Hospital efficiency: directed internship: Deloitte & NOVA SBE

A Work Project, presented as part of the requirements for the Award of a Masters Degree in Economics from the NOVA – School of Business and EconomicsIn a context of economic recession, where resource scarcity follows every manager, efficiency is the only way out. Health Care is no exception. Continuous budgetary cuts from central authorities led to increasing pressures in hospital managers to achieve efficient results. In light of being able to quantify efficiency, this work project has the aim of identifying the best of two frontier based analysis (Stochastic Frontier Analysis and Data Envelopment Analysis) by performing efficiency estimations for a single year using variables from the Portuguese reality, allowing the identification of inefficiency sources. Efficiency scores will be obtained to compare hospitals for efficiency ranks and several efficiency-seeking suggestions will be stated in the end. The scores obtained from the estimations show that some hospitals still have a rough path to endure if they are to achieve economic efficiency. From the analysis we can see that efficient hospitals vary for each model. (8 in SFA [hospitals with a score higher than 0.95] and 17 in DEA). Estimation outputs suggest that changes in hospital size or services provided should occur in order to achieve higher efficiency, which is in light with the presently taken health policies

Host Adaptation Is Contingent upon the Infection Route Taken by Pathogens

Evolution of pathogen virulence is affected by the route of infection. Also, alternate infection routes trigger different physiological responses on hosts, impinging on host adaptation and on its interaction with pathogens. Yet, how route of infection may shape adaptation to pathogens has not received much attention at the experimental level. We addressed this question through the experimental evolution of an outbred Drosophila melanogaster population infected by two different routes (oral and systemic) with Pseudomonas entomophila. The two selection regimes led to markedly different evolutionary trajectories. Adaptation to infection through one route did not protect from infection through the alternate route, indicating distinct genetic bases. Finally, relatively to the control population, evolved flies were not more resistant to bacteria other than Pseudomonas and showed higher susceptibility to viral infections. These specificities and trade-offs may contribute to the maintenance of genetic variation for resistance in natural populations. Our data shows that the infection route affects host adaptation and thus, must be considered in studies of host-pathogen interaction.FCT fellowships: (#SFRH/BPD/62964/2009, #SFRH/BD/82299/2011), Instituto Gulbenkian de Ciência/Fundação Calouste Gulbenkian

Host adaptation to viruses relies on few genes with different cross-resistance properties

The deposited article is a post-print version and has peer review. This deposit is composed by the main article, and it hasn't any supplementary materials associated. The supplementary materials of the publication are only present in the editor's page of this article. This publication hasn't any creative commons license associated.Host adaptation to one parasite may affect its response to others. However, the genetics of these direct and correlated responses remains poorly studied. The overlap between these responses is instrumental for the understanding of host evolution in multiparasite environments. We determined the genetic and phenotypic changes underlying adaptation of Drosophila melanogaster to Drosophila C virus (DCV). Within 20 generations, flies selected with DCV showed increased survival after DCV infection, but also after cricket paralysis virus (CrPV) and flock house virus (FHV) infection. Whole-genome sequencing identified two regions of significant differentiation among treatments, from which candidate genes were functionally tested with RNAi. Three genes were validated--pastrel, a known DCV-response gene, and two other loci, Ubc-E2H and CG8492. Knockdown of Ubc-E2H and pastrel also led to increased sensitivity to CrPV, whereas knockdown of CG8492 increased susceptibility to FHV infection. Therefore, Drosophila adaptation to DCV relies on few major genes, each with different cross-resistance properties, conferring host resistance to several parasites.Fundação para a Ciência e a Tecnologia grants: (SFRH/BPD/62964/2009, SFRH/BD/82299/2011, PTDC/SAU-IMU/120673/2010); Austrian Science Fund grants: (P22725, P19467); European Research Council grant: (ArchAdapt); Instituto Gulbenkian de Ciência/Fundação Calouste Gulbenkian; Vetmeduni.info:eu-repo/semantics/publishedVersio

Comportamento mecânico de sistemas de reforço de paredes de alvenaria

Na presente dissertação analisa-se o comportamento mecânico de reforços de paredes de alvenaria de pedra. As paredes de alvenaria de edifícios antigos necessitam frequentemente de ser reforçadas, para melhorar a capacidade resistente desses edifícios, em particular às ações sísmicas. Elabora-se uma pesquisa bibliográfica, trabalhos de campo e estudam-se trabalhos de referência experimentais. Apresenta-se neste trabalho um estudo experimental, em que se analisa o comportamento de um modelo de alvenaria de pedra irregular, reforçado com um revestimento de argamassa bastarda, que integra uma rede de fibras de vidro e confinamento transversal constituído por fitas de aço inox. Realiza-se a modelação numérica de muretes de alvenaria ordinária com o programa SAP2000. Pretende-se assim analisar a distribuição de esforços e das deformações de uma estrutura em alvenaria

Evolution of Drosophila resistance against different pathogens and infection routes entails no detectable maintenance costs

