Structural transformation in the product space: Patterns and implications

Product fundamentals are essential in explaining heterogeneity in the product space. The scope for adapting and transferring capabilities into the production of different goods determines the speed and intensity of the structural transformation process and entails dissimilar development opportunities for nations. Future specialization patterns become then partly determined by the current network of products’ relatedness. Building on previous literature, this paper explicitly compares methodological concepts of product connectivity to conclude in favor of the density measure we propose combined with the Revealed Relatedness Index (RRI) approach presented by Freitas and Salvado (2011). Overall, RRI specifications displayed more consistent behavior when different time horizons are equated

Adherence to antihypertensive therapy : analysis of initiation, implementation, discontinuation and possible risk factors in portuguese primary care units

ABSTRACT: RATIONALE AND BACKGROUND: Cardiovascular disease is a major cause of morbidity Worldwide, being responsible for up to 32% of all deaths in Portugal. Hypertension is highly prevalent and one of the major risk factors for cardiovascular disease. Over 42% of the Portuguese adults (18-90 years) would have hypertension. Even though the benefits of antihypertensive drugs in reducing the risk of major cardiovascular events have been extensively demonstrated, the control of hypertension continues to be inadequate. The precise reasons for patients not achieving target blood pressure despite being treated are not completely clear yet, but one major (and modifiable) reason is the fact that patients often do not only fail to take their medication as has been prescribed, but also fail to use it for a long uninterrupted period of time. A substantially poorer medication adherence rate is observed when analysing newly diagnosed patients, and accounting for those who fail to initiate treatment, fail to ever refill, and time after discontinue, rather than the more commonplace approach of only observing ongoing users. Conventional adherence measures therefore systematically underestimate the public health burden of poor medication adherence of newly prescribed medications. OBJECTIVE: The main objective of this thesis is to determine adherence to antihypertensive therapy in newly treated hypertensive patients in primary health care units from Lisbon and Tagus Valley Region. METHODS: This thesis reports data from a large, population-based, retrospective, cohort study that assessed adherence to antihypertensive therapy, in all its components, i.e., initiation, implementation and discontinuation, in newly diagnosed and treated hypertensive patients in primary health care units of Lisbon and Tagus Valley from January 1st to March 31st 2011 who used no antihypertensive drugs prior to January 1st 2011. We’ve also determined primary adherence rate to antihypertensive drugs, expressed as the number of claims records divided by the total number of prescriptions records. Data were collected from SIARS for each patient during a two-year period after the date of the first acquisition. Initiation was determined by the acquisition of a first prescription in a pharmacy within a six-month period. Implementation was quantified by estimation of Medication Possession Ratio and persistence was determined by the proportion of patients remaining on any antihypertensive drug regardless of switching or the use of multiple drugs during follow-up. Persistence was analysed considering a maximum allowed treatment gap of 90 days. Reinitiation was also analysed. Initiation and persistence were analysed by Kaplan-Meier survival analysis and Cox proportional hazard regression was used to estimate hazard ratios for initiation and discontinuation. Logistic regression was used to estimate the odds ratio for poor implementation of the prescribed AHT therapy. RESULTS: Overall primary adherence rate was 58.5%, increasing with age. Primary adherence rates were higher for men, patients living in the Lisbon Metropolitan Area and diagnosed with ICPC-2 code k87. Drugs acting on the Renin-angiotensin system had the highest primary adherence rates, increasing for fixed-dose combinations and diminishing with the increase of out-of-pocket cost for patients. Of the 10,204 cohort members, 493 (4.8%) never acquired any antihypertensive drug and 855 more (8.4%) initiated hypertension treatment with a considerable delay (six-months or longer) after the first prescription, being classified as ‘non-users’. After adjustment for all the potential predictors of initiation, women, and patients aged 45-64 years, who received an initial prescription of with two or more drugs had higher initiation rates. Among patients with a first dispensing (n=8,856), 638 (7.2%) patients discontinued antihypertensive therapy after acquiring just the first prescription and 519 more (5.9%) completely discontinued treatment during the first year, making a total of 1,157 (13.1%) patients who were no longer on treatment at the end of the first year. During the second year, 904 (10.2%) more discontinued antihypertensive therapy. However, in spite of 6,157 patients being still on treatment two years after the initiation of hypertension treatment, only 539 (8.8%) of them were classified as continuous users, i.e. had no treatment gap or grace period of 90 days or longer, meaning that the remaining 5,618 (91.2%) were using antihypertensive therapy in an ‘on and off’ basis, discontinuing and reinitiating it over time. The risk of complete discontinuation was higher for younger patients, treated with monotherapy and followed by a single physician. Analysing the implementation of hypertension treatment in the two-year observation period, among patients with a first dispensing only 456 (5.1%) had in their possession antihypertensive drugs for 80% or more days, regardless the occurrence of lapses in implementation, i.e. treatment gap or grace periods of 90 days or longer, which occurred in 233 (51.1%) of this patients with a high level of implementation. Younger patients and with a higher buying power had a higher risk for poor implementation. However, and in spite of increasing persistence, the use of more drugs during the follow-up decreased the medication possession ratio for this patients. CONCLUSION: The results of this thesis confirm previous observations that in clinical practice hypertension treatment is frequently abandoned and poorly implemented over time. Our results demonstrated that almost one out of five (19.5%) patients either never initiated treatment, did it with a considerable delay (after six months or more after their first prescription) or completely discontinued it just after acquiring their first antihypertensive drug, being the risk for discontinuation most pronounced during the first year. Low adherence rates to antihypertensive therapy, in all its components, are an especially alarming finding, since this condition contributes greatly to the burden of mortality and morbidity from cardiovascular disease in Portugal. Until this thesis, little was known in Portugal about adherence to antihypertensive therapy, especially at a population level. With this thesis we demonstrated not just the patterns of adherence to antihypertensive therapy but also some possible risk factors for non-adherence

The use of bone bridges in transtibial amputations

OBJETIVO: Descrever a técnica da osteoperiosteoplastia em adultos e apresentar a variação para a utilização em crianças, procurando demonstrar sua aplicabilidade como opção nas amputações transtibiais eletivas. CASUÍSTICA E MÉTODOS: O artigo apresenta um estudo prospectivo de 15 amputações transtibiais realizadas entre 1992 e 1995 em que se utilizou a técnica da osteoperiosteoplastia. A idade dos pacientes variou de 8 a 48 anos, com média de 22,53 anos. A técnica consistiu na confecção de um cilindro de periósteo retirado da tíbia, contendo fragmentos de osso cortical presos ao mesmo, para promover uma sinostose tibiofibular na extremidade distal do coto de amputação. Observou-se que os fragmentos de osso cortical eram dispensáveis quando a técnica foi empregada em crianças, pela maior capacidade osteogênica do periósteo. Isto levou a uma variação da técnica original, que consiste numa periosteoplastia sem a utilização de fragmentos de osso cortical. RESULTADOS: O tempo médio despendido com a técnica, sem variação significativa entre adultos e crianças, foi de 171 minutos. A adaptação da prótese definitiva dos pacientes foi obtida entre 20 e 576 dias, com média de 180 dias. Revisões da técnica empregada foram necessárias em três amputações (20%). CONCLUSÃO: A técnica encontra aplicação nas amputações transtibiais em que o comprimento final do coto seja próximo da transição musculotendínea do gastrocnêmio e nas revisões de cotos de amputação de crianças onde a técnica mostrou ser efetiva na prevenção das lesões decorrentes do excessivo crescimento ósseo.We sought to describe the bone bridge technique in adults, and present a variation for use in children, as well as to present its applicability as an option in elective transtibial amputations. This paper presents a prospective study of 15 transtibial amputations performed between 1992 and 1995 in which the bone bridge technique was employed. The patients' ages ranged from 8 to 48 years, with an average of 22.5 years. This technique consisted of the preparation of a cylinder of periosteum extracted from the tibia and with cortical bone fragments attached to it to promote a tibiofibular synostosis on the distal extremity of the amputation stump. We noted that the cortical bone fragments were dispensable when the technique was employed in children, due to the increased osteogenic capacity of the periosteum. This led to a variation of the original technique, a bone bridge without the use of the cortical bone fragments. RESULTS: The average time spent with this procedure, without any significant variation between adults and children, was 171 minutes. The adaptation to the definitive prosthesis was accomplished between 20 and 576 days, with an average of 180 days. Revision of the procedure was necessary in 3 amputations. CONCLUSIONS: This technique may be employed in transtibial amputations in which the final length of the stump lies next to the musculotendinous transition of the gastrocnemius muscle, as well as in the revision of amputation stumps in children, where the procedure has been shown to be effective in the prevention of lesions due to excessive bone growth

Incorporação de resíduos cerâmicos em argamassas de cal aérea sujeitas a condições severas de humidade e salinidade

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Civil na Área de Especialização de EdificaçõesA conservação do património edificado constitui nos dias de hoje uma prioridade. Torna-se assim fundamental o conhecimento da composição e comportamento dos revestimentos antigos, garantindo um elevado grau de c ompatibilidade entre materiais e adequabilidade das intervenções de conservação e reabilitação. Em Portugal existe um grande número de obras situadas junto da orla costeira. Apesar das condições de elevada humidade relativa e salinidade, estes revestimentos apresentam boa durabilidade. O estudo de viabilidade da reutilização de resíduos em argamassas ganhou uma nova dimensão, permitindo não só a diminuição dos impactes ambientais, provenientes da sua colocação em aterro, bem como redução do consumo de recursos naturais. Com o objetivo de explorar a viabilidade da incorporação de resíduos de azulejos cerâmicos vidrados em argamassas, destinadas à reabilitação de rebocos antigos sujeitos a condições severas de humidade e salinidade, foram for muladas argamassas de cal aérea com diferentes teores de substituição do ligante, submetidas a diferentes condições de cura. As argamassas formuladas foram sujeitas a cura laboratorial e em ambiente marítimo de elevada humidade e salinidade. Foi feita a caracterização física, química, mineralógica e mecânica de modo a avaliar o seu desempenho ao longo do tempo. Em muitas propriedades estudadas verificou -se a melhoria do desempenho das argamassas, devido à substituição da cal pelo pó cerâmico.Abstract: The conservation of the built patrimony is a priority. Knowing the composition of ancient mortars is essential to guarantee a high compatibility degree between materials. Portugal has a large number of constructions along the coast line. Despite the high humidity and soluble salts, ancient mortars demonstrate good performance and durability. The main subject of this work is to evaluate the viability of incorporating glazed ceramic residues in air lime repair mortars, subjected to sea environment. The studied formulations were based in air lime mortars with partial substitutions of lime weight by the ceramic residue, exposed to sea environment curing conditions. The reuse of construction and industrial residues in mortars allows the decrease of environmental impacts from their placement in embankment, and the reduction of consumption of the natural resources. The studied formulations were exposed to different curing conditions, in laboratory and in sea environment. The mortars were evaluated with physical, chemical and mineralogical tests over time. The partial substitution of the lime for the ceramic residue improved many of the studied properties

Cooperação descentralizada e participativa entre Portugal e Moçambique: o exemplo do município da Matola

Mestrado em Desenvolvimento e Cooperação InternacionalO surgimento de novos actores, para além dos Estados, contribuiu para uma adaptação e consequente evolução no panorama da cooperação para o desenvolvimento. Neste âmbito, a cooperação intermunicipal, uma tipologia de cooperação descentralizada, corresponde ao estabelecimento de relações entre duas ou mais comunidades, tendo como principais actores os Municípios ou seus equivalentes, de acordo com o sistema de organização administrativo dos países, podendo assumir várias formas, a saber: geminações, protocolos, acordos de cooperação e redes. Num país como Moçambique, um dos mais pobres do mundo, o Município da Matola, onde está concentrado o maior parque industrial do país, é considerado um laboratório para aferir o grau de sucesso, quer da própria experiência de descentralização em Moçambique, quer das possibilidades que os projectos de cooperação intermunicipal encerram, nomeadamente com o Município de Loures (Portugal). À procura de soluções locais, integradas e sustentáveis, de desenvolvimento, fruto da emergência da própria sociedade civil moçambicana e da consequente proliferação de ONG nacionais e estrangeiras, e de uma dinâmica crescente que cruza diferentes sectores da população, pretende-se associar o reforço dos laços entre os municípios como um factor de sucesso, em termos de sustentabilidade dos projectos de desenvolvimento, numa abordagem bottom-up, em virtude de uma maior participação das comunidades e da integração de diferentes entidades na concepção, implementação e avaliação dos mesmos.The emergence of new actors, besides states, has contributed to an adaptation, and consequent evolution on development cooperation. In this sense, inter-municipal cooperation, a form of decentralised cooperation, entails the establishment of relations between two or more communities where the main actors are the Municipal Councils or their equivalent, in accordance with the organisational system of the involved countries. This cooperation can take on the forms of twinning, protocols, cooperation agreements, and networks. In a country like Mozambique, one of the poorest in the world, the Community of Matola, where it is concentrated the most important industrial centre in the country, is considered a laboratory to assess the success level, on the decentralisation process experience in Mozambique, and on the possibilities of inter-municipal cooperation projects, above all with the Community of Loures (Portugal). Joining the look for local, integrated and sustainable solutions of development, as a result of the emergence of the Mozambican civil society, and consequently of the proliferation of national and foreigner NGOs, and of a dynamic which cuts different sectors of the population; there's the enforcement of the links between the local communities as a factor of success, in terms of sustainability of the development projects, in a bottom-up approach, because of the larger participation of communities and the integration of different entities in mutually conception, implementation, and evaluation of the projects

EDUCAÇÃO ESCOLAR PARA TODOS! : e as diferenças?

