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Atualmente o índice de mulheres eleitas na política brasileira, é baixíssimo. Desse modo, faz-se necessário que mais mulheres sejam eleitas, para dar voz à representatividade feminina, para que haja de fato uma representação de gênero. Atualmente o direito feminino fica sub-representado, uma vez que em sua grande maioria o legislativo é dominado por homens. E é possível neste aspecto identificar onde o patriarcado, com a subjugação feminina, defronta com o questionamento de qual o papel da mulher politicamente, para mudar a realidade feminina ante o papel da mulher na obra O Conto da Aia. O intuito do presente artigo é analisar o papel da mulher na política brasileira, bem como, verificar a importância do feminismo como movimento transformador e de luta para as mulheres, descrevendo como o feminismo existe para evitar a nulidade de direitos feminino. Para a realização do presente artigo, foi utilizado o método de abordagem dedutivo, com pesquisas bibliográficas, revisão doutrinária, busca em artigos científicos, bem como a análise sobre a legislação brasileira, aplicado ao real papel da mulher na política brasileira. Desta forma conclui-se que as mulheres ocupam menos cargos de poder que os homens, a raiz deste problema é encontrada no sistema patriarcal, que desde sempre colocou a mulher num patamar inferior que o homem com ideias sexistas.

Background Acute pulmonary thromboembolism (PE) is a life-threatening disease. Cardiac biomarkers like lactate, NT-proBNP and troponin I have been reported to predict prognosis of acute PE however, the prognostic importance of these factors on long-term mortality is not known. Objectives To assess the prognostic role of biomarkers lactate, NT-proBNP and troponin I in acute PE. Methods: We retrospectively assessed 131 consecutive patients diagnosed with acute PE. Prognostic impact of both lactate, NT-proBNP and troponin was assessed. Results Out of 131 patients with acute PE, the median age was 67.6 ± 15.3 years and 71.0% were female. Mean follow-up was 44.8 ± 37.3 months. Overall in-hospital mortality was 8.4%, 30-day mortality 13.0% and 1-year mortality 20.6%. Twenty-six patients (19.8%) had a recent hospitalization and 21 (16.0%) a medical history of active cancer. ROC curves shown that lactate has a good discriminatory power for in-hospital mortality, with an area under the curve (AUC) of 0.84 and p-value 0.001, unlike NT-proBNP (AUC 9.45, p-value 0.76) and troponin (AUC 0.64, p-value 0.12). Serum lactate equal or superior to 2.05 mmol/L were associated with higher in-hospital mortality (odds ratio [OR] 23.1, 95% confidence interval (CI) 2.8–187.7), when compared with lower levels. The impact of this parameter was independent of hypotension, tachycardia or active neoplasia (p-value 0.006, OR 21.3, 95% CI 2.4–187.3). Conclusions This study revealed that lactate has a better discriminatory power when compared to NT-proBNP and troponin in predicting prognosis in acute PE patients. Its routinely addition to current stratification tools could be of interest.

Background Acute pulmonary embolism (PE) is a life-threatening disease and an early diagnosis and herapy are crucial. Several parameters for risk stratification have been evaluated and it's important to assess their impact on clinical practice. Objective We assessed four different parameters (clinical, echocardiographic, analytical and anatomical imaging parameters) - PESI class; PESI-Echo score; lactate and troponin I values and central or peripheral thrombi location. We determined a composite outcome of adverse events: shock, acute ventilatory failure, severe bleeding events or in-hospital mortality. Methods Retrospective single center analysis including 131 patients admitted for PE. Results Mean age of 67.6 ± 15.3 years-old and 71% patients were female. Eighty patients (63.4%) had arterial hypertension, 27.4% had a recent hospitalization or surgery and 16% an active neoplasm disease. According to the PESI classification, 29.8% of the patients were in class V, 26.7% in class III and 17.6% in class II. This classification had a weak positive correlation with the outcome (P < 0.001; r = 0.37) as PESI-Echo score (p 0.018; r = 0.36). The majority (72.2%) of the in-hospital adverse events occurred in PESI class V patients. Analytic parameters determined at hospital admission had a good discriminative power to predict the outcome, mainly lactate value (AUC 0.864; P < 0.001). PESI-Echo score presented the best discriminative power (AUC 1.0), followed by PESI class (AUC 0.925) and lactate (AUC 0.856). The cut-off value for PESI-Echo was 211. Conclusion The association of clinical and echocardiographic parameters was superior as a predictor of adverse events when compared with their isolated use.

Introduction Left ventricular thrombi may develop as a complication of myocardial infarction. Transthoracic echocardiography (TTE) has a low sensitivity for thrombus detection and other imaging methods are usually required. Case report A 32-years-old man with a past medical history of smoking habits, obesity and a ST-segment elevation myocardial infarction (STEMI) diagnosed on December 2017. Primary angioplasty was performed with stent implantation in the anterior descending coronary artery. TTE revealed severe systolic dysfunction (SD) and an apical aneurysm with thrombus formation. Six months after anticoagulation with warfarin, a cardiac magnetic resonance revealed thrombus resolution and it was decided to stop warfarin. On September 2021, the patient presented to the Emergency Department referring sudden chest pain. The electrocardiogram showed an anterior STEMI and in the Cath Lab a late stent thrombosis was evident. TTE revealed a severe SD and akinesia of apical segments (poor acoustic window). On the 3rd day of hospital stay, the patient developed backache and Murphy´s punch sign. Imaging workup was suggestive of right renal infarction. At this time, the suspicion of embolic source arises, and the patient underwent contrast echocardiography demonstrating a filling defect suggestive of an apical thrombus. Therapy with warfin was reinitiated concomitantly with dual antiplatelet therapy. Conclusion This is a particular case of an apical thrombus formation occurring twice in a young patient. There is a lack of evidence about the adequate screening methods and therapeutic approach. More cases need to be reported to understand the best approach in each case to minimize complications.