The deposited article is a post-print version and has peer-review. The deposited article version contains attached the supplementary materials within the pdf. This publication hasn't any creative commons license associated.Pathogens exert a strong selective pressure on hosts, entailing host adaptation to infection. This adaptation often affects negatively other fitness-related traits. Such trade-offs may underlie the maintenance of genetic diversity for pathogen resistance. Trade-offs can be tested with experimental evolution of host populations adapting to parasites, using two approaches: (1) measuring changes in immunocompetence in relaxed-selection lines and (2) comparing life-history traits of evolved and control lines in pathogen-free environments. Here, we used both approaches to examine trade-offs in Drosophila melanogaster populations evolving for over 30 generations under infection with Drosophila C Virus or the bacterium Pseudomonas entomophila, the latter through different routes. We find that resistance is maintained after up to 30 generations of relaxed selection. Moreover, no differences in several classical life-history traits between control and evolved populations were found in pathogen-free environments, even under stresses such as desiccation, nutrient limitation, and high densities. Hence, we did not detect any maintenance costs associated with resistance to pathogens. We hypothesize that extremely high selection pressures commonly used lead to the disproportionate expression of costs relative to their actual occurrence in natural systems. Still, the maintenance of genetic variation for pathogen resistance calls for an explanation.Fundação para a Ciência e a Tecnologia grants: (#SFRH/BD/82299/2011, #SFRH/BPD/62964/2009); Instituto Gulbenkian de Ciência; Fundação Calouste Gulbenkian.info:eu-repo/semantics/publishedVersio

Diagnosis of Bovine Digital Dermatitis: Exploring the Usefulness of Indirect ELISA

The precision by which animal diseases are diagnosed affects our ability to make informed decisions with regards to animal health management, from a clinical and economic perspective. Lameness is a major health condition in dairy cattle. The underlying causes of lameness include bovine digital dermatitis (BDD), which is reported as one of the main causes of infectious lameness in dairy cattle. Presently, the gold standard for BDD diagnosis in dairy cattle is visual inspection of lifted hooves—a labour intensive and subjective method. Research has suggested that Treponema spp. are the main pathogens associated with the establishment of BDD. We explored the potential of indirect enzyme-linked immunosorbent assay (ELISA) as a diagnostic serological tool in the identification of cows at different stages of BDD. Additionally, we evaluated the predictive power of this diagnostic tool on the future occurrence of BDD lesions. A total of 232 cows from three farms were used in the study. Serum samples and hoof health data were collected at three time points: ~ 30 days pre-calving, around calving, and approximately 30 days post-calving. The mean absorbance from the ELISA test was compared across different clinical presentations of BDD as assessed by visual inspection of the hooves according to the M-stage classification system. A transition model was developed to estimate the probability of lesion occurrence in time t + 1 based on the spectrophotometer (absorbance) reading in time t. The mean absorbance reading for both IgG1 and IgG2 anti-Treponema antibodies was associated with disease presence—apart from M4.1 lesions, animals with no lesions had a lower mean when compared to animals with lesions regardless of the score. Additionally, the mean absorbance reading of animals with active lesions was higher when compared to animals with no lesions. However, the anti-Treponema antibody assays failed to identify disease presence in a consistent manner. Moreover, indirect ELISA readings were not a predictor of the future occurrence of BDD lesions. In conclusion, although the levels anti-Treponema antibodies were associated with disease presence, the ELISA test failed to detect disease unequivocally and had no predictive value in the future occurrence of BDD lesions

Alternative Splicing and Gene Duplication in the Evolution of the FoxP Gene Subfamily

The FoxP gene subfamily of transcription factors is defined by its characteristic 110 amino acid long DNA-binding forkhead domain and plays essential roles in vertebrate biology. Its four members, FoxP1–P4, have been extensively characterized functionally. FoxP1, FoxP2, and FoxP4 are involved in lung, heart, gut, and central nervous system (CNS) development. FoxP3 is necessary and sufficient for the specification of regulatory T cells (Tregs) of the adaptive immune system

Ocorrência e estrutura de nectários extraflorais em Pterodon pubescens Benth. e em Pterodon polygalaeflorus Benth

Nectários extraflorais (NEFs) são estruturalmente variáveis e de ampla ocorrência entre as angiospermas. A ocorrência dos NEFs nas folhas de Pterodon polygalaeflorus Benth. e Pterodon pubescens Benth. (Fabaceae: Papilionoideae) foi detectada em espécimes adultas, durante a produção de novas gemas e flores. Os objetivos deste estudo foram registrar a ocorrência de NEFs em P. pubescens e P. polygalaeflorus, e fornecer dados comparativos sobre a estrutura anatômica destas estruturas. Os NEFs ocorrem na raque e estão localizados sob a inserção de cada peciólulo. Cada nectário consiste de uma pequena elevação cuja porção apical é fortemente invaginada, resultando em uma depressão (o pólo secretor), característica comum a ambas as espécies. Tricomas tectores unicelulares ocorrem ao longo da raque, sendo menos numerosos em P. polygalaeflorus, enquanto em P. pubescens eles cobrem todo o NEF. O tecido secretor consiste de células parenquimáticas com citoplasma denso. O néctar alcança a superfície dos NEFs pela ruptura da fina cutícula que cobre o pólo secretor, uma vez que ambas as espécies não apresentam estômatos ou qualquer outra interrupção da epiderme neste local. A diferença básica entre as duas espécies, em relação aos NEFs, é a densidade da pubescência, que é sempre maior em P. pubescens. Modificações estruturais e de dimensões podem ser observadas até mesmo entre os nectários basais e apicais de uma mesma raque, e portanto tais modificações não apresentam valor taxonômico.Extrafloral nectaries (EFNs) are structurally variable and widely spread among the angiosperms. The occurrence of EFