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This study aims to analyze the influence of the effectiveness of internal control, the effect of suitability of compensation and the effect of enforcement of regulations and analyze the influence of organizational culture on the tendency of committing fraud. The population of this study were all staff and employees of W – Four Supermarket, Lda, with the total of 180 people and a sample which compose of 65 people. The data collection method used was a questionnaire. Data analysis techniques using SPSS. The results showed that internal control had a positive and significant effect on the tendency of committing fraud, the appropriateness of compensation had a positive and significant effect on the tendency of committing fraud, enforcement of regulations had no effect on the tendency of committing fraud, and organizational culture had no effect on the tendency of committing fraud.

Mangrove distribution maps are used for a variety of applications, ranging from estimates of mangrove extent, deforestation rates, quantify carbon stocks, to modelling response to climate change. There are multiple mangrove distribution datasets, which were derived from different remote sensing data and classification methods, and so there are some discrepancies among these datasets, especially with respect to the locations of their range limits. We investigate the latitudinal discrepancies in poleward mangrove range limits represented by these datasets and how these differences translate climatologically considering factors known to control mangrove distributions. We compare four widely used global mangrove distribution maps - the World Atlas of Mangroves, the World Atlas of Mangroves 2, the Global Distribution of Mangroves, the Global Mangrove Watch. We examine differences in climate among 21 range limit positions by analysing a set of bioclimatic variables that have been commonly related to the distribution of mangroves. Global mangrove maps show important discrepancies in the position of poleward range limits. Latitudinal differences between mangrove range limits in the datasets exceed 5°, 7° and 10° in western North America, western Australia and northern West Africa, respectively. In some range limit areas, such as Japan, discrepancies in the position of mangrove range limits in different datasets correspond to differences exceeding 600 mm in annual precipitation and > 10 °C in the minimum temperature of the coldest month. We conclude that dissimilarities in mapping mangrove range limits in different parts of the world can jeopardise inferences of climatic thresholds. We expect that global mapping efforts should prioritise the position of range limits with greater accuracy, ideally combining data from field-based surveys and very high-resolution remote sensing data. An accurate representation of range limits will contribute to better predicting mangrove range dynamics and shifts in response to climate change.

Objectives To compare the efficacy and safety of a new formulation of a fixed dose combination of glucosamine sulfate (GS; 1500 mg) and bovine chondroitin sulfate (CS; 1200 mg) versus the reference product (RP) in patients with knee osteoarthritis (OA). Methods In this multicenter, randomized, single-blind trial, 627 patients with knee osteoarthritis (OA)—Kellgren-Lawrence grades 2 or 3 and mean score ≥ 40 mm in the WOMAC pain subscale—were randomized to receive GS/CS or the RP for 24 weeks. The primary efficacy endpoint was the absolute change in WOMAC pain subscale score. The secondary endpoints included the following: WOMAC total and subscale scores, overall assessment of the disease by the patient and the investigator, SF-12 score, OMERACT-OARSI response rate to the treatment, and rescue medication use. Results Mean reductions of WOMAC pain score were − 35.1 (sd = 23.2) mm in the GS/CS group and − 36.5 (sd = 24.9) mm in the RP group. The difference between the adjusted means of both treatments confirmed the non-inferiority of GS/CS versus the RP. Improvement was observed in pain, stiffness, physical function and total WOMAC score, as well as in overall OA assessment by the patient and the investigator for both groups. No improvement was observed in SF-12. The rate of OMERACT-OARSI responders was 89.4% in GS/CS group and 87.9% in the RP group. Headache and changes in glucose tolerance were the most frequent treatment-related adverse events. Conclusions The new formulation of a fixed-dose combination of glucosamine sulfate and bovine chondroitin sulfate was non-inferior to the RP in symptomatic treatment of knee OA, with a high responder rate and good tolerability profile. Trial registration ClinicalTrials.gov; Registration number NCT02830919; Date of registration: July 13, 2016; First randomization date: December 05, 2016).

Aim: To evaluate the effect of oral caffeine supplementation and strenuous intermittent exercise on muscle damage markers in soccer players. Materials and Methods: 15 male professional soccer players completed a placebo controlled double blind test protocol. At 45 min before exercise, participants ingested 5.5 mg·kg -1 body mass of caffeine (CAF, n=8) or cellulose (CEL, n=7). The exercise was 2 trials of 6 sets of 10 sprints (20 m each) with 10 s recovery time between sprints, 2 min between sets and 15 min between trials. Blood samples were collected before (PRE), 24, 48 and 72 h after exercise. Serum activity of creatine kinase (CK), lactate dehydrogenase (LDH), aspartate aminotransaminase (AST), and alanine aminotrasaminase (ALT) were quantified. Results: Serum enzyme activity was enhanced by exercise in both groups, without a synergistic effect of caffeine. Conclusion: Our results suggest muscle damage markers increases after physical activities, but caffeine supplementation (5.5 mg·kg -1 body mass) has no influence upon serum enzymes reflective of muscle

DESCRICAO DO METODO DE COLETA DE EVIDENCIAS: Reuniao consensual para elaboracao do texto com inclusao das citacoes bibliograficas, numa colaboracao de reumatologistas com as especialidades de reumatologia pediatrica, dermatologia, gastroenterologia e oftalmologia. Foram convidados 12 reumatologistas responsaveis pelo ambulatorio de espondiloartropatias em suas instituicoes (ou seus representantes); cada participante foi convidado a fazer uma analise critica, utilizando o conceito da medicina baseada em evidencias, de um aspecto diferente dentro do espectro do tratamento das espondiloartropatias. Foi convidado um especialista de cada area para fazer a mesma analise critica nos topicos espondiloartropatias juvenis (reumatologista pediatrico), psoriase (dermatologista), doencas inflamatorias intestinais (gastroenterologista) e uveite anterior (oftalmologista). Apos a elaboracao de um texto-base de apoio para as discussoes, todos os especialistas se reuniram, no periodo entre 22 e 24 de abril de 2004, a fim de discutir individualmente cada um dos 16 topicos elaborados e estabelecer um consenso baseado em evidencias, a partir do qual os coordenadores redigiram o texto do consenso, submetido a apreciacao de todos os participantes para a realizacao dos ajustes finais. GRAU DE RECOMENDACAO E FORCA DE EVIDENCIA: A: Estudos experimentais e observacionais de melhor consistencia. B: Estudos experimentais e observacionais de menor consistencia. C: Relatos de casos, estudos nao controlados. D: Opiniao desprovida de avaliacao critica, baseada em consensos, estudos fisiologicos ou modelos animais. OBJETIVOS: Oferecer informacoes sobre a otimizacao do tratamento das diferentes espondiloartropatias. CONFLITO DE INTERESSE: Os autores Sampaio-Barros PD, Carneiro SCS, Hilario MOE, Xavier RM e Ximenes AC declararam vinculo com a Industria Farmaceutica.

DESCRICAO DO METODO DE COLETA DE EVIDENCIAS: Reuniao consensual e multidisciplinar com a participacao de medicos reumatologistas, fisiatra e ortopedista para elaboracao do texto final. O texto inicial tomou por base o documento do Colegio Americano de Reumatologia "Guidelines for the management of rheumatoid arthritis" e tambem o texto das "Diretrizes do Ministerio da Saude para o Diagnostico e Tratamento da Artrite Reumatoide", acrescido da experiencia de reumatologistas, e complementado por extensa revisao bibliografica, com prioridade para meta-analises. Os participantes, divididos em tres grupos, produziram o texto basico, cujas recomendacoes foram submetidas a revisao e a aprovacao pelo conjunto dos participantes. Depois, disponibilizados na internet, foi objeto de novas sugestoes por parte de outros especialistas, ate alcancar a forma final. GRAU DE RECOMENDACAO E FORCA DE EVIDENCIA: A: Estudos experimentais e observacionais de melhor consistencia. B: Estudos experimentais e observacionais de menor consistencia. C: Relatos de casos (estudos nao controlados). D: Opiniao desprovida de avaliacao critica, baseada em consensos, estudos fisiologicos ou modelos animais. OBJETIVOS: Estabelecer diretrizes claras e sucintas para o diagnostico e tratamento da artrite reumatoide. CONFLITO DE INTERESSE: Os autores Laurindo IMM, Ximenes AC, Lima FAC, Pinheiro GRC, Bertolo MB, Xavier RM, Ciconelli RM e Radominski SC declararam vinculo com a Industria Farmaceutica.

DESCRIÇÃO DO MÉTODO DE COLETA DE EVIDÊNCIAS: Reunião consensual para elaboração do texto com inclusão das citações bibliográficas, numa colaboração de reumatologistas com as especialidades de reumatologia pediátrica, dermatologia, gastroenterologia e oftalmologia. Foram convidados 12 reumatologistas responsáveis pelo ambulatório de espondiloartropatias em suas instituições (ou seus representantes); cada participante foi convidado a fazer uma análise crítica, utilizando o conceito da medicina baseada em evidências, de um aspecto diferente dentro do espectro do tratamento das espondiloartropatias. Foi convidado um especialista de cada área para fazer a mesma análise crítica nos tópicos espondiloartropatias juvenis (reuma-tologista pediátrico), psoríase (dermatologista), doenças inflamatórias intestinais (gastroenterologista) e uveíte anterior (oftalmologista). Após a elaboração de um texto-base de apoio para as discussões, todos os especialistas se reuniram, no período entre 22 e 24 de abril de 2004, a fim de discutir individualmente cada um dos 16 tópicos elaborados e estabelecer um consenso baseado em evidências, a partir do qual os coordenadores redigiram o texto do consenso, submetido à apreciação de todos os participantes para a realização dos ajustes finais. GRAU DE RECOMENDAÇÃO E FORÇA DE EVIDÊNCIA A: Estudos experimentais e observacionais de melhor consistência B: Estudos experimentais e observacionais de menor consistência C: Relatos de casos, estudos não controlados D: Opinião desprovida de avaliação crítica, baseada em consensos, estudos fisiológicos ou modelos animais. OBJETIVOS: Oferecer informações sobre a otimização do tratamento das diferentes espondiloartropatias. CONFLITO DE INTERESSE: Os autores Sampaio-Barros PD, Carneiro SCS, Hilário MOE, Xavier RM e Ximenes AC declararam vínculo com a Indústria Farmacêutica.

Introdução: O stent farmacológico liberador de sirolimus Firebird® já demonstrou eficácia na inibição de hiperplasia neointimal em pacientes selecionados submetidos à intervenção coronária percutânea. Nosso objetivo foi avaliar o desempenho e o resultado clínico tardio do dispositivo Firebird® em pacientes submetidos à intervenção coronária percutânea na prática diária nacional. Métodos: O Registro CLARIFIRE foi um estudo prospectivo, não randomizado, multicêntrico, que incluiu 455 pacientes (536 lesões) em 14 centros no Brasil entre dezembro de 2008 e maio de 2011. O seguimento clínico foi realizado aos 1, 6, 12 e 24 meses, e os eventos adversos foram adjudicados por um Comitê de Eventos Clínicos independente. Resultados: A média das idades foi de 61,1 ± 10,4 anos, 30,8% eram do sexo feminino, 41,9% tinham diabetes e 58,2% apresentaram-se com angina estável. O vaso-alvo mais prevalente foi a artéria descendente anterior (46,5%), 29,9% eram lesões reestenóticas e 8% lesões em bifurcação. Foram implantados 613 stents e as médias de extensão e diâmetro nominal dos stents foram 22,0 ± 6,4 mm e 2,90 ± 0,40 mm, respectivamente. O sucesso do procedimento foi de 97,6%. A taxa cumulativa de eventos cardíacos adversos maiores aos 12 meses (desfecho primário) foi 8,1%. Considerando-se os eventos pós-hospitalização até 24 meses (409/455), observaram-se eventos cardíacos adversos maiores em 9,8%, morte cardíaca em 3,9% e revascularização do vaso-alvo em 7,6%. Já a trombose de stent (definitiva/provável) ocorreu em nove casos (2%) até 30 dias, sem ocorrências subsequentes. Conclusões: O stent farmacológico liberador de sirolimus Firebird ® demonstrou desempenho favorável, Além de segurança e eficácia sustentadas no tratamento de pacientes da prática diária, conforme evidenciado pela elevada taxa de sucesso do procedimento e pela ocorrência relativamente baixa de eventos adversos ao final de 2 anos. Background: The Firebird™ sirolimus-eluting stent has proven to be effective in inhibiting neointimal hyperplasia in selected patients undergoing percutaneous coronary intervention. Our objective was to evaluate the performance and long-term outcomes of Firebird ™ in patients undergoing percutaneous coronary intervention in daily practice in Brazil. Methods: The CLARIFIRE Registry was a prospective, non-randomized, multicenter study enrolling 455 patients (536 lesions) in 14 Brazilian sites between December 2008 and May 2011. Clinical follow-up was performed at 1, 6, 12, and 24 months, and adverse events were adjudicated by the independent Clinical Events Committee. Results: Mean age was 61.1 ± 10.4 years, 30.8% were women, 41.9% had diabetes, and 58.2% had stable angina. The left anterior descending artery was the most prevalent target vessel (46.5%), 29.9% were restenotic lesions, and 8% were bifurcations. Six hundred and thirteen stents were implanted, and the mean nominal stent length and diameter were 22.0 ± 6.4 mm and 2.90 ± 0.40 mm, respectively. Procedural success was 97.6%. The cumulative major adverse cardiac events rate at 12 months (primary endpoint) was 8.1%. Considering post-discharge events up to 24 months (409/455), major adverse cardiac events were observed in 9.8%, cardiac death in 3.9%, and target vessel revascularization in 7.6% of the patients. Definite/probable stent thrombosis was observed in nine cases (2%) up to 30 days, and no further occurrences were found. Conclusions: The Firebird ™ sirolimus-eluting stent has demonstrated good performance and sustained safety and efficacy for patients treated in daily practice, as evidenced by the high procedural success rates and relatively low adverse event rates after 2 years.

Introdução: O stent farmacológico liberador de sirolimus Firebird® já demonstrou eficácia na inibição de hiperplasia neointimal em pacientes selecionados submetidos à intervenção coronária percutânea. Nosso objetivo foi avaliar o desempenho e o resultado clínico tardio do dispositivo Firebird® em pacientes submetidos à intervenção coronária percutânea na prática diária nacional. Métodos: O Registro CLARIFIRE foi um estudo prospectivo, não randomizado, multicêntrico, que incluiu 455 pacientes (536 lesões) em 14 centros no Brasil entre dezembro de 2008 e maio de 2011. O seguimento clínico foi realizado aos 1, 6, 12 e 24 meses, e os eventos adversos foram adjudicados por um Comitê de Eventos Clínicos independente. Resultados: A média das idades foi de 61,1 ± 10,4 anos, 30,8% eram do sexo feminino, 41,9% tinham diabetes e 58,2% apresentaram-se com angina estável. O vaso-alvo mais prevalente foi a artéria descendente anterior (46,5%), 29,9% eram lesões reestenóticas e 8% lesões em bifurcação. Foram implantados 613 stents e as médias de extensão e diâmetro nominal dos stents foram 22,0 ± 6,4 mm e 2,90 ± 0,40 mm, respectivamente. O sucesso do procedimento foi de 97,6%. A taxa cumulativa de eventos cardíacos adversos maiores aos 12 meses (desfecho primário) foi 8,1%. Considerando-se os eventos pós-hospitalização até 24 meses (409/455), observaram-se eventos cardíacos adversos maiores em 9,8%, morte cardíaca em 3,9% e revascularização do vaso-alvo em 7,6%. Já a trombose de stent (definitiva/provável) ocorreu em nove casos (2%) até 30 dias, sem ocorrências subsequentes. Conclusões: O stent farmacológico liberador de sirolimus Firebird ® demonstrou desempenho favorável, Além de segurança e eficácia sustentadas no tratamento de pacientes da prática diária, conforme evidenciado pela elevada taxa de sucesso do procedimento e pela ocorrência relativamente baixa de eventos adversos ao final de 2 anos.

The aim of this study was to specify in patients with tight mitral stenosis whether lung diffusing capacity could play a role in their exercise intolerance. A similar study was recently carried out in patients with moderate chronic heart failure. Ten patients with tight mitral stenosis were studied before and 6 months after successful percutaneous transvenous balloon valvuloplasty and compared to six control subjects. Measurements of diffusing capacity, evaluated by the lung transfer factor (TLCO) and by the transfer coefficient (TLCO/VA), obtained at rest and during early recovery after cardiopulmonary exercise testing were performed. Cardiac output was determined non-invasively, both at rest and during exercise, using the carbon dioxide exponential rebreathing technique. Prior to valvuloplasty, TLCO and TLCO/VA were not different at rest between the two groups. During exercise, patients differed from control subjects, with lower oxygen uptake (P < 0.001) and lower cardiac output at peak exercise (P < 0.001). These values at peak exercise were significantly correlated (P = 0.02; r = 0.75). Moreover, patients differed from control subjects at early recovery after peak exercise with an absence of increase in TLCO (P < 0.05). Six months after valvuloplasty, a decrease of both TLCO (P < 0.01) and TLCO/VA (P < 0.05) was observed at rest. During exercise, comparison of patients demonstrated a significant increase of both peak exercise oxygen uptake (SLVO2, P < 0.01) and cardiac output (P < 0.001). At early recovery after peak exercise there was a significant increase in TLCO (P < 0.05) and TLCO/VA (P < 0.01), such that a delta TLCO and a delta TLCO/VA appeared (P < 0.05) identical to that observed in control subjects. Moreover, delta SLVO2 was significantly correlated in patients with delta Q+ delta TLCO/VA (P = 0.02; r = 0.72). In conclusion, this study suggests a role, at least partial, of lung diffusing capacity in exercise intolerance in patients with tight mitral stenosis and in the improvement of their aerobic exercise capacity demonstrated after successful percutaneous balloon valvuloplasty.

In order to test the hypothesis of pulmonary diffusing capacity involvement in exercise limitation in subjects with chronic heart failure (CHF), lung transfer factor (TLCO), oxygen saturation (SaO2), cardiac output (CO) and gas exchange were studied over the course of an incremental exercise test in 10 patients and 10 controls. The TLCO and transfer coefficient for carbon monoxide (TLCO/VA) were measured at rest and during recovery by the single breath method. The SaO2 was followed non-invasively with a finger oximeter and CO was determined according to the carbon dioxide rebreathing method. Analysis of respiratory variables at maximal effort showed significantly lower values in patients with CHF as regards peak oxygen uptake (VO2), minute ventilation (VE), heart rate (HR), oxygen pulse (O2 pulse), and CO with higher ventilatory reserve (VR) than controls. At a comparable workload (30 W), patients with CHF demonstrated higher values for VE and lower values for CO than controls. The TLCO, expressed as percent of predicted values, was significantly lower in CHF patients than controls, respectively, at rest (90.5 +/- 3.75% vs 106.8 +/- 3.8%) and within 5 min after maximal exercise (87 +/- 4.4% vs 117.4 +/- 3.81%). The TLCO/VA showed comparable data between the two groups at rest (81.7 +/- 3.28 vs 90.3 +/- 2.86%). However, significantly lower values of TLCO/VA were obtained for CHF after maximal exercise in comparison to control subjects (77.5 +/- 3.85% vs 96.3 +/- 3.95%). These results confirm the alteration of the main variables in relation to cardiopulmonary exercise limitation in-tHF, and indicate a significant decrease in TLCO and TLCO/VA after maximal exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

BACKGROUND Treatment of rheumatoid arthritis (RA) has evolved dramatically in the last decade. However, little is known about the way rheumatologists in Latin America treat their patients in clinical practice, outside the scope of clinical trials. OBJECTIVE The objective of this study was to describe treatment patterns at disease onset in early RA with data from a large, multicenter, multinational inception cohort of Latin American patients. METHODS Consecutive patients with early RA (

This study analysed the frequency of anterior uveitis (AU) and its correlations in a large cohort of patients with spondyloarthritis (SpA).A common protocol of investigation was prospectively applied to 2012 SpA patients in 85 centres from 10 Ibero-American countries. Clinical and demographic variables and disease indexes were investigated. Categorical variables were compared by χ2 and Fisher's exact test, and continuous variables were compared by ANOVA or Kruskal-Wallis test. A value of p0.05 was considered significant.AU was referred by 372 SpA patients (18.5%). AU was statistically associated with inflammatory low back pain (p0.001), radiographic sacroiliitis (p0.001), enthesopathies (p=0.004), urethritis/acute diarrhoea (p0.001), balanitis (p=0.002), hip involvement (p=0.002), HLA-B27 (p=0.003), and higher C-reactive protein (p=0.001), whilst it was negatively associated with the number of painful (p=0.03) and swollen (p=0.005) peripheral joints, psoriatic arthritis (p0.001), psoriasis (p0.001), nail involvement (p0.001), and dactilitis (p=0.062; trend). No association with gender, race, and indices (disease activity, functionality and quality of life) was observed. Logistic regression showed that ankylosing spondylitis (p=0.001) and HLA-B27 (p=0.083; trend) was significantly associated with AU, while extra-articular manifestations (predominantly psoriasis) were negatively associated (p=0.016).Anterior uveitis is a frequent extra-articular manifestation in SpA patients, positively associated with axial involvement and HLA-B27 and negatively associated with peripheral involvement and psoriatic arthritis.

This article concerns seasonal variations in the phosphate concentrations in two coastal lagoons near Montpellier (Mediterranean coast, France). The o-P concentration in the overlying water is highest during summer. The role of the sediment, particularly that of the different P fractions in the sediment, is discussed. Significant variations, especially in the FeOOH ≈ P fraction, occur. For both Tot-Psed and the Fe00H≈P fraction a gradient from surface to bottom is observed, as well as a distinct decrease in the FeOOH≈P fraction in the surface sediments during summer and autumn. Variations in the FeOOH≈P fraction appear to be compensated by variations in the CaC03≈P fraction. These variations appear to be determined by the ferric hydroxide concentration. This compound represents only a small part (maximally 15%) of the total iron in the sediments and is related to the dissolved oxygen content of the immediately overlying water. Besides the fractions o-P, Fe(OOH)≈P, a large part of the CaC03≈P fraction is potentially bioavailable. A large proportion of the Tot-Psed is therefore bioavailable.[/p]

This paper presents a design, mathematical modeling, simulation results and laboratory implementation of a 300W high gain dc-dc boost converter with a coupled inductor, to step up the 24V of a battery bank to 311Vdc, aiming to supply residential loads with dc voltage in an off-grid PV system. The converter can supply most of the residential ac loads which input stage is a single-phase rectifier. Laboratory tests with the 300W converter supplying electronic lights, mobile charger and audio-video system ac showed the viability of the proposed idea.

The collapse of a tension leg platform (TLP) tendon system due to progressive fatigue of several joints is investigated. Two solution methods for the system reliability problem are proposed. The first method is based on the failure path approach and the second on the order statistics approach. The effects of redundancy and uncertainties involved in the problem are analyzed. Inspection of selected joints is also included in order to evaluate its impact on system reliability.

DESCRIÇÃO DO MÉTODO DE COLETA DE EVIDÊNCIAS: Reunião consensual e multidisciplinar para elaboração do texto com inclusão das citações bibliográficas, numa colaboração das especialidades de reumatologia, ortopedia e traumatologia, neurocirurgia, radiologia, medicina física e reabilitação e patologia da coluna vertebral. A partir de um texto básico referencial elaborado pelo editor médico, os participantes, divididos em cinco grupos de trabalho, geraram, por acréscimos e subtrações ao texto básico, recomendações aprovadas, posteriormente, em plenária, que permitiram a edição de um texto preliminar. O documento do consenso foi veiculado pela Internet, para consulta pública, tendo recebido várias sugestões e comentários de especialistas no assunto. As propostas foram devidamente avaliadas por uma comissão julgadora e revisora, que selecionou as que foram incorporadas ao texto preliminar. O editor médico, a partir da versão revisada, chegou ao texto final publicado, que recebeu da Biblioteca Nacional o ISBN n° 85-901548-1-5. Uma versão resumida do referido consenso, com algumas adequações, foi elaborada em trabalho colaborativo entre o editor médico e a comissão técnica do projeto diretrizes AMB/CFM. GRAU DE RECOMENDAÇÃO E FORÇA DE EVIDÊNCIA: A: Grandes ensaios clínicos aleatorizados e meta-análises. B: Estudos clínicos e observacionais bem desenhados. C: Relatos e séries de casos clínicos. D: Publicações baseadas em consensos ou opiniões de especialistas. OBJETIVOS: Oferecer informações sobre o diagnóstico e tratamento das lombalgias e lombociatalgias. PROCEDIMENTOS: Diagnósticos e terapêuticos para as lombalgias e lombociatalgias.

Abstract FPSO/FSO projects are becoming more popular as the facilities of choice to develop offshore hydrocarbon resources, particularly for marginal fields and deepwater locations. This has created a potential shortage of experienced manpower to handle these projects. To ensure successful project execution, FPSO/FSO projects should be carefully planned to be efficient. In order to make this process more efficient, both oil company (owner) and shipyard's (contractor) perspectives must be taken into consideration. The objective of this paper is to provide such an owner and shipyard perspective in contracting and executing a FPSO/FSO project. This is a very wide subject and difficult to cover all aspects in one paper. Authors intend to also present another paper later at another conference as a compendium to this paper so that this subject is comprehensively addressed. Introduction Authors' Companies have been involved with each other in three new build, oil and gas FPSO/FSO projects and many oil tanker projects. These three new purpose built FSO/FPSOs are shown in Figures 1 to 3. Both companies have had many other FPSO and FSO project experiences. This paper's objective is to provide the perspectives and experiences of the Oil Company and a Shipyard in executing new build FPSO projects. Some of the major factors that are important to an oil company are:A robust Health, Safety and Environmental (HSE) plan during project execution as well as operations during long field life.Good Operability (Operations Assurance - OA) including reliability, low and easy maintenance, long life and no dry docking. All of which is to be achieved with a fit for purpose, good quality FPSO with many custom features.A fair market value project cost with minimal growth during project execution - a major challenge in many FPSO projects.A contracted schedule with minimal delay to the original schedule - a major challenge in many FPSO projects. Figure 1: Sanha LPG FPSO Under Construction for Angola (Available in full paper) Figure 2: Escravos LPG FSO in Nigeria Operating Since 1997 (Available in full paper) The shipyard should have similar objectives to meet the oil company's objectives, but their emphasis and priorities are somewhat different:A contracted cost based on a proposal of making a reasonable profit. This has been a shipyard major challenge in many FPSO projects.A project execution with a minimum number of changes. The shipyard can remain cost effective only by execution of projects in an assembly line and systemic process with minimum changes.A contracted schedule that can meet all the milestone dates. This has been a major challenge in many FPSO projects. From a shipyard perspective, it is important to meet this challenge as failure would lead to an adverse domino effect with other ongoing contracts due to dry dock/slip availability.A strong HSE plan. Ensuring a strong HSE plan has shown to increase productivity. Figure 3: Anoa Natuna FPSO in Indonesia Operating Since 1990 (Available in full paper) This paper address the following issues involved in the design and fabrication of an FPSO:Contracting Scheme;Standards and Specifications;Execution;Costs; andLessons.

The synthesis of six 2-methyl-3-arylidenoaminocyclohexeno [b] thieno [2,3-d]-3,4-dihydropyrimidin-4-ones is described. The biological activity of these new compounds was screened against several Gram-positive and Gram-negative bacteria. The activity of our compounds is 5 to 320 fold less active than ciprofloxacin.

The Mejean Lagoon (France) is a confined, shallow system,0.7 m in depth, with a surface area of 747 ha.Its sediments have a fine granulometry and are evenly distributed.The bathymetry and hydrodynamic behaviour of the basin create two zones with restricted exchanges between them.The western part (60% of the total surface area) is rich in dissolved phosphate (> 1 mg 1−1 in summer) and receives the majority of the phosphate (P) inputs from the watershed.The heavy macroalgal population consists of Gracilaria throughout the year and Ulva in summer and autumn.Phytoplankton levels sometimes reach 100 μg 1-1 of chlorophyll a.The sediment-water phosphate exchange varies with environmental conditions and macroalgal growth.P mobility was studied on the basis of these characteristics.Algal biomass and water characteristics were measured at 15-day intervals throughout 1993. A seasonal study was conducted in 1994 to investigate which P fractions in the sediment were involved in the exchanges. The springtime rise in temperature reactivated decomposition of the macroalgal biomass that had accumulated in autumn. The redox potential (E H) fell as a result of this biological activity, leading to a decrease in the inorganic P fractions.This P release accounts for the higher P water concentrations observed in the lagoon in summer.The mobility of P fractions shows that the P stored in the sediments plays an active role in the dynamics of the overlying water. Seasonal variations in these fractions explain the patterns of P storage and mobilization.

Background The spondyloarthritides (SpA) represent a group of chronic diseases that affect around 1% of the population. Enthesitis is a frequent clinical complaint in SpA patients that need to be better investigated Objectives To analyze the impact of the entheseal inflammatory involvement in a large Brazilian cohort of SpA patients. Methods A common protocol of investigation was prospectively applied to 1505 SpA patients in 29 centers distributed through the main geographical regions in Brazil. Clinical and demographic variables and disease indexes (BASDAI, BASFI, BASRI, ASQoL) were investigated. MASES (Maastricht Ankylosing Spondylitis Enthesitis Score) was used to investigate the entheseal component. Ankylosing spondylitis (AS) was the most frequent disease (65.4%) that also included psoriatic arthritis (18.4%), undifferentiated SpA (6.7%), reactive arthritis (3.3%), and enteropathic arthritis (3.2%). Results Enthesitis was referred by 54% of the SpA patients, with a mean of 2.12±2.98 enthesis affected. It was present in 53.3% of the AS patients, 54.4% in psoriatic arthritis, and 70.4% in undifferentiated SpA. Enthesitis was significantly more frequent in patients with axial + peripheral joint involvement compared to isolated involvement (p Conclusions The presence of enthesitis in SpA patients was frequent and caused a significant negative impact in the quality of life, associated to a more extensive joint involvement and functional incapacity. References Doward LC et al. Development of the ASQoL: a quality of life instrument specific to ankylosing spondylitis. Ann Rheum Dis 2003;62:20-6 Jones SD et al A new scoring system for the Bath Ankylosing Spondylitis Metrology Index (BASMI). J Rheumatol 1995;22:1609 Malorie P et al. A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Functional Index. J Rheumatol 1994;21: 2281-5 Sampaio-Barros PD et al. Primary ankylosing spondylitis: patterns of disease in a Brazilian population of 147 patients. J Rheumatol 2001;28:560-5. Disclosure of Interest None Declared

The aim of this study was to bring to light new and simple criteria, obtained during cardiopulmonary exercise testing, in order to demonstrate in patients the cardiac or the pulmonary origin of a comparable exertional dyspnea. Forty male subjects were compared, who exercised with a 30-W/3-min protocol and were divided into three groups: the cardiac heart failure (CHF) group (n = 15), the chronic obstructive lung disease (COLD) group (n = 15), and the control group (n = 10). The two groups of patients differed totally from the control group concerning their spirometric values at rest and a clear inability during effort which was confirmed by all the studied cardiopulmonary parameters at maximal exercise. The CHF and COLD groups differed slightly concerning their maximum symptom-limited oxygen uptake, only when related to body mass (13.26 +/- 0.69 ml/kg/min in CHF group, 17.05 +/- 1.59 ml/kg/min in COLD group; p0.05), and concerning their maximum ventilatory equivalent for oxygen which tended to be higher in the CHF group in comparison with the COLD group (p = 0.082). Furthermore, and as foreseen, the two groups of patients clearly differed at maximum exercise concerning the ventilatory reserve respiratory parameter (49.73 +/- 3.18 percent in CHF group, 8.38 +/- 5.85 percent in COLD group; p0.01). On the other hand, they did not differ concerning cardiac parameters or those considered as such (maximum heart rate [HR], HR reserve, HR response, maximum O2 pulse measurement). While their maximum ventilation was similar in the CHF and COLD groups, a difference in adaptation during exercise was found by observing their breathing pattern. In the CHF group, this was demonstrated by a significantly lower breathing frequency at maximum exercise (31.24 +/- 1.53 beats/min vs 37.75 +/- 2.24 beats/min; p0.05) and a tidal volume that tended to be higher at maximum exercise (p = 0.077) and significantly higher at 60-W work load (p0.05). This work shows that the study of ventilatory reserve and breathing pattern during exercise testing allows one to discriminate if dyspnea on exertion in patients is due to cardiac or respiratory disease.

Pathological samples (55) of serum selected from patients with Seronegative Spondylarthropathies, Systemic Lupus Erythematosus and Rheumatoid Disease were studied. The serum of all these patients showed negative rheumatoid factor by latex fixation reaction. The determination of the interference on the phagocytosis of gamma globulin aggregated by guinea pig's macrophages was obtained by one formula. The serum characterization was determined by selecting the ones that presented the most expressive results in the phagocytosis interference, by facilitation or inhibition. The results, in absolute and percentage values, showed the predominance of the interference phenomenon in phagocytosis, with significant statistical values (p0.05), when compared with normal serum. The comparative analysis among the diseases studied in the quantification of the serum interference in the phagocytosis of the immunocomplexes has not showed any significant difference. The phagocytosis inhibition occurred with more preponderance in the serum of patients with Reiter's Syndrome and Psoriatic Arthritis; in serum patients with Reiter's Syndrome there was a statistically significant difference in the inhibition of the phagocytosis (p = 0.0247). The serum characterization did not show that the serum fraction was responsible for the phagocytosis interference. In this stage it has been verified that there has not been an uniformity in the graphic curve of dilutions studied. The possibility of the existence of more than one element with interference in the phagocytosis of the studied immunocomplexes was mentioned.

Comprehensive 2 D/Doppler examination of 98 patients (mean age 56), implanted between September 1984 and February 1991, with normally functioning aortic (n = 49) and mitral (n = 49) Omnicarbon valves (OC) were analyzed in order to characterize the normal hemodynamic profiles of the OC valves. The mean time from implantation was 36.4 months (range 6 to 78). The following parameters were assessed (average of 5 measurements): peak transvalvular velocity (peak V), peak instantaneous gradient (peak G), mean transvalvular gradient (mean G), effective aortic valve area (ef Va), modified aortic valve area (m Va), aortic permeability index (PI), mitral valve area (Mit Va). Doppler data were correlated to prosthetic sizes (ranging from 21-29 mm for aortic OC and from 23-31 mm for mitral OC). The study establishes normal Doppler hemodynamics for each size (especially in aortic position) of OC valves and shows excellent performance. Significant correlations between peak G, mean G, Pl, and prosthetic aortic valve size (AS) were moderate. By contrast there were strong relationships between AS and ef Va (r = 0.56, p0.001) or mVa (r = 0.55, p0.001). These data should be helpful to identify OC prosthetic dysfunction.