Funding Acknowledgements Type of funding sources: None. Background ST-segment elevation myocardial infarction (STEMI) has high levels of morbidity and mortality. Multiple risk factors may contribute to clinical outcomes and some studies demonstrate gender-related differences in baseline characteristics and in-hospital management. Purpose To access the difference in clinical characteristics and prognostic outcomes between men and women who were admitted in our Cardiac Intensive Care Unit with STEMI diagnosis. Methods We retrospectively analyzed 121 non-consecutive patients with STEMI during a mean follow-up period 135 ± 31 weeks. We accessed baseline characteristics and time course of events (symptom onset-to-door admission; time to first EKG; time to fibrinolytic therapy; door-to-cath lab time and time from fibrinolytic therapy to PCI (for patients transferred from another centers). Primary endpoint (PE) was a composite of in-hospital cardiovascular death, arrhythmic events or STEMI evolution in Killip-Kimbal III or IV. Secondary endpoint (SE) was in-hospital major bleeding events, considered intracerebral hemorrhage, cases of hemodynamic compromise or requiring a blood transfusion. Tertiary endpoint (TE) included admissions to the emergency department or hospitalization by heart failure decompensation, acute or chronic coronary syndromes and all-cause mortality. Results Of the 121 patients, 102 were male (84.3%) and 19 (15.7%) female. The mean age was 58.3 ± 12.7 years and women had a superior mean age (69.8 ± 12.2 years) vs. Men mean age 56 ± 11.6 years. Hypertension was more prevalent in women (84.2% vs. 47.1%, respectively; p 0.003) and also diabetes – 36.8% of women had type 2 diabetes (vs 10.8% of men) and 5.3% of these female patients requires insulin therapy (vs 2% of men; p 0.021). According to Charlson Comorbidity Index (CCI), women had a higher disease burden with 73.7% of them included into the moderate or severe group of mortality risk, compared to 42.2% of men (p 0.014). Conversely, less women smoke (31.6% vs. 82.2%; p Time since symptom onset to door admission was estimated on 510 ± 1149 minutes and the mean women delay was superior (557 ± 858 minutes). Regarding to in-hospital hemorrhagic events (secondary endpoint), female patients had a statistically significant higher risk (22.2% vs. 7.1%, p 0.045), independently of hypertension, diabetes or anticoagulant therapy (r=0.249; ANOVA p-value < 0.005), but it was associated with higher CCI (p 0.033). No other gender differences in outcomes or survival function were observed. Conclusion Our study demonstrates gender-related differences among patients with STEMI. Indeed, women were older, had more clinical cardiovascular risk factors and tend to delay hospital admission after symptoms onset. Secondary endpoint was statistically more frequent in women, but no other differences in outcomes were observed.

Pensamento Computacional engloba a habilidade de utilizar noções e técnicas da ciência da computação na resolução d e problemas do cotidiano e nas mais diversas áreas do conhecimento. A robótica tem se apresentado como uma forma atrativa de trabalhar o pensamento computacional com os estudantes O presente trabalho apresenta um projeto de extensão executado no Instituto Federal de Educação , Ciência e Tecnologia da Bahia (IFBA), campus Jacobina, que teve por objetivo potencializar as habilidades do pensamento computacional em alunos do ensino médio da rede pública através da robótica pedagógica.

Este trabalho apresenta os resultados de uma pesquisa científica realizada com estudantes concluintes do ensino médio que buscou entender as razões que levam meninas a não escolherem cursos superiores na área de computação. O estudo apontou que os meninos levam vantagem em conhecimentos básicos sobre computação e sugere que a origem do desinteresse feminino pela área pode estar associada, entre outros fatores, à falta de estímulos oriundos da família e da escola.

International audience; This cross-sectional study evaluates the association of major adverse cardiac events (MACE) integrated with fractional flow reserve as the management strategy for diabetes with outcomes in patients with ambiguous lesions who undergo angiography.Key PointsQuestionWhat are the usefulness, rate of major adverse cardiovascular events (MACE), and clinical outcomes of routinely integrating fractional flow reserve in the management strategy for patients with diabetes who undergo coronary angiography? FindingsIn this cross-sectional study of 1983 patients, overall reclassification by fractional flow rate was high and similar in patients with diabetes (41.2%) and patients without diabetes (37.5%); however, reclassification from medical treatment to revascularization was more frequent among patients with diabetes. The rate of 1-year MACE was similar in reclassified (9.7%) and nonreclassified (12.0%) patients with diabetes, and the rate of MACE of patients deferred based on fractional flow reserve was similar among those with and without diabetes. MeaningThe findings suggest that management strategies guided by fractional flow reserve, including revascularization deferral, may be useful for patients with diabetes.ImportanceApproximately one-third of patients considered for coronary revascularization have diabetes, which is a major determinant of clinical outcomes, often influencing the choice of the revascularization strategy. The usefulness of fractional flow reserve (FFR) to guide treatment in this population is understudied and has been questioned. ObjectiveTo evaluate the usefulness and rate of major adverse cardiovascular events (MACE) of integrating FFR in management decisions for patients with diabetes who undergo coronary angiography. Design, Setting, and ParticipantsThis cross-sectional study used data from the PRIME-FFR study derived from the merger of the POST-IT study (Portuguese Study on the Evaluation of FFR-Guided Treatment of Coronary Disease [March 2012-November 2013]) and R3F study (French Study of FFR Integrated Multicenter Registries Implementation of FFR in Routine Practice [October 2008-June 2010]), 2 prospective multicenter registries that shared a common design. A population of all-comers for whom angiography disclosed ambiguous lesions was analyzed for rates, patterns, and outcomes associated with management reclassification, including revascularization deferral, in patients with vs without diabetes. Data analysis was performed from June to August 2018. Main Outcomes and MeasuresDeath from any cause, myocardial infarction, or unplanned revascularization (MACE) at 1 year. ResultsAmong 1983 patients (1503 [77%] male; mean [SD] age, 65 [10] years), 701 had diabetes, and FFR was performed for 1.4 lesions per patient (58.2% of lesions in the left anterior descending artery; mean [SD] stenosis, 56% [11%]; mean [SD] FFR, 0.81 [0.01]). Reclassification by FFR was high and similar in patients with and without diabetes (41.2% vs 37.5%, P=.13), but reclassification from medical treatment to revascularization was more frequent in the former (142 of 342 [41.5%] vs 230 of 730 [31.5%], P=.001). There was no statistical difference between the 1-year rates of MACE in reclassified (9.7%) and nonreclassified patients (12.0%) (P=.37). Among patients with diabetes, FFR-based deferral identified patients with a lower risk of MACE at 12 months (25 of 296 [8.4%]) compared with those undergoing revascularization (47 of 257 [13.1%]) (P=.04), and the rate was of the same magnitude of the observed rate among deferred patients without diabetes (7.9%, P=.87). Status of insulin treatment had no association with outcomes. Patients (6.6% of the population) in whom FFR was disregarded had the highest MACE rates regardless of diabetes status. Conclusions and RelevanceRoutine integration of FFR for the management of coronary artery disease in patients with diabetes may be associated with a high rate of treatment reclassification. Management strategies guided by FFR, including revascularization deferral, may be useful for patients with diabetes.

According to the literature, the pegmatites of Madeira granite, located in the mining district of Pitinga (Amazonas, Brazil), belong to the albite granite facies. Previous studies have proposed that these pegmatitic bodies are associated with N320/60SW oriented faults and are rich in rare earth elements (REE). Due to this, the characterization of these pegmatites was carried out based on mineral chemistry and whole rock geochemistry. The paragenesis is composed of albite, microcline, quartz, polylithionite, riebeckite, fluoro-arfvedsonite, fluoro-eckermannite, cryolite, xenotime, gagarinite-(Y), hematite, zircon, pyrochlore, cassiterite, thorite, zircon, columbite, magnetite, galena, sphalerite and native bismuth. Based on the chemical composition and typical minerals, they were divided into: PEG ANF (medium K and Na, riebeckite and genthelvite), PEG POL (high K, polylithionite and xenotime) and PEG CRIO [high K, very rich in F; cryolite and gagarinite- (Y)]. Mineral chemistry data and structure of the major minerals of the pegmatites are presented and compared with those of the albite granite. The integration of mineralogical data with the geochemistry of the three types of pegmatites characterizes the hosting rock as the parent rock, records the enrichment in F, REE and elements of group 1 and allows following the chemical-mineralogical evolution of the albite granite giving rise to the late residual facies (PEG CRIO).

A disciplina introdutória de Lógica de Programação constitui a base de formação dos estudantes dos cursos técnicos e superiores daárea de Computação. Assimilar os conteúdos abordados nessa disciplina requer dos estudantes uma nova forma de pensar e habilidades que normalmente não são desenvolvidas no ensino regular. Como resultado, a disciplina apresenta altos índices de reprovação e desistência, sendo normalmente uma das disciplinas que mais reprova nesses cursos. A preocupação com as altas taxas de reprovação e evasão nesta disciplina tem levado professores e pesquisadores a buscarem alternativas à forma tradicional de ensino de algoritmos e programação, onde o aluno é o agente passivo da aprendizagem, e o professor o agente transmissor dos conteúdos. Nesse contexto, o presente trabalho apresenta uma proposta de gamificação da disciplina Lógica de Programação e reporta os resultados obtidos com aplicação da proposta em uma turma do Curso Técnico de Informática, do IFBA, campus Jacobina.

Aprender programação não é uma tarefa considerada simples por grande parte dos estudantes dos cursos técnicos e superiores de Informática. Essa dificuldade é refletida nos altos índices de evasão e reprovação nas disciplinas introdutórias de programação. Dentre os fatores que influenciam o baixo rendimento dos alunos e suas dificuldades em assimilar os conteúdos de programação destacam-se o precário embasamento lógico-matemático dos estudantes e a falta de experiência prévia em programação. A fim de promover um primeiro contato com programação para os alunos, antes do início das aulas, foi realizado um projeto de extensão no IFBA, campus Jacobina, onde os alunos ingressantes no Curso Técnico Subsequente de Informática participaram de um curso introdutório de programação, utilizando a ferramenta Scratch. Este artigo relata os efeitos da execução do projeto em relação às taxas de reprovação na disciplina Lógica de Programação do referido curso no segundo semestre de 2017.

Submitted by Carina Machado Pereira null (carina-mp@hotmail.com) on 2018-03-22T19:01:38Z No. of bitstreams: 1 Dissertação Carina M. Pereira.pdf: 729733 bytes, checksum: e6cde5eebf546947e49ee53e3780d2ec (MD5) Rejected by Elza Mitiko Sato null (elzasato@ibilce.unesp.br), reason: Solicitamos que realize correções na submissão seguindo as orientações abaixo: Problema 01) Falta a FICHA CATALOGRÁFICA (Obrigatório pela ABNT NBR14724) Problema 02) A ordem das páginas pré-textuais estão incorretas, páginas pré-textuais (capa, folha de rosto, ficha catalográfica, folha de aprovação, dedicatória, agradecimentos, epígrafe, resumo na língua vernácula, resumo em língua estrangeira, listas de ilustrações, de tabelas, de abreviaturas, de siglas e de símbolos e sumário). Na página da Seção de pós-graduação, em Instruções para Qualificação e Defesas de Dissertação e Tese, você pode acessar o modelo das páginas pré-textuais. Lembramos que o arquivo depositado no repositório deve ser igual ao impresso. Agradecemos a compreensão. on 2018-03-23T13:01:20Z (GMT) Submitted by Carina Machado Pereira null (carina-mp@hotmail.com) on 2018-03-23T17:14:33Z No. of bitstreams: 1 Dissertação Carina M. Pereira.pdf: 2031700 bytes, checksum: 7b76a8db4282c0aa5864573191ab4d94 (MD5) Approved for entry into archive by Elza Mitiko Sato null (elzasato@ibilce.unesp.br) on 2018-03-28T17:58:41Z (GMT) No. of bitstreams: 1 pereira_cm_me_sjrp_par.pdf: 608302 bytes, checksum: 034b4939a43fdefceb239eb2d8908612 (MD5) Made available in DSpace on 2018-03-28T17:58:41Z (GMT). No. of bitstreams: 1 pereira_cm_me_sjrp_par.pdf: 608302 bytes, checksum: 034b4939a43fdefceb239eb2d8908612 (MD5) Previous issue date: 2018-03-06 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) A hepatite C é uma doença causada pelo vírus da Hepatite C (HCV) que acomete aproximadamente 115 milhões de pessoas. O tratamento atual para os pacientes infectados consiste na combinação de antivirais de ação direta (DAAs), que apesar de apresentar resposta virológica sustentada satisfatória já apresentam variantes resistentes descritas. Estes medicamentos também representam significativos gastos para o sistema público de saúde, além de causarem efeitos colaterais. Desta forma, o desenvolvimento de novos agentes terapêuticos se faz necessário. Compostos naturais e seus derivados sintéticos têm sido descritos pela atividade antiviral contra diversos vírus, como os vírus da Dengue (DENV), Febre amarela (YFV), Herpes (HSV), Imunodeficiência Humana (HIV) e HCV. Nesse estudo, a atividade antiviral de 10 compostos isolados de venenos de serpentes do gênero Bothrops (TOXs) e de 16 acridonas sintéticas (Facs) foi avaliada, utilizando linhagem celular Huh-7.5 e partículas virais JFH-1 HCVcc genótipo 2a. Oito TOXs e dois Facs inibiram significativamente a infecção pelo HCV. Os compostos com maior inibição, TOX1 (SI = 1736), TOX3 (SI = 13,5), Fac15 (SI = 1,72) e Fac17 (SI = 1,65), demonstraram reduzir a infecção em 96%, 84,7%, 58% e 48%, respectivamente, agindo diretamente nas partículas virais. TOX1 e Fac15 também reduziram a infectividade viral em 87% e 39% nas células hospedeiras por ação protetora, após o pré-tratamento das células. Com este trabalho, concluímos que tanto os compostos isolados de venenos de serpentes do gênero Bothrops quanto as acridonas sintéticas podem ser eficientes na inibição do HCV. Hepatitis C is a disease caused by Hepatitis C virus (HCV) that affects approximately 115 million people. The current treatment for infected patients consists of the combination of direct acting antivirals (DAAs), which despite presenting satisfactory sustained virological response already presents resistant variants described. These drugs also represent significant costs to the public health system and cause side effects. Therefore, the development of new therapeutic agents is needed. Natural compounds and their synthetic derivatives have been described as antivirals against several viruses as Dengue (DENV), Yellow fever (YFV), Herpes (HSV), Human immunodeficiency virus (HIV) and HCV. In this study, the antiviral activity of 10 compounds isolated from Bothrops snake venoms (TOXs) and 16 synthetic acridones (Facs) was evaluated, using Huh-7.5 cell line and JFH-1 HCVcc genotype 2a virus particles. Eight TOXs and two Facs significantly inhibited the HCV infection. The compounds with the highest inhibition, TOX1 (SI = 1736), TOX3 (SI = 13.5), Fac15 (SI = 1.72) and Fac17 (SI = 1.65), demonstrated to reduce the infection in 96%, 84.7%, 58% and 48%, respectively, by acting directly on the viral particles. TOX1 and Fac15 also reduced 87% and 39% of viral infectivity in host cells by protective action after pre-treatment of cells. With this work, we conclude that either compounds isolated from Bothrops snake venoms and synthetic acridones may be efficient in inhibiting HCV.

Dissertação de mestrado em Comunicação, Arte e Cultura, Esta investigação tem como objetivo central analisar o papel da cultura no desenvolvimento local no distrito de Bragança, salientando não só a relação existente entre os diferentes bens e atividades culturais e as dinâmicas do desenvolvimento local, como também o turismo cultural e as políticas culturais subjacentes. Pretende-se também compreender qual a perceção que os agentes institucionais, os agentes turísticos, os visitantes e os potenciais visitantes têm do distrito e das dinâmicas culturais existentes. Sendo o distrito de Bragança geograficamente muito extenso, optouse por focar a atenção em apenas três municípios: Bragança, Miranda do Douro e Vimioso. A relevância teórica deste estudo deve-se ao facto de contribuir para a reflexão da relação existente entre os conceitos de cultura, política cultural, desenvolvimento e turismo. Este estudo visa igualmente compreender quais os objetivos, estratégias e metas propostas pelos diferentes municípios no âmbito cultural e quais os efeitos das suas políticas nas comunidades locais. Pretende-se perceber se existe retorno efetivo do investimento feito, se o estereótipo e a imagem de um distrito retrógrado, inculto e longínquo, com acessos difíceis, ainda prevalece e diagnosticar as causas pelas quais os municípios em estudo se apresentam (ou não) pouco atrativos para o turista nacional, apesar da sua eclética oferta cultural. Assim, para se conseguir uma visão mais abrangente deste fenómeno, no distrito de Bragança, é necessário englobar toda uma série de parceiros culturais. Deste modo, o presente estudo pretende identificar quais os problemas subjacentes ao setor e quais as soluções apresentadas para promover e desenvolver o território., The central aim of this research work is to analyse the role of culture in local development in the district of Bragança, highlighting the existing connection not only between the various cultural goods and activities and the local development dynamics, but also between cultural tourism and the underlying cultural policies. Also, we intend to assess the perception that institutional agents, tourist agents, visitors and potential visitors have of the district and of the existing cultural dynamics. Since the district of Bragança is quite vast geographically, a choice was made to focus only on three municipalities: Bragança, Miranda do Douro and Vimioso. The theoretical relevance of this study lies on the fact that it contributes to the reflection on the existing connection among the concepts of culture, cultural policy, development and tourism. This study also aims to understand the goals, strategies and aims proposed by the various councils regarding culture as well as the effects of their policies upon local communities. We intend to assess whether there is an effective return of the investment made and whether the stereotype and image of a backward, uncultured, remote and hard-to-reach district still prevails; and assess the causes for the municipalities under study to be (or not) unappealing to the national tourist despite their eclectic cultural offer. Therefore, in order to obtain a broader outlook of this phenomenon in the district of Bragança, it is necessary to encompass a whole set of cultural partners and stakeholders. Thus, this research study aims to identify the problems undermining the sector as well as the solutions presented to promote and develop this territory.

Background— Fractional flow reserve (FFR) is not firmly established as a guide to treatment in patients with acute coronary syndromes (ACS). Primary goals were to evaluate the impact of integrating FFR on management decisions and on clinical outcome of patients with ACS undergoing coronary angiography, as compared with patients with stable coronary artery disease. Methods and Results— R3F (French FFR Registry) and POST-IT (Portuguese Study on the Evaluation of FFR-Guided Treatment of Coronary Disease), sharing a common design, were pooled as PRIME-FFR (Insights From the POST-IT and R3F Integrated Multicenter Registries - Implementation of FFR in Routine Practice). Investigators prospectively defined management strategy based on angiography before performing FFR. Final decision after FFR and 1-year clinical outcome were recorded. From 1983 patients, in whom FFR was prospectively used to guide treatment, 533 sustained ACS (excluding acute ST-segment–elevation myocardial infarction). In ACS, FFR was performed in 1.4 lesions per patient, mostly in left anterior descending (58%), with a mean percent stenosis of 58±12% and a mean FFR of 0.82±0.09. In patients with ACS, reclassification by FFR was high and similar to those with non-ACS (38% versus 39%; P =NS). The pattern of reclassification was different, however, with less patients with ACS reclassified from revascularization to medical treatment compared with those with non-ACS ( P =0.01). In ACS, 1-year outcome of patients reclassified based on FFR (FFR against angiography) was as good as that of nonreclassified patients (FFR concordant with angiography), with no difference in major cardiovascular event (8.0% versus 11.6%; P =0.20) or symptoms (92.3% versus 94.8% angina free; P =0.25). Moreover, FFR-based deferral to medical treatment was as safe in patients with ACS as in patients with non-ACS (major cardiovascular event, 8.0% versus 8.5%; P =0.83; revascularization, 3.8% versus 5.9%; P =0.24; and freedom from angina, 93.6% versus 90.2%; P =0.35). These findings were confirmed in ACS explored at the culprit lesion. In patients (6%) in whom the information derived from FFR was disregarded, a dire outcome was observed. Conclusions— Routine integration of FFR into the decision-making process of ACS patients with obstructive coronary artery disease is associated with a high reclassification rate of treatment (38%). A management strategy guided by FFR, divergent from that suggested by angiography, including revascularization deferral, is safe in ACS.

Introduction and aims Randomized trials and registries have shown that drug-eluting stents (DES) have an overall better performance than bare-metal stents in patients treated in the setting of both ST-segment and non-ST-segment elevation acute coronary syndromes, mainly by reducing restenosis. Whether or not the use of newer second-generation devices (vs. first-generation DES) differs in these high-risk patients remains to be determined. Methods and results In a single-centre prospective registry, 3266 patients underwent a percutaneous coronary intervention with at least one DES from January 2003 to December 2009. Of these, 1423 (43.6%) were treated in the setting of an acute coronary syndrome, using either first-generation-only DES [paclitaxel or sirolimus; n=923 (64.9%)] or second-generation-only [zotarolimus or everolimus; n=500 (35.1%)]. The occurrence of death from any cause, nonfatal myocardial infarction or target vessel failure (composite primary endpoint) was compared between these two groups; repeat revascularization of the index stented lesion and definite stent thrombosis [according to the academic research consortium (ARC) definition] were assessed as isolated secondary outcomes. At a median follow-up of 598 days (interquartile range 453-1206), the incidence of death was 10.7% (152), 136 patients (9.6%) had a new myocardial infarction and target vessel failure events occurred in 147 patients (10.3%). Disparity in the follow-up duration was accounted for by considering only the 1-year major adverse cardiac event rate (n=161; 11.3%). After adjustment for baseline characteristics using a Cox proportional hazard model, we could not find a significant difference in the incidence of the composite primary endpoint at 1-year between first-generation (10.8%) and second-generation DES (12.2%) [hazard ratio (HR): 1.1; 95% confidence interval (CI): 0.82-1.57, P=0.463], nor in the occurrence of repeat target lesion revascularization (3.6 vs. 4.4%; HR 1.35; 95% CI 0.77-2.34; P=0.293). In a per patient analysis, at 1 year, ARC-definite ST was documented in 1.0% of patients treated with second-generation DES versus 2.8% in those treated with first-generation DES (corrected HR 0.36; 95% CI 0.14-0.94; P=0.037), owing mostly to a higher difference in late ST. Conclusion Our results suggest that both first-generation and second-generation DES seem to be similarly effective in patients undergoing a percutaneous coronary intervention in the setting of acute coronary syndromes. However, newer second-generation devices may offer potential advantages because of a significantly lower incidence of ARC-definite ST.

Os pegmatitos estudados estão associados à fácies albita granito do granito Madeira, a qual corresponde ao depósito de Sn-Nb-Ta (F, ETR, U, Th) Madeira, na mina Pitinga (AM) e estão associados a falhas de orientação N320/60SW. Estas rochas contêm minerais poucos comuns como gagarinita (NaCaYF6), genthelvita (Zn4Be3(SiO4)3S) e polilitionita (KLi2AlSi4O10(F, OH)2), além de grandes quantidades de criolita (Na3AlF6). Com base na composição química e mineralógica, estes pegmatitos foram classificados em três tipos: PEG ANF (teores médios de K e Na, com alta concentração de anfibólios), PEG POL (rico em K e com alta concentração de polilitionita) e PEG CRIO (rico em Na e com alta concentração de criolita). Estes pegmatitos contêm altos teores de ETR (especialmente ETRP) e Y, que estão concentrados principalmente na xenotima e na gagarinita. Estes elementos também ocorrem em elevados teores na grande parte dos demais minerais analisados. Também se destacam as concentrações anômalas de F, muito superiores às detectadas nos pegmatitos de outras localidades, e que promoveram o enriquecimento em Li, Na, K, Rb e Cs. A similaridade na composição química do AGN com os pegmatitos indica que eles possuem a mesma fonte. The pegmatites studied are associated with the albite granite facies of the Madeira granite, which corresponds to the Sn-Nb-Ta (F, ETR, U, Th) Madeira deposit at the Pitinga mine (AM). They are associated with N320/60SW orientation faults. These rocks contain few common minerals such as gagarinite (NaCaYF6), genthelvite (Zn4Be3(SiO4)3S) and polylithionite (KLi2AlSi4O10(F,OH)2), as well as large amounts of cryolite (Na3AlF6). Based on the chemical and mineralogical composition, these pegmatites were classified into three groups: PEG ANF (medium K and Na, with high concentration of amphiboles), PEG POL (K rich and with high polylithionite concentration) and PEG CRIO (rich in Na and with high concentration of cryolite). These pegmatites contain high levels of REE (especially HREE) and Y, which are mainly concentrated in xenotime and gagarinite. These elements also occur at high levels in most of the other minerals analyzed. Anomalous concentrations of F, much higher than those detected in pegmatites from other localities, were also highlighted, and promoted enrichment in Li, Na, K, Rb and Cs. The similarity in the chemical composition of AGN with pegmatites indicates that they have the same source.

Background— Penetration of fractional flow reserve (FFR) in clinical practice varies extensively, and the applicability of results from randomized trials is understudied. We describe the extent to which the information gained from routine FFR affects patient management strategy and clinical outcome. Methods and Results— Nonselected patients undergoing coronary angiography, in which at least 1 lesion was interrogated by FFR, were prospectively enrolled in a multicenter registry. FFR-driven change in management strategy (medical therapy, revascularization, or additional stress imaging) was assessed per-lesion and per-patient, and the agreement between final and initial strategies was recorded. Cardiovascular death, myocardial infarction, or unplanned revascularization (MACE) at 1 year was recorded. A total of 1293 lesions were evaluated in 918 patients (mean FFR, 0.81±0.1). Management plan changed in 406 patients (44.2%) and 584 lesions (45.2%). One-year MACE was 6.9%; patients in whom all lesions were deferred had a lower MACE rate (5.3%) than those with at least 1 lesion revascularized (7.3%) or left untreated despite FFR≤0.80 (13.6%; log-rank P =0.014). At the lesion level, deferral of those with an FFR≤0.80 was associated with a 3.1-fold increase in the hazard of cardiovascular death/myocardial infarction/target lesion revascularization ( P =0.012). Independent predictors of target lesion revascularization in the deferred lesions were proximal location of the lesion, B2/C type and FFR. Conclusions— Routine FFR assessment of coronary lesions safely changes management strategy in almost half of the cases. Also, it accurately identifies patients and lesions with a low likelihood of events, in which revascularization can be safely deferred, as opposed to those at high risk when ischemic lesions are left untreated, thus confirming results from randomized trials. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01835808.

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Penetration of fractional flow reserve (FFR) in clinical practice varies extensively, and the applicability of results from randomized trials is understudied. We describe the extent to which the information gained from routine FFR affects patient management strategy and clinical outcome.Nonselected patients undergoing coronary angiography, in which at least 1 lesion was interrogated by FFR, were prospectively enrolled in a multicenter registry. FFR-driven change in management strategy (medical therapy, revascularization, or additional stress imaging) was assessed per-lesion and per-patient, and the agreement between final and initial strategies was recorded. Cardiovascular death, myocardial infarction, or unplanned revascularization (MACE) at 1 year was recorded. A total of 1293 lesions were evaluated in 918 patients (mean FFR, 0.81±0.1). Management plan changed in 406 patients (44.2%) and 584 lesions (45.2%). One-year MACE was 6.9%; patients in whom all lesions were deferred had a lower MACE rate (5.3%) than those with at least 1 lesion revascularized (7.3%) or left untreated despite FFR≤0.80 (13.6%; log-rank P=0.014). At the lesion level, deferral of those with an FFR≤0.80 was associated with a 3.1-fold increase in the hazard of cardiovascular death/myocardial infarction/target lesion revascularization (P=0.012). Independent predictors of target lesion revascularization in the deferred lesions were proximal location of the lesion, B2/C type and FFR.Routine FFR assessment of coronary lesions safely changes management strategy in almost half of the cases. Also, it accurately identifies patients and lesions with a low likelihood of events, in which revascularization can be safely deferred, as opposed to those at high risk when ischemic lesions are left untreated, thus confirming results from randomized trials.URL: http://www.clinicaltrials.gov. Unique identifier: NCT01835808.

We discuss the effects of a strong magnetic field on B and D mesons, focusing on the changes of the energy levels and the masses of the bound states. Using the Color Evaporation Model we discuss the possible changes in the production of J/ψ and Υ. We briefly comment the recent experimental data.

When compared to their first-generation (1stGEN) counterparts, second-generation (2ndGEN) drug-eluting stents (DESs) have been associated with better clinical outcomes in randomized clinical trials, namely by reducing the rates of stent thrombosis (ST). Our goal was to investigate whether or not the broad use of newer devices would translate into higher safety in a real-world population. For that purpose, we compared the occurrence of definite ST at 12 months between two patient subsets from a large-volume single-center registry, according to the type of DES used. Total mortality was a secondary endpoint.Between January 2003 and December 2010, a total of 3806 patients were submitted to percutaneous coronary intervention (PCI) with only 1stGEN or 2ndGEN DES: 2388 patients (62.7%) were treated with 1stGEN DES only (sirolimus-eluting stent [SES] = 1295 [34.0%]; paclitaxel-eluting stent [PES] = 943 [24.8%]; both stent types were used in 150 patients) and 1418 patients (37.3%) were treated with 2ndGEN DESs only. The total incidence of definite ST (as defined by the Academic Research Consortium) at 12 months was 1.2% (n = 46). After correction for baseline differences between study groups and other variables deemed to influence the occurrence of ST, the use of 1stGEN DES was associated with a significant 2.4-fold increase in the risk of definite ST (95% confidence interval [CI], 1.05-5.42; P=.039) at 12 months; adjusted risk was higher with PES (hazard ratio [HR], 3.6; 95% CI, 1.48-8.70; P=.005) than with SES (HR, 2.3; 95% CI, 0.92-5.65; P=.074). Total mortality (3.7% vs 3.5%) did not differ significantly between groups (adjusted HR, 1.2; 95% CI, 0.81-1.84, P=.348).Our data suggest that in the real-world setting of contemporary PCI, the unrestricted use of newer 2ndGEN DESs translates into an improvement in PCI safety (relative to 1stGEN DESs), with a significantly lower risk of definite ST at 12 months.

It is well known that in noncentral heavy-ion collisions a transient strong magnetic field is generated in the direction perpendicular to the reaction plane. The maximal strength of this field is estimated to be $eB \sim m^2_{\pi} \sim 0.02 \text{GeV}^2$ at the RHIC and $eB \sim 15 m^2_{\pi} \sim 0.3 \text{GeV}^2$ at the LHC. We investigate the effects of a strong magnetic field on $B$ and $D$ mesons, focusing on the changes of the energy levels and the masses of the bound states. Using the Color Evaporation Model we discuss the possible changes in the production of $J/\psi$ and $\Upsilon$., Comment: 18 pages, 7 figures

Coronary subclavian steal syndrome is a rare ischemic cause in patients after myocardial revascularization surgery. Subclavian artery stenosis or compression proximal to the internal mammary artery graft is the underlying cause. The authors present a clinical case of a patient with previous history of non-ST elevation myocardial infarction, triple coronary bypass, and effort angina since the surgery, with a positive ischemic test. Coronary angiography revealed a significant stenosis of the left subclavian artery, proximal to the internal mammary graft.

We expect a strong magnetic field to be produced in the perpendicular direction to the reaction plane, in a noncentral heavy-ion collision . The strength of the magnetic field is estimated to be eB ∼ m2π ∼ 0.02 GeV2 at the RHIC and eB ∼ 15m2π ∼ 0.3 GeV2 at the LHC. We investigate the effects of the magnetic field on B0 and D0 mesons, focusing on the changes of the energy levels and of the mass of the bound states.

