) of adeB was observed together with mutations in the sequences of AdeRS local and of BaeS global regulators in all 15 selected isolates. Long-read WGS of isolate no. AB96 revealed the presence of AbaR25 resistance island and its two disrupted elements: the first contained a duplicate ISAba1-blaOXA-23, and the second was located between adeR and adeA in the efflux operon. This insert was flanked by two copies of ISAba1, and one of them provides a strong promoter for adeABC, elevating the adeB expression levels. Our study for the first time reports the involvement of the insertion of the ΔAbaR25-type resistance island fragment with ISAba1 element upstream the efflux operon in the carbapenem resistance of A. baumannii.

Despite numerous advances in their content and structure over recent years, paper information leaflets for medicines are often hard to read for people with visual impairments, contain a lot of technical information, and people suffering from chronic conditions may find it challenging to identify all side-effects or dangers of taking a drug in their situation. Likewise, for people already taking different drugs, identifying contraindications may be time-intensive and easily overlooked, posing a risk for affected patients. Electronic product information (ePI), or eLeaflets, provide an opportunity for improvements in how patients interact with the information provided. We summarise opportunities of ePI and experiences from a co-creation process of such an app together with patients as part of the Pharmaledger project and put it into context of the current policy environment in the EU in light of EMA’s key principles for the adoption of ePI in medicine. While more patient-friendly information remains a significant ask, ePI has the potential to make leaflets easier and quicker to read through search and zoom functions, provide a safe digital medicine cabinet employing blockchain technology, enables patients to identify falsified product boxes, receive real-time updates when a product expires or is being recalled by the manufacturer, and potentially even include a reminder function to increase adherence. We present a potential research agenda across disciplines for interested researchers. While many welcome the benefits of ePI, we urge policymakers to keep in mind that some groups, specifically people with low technical literacy, should not be left without alternatives. We recommend early initiatives to ensure a widespread understanding of how ePI works across populations while also taking this opportunity to use new insights to improve leaflets on paper.

In the past two decades, China’s urbanization has advanced rapidly. In 2018, Xi’an was successfully selected as a national central city, and the Guanzhong Plain urban agglomeration (GZPUA) is emerging rapidly due to Xi’an. This study focuses on the current ecological status of the region and how to strike a balance between economic development and ecological protection. This study uses the ecological vulnerability of the Guanzhong urban agglomeration as a starting point to investigate the changes in its spatial and temporal distribution of ecological vulnerability and the primary driving factors, as well as to investigate the interaction between the changes in ecological vulnerability and urban agglomeration development in the GZPUA region. Using the “sensitivity–elasticity–pressure (SEP)” assessment framework model, this paper selects the spatial distribution data of natural, social, and economic sources in 2000 and 2020 based on the ecological environment characteristics of GZPUA. By using spatial principal component analysis, this paper quantitatively evaluates the ecological vulnerability changes of GZPUA in two periods, 2000 and 2020, with 1000 m × 1000 m raster as the evaluation unit, classifies the ecological vulnerability of the area into levels, and conducts a sub-regional in-depth study from different administrative regions. This research helps to comprehend the change in ecological environment quality in the GZPUA and provides a basis for ecological environment management decisions in the region. The results showed that (1) the ecological vulnerability of the Guanzhong Plain urban agglomeration as a whole is moderate, with the highest ecological vulnerability index (EVI) value of 0.89 and the lowest EVI value of 0.087 in 2000, and the highest EVI value of 0.93 and the lowest EVI value of 0.082 in 2020. The percentage of areas with the highest ecological vulnerability (moderate or severe) was 5.07% in 2000 and 15.11% in 2020. (2) The variation scope of the integrated EVI in the study region is 1.78–4.96 (2000) and 1.81–4.99 (2020), among which the EVI values in Xi’an, Bei Lin, Lian Hu, and Xin Cheng are the highest and the EVI values in Tai Bai, Zhou Zhi, and Feng Xian are the lowest. (3) In the central region of GZPUA, the spatial variation of CEVI is distributed in a circle that is highly congruent with the region’s economic and population development characteristics, whereas the spatial variation of CEVI in the southern mountainous region of the study area is primarily constrained by the topography and natural conditions. This region has low CEVI because of the high mountains and thick forests, which is a crucial ecological barrier for the GZPUA. (4) The EVI, ecological sensitivity index (ESI), ecological elasticity index (EEI), and ecological pressure index (EPI) have a strong relationship with land use. Among them, farmland and built-up land showed highly significant correlations with the EVI, ESI, EEI, and EPI (p < 0.01).