The accumulation of nutrients, with its short or long term consequences (eutrophication, dystrophic crisis), is a major problem in coastal lagoons. During 1990 a study was carried out at three sampling sites in two coastal lagoons near Montpellier in order to estimate the quantities present and the exchanges between compartments: variables were measured simultaneously in the overlying water, the interstitial water and the sediments. Monthly analyses of the overlying water (temperature, salinity, dissolved oxygen, orthophosphate, ammonium, nitrate and chlorophyll a) allow a general understanding of the functioning of these lagoons and a characterization of each site. The orthophosphate concentration is distinctly higher in summer.

OBJECTIVE: To study the possibility of reducing the pain and discomfort experienced during mammography, by means of using an analgesic as premedication. PATIENTS AND METHODS: This was a randomized double-blind placebo-controlled clinical trial testing ketorolac tromethamine for reducing the pain and discomfort experienced during mammography. There were 308 participants in the study, who all signed a free and informed consent statement. Of these, 153 patients (group 1) received 10 mg of ketorolac tromethamine orally and 155 (group 2) received placebo orally, 60 minutes before undergoing mammographic examination. After taking the medication and while waiting to undergo the procedure, the patients themselves filled out a form asking about personal data and possible factors relating to pain and discomfort while undergoing mammography. After the examination, the patients subjectively assessed the pain and discomfort experienced during the examination using a visual analog scale (VAS) graded from zero to ten. The statistical analysis consisted of characterizing the groups using absolute and relative frequencies and comparing the dependent and independent variables between the groups using the chi-squared association test, with Yates correction when necessary. RESULTS: The mean VAS pain level presented by the patients was 3.36 and the median was 2.90. It was observed that 51 (16.6%) of the patients did not present any pain, 106 (34.4%) presented mild pain, 94 (30.5%) moderate pain, 40 (13%) severe pain and 17 (5.5%) intolerable pain. With regard to discomfort, 68 (54.9%) reported tolerable discomfort, 63 (20.5%) a lot of discomfort and 8 (2.6%) intolerable discomfort. Among the factors related to pain, only the presence of previous mastalgia was significant (p < 0.05). Somnolence was the adverse event most present: 2.6 and 5.8% in the ketorolac and placebo groups, respectively. CONCLUSIONS: The use of 10 mg of ketorolac tromethamine did not have any influence regarding reduction of the pain and discomfort experienced by the patients during mammography, when compared with placebo. Among the factors studied, the only one associated with greater possibility of pain and discomfort while undergoing mammography was a history of mastalgia. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4014.

An open, noncomparative study at 8 rheumatology centers in Brazil assessed the efficacy and safety of auranofin (AF) when given for up to 24 months. The study enrolled 80 patients with classic or definite rheumatoid arthritis (RA); disease was severe in 20 (25%), moderate in 55 (69%), and mild in 5 (6%). Patients received auranofin, 3 mg twice daily, and varying doses of anti-inflammatory drugs (aspirin, nonsteroidal anti-inflammatory drugs, and corticosteroids). Sixty patients (75%) completed the full 24 months of therapy. No patients were withdrawn from therapy because of insufficient therapeutic effect. There was statistically significant improvement (p less than 0.001) in 9 clinical parameters of disease activity, evident as early as 3 months after beginning AF therapy, increasing steadily over 12 months, and remaining at improved levels for another 12 months. Improvements in some parameters were particularly striking. By 24 months, assessment of well-being had increased by 150%, intensity of pain had decreased by 66%, and duration of morning stiffness had decreased by 78%. The average daily dose of anti-inflammatory drugs also decreased over time. The safety profile of AF was similar to that found in comparable trials. Ten patients (12.5%) were withdrawn because of adverse events: 6 for diarrhea (7.5%), 2 for proteinuria (2.5%), and 1 each for pruritus and anemia (1.25%). Adverse events occurred in 24 of 80 patients; some reported more than one adverse event. The most common adverse events were loose stools (20 patients) or diarrhea (11 patients).(ABSTRACT TRUNCATED AT 250 WORDS)

Elastic compression of the lower limb was critically evaluated in 105 hospital patients relative to reduction of the venous pool, effect upon venous hemodynamics, and the degree of compression commensurate with maximum reduction of venous stasis. Pressure studies and phlebograms were performed with and without knee-high elastic support of varying compression pressures. It was demonstrated that elastic support of 16 to 20 mm Hg effects significant reduction of the venous pool of the leg with improved venous return. The results of the study strongly suggest that knee-high elastic compression of the limb is effective in combating stasis in the deep veins as well as in the superficial varicose veins, and support its use when stasis is a predominant cause of phlebothrombosis in the confined patient.