Dissertação mestrado em Psicologia, área de Psicologia Escolar, Assiste-se, hoje, a uma crescente corresponsabilização do aluno no seu processo de aprendizagem, facto pelo qual a promoção da auto-regulação vem progressivamente adquirindo espaço próprio e intencional nos contextos educativos, nomeadamente através da área de Estudo Acompanhado. Esta dissertação estuda a promoção da auto-regulação da aprendizagem, em particular os impactos psicoeducacionais de um projecto inovador ancorado na utilização da narrativa como meio para transmitir e discutir estratégias de aprendizagem. A ferramenta instrutiva em análise assenta num racional teórico sociocognitivo e constitui uma proposta organizadora da área curricular não disciplinar de Estudo Acompanhado. A revisão da literatura incidiu sobre a definição de auto-regulação da aprendizagem, as diferentes perspectivas teóricas que a descrevem e explicam, particularmente a perspectiva sociocognitiva, e as diferentes componentes deste constructo. Analisam-se também os elementos nucleares na promoção da auto-regulação e o papel do professor nesta área. A estrutura e organização do projecto são descritos, em seguida, bem como algumas das propostas de actividade que o mesmo integra. Na componente empírica desta tese tomou-se uma amostra de 108 sujeitos de uma instituição privado do cento do Porto a frequentar o 2.º Ciclo do Ensino Básico. Durante dois anos os alunos desta instituição que iniciaram este ciclo de ensino no ano lectivo 2002/2003, participaram nas aulas de Estudo Acompanhado adoptando os manuais do projecto, propostos para o 5.º e 6.º anos de escolaridade. Os resultados obtidos apontam para um impacto positivo do projecto no primeiro ano diminuindo ao longo do 6.º ano. Não se verificam diferenças estatisticamente significativas entre os rapazes e as raparigas, tal como o tempo de estudo numa semana com ou sem exercícios escritos não difere com os níveis de percepção que os alunos têm dos seus processos auto-regulatórios. Relativamente ao rendimento escolar encontraram-se valores significativos na fase de execução do processo auto-regulatório na disciplina de Língua Portuguesa e Matemática ao nível do 5.ºano de escolaridade, e na fase de planificação do processo auto-regulatório na disciplina de Matemática no 6.ºano de escolaridade. Deste modo, os dados sugerem a necessidade de diversificar as amostras, as medidas e as metodologias de avaliação para concluir da eficácia do projecto., Nowadays, it’s possible to verify an increasing co-responsibility of the student in his own learning process, which constitutes the basis for the progressive acquisition on the part of the promotion of self-regulation of an intentional space in educational contexts, namely through the domain of “Supported Study”. The present study researches the promotion of self-regulation in learning and, more specifically, the effects of a psycho-educational project anchored in the use of the narrative as a tool to transmit and discuss learning strategies. This instructional tool was designed under the socialcognitive theoretical framework and constitutes an organizational proposal for the non-disciplinary curricular area of “Supported Study”. The review of the literature focused the definition of self-regulation in learning, the different theoretical perspectives that describe and explain this construct and its different components, with a particular emphasis conferred to the social-cognitive perspective. The nuclear elements that were considered in the promotion of self-regulation and the teacher’s role are also analysed. The structure and organization of the project are described, as well as some of the activities that were proposed. In what concerns the empirical component of this thesis, the sample was composed by 108 students attending the 2nd cycle of Elementary School in a private institution situated in the centre of Oporto. Students that initiated this cycle of studies in the school year of 2002/2003 participated for two years in the classes of “Supported Study”, adopting the manuals of the project that were proposed for the 5th and 6th grade. Results demonstrate a positive impact of the project in the first year, with a decrease during the 6th grade. No statistically significative differences were found taking the variable gender. Also, study time during a week, with or without written exercises, doesn’t differ taking into consideration the students’ perception of their own self-regulatory processes. In what concerns academic achievement, data show, in the first year, a statistically significative relation between the execution phase of self-regulated learning process and students’ academic achievement in Portuguese and Mathematics and, in the second year, a statistically significative relation between the planning phase of self-regulated learning process and students’ academic achievement in Mathematics. Consequently, the data suggest the need to diversify the samples, the measures and methodologies of evalution to conclude the efficacy of the project.

Aim: Quantify the extent of residual coronary disease after coronary bypass surgery (CABG) in very old patients (> 80) with multivessel disease and evaluate its impact on 1 year prognosis. Methods: Retrospective analysis from a single centre of 122 consecutive patients with ≥80 years of age undergoing isolated CABG between January 2005 and December 2010 (mean age 83±2; 63% men and 30% diabetics). We have identified 45 patients (37%) with complete revascularization (group A) and 77 patients (63%) with incomplete revascularization (group B). The baseline syntax score (SS), the residual syntax score after surgery (rSS) and the difference between the two syntax scores (Δ SS) were calculated. Kaplan Meier curves were used to compare the overall survival free from death and major cardiovascular events (MACCE: death, myocardial infarction, stroke and revascularization) at one year of follow-up. The area under the ROC curve (AUC) was used as a measure of discriminatory power of Syntax scores for MACCE and the test used to adjust the model was Hosmer-Lemeshow. Results: At one year follow-up (obtained in 96% of pts) freedom from primary composite end point was 79% (12,6% death, 9,0% myocardial infarction, 3,4% stroke and 0,8% revascularization). There were no differences in baseline clinical characteristics between the groups, which had similar surgical risk (median EuroSCORE II 3,91±2,8 vs 4,27±4,3; p=0,504). Group B patients showed a trend to higher rate of MACCE at 1 year (27,0 vs. 11,4; p=0,062), without differences in mortality (14,9 vs. 9,1; p=0,409). The subgroup analysis in the Kaplan-Meyer method revealed that MACCE was significantly lower in group A compared to group B (7,5% vs. 24,2% at 1 year, Log-rank p=0,033) and there was no difference in mortality between the two groups (5,0% vs. 12,1% at 1 year, Log-rank p=0,219). The SS and the ΔSS were not predictors of MACCE at 1 year (AUC: 0,51; 0,41-0,61; p=0,888; Hosmer Lemeshow: p=0,384) and (AUC: 0,56; 0,46-0,65; p0,406; Hosmer Lemeshow: p=0,904), respectively; the rSS showed a limited discriminatory power (AUC: 0,65; 0,55-0,74; p=0,049; Hosmer Lemeshow: p=0,292). Conclusions: The incomplete surgical revascularization in very old patients can be associated with more major cardiovascular events following. Further studies are needed to properly assess the impact of this strategy in this patient population.