Neste texto, os autores apresentam e discutem conceitos produzidos sobre a educação escolar, as diferenças e os sujeitos, problematizando a influência desses discursos nas propostas de currículos, finalidades e práticas para a educação. As análises são fundamentadas em pesquisa teórico-bibliográfica realizada com a orientação de estudos pós-críticos, que permitem modos alternativos de olhar para a educação, compreendendo-a como fenômeno histórico e social produtor de práticas discursivas que circunscrevem os sujeitos, os saberes em uma ordem estabelecida, que define e marca as diferenças na relação com uma identidade requerida. Discutem a constituição do ideal de educação escolar para todas as pessoas, problematizando os discursos históricos e filosóficos sobre as finalidades da formação humana para a autonomia e cidadania. Também problematizam o conceito de diferença e de discursos que forjam essa diferença, com base no pensamento de Gilles Deleuze em diálogo com Michel Foucault. A educação escolar é posta em análise para confrontar os discursos que fundamentam seus currículos e práticas, produzindo identidades e diferenças.In this text, the authors present and discuss concepts produced about school education, differences and subjects, questioning the influence of these discourses on curriculum proposed, purposes and practices for education. The analyzes are based on theoretical-bibliographic research carried out with the guidance of post-critical studies, which allow alternative ways of looking at education, understanding it as a historical and social phenomenon that produces discursive practices that circumscribe the subjects, the knowledge in a established order, which defines and marks the differences in the relationship with a required identity. They discuss the constitution of the ideal of school education for all people, questioning the historical and philosophical discourses about the purposes of human formation for autonomy and citizenship. They also problematize the concept of difference and the discourses that forge this difference, based on the thinking of Gilles Deleuze in dialogue with Michel Foucault. School education is analyzed in order to confront the discourses discourses that support its curriculum and practices, producing identities and differences

Turismo de eventos: festivais temáticos Viking Euro-região da Galiza e Norte de Portugal

