Implementação de um Sistema de Gestão Integrado numa Empresa do Setor Alimentar

O presente trabalho de investigação está inserido no âmbito da unidade curricular Dissertação/Projeto/Estágio do 2ºano do Mestrado em Engenharia mecânica – Ramo Gestão Industrial do Instituto Superior de Engenharia do Porto. Este trabalho foi desenvolvido em ambiente empresarial e tem como principal desafio a idealização de um sistema de gestão integrado de desempenho. Este sistema envolveu a aplicação de um modelo de referência idealizado no contexto da empresa em estudo. O objetivo deste modelo é o auxílio à tomada de decisão por parte dos diversos intervenientes do sistema. Os sistemas de gestão de desempenho integrados são, cada vez mais, cruciais para o sucesso das empresas, uma vez que permitem a análise dos diversos fatores que contribuem para o alcance dos objetivos propostos. Estes sistemas de gestão de desempenho permitem ainda, ao utilizador, uma tomada de decisão ágil e baseada em evidências. O projeto iniciou-se com uma pesquisa bibliográfica dos conceitos Kaizen seguida da integração na empresa. Paralelamente a uma pesquisa bibliográfica focada na gestão de desempenho, foi feito o levantamento dos indicadores de desempenho presentes na empresa e as suas necessidades ao nível do controlo de desempenho. Foi então desenvolvido um modelo de referência que tem por base a organização dos indicadores de desempenho com o intuito de auxiliar a tomada de decisão. Finalmente aplicou-se o modelo de referência ao caso em estudo. A aplicação do modelo em contexto da empresa permite definir ações de melhoria para a resolução de problemas identificados pelos indicadores definidos. O culminar do projeto resulta na apresentação de um modelo de referência para a gestão de desempenho baseado na organização dos indicadores de desempenho, com o intuito de auxiliar a tomada de decisão. É também apresentada a aplicação do modelo no contexto da empresa em análise.This paper is based on the discipline of Dissertation/Project/Internship of the Master’s degree in Industrial Management of the mechanical engineering department of Instituto Superior de Engenharia do Porto. The project was developed while working in a company and its main objective is the development and implementation of a performance management system. The focus of this model is to help the various stakeholders in the decision making process. The integrated management systems are getting more and more vital to the company success, because the allow the analysis of the factors that contribute to the achievement of the proposed objectives. These systems also allow a quicker decision making process. This Project started with a bibliographic research on the Kaizen methodology, followed by the first contact with the company in analysis. While doing the research on performance management and existing reference models, a study was made in the company with the objective of learning the existing performance measures, and the company’s needs at the performance control level. It was then developed que reference model that is based on the organization of performance indicators in order to achieve a better decision making process. This reference model was then applied to the company. This application allowed the selection of improvement in order to solve the problems Identified The project ends with the presentation of a reference model based on the organization of performance indicators, that facilitates the decision making process. It is also presented the application of the model in the company in study

Common genetic polymorphisms in the ABCB1 gene are associated with risk of major depressive disorder in male Portuguese individuals

Major depressive disorder (MDD) is a highly prevalent disorder, which has been associated with an abnormal response of the hypothalamus–pituitary–adrenal (HPA) axis. Reports have argued that an abnormal HPA axis response can be due to an altered P-Glycoprotein (P-GP) function. This argument suggests that genetic polymorphisms in ABCB1 may have an effect on the HPA axis activity; however, it is still not clear if this influences the risk of MDD. Our study aims to evaluate the effect of ABCB1 C1236T, G2677TA and C3435T genetic polymorphisms on MDD risk in a subset of Portuguese patients. DNA samples from 80 MDD patients and 160 control subjects were genotyped using TaqMan SNP Genotyping assays. A significant protection for MDD males carrying the T allele was observed (C1236T: odds ratio (OR) = 0.360, 95% confidence interval [CI]: [0.140– 0.950], p = 0.022; C3435T: OR= 0.306, 95% CI: [0.096–0.980], p = 0.042; and G2677TA: OR= 0.300, 95% CI: [0.100– 0.870], p = 0.013). Male Portuguese individuals carrying the 1236T/2677T/3435T haplotype had nearly 70% less risk of developing MDD (OR = 0.313, 95% CI: [0.118–0.832], p = 0.016, FDR p = 0.032). No significant differences were observed regarding the overall subjects. Our results suggest that genetic variability of the ABCB1 is associated with MDD development in male Portuguese patients. To the best of our knowledge, this is the first report in Caucasian samples to analyze the effect of these ABCB1 genetic polymorphisms on MDD risk

The role of IL18-607C > A and IL18-137G > C promoter polymorphisms in antidepressant treatment phenotypes: A preliminary report

Recent studies suggest that immune activation and cytokines, such as IL-18, are involved in depression. IL-18 is expressed in brain and is increased in patients with moderate to severe depression. In this study we aim to evaluate the role of IL18-607C > A and IL18-137G > C promoter polymorphisms in antidepressant treatment phenotypes, specifically relapse and treatment resistant depression (TRD). We genotyped the referred polymorphisms in a subset of 80 MDD patients followed at Hospital Magalhães Lemos, Portugal, within a period of 27 months. Patients carrying IL18-607 CA or AA genotypes were significantly more prone to relapse after AD treatment and present a significantly lower time to relapse than patients carrying CC genotype. Similarly, patients carrying IL18-137 GC or CC genotypes have a significantly higher risk of relapse and display relapse significantly earlier than the ones carrying GG genotype. Due to the low number of IL18-607 CC and IL18-137 GG in the relapse subgroup (n = 3 and n = 5, respectively), results were validated by bootstrapping analysis, and remained significant. No association was found between the evaluated genetic polymorphisms and TRD. IL18 peripheral mRNA levels were upregulated in IL18-607 CA or AA carriers. This preliminary report indicates that IL18-607C > A and IL18-137G > C genetic polymorphisms seem to influence depression relapse after antidepressant treatment in our subset of depressed patients, and may possibly contribute to the disregulated IL-18 levels found in patients with depression.info:eu-repo/semantics/publishedVersio

IL6-174G > C genetic polymorphism influences antidepressant treatment outcome

Background: Major depressive disorder is a condition associated with dysregulated cytokine levels; among these, IL6. Furthermore, genetic variations within cytokine genes have been proposed to predict antidepressant treatment outcome. Objectives: This study aims to evaluate the role of IL6-174G > C and IL6R D358A A > C functional poly-morphisms in antidepressant treatment phenotypes, specifically remission, relapse, and treatment resistant depression (TRD). Methods: The referred polymorphisms were genotyped in 80 MDD patients followed at Hospital Magalh~aes Lemos, Portugal, within a period of 27 months. Results: It was found that patients carrying IL6-174 GC genotype present a protection towards the development of TRD (OR ¼ 0.242; 95% CI ¼ 0.068–0.869; p ¼ .038), when compared with GG genotype. Additionally, carriers of IL6-174 CC genotype remit earlier than patients with IL6-174 GG/GC genotypes, with a median time to remission of 6 weeks for CC carriers and 15 weeks for GG or GC carriers (p ¼ .030, Log-rank test). No association was found between IL6R D358A genetic polymorphism and any of the treatment phenotypes evaluated. Conclusions: The IL6-174G > C polymorphism influences antidepressant treatment outcome in this sub-set of MDD patients, providing a putative mechanistic link for the dysregulated IL-6 levels described in the literature in patients with TRD.info:eu-repo/semantics/publishedVersio

Determinants of HIV late presentation among men who have sex with men in Portugal (2014–2019): who’s being left behind?