Cette étude exploratoire descriptive transversale évalue la gestion de la pénurie des équipements de protection individuelle (EPI) aux hôpitaux Libanais faisant face à la pandémie en mettant en évidence la performance et la satisfaction des personnels de santé envers cette gestion. Deux questionnaires en ligne ont été envoyés pour les hôpitaux choisis : un questionnaire pour la direction et l’autre pour les personnels de santé. Neufs hôpitaux publics et privés et 282 professionnels de santé de tout le Liban ont participé. Selon les résultats, tous les hôpitaux ont un plan d’urgence et des politiques écrites concernant l’utilisation des EPI, et qui sont conformes aux déclarations émises par l’OMS. La majorité des hôpitaux (67%) rencontrent des difficultés pour amener les EPI aux employés. La moyenne de satisfaction des participants concernant les politiques et les plans pris par la direction en cas de pénurie est de 7,6/10. Finalement, les hôpitaux Libanais ont essayé de gérer la pénurie d’EPI par leurs méthodes malgré les difficultés.

Cette ��tude exploratoire descriptive transversale ��value la gestion de la p��nurie des ��quipements de protection individuelle (EPI) aux h��pitaux Libanais faisant face �� la pand��mie en mettant en ��vidence la performance et la satisfaction des personnels de sant�� envers cette gestion. Deux questionnaires en ligne ont ��t�� envoy��s pour les h��pitaux choisis : un questionnaire pour la direction et l���autre pour les personnels de sant��. Neufs h��pitaux publics et priv��s et 282 professionnels de sant�� de tout le Liban ont particip��. Selon les r��sultats, tous les h��pitaux ont un plan d���urgence et des politiques ��crites concernant l���utilisation des EPI, et qui sont conformes aux d��clarations ��mises par l���OMS. La majorit�� des h��pitaux (67%) rencontrent des difficult��s pour amener les EPI aux employ��s. La moyenne de satisfaction des participants concernant les politiques et les plans pris par la direction en cas de p��nurie est de 7,6/10. Finalement, les h��pitaux Libanais ont essay�� de g��rer la p��nurie d���EPI par leurs m��thodes malgr�� les difficult��s.

Nos tempos que correm, denota-se, cada vez mais, uma crescente importância da condigna e eficaz proteção da saúde pública. É de realçar, também, que é muitas vezes nos tempos mais difíceis, tal como durante a pandemia Covid-19, quando surge espaço para a inovação e criação. Deste modo, o presente relatório destaca um Estudo de Usabilidade de um novo produto – Viseira ViVe – desenvolvido pelo ISEC em copromoção com a empresa SOLIEN durante o ano de 2021. Este produto consiste numa viseira com capacidade de desembaciamento através de ventilação forçada, permitindo ao utilizador um maior conforto durante o seu uso, revelando uma maior eficácia comparativamente aos seus homólogos não ventilados. Neste relatório é, então, realizada uma breve introdução das atividades efetuadas, explicitando o enquadramento do Projeto ViVe, bem como as metodologias e objetivo principal do mesmo – desenvolvimento e criação de um EPI – Equipamento de Proteção Individual - inovador e direcionado a uma imensidão de potenciais utilizadores. Foi realizada uma Revisão da Literatura relativa à Usabilidade de Produtos e como a medir. Para o caso específico do Projeto ViVe, optou-se pelo questionário SUS (Brooke, 1996) como auxiliar principal para o cálculo da usabilidade do produto. Assim, é também especificada a constituição deste questionário, as suas vantagens e a conversão do score final para uma medida de usabilidade – Excelente, Boa, Mediana ou Má. No total, 53 voluntários testaram completamente a viseira, sendo estes nos seguintes perfis: Funcionários de atendimento ao público; Cabeleireiros; Cozinheiros; Dentistas; Enfermeiros, Fisioterapeutas e socorristas do INEM; Engenheiros e Operários; Médicos; Professores; Bombeiros. Os resultados obtidos mostraram que a perceção da usabilidade pelos utilizadores pode ser classificada de muito boa (KPI = 84, após uma semana e após um mês), variando entre boa (KPI = 69, Professores) e excelente (KPI = 96, Bombeiros) nos resultados obtidos após uma semana. Os dados sugerem a manutenção dos resultados após um mês de utilização. Certas características (como a estabilidade de fixação da viseira ou o seu aperto) foram alvo de algumas críticas e sugestões de melhoria por parte dos utilizadores, sendo importante realizar um trabalho futuro com vista a melhorar estas imperfeições do produto, bem como testar o produto em outros segmentos que, presumivelmente, se relacionarão positivamente com o produto.

En este Trabajo de Fin de Grado se plantea la mejora de una herramienta software de simulación del proceso de adquisición de imágenes por resonancia magnética (MRI) mediante la adición de una interfaz gráfica de usuario (GUI) que disponga de un editor de secuencias, así como de capacidades gráficas avanzadas para que sirvan de guía al usuario. La idea de esta aplicación surge del estudio de una herramienta de simulación de MRI ya existente, KomaMRI.jl, desarrollada en el lenguaje de programación Julia. La herramienta cuenta con un enorme potencial en cuanto a metodología de simulación se refiere, pero carece de una GUI que facilite la creación de secuencias y la observación del efecto de los gradientes de selección de slice. Con esta motivación se fija el objetivo principal de este proyecto: diseñar una GUI para que la composición de secuencias de MRI resulte más sencilla de cara al usuario. Se ha desarrollado una aplicación a partir de la combinación de los lenguajes C++/Qt, QML y Julia, que permite crear secuencias de MRI arbitrarias mediante la concatenación y agrupación de bloques. Estos bloques implementan los elementos básicos de una secuencia, que son, esencialmente, gradientes y pulsos electromagnéticos de radiofrecuencia. Asimismo, se ha integrado una herramienta que permite visualizar en tres dimensiones el corte seleccionado por los gradientes. Como resultados, se han verificado tanto las imágenes generadas por la simulación como los modelos tridimensionales proporcionados por la herramienta de visualización 3D. Por otra parte, tanto el desarrollo como el uso de la herramienta nos han proporcionado nuevas perspectivas de trabajo futuro, entre las que se plantea la creación de una aplicación web y su integración con una versión del simulador desarrollada en OpenCL por miembros del mismo grupo de investigación en el que se ha realizado este proyecto., This Batchelor thesis is focused on the improvement of a software tool to simulate the magnetic resonance image (MRI) acquisition and reconstruction process, by adding a graphical user interface (GUI) that incoporates a sequence editor as well as advanced graphical capabilities to guide the user. The application idea arises from the analysis of an existing MRI simulation tool, KomaMRI.jl, developed in the Julia programming language. The tool has enormous potential in terms of simulation methods, but lacks a GUI that eases sequence creation and observation of the slice selection gradient effects. With this motivation, the main objective of this project is set: to design a GUI to make the composition of MRI sequences easier for the user. The application has been developed from the combination of C++/Qt, QML and Julia, and allows creating arbitrary MRI sequences by arranging and grouping blocks. These blocks implement the basic sequence elements, which are essentially gradients and radiofrecuency electromagnetic pulses. A tool has also been integrated in order to visualize the slice selected by the gradients in three dimensions. As results, both the images generated by the simulation and the three-dimensional models provided by the 3D visualization tool have been verified. In addition, both the development and usage of the tool give rise to new future work perspectives, suach as the creation of a web application and its integration with a simulator version developed in OpenCL by members of the same research group in which this project has been carried out., Departamento de Teoría de la Señal y Comunicaciones e Ingeniería Telemática, Grado en Ingeniería de Tecnologías de Telecomunicación

Percutaneous needle electrolysis (PNE) consists of the ultrasound-guided application of a galvanic electrical current through a solid filament needle. One proposed therapeutic mechanism for this intervention is a potential thermal effect. The aim of this study was to investigate if the application of PNE induces changes in temperature in different cadaveric musculoskeletal tissues. A repeated measure experimental cadaveric study was designed with 10 cryopreserved knees (5 men, 5 women). Sterile stainless-steel needles of 40 mm length and 0.30 mm caliber were used in this study. An ultrasound-guided needling puncture was performed in the targeted tissue (patellar tendon, infra-patellar fat, and vastus medialis muscle). Additionally, the tip of the needle was placed next to the thermometer sensor at the minimum possible distance without direct contact with it. The temperature differences before and after different applications were measured. The applications were: three applications for 3 s of 3 mA of intensity (3:3:3) when the tendon was the targeted tissue, three applications for 3 s of 1.5 mA of intensity (1.5:3:3) when the fat or muscle was the targeted tissue, and 24 s of 1 mA of intensity (1:24:1) in all tissues. No statistically significant Group*Time interactions were found in any tissue (tendon: F = 0.571, p = 0.459, ŋ2 = 0.03; fat pad: F = 0.093; p = 0.764, ŋ2 = 0.01; muscle: F = 0.681; p = 0.420, ŋ2 = 0.04). Overall, no changes in temperature were observed between both applications in the tendon (3:3:3 vs. 1:24:1) and fat/muscle (1.5:3:3 vs. 1:24:1) tissues. The application of two different percutaneous needle electrolysis protocols did not produce appreciable thermal changes in the tendon, fat, and muscle tissues of human cadavers. The results from the current cadaver study support that a thermal effect should not be considered as a mechanism of clinical action regardless of the targeted human tissue when applying percutaneous needle electrolysis since no changes in temperature after its application were observed. info:eu-repo/semantics/publishedVersion

En las últimas décadas, el estudio de las bombas de eflujo bacterianas ha sido clave para conocer el impacto en la multirresistencia a antimicrobianos. La resistencia puede atribuirse al uso indebido y fuera del control sanitario, tanto en el tratamiento de infecciones clínicas como su utilización en sectores alimentarios, siendo una amenaza para la salud pública que alcanza ya niveles globales. Uno de los mecanismos de resistencia más extendidos es la capacidad de exportación de medicamentos mediante sistemas de eflujo. Las bombas de eflujo no solo intervienen en la expulsión del fármaco fuera de la célula bacteriana, sino que son la causa principal de la virulencia y adaptación que inducen la resistencia a los antimicrobianos en el transcurso de la infección. La inhibición de estas bombas es una estrategia de interés, ya que el descubrimiento y la síntesis de nuevos antibióticos está disminuyendo. Esta revisión se centra en la descripción de los distintos inhibidores de bombas de eflujo (EPI: Efflux Pump Inhibitors), tanto de fuentes naturales como sintéticas, así como de las bacterias a las que afectan. Además, comprobamos el poder inhibitorio de varios EPI en bacterias significativamente clínicas como Pseudomonas aeruginosa, Staphylococcus aureus y Salmonella Typhimurium. Los resultados podrían extrapolarse a otras especies bacterianas y constituir una nueva estrategia en la búsqueda de terapias antimicrobianas. Universidad de Sevilla. Grado en Farmacia