Dissertação de mestradoOs guerreiros nórdicos denominados de “Vikings” deixaram marca na Europa e até aos nossos dias seguiram-se testemunhos da sua expressão literária, influenciados pela sua característica misteriosa e incerta. A comunidade científica tem desconstruído ideias construídas sobre o imaginário popular. Atrações turísticas podem ser vistas como uma ferramenta lúdica, mas também pedagógica, através das atividades que protagonizam. Nessa perspetiva, serão os festivais temáticos Viking culturalmente sustentáveis? Objetivo - O objetivo principal deste estudo consiste em examinar a sustentabilidade na oferta de festivais temáticos viking na Euro-região da Galiza e Norte de Portugal. A investigação vigente pretende identificar as práticas sustentáveis recomendadas e praticadas na produção de Festivais Temáticos Viking e consequentemente avaliar a performance dos Festivais através dos indicadores de sustentabilidade cultural no contexto conservador. Metodologia - Na presente investigação, o método qualitativo foi a metodologia adotada para este estudo. Foi utilizado como instrumento de estudo entrevistas semiestruturadas. Deste modo foram realizadas nove entrevistas, a 3 animadores socioculturais, 3 organizadores de eventos/representantes do festival, 2 especialistas em estudos nórdicos e 1 em estudos de festivais vikings na euro-região da Galiza e Norte de Portugal. Limitações e investigações futuras – Desde o início compreendeu-se que pelo facto de esta investigação ser pioneira no estudo de Festivais Temáticos Viking no território explorado iria debater-se com a inexistência de recursos específicos relativos ao objeto de estudo, como literatura e estudos empíricos. Contrapondo por exemplo com a densa narrativa e documentos bibliográficos sobre a cultura nórdica (viking). Consequentemente a condução da investigação foi direcionada de forma mais ampla e subjetiva no sentido de compreender a lógica e performance dos festivais. O contacto mais próximo com um maior número de participantes neste estudo foi outro entrave registado. As entrevistas foram realizadas por videoconferência o que minimizou a informação pretendida. Foram igualmente registados cortes de conexão durante as entrevistas. A pandemia também resultou na dificuldade em contactar com entidades de cariz internacional como projetos de voluntariado nas atrações turísticas de memória Viking. Como oportunidades de estudos futuros o autor denotou a necessidade do estudo específico de outros stakeholders, sobretudo na sua atitude e participação nos festivais assim como relativamente ao estudo das motivações intrínsecas dos turistas na procura deste tipo de turismo.The Nordic warriors called "Vikings" left their trace in Europe, and to this day there have been testimonies of their literary expression, influenced by their mysterious and uncertain characteristics. The scientific community has deconstructed preconceived ideas from the popular imagination. Tourist attractions can be seen as an entertaining but also pedagogical tool through the activities they feature. From this perspective, are Viking-themed festivals culturally sustainable? Goals - The main objective of this study is to examine sustainability in the production of Viking Theme Festivals in the Euro-region of Galicia and Northern Portugal. The current research aims to identify the sustainable practices recommended and performed in the production of Viking Theme Festivals and consequently to evaluate the performance of the festivals through the indicators of cultural sustainability in the conservative context. Methodology - In the present research, the qualitative method was the instrument used for this study through semi-structured interviews. Thus, nine interviews were conducted, to 3 socio-cultural animators, 3 event organizers/festival representatives, 2 specialists in Nordic studies and 1 in Viking festival studies in the Euro-region of Galicia and Northern Portugal. Limitations and future research - From the beginning it was understood that because this research was pioneering in the study of Viking themed festivals in the explored territory it would be faced with a lack of specific resources related to the object of study, such as literature and empirical studies. Contrasting for example with the dense narrative and literature papers on Nordic (Viking) culture. Consequently, the research was more broadly and subjectively directed towards understanding the logic and performance of the festivals. Closer contact with a larger number of participants in this study was another constraint. The interviews were conducted by videoconference which minimized the information required. Disconnections were also recorded during the interviews. The pandemic also resulted in difficulty in contacting entities of an international nature such as volunteer projects at Viking memory tourist attractions. As opportunities for future studies the author denoted the need for the specific study of other stakeholders, especially in their attitude and participation in the festivals as well as regarding the study of the intrinsic motivations of tourists in seeking this new type of tourism

The role of Dark Matter interaction in galaxy clusters

We consider a toy model to analyze the consequences of dark matter interaction with a dark energy background on the overall rotation of galaxy clusters and the misalignment between their dark matter and baryon distributions when compared to {\Lambda}CDM predictions. The interaction parameters are found via a genetic algorithm search. The results obtained suggest that interaction is a basic phenomenon whose effects are detectable even in simple models of galactic dynamics.Comment: RevTeX 4.1, 5 pages, 3 figure

Deep dense and convolutional autoencoders for machine acoustic anomaly detection

Recently, there have been advances in using unsupervised learning methods for Acoustic Anomaly Detection (AAD). In this paper, we propose an improved version of two deep AutoEncoders (AE) for unsupervised AAD for six types of working machines, namely Dense and Convolutional AEs. A large set of computational experiments was held, showing that the two proposed deep autoencoders, when combined with a mel-spectrogram sound preprocessing, are quite competitive and outperform a recently proposed AE baseline. Overall, a high-quality class discrimination level was achieved, ranging from 72% to 92%.European Structural and Investment Funds in the FEDER component, through the Operational Competitiveness and Internationalization Programme (COMPETE 2020) - Project n ∘ 039334; Funding Reference: POCI-01-0247-FEDER-039334

Accessibility Evaluation of E-Government Mobile Applications in Brazil

AbstractThe provision of e-government services using mobile applications (known as m-government) has had a significant growth in recent years. However, it is very important that such applications be accessible to people with disabilities in order to ensure inclusive access. Using appropriate accessibility auditing methods is very important to help identify accessibility problems in interactive systems during their development. However, there has been little support in terms of formal standard accessibility guidelines to help develop and evaluate mobile applications. In this paper, we present a case study with the evaluation of four e-government mobile applications in Brazil using the Web Content Accessibility Guidelines (WCAG) 2.0. The paper discusses the methodological adaptations of WCAG 2.0 for the context of mobile applications and its current limitations. The results of the evaluations performed in the four applications in the case study showed that many elementary accessibility problems widely known by HCI researchers were encountered extensively in the applications evaluated. This highlights the importance of furthering research in accessibility design and evaluation of mobile applications, in order to provide more inclusive access to essential applications used by all citizens, such as e-government services