Introduction: HIV late presentation (LP) remains excessive in Europe. We aimed to analyze the factors associated with late presentation in the MSM population newly diagnosed with HIV in Portugal between 2014 and 2019. Methods: We included 391 newly HIV-1 diagnosed Men who have Sex with Men (MSM), from the BESTHOPE project, in 17 countrywide Portuguese hospitals. The data included clinical and socio-behavioral questionnaires and the viral genomic sequence obtained in the drug resistance test before starting antiretrovirals (ARVs). HIV-1 subtypes and epidemiological surveillance mutations were determined using different bioinformatics tools. Logistic regression was used to estimate the association between predictor variables and late presentation (LP). Results: The median age was 31 years, 51% had a current income between 501-1,000 euros, 28% were migrants. 21% had never been tested for HIV before diagnosis, with 42.3% of MSM presenting LP. 60% were infected with subtype B strains. In the multivariate regression, increased age at diagnosis, higher income, lower frequency of screening, STI ever diagnosed and higher viral load were associated with LP. Conclusion: Our study suggests that specific subgroups of the MSM population, such older MSM, with higher income and lower HIV testing frequency, are not being targeted by community and clinical screening services. Overall, targeted public health measures should be strengthened toward these subgroups, through strengthened primary care testing, expanded access to PrEP, information and promotion of HIV self-testing and more inclusive and accessible health services.info:eu-repo/semantics/publishedVersio

HIV-1-Transmitted Drug Resistance and Transmission Clusters in Newly Diagnosed Patients in Portugal Between 2014 and 2019

Objective: To describe and analyze transmitted drug resistance (TDR) between 2014 and 2019 in newly infected patients with HIV-1 in Portugal and to characterize its transmission networks. Methods: Clinical, socioepidemiological, and risk behavior data were collected from 820 newly diagnosed patients in Portugal between September 2014 and December 2019. The sequences obtained from drug resistance testing were used for subtyping, TDR determination, and transmission cluster (TC) analyses. Results: In Portugal, the overall prevalence of TDR between 2014 and 2019 was 11.0%. TDR presented a decreasing trend from 16.7% in 2014 to 9.2% in 2016 (p for-trend = 0.114). Multivariate analysis indicated that TDR was significantly associated with transmission route (MSM presented a lower probability of presenting TDR when compared to heterosexual contact) and with subtype (subtype C presented significantly more TDR when compared to subtype B). TC analysis corroborated that the heterosexual risk group presented a higher proportion of TDR in TCs when compared to MSMs. Among subtype A1, TDR reached 16.6% in heterosexuals, followed by 14.2% in patients infected with subtype B and 9.4% in patients infected with subtype G. Conclusion: Our molecular epidemiology approach indicates that the HIV-1 epidemic in Portugal is changing among risk group populations, with heterosexuals showing increasing levels of HIV-1 transmission and TDR. Prevention measures for this subpopulation should be reinforced.info:eu-repo/semantics/publishedVersio

Influence of il6-174g>c, il6-6331t>c and il6r d358a a>c il-6 genetic polymorphisms in antidepressant treatment phenotypes

Several studies associated Major Depressive Disorder (MDD) with an increased production of pro-inflammatory cytokines, such as interleukin 6 (IL-6). Serum IL-6 levels were found to be significantly increased in subjects with MDD and with Treatment Resistant Depression (TRD). Moreover, ketamine, a drug with fast-acting antidepressant properties, has proven to reduce IL-6 levels in rat prefrontal cortex and hippocampus. However, despite the clear influence of IL-6 in the pathophysiology of depression and in antidepressant response, studies evaluating the impact of IL-6 functional genetic polymorphisms on treatment response phenotypes are scarce.info:eu-repo/semantics/publishedVersio

Role of pharmacogenomics in predicting antidepressant response and individualizing therapy

Major Depressive Disorder (MDD) is a highly prevalent chronic psychiatric condition with significant morbidity. Despite several antidepressants drugs (AD) available, a wide fraction of patients fail to respond, present relapse or display treatment resistant depression (TRD). Pharmacogenomics could help identify patients at risk of relapse or TRD and possibly have a direct impact on personalizing therapy. Additionally, recent studies suggested that immune activation and cytokines may be involved in depression, and its normalization occurs after antidepressant treatment. The proinflammatory cytokines interleukin-18 (IL-18) and IL-6 are less reported in depression, but considered to be relevant since they have been found to be increased in patients with depression.info:eu-repo/semantics/publishedVersio

Influence of common ABCB1 genetic polymorphisms in the risk of Major Depressive Desorder and ntidepressant treatment phenotypes

Major depressive Disorder (MDD) is a highly prevalent disorder, which has been associated with na abnormal response of hypothalamus-pituitary-adrenal (HPA) axis.info:eu-repo/semantics/publishedVersio