Oyun tabanlı sözcük öğreniminin önemini gösteren çok çeşitli çalışma yapılmış olmakla birlikte bunların çoğu dijital oyunlardan oluşmaktadır. Bu araştırma, üç farklı dijital olmayan kelime kartı oyununun, Türkiye'deki bir devlet üniversitesinin yabancı dil hazırlık okulunda İngilizceyi yabancı dil olarak öğrenen öğrencilerin sözcük öğrenimi üzerindeki etkisini araştırmayı ve öğrencilerin ve öğretmenlerin bunların kullanıma ilişkin görüşlerini incelemeyi amaçlar. Oyun tabanlı öğrenme aktivitelerinin Türk yabancı dil hazırlık sınıfı öğrencilerinin kelime öğrenimi üzerindeki etkilerini görmek amacıyla yarı deneysel karma araştırma deseni kullanılmıştır. Öncelikle, oyun tabanlı öğrenmenin orta seviye İngilizce öğrencileri üzerindeki etkisini görmek için 2018-2019 bahar döneminde bir pilot çalışma gerçekleştirilmiştir. Bir sonraki yarıyılda, araştırma tasarımı, dil ile ilgili ana dalları takip eden orta seviyedeki öğrencilere uygulanmıştır. Çalışmada, araştırmacı tarafından geliştirilen üç farklı oyunu oynayan deney grubu (n = 53) ve kontrol (n = 55) grubu bulunmaktadır. Veriler, katılımcıların ön ve son testleri, katılımcı anketi ve oyunları yöneten öğretmenlerle yapılan görüşmeler yoluyla toplanmıştır. Deney grubu (Ort = 3.96, SS = 4.719) ile kontrol grubunun (Ort = .58, SS = 2.671) puanları arasında istatistiksel olarak anlamlı bir fark bulunmuştur; t (106) = 4.603, p = .000. Deneysel uygulama sözcük dağarcığında daha yüksek bir artışla sonuçlanmıştır. Çalışmanın sonuçları, oyun oynamanın hedef demografideki öğrencilerle kelime kazanımı üzerinde olumlu bir etkiye sahip olduğunu ve hem eğitmenlerin hem de öğrencilerin bu oyunlara büyük ölçüde olumlu bir bakış açısına sahip olduğunu göstermektedir.

PURPOSE: Severe geometric distortions induced by tissue susceptibility, water-fat chemical shift, and eddy currents pose a substantial obstacle in single-shot EPI, especially for high-resolution imaging at ultrahigh field. View angle tilting (VAT)-EPI can mitigate in-plane distortion. However, the accompanied strong image blurring prevented its widespread applications. On the other hand, point-spread function mapping (PSF)-EPI can correct distortion and blurring accurately but requires prolonged scan time. We present fused VAT-PSF-EPI and possibilities for acceleration. METHODS: MR signal equations were explicitly derived to quantify image blurring in VAT-EPI and the maximum acceleration capacity in VAT-PSF-EPI. To validate the theoretical prediction, phantom measurements with varying in-plane parallel imaging factors, slice thicknesses, and RF pulses were conducted at 7 Tesla. In addition, in vivo human brain scans were acquired with T2 and diffusion weighting to assess distortion and blurring correction. RESULTS: VAT can effectively suppress distortion, and the introduced image blurring is corrected through PSF encoding. Up to fourfold acceleration (only 5 shots) in VAT-PSF-EPI was achieved compared with standard PSF-EPI without VAT. VAT-induced signal loss was mitigated by adjusting the sequence parameters and EPI resolution. In vivo T2 -weighted EPI data with 1.4 mm3 resolution demonstrate immunity to water-fat chemical shift-induced distortion. Very high-spatial resolution diffusion-weighted EPI (0.7 × 0.7 × 2.8 mm3 and 1.2 mm3 ) demonstrates the immunity to eddy current-induced distortion. CONCLUSION: VAT-PSF-EPI is a novel spin-echo EPI-based sequence for fast high-resolution diffusion imaging at ultrahigh field.

Esta investigación tiene como objeto de estudio la elaboración, aplicación y evaluación de un programa de mejora del nivel de inglés a partir de una propuesta CLIL en Música, desde un enfoque plurilingüe integrador de las lenguas (Programa CLILPLU). Dicho programa se llevó a cabo, de modo transversal, de 2014 a 2017 con un grupo (muestra de 18 estudiantes) de ciclo superior de educación primaria, en un centro escolar público. El programa se efectuó a demanda de la dirección del centro. Derivado de lo anterior, el objetivo principal de esta tesis es: elaborar, aplicar y evaluar un programa para mejorar las competencias en Inglés y Música, fomentar el desarrollo de la competencia plurilingüe y el aprendizaje cooperativo, en el ciclo superior de educación primaria. Con la adopción de la metodología CLIL (Música en inglés), el uso de una pedagogía musical activa y el trabajo por proyectos plurilingües, se alcanza el objetivo marcado, y los resultados obtenidos permiten constatar un aumento no solo de las competencias en el nivel de inglés, sino en la materia de Música, el fomento del desarrollo de la competencia plurilingüe y la cooperación entre iguales. Los datos cuantitativos que permiten constatar este aumento de competencias provienen tanto de evaluaciones externas (PCBE para la evaluación del nivel de inglés), como de las internas del centro (PICA). Los datos cualitativos que corroboran también esta mejora competencial provienen del análisis documental (recogido durante los tres cursos) y las entrevistas realizadas a todos los agentes educativos (familia, alumnado y profesorado), permitiendo concluir que el programa desarrollado, implementado y evaluado (CLILPLU en el texto) responde con éxito a la hipótesis inicialmente, esto es, a través del enfoque CLIL, unido con el EPI, se puede conseguir un programa muy eficaz y eficiente: eficaz porque se aumenta el dominio competencial en Inglés y Música, y eficiente, porque únicamente se requiere aplicar la metodología del trabajo por proyectos plurilingües y la pedagogía activa de la música, el enfoque CLIL y el EPI. Como resultados no previstos más relevantes, cabe destacar, entre otros, el aumento de la mejora competencial en las otras lenguas curriculares y la mejora de las relaciones interpersonales del grupo de estudiantes. Aquesta recerca té com a objecte d'estudi l'elaboració, aplicació i avaluació d'un programa de millora del nivell d'anglès a partir d'una proposta CLIL en Música, des d'un enfocament plurilingüe integrador de les llengües (Programa CLILPLU). Aquest programa es va dur a terme, de manera transversal, de 2014 a 2017 amb un grup (mostra de 18 estudiants) de cicle superior d'educació primària, en un centre escolar públic. El programa es va efectuar a demanda de la direcció del centre. Derivat de l'anterior, l'objectiu principal d'aquesta tesi és: elaborar, aplicar i avaluar un programa per a millorar les competències en Anglès i Música, fomentar el desenvolupament de la competència plurilingüe i l'aprenentatge cooperatiu, en el cicle superior d'educació primària. Amb l'adopció de la metodologia CLIL (Música en anglès), l'ús d'una pedagogia musical activa i el treball per projectes plurilingües, s'aconsegueix l'objectiu marcat, i els resultats obtinguts permeten constatar un augment no sols de les competències en el nivell d'anglès, sinó en la matèria de Música, el foment del desenvolupament de la competència x plurilingüe i la cooperació entre iguals. Les dades quantitatives que permeten constatar aquest augment de competències provenen tant d'avaluacions externes (PCBE per a l'avaluació del nivell d'anglès), com de les internes del centre (PICA). Les dades qualitatives que corroboren també aquesta millora competencial provenen de l'anàlisi documental (recollit durant els tres cursos) i les entrevistes realitzades a tots els agents educatius (família, alumnat i professorat), permetent concloure que el programa desenvolupat, implementat i avaluat (CLILPLU en el text) respon amb èxit a la hipòtesi inicialment, això és, a través de l'enfocament CLIL, unit amb l’EPI, es pot aconseguir un programa molt eficaç i eficient: eficaç perquè s'augmenta el domini competencial en Anglès i Música, i eficient, perquè únicament es requereix aplicar la metodologia del treball per projectes plurilingües i la pedagogia activa de la música, l'enfocament CLIL i l'EPI. Com a resultats no previstos més rellevants, cal destacar, entre d’altres, l'augment de la millora competencial en les altres llengües curriculars i la millora de les relacions interpersonals del grup d’estudiants. The purpose of this research is to explore the development, implementation, and evaluation of a program to improve the level of English from a CLIL proposal in Music, from a multilingual approach integrating languages (the CLILPLU Program). This program was carried out from 2014 to 2017 with a group (sample of 18 students) of the upper cycle of primary education (5th and 6th grades), in a public school. The program was carried out at the request of the center's management. The main objective of this thesis is to develop, implement and evaluate a program to improve competencies in English and Music, foster the development of multilingual competence and cooperative learning in the upper cycle of primary education. Combining active music pedagogy and multilingual project work using CLIL methodology (Music in English) resulted in an increase of music and English skills, the promotion of the development of multilingual competence and cooperation among equals. An increase in competencies were confirmed both quantitatively and qualitatively. Quantitative data included the external evaluation PCBE for the evaluation of English as well as the internal evaluation of the center PICA. Qualitative data was derived from documentary analysis collected during the three courses and the interviews conducted with all educational parties involved (family, students and teachers). This study showed that the CLILPLU program responds to the initial hypothesis and it was very effective and efficient in improving the proficiency of English and music skills of the students included in this study by implementing the CLIL approach and EPI. In addition to this, we also demonstrated, as the most relevant unplanned results, an improvement in competency of other curricular languages as well as an increase of interpersonal relations between the students in the group.

This paper investigates the factors (such as different sources of financing, energy audits and internal monitoring activities) affecting the propensity of European small and medium sized enterprises (SMEs) to adopt energy efficiency measures (EEMs). For this purpose, a Probit model is estimated using data from the 2017 Flash Eurobarometer survey covering a large sample of European firms. The analysis is carried out for the full sample as well as for clusters based on an environmental performance index (EPI) and on the level of economic development in turn. The results indicate that internal financing always has a positive effect on a firm's propensity to adopt EEMs. Private external sources of financing appear to be more important for Western European firms as well as for those located in countries with a greater level of environmental awareness; in the latter, when firms combine private financing with energy audits or internal monitoring activities the propensity to adopt EEMs increases further. By contrast, in the Eastern Countries this occurs when firms simultaneously rely on public funds and monitoring activities.

Neuroimaging studies have revealed important pathomechanisms related to disorders of brain-gut interactions, such as irritable bowel syndrome and functional dyspepsia. More detailed investigations aimed at neural processing in the brainstem, including the key relay station of the nucleus of the solitary tract (NTS), have hitherto been hampered by technical shortcomings. To ascertain these processes in more detail, we used multi-echo multiband 7T functional magnetic resonance imaging (fMRI) and a novel translational experimental model based on a nutrient-derived intestinal chemonociceptive stimulus. In a randomized cross-over fashion, subjects received duodenal infusion of capsaicin (the pungent principal in red peppers) and placebo (saline). During infusion, fMRI data and concomitant symptom ratings were acquired. Of 26 healthy female volunteers included, 18 were included in the final analysis. Significantly increased brain activation over time during capsaicin infusion, as compared to placebo, was observed in brain regions implicated in pain processing, in particular the NTS. Brain activation in the thalamus, cingulate cortex and insula were more pronounced in subjects who reported abdominal pain (visual analogue scale > 10mm), as compared to subjects who experienced no pain. On the contrary, activations at the level of the NTS were independent of subjective pain ratings. The current experimental paradigm therefore allowed us to demonstrate activation of the principal relay station for visceral afferents in the brainstem, the NTS, which was engaged irrespective of the conscious pain response. These findings contribute to understanding the fundamental mechanism necessary for developing novel therapies aimed at correcting disturbances in visceral afferent pain processing.

Received: July 11th, 2021 ; Accepted: December 5th, 2021 ; Published: January 25th, 2022 ; Correspondence: janis.iejavs@e–koks.lv Fast-growing imported plantation tree species have become an available wood resource for Europe’s wood industry in the last decades. This sustainable alternative may reduce the gap between the increasing demand for and decreasing supply of the local tree species. The aim of the study was to evaluate the performance of eucalyptus (Eucalyptus grandis) and radiata pine (Pinus radiata D.Don) wood in face-bonding with polyvinyl acetate (PVAc) and emulsion polymer isocyanate (EPI) adhesive for the production of non-structural semi-finished glued laminated timber members for window manufacturing. Test specimen preparation and testing were performed according to European standards. Tensile shear strength and wood failure percentages were determined as bonding performance indicators for 3 adhesives and 3 selected bonding parameters (pressure, pressing time and adhesive spread) in 27 variations after boiling the specimens in water. According to the results, the bonding variables influence the glue-line tensile shear strength and wood failure percentages. Bonding pressure and pressing time were evaluated as the most significant factors influencing shear strength of bonded joints. For all bonding variations the average level of shear strength from 3.45 to 5.23 MPa were reached for PVAc adhesive and from 3.78 to 9.65 MPa for EPI adhesives. Both EPI adhesives provide higher performance compared to PVAc adhesive. In the case of bonding fast-growing tree species, the highest shear strength values were achieved using the lowest pressure of 0.8 MPa, adhesive spread from 150 to 180 g m-2 and longest pressing time of 40 min. Based on the general evaluation of the results, it can be stated that the wood of eucalyptus and radiata pine bonded with both EPI adhesives presents great potential for non-structural semi-finished glued laminated timber member production, especially for the use in humid conditions.

Background Hepatitis B virus (HBV) infection despite being a vaccine preventable disease remains a global public health problem. In Cameroon, the hepatitis B vaccine was introduced in the expanded program on immunisation in 2005, but there has been limited evaluation of the HBV surface antibody response post vaccination. Objective We investigated the immune response to hepatitis B vaccine in infants who received the DPT-Hep B-Hib vaccine, and we assessed HBsAg carriage in non-responders. We also investigated factors associated with non-response or poor response. Methods Using a hospital based cross sectional design and a structured questionnaire over a four-month period (January to April 2019), we collected data to determine factors associated with hepatitis B surface antibody (anti-HBs) response from infants aged 6 to 9 months attending infant welfare clinics (IWC) at the Buea and Limbe regional hospitals. We collected venous blood and measured anti-HBs titres using a quantitative Foresight® ELISA. We entered and analysed data using EpiData version 3.1 and SPSS version 25 respectively. Results Of the 161 infants enrolled, 159 (98.8%) developed anti-HBs antibodies. Of these 159, 157 (97.5%) and 117 (72.7%) developed ≥ 10.0 mIU/ml (seroprotection) and ≥ 100.0 mIU/ml anti-HBs titres respectively. Being younger (6 months old) was associated with seroprotection (Cramer V = 0.322, p = 0.001). Spearman rho’s relational analysis showed that immunity against HBV reduced as the duration since the last dose increased (r = −0.172; P = 0.029). However, a Firth logistic regression showed no significant association of factors with inadequate immunity. All 12 (7.5%) infants exposed to HBV at birth, received the hepatitis B vaccine at birth, including four who received HBIG, and all were protected. Four infants (2.5%) had anti-HBs titres Conclusion The seroprotective rate following hepatitis B vaccination of infants is high even in exposed infants. Our study suggests that Cameroon’s HBV vaccine in the Expanded Program on Immunisation (EPI) is effective against HBV, although we could not account for the 2.5% non-response rate. Large scale studies are needed to further explore non-response to the vaccine.

In the cybersecurity field, the generation of random numbers is extremely important because they are employed in different applications such as the generation/derivation of cryptographic keys, nonces, and initialization vectors. The more unpredictable the random sequence, the higher its quality and the lower the probability of recovering the value of those random numbers for an adversary. Cryptographically Secure Pseudo-Random Number Generators (CSPRNGs) are random number generators (RNGs) with specific properties and whose output sequence has such a degree of randomness that it cannot be distinguished from an ideal random sequence. In this work, we designed an all-digital RNG, which includes a Deterministic Random Bit Generator (DRBG) that meets the security requirements for cryptographic applications as CSPRNG, plus an entropy source that showed high portability and a high level of entropy. The proposed design has been intensively tested against both NIST and BSI suites to assess its entropy and randomness, and it is ready to be integrated into the European Processor Initiative (EPI) chip.

Esta dissertação inclui as críticas e sugestões feitas pelo Júri. Submitted by Iolanda Valente (ivalente@iscap.ipp.pt) on 2022-02-14T08:47:29Z No. of bitstreams: 1 João_Monteiro_ML_2021.pdf: 1947402 bytes, checksum: ade56e44e119d747c443a416dfc19e68 (MD5) Made available in DSpace on 2022-02-14T08:47:29Z (GMT). No. of bitstreams: 1 João_Monteiro_ML_2021.pdf: 1947402 bytes, checksum: ade56e44e119d747c443a416dfc19e68 (MD5) Previous issue date: 2021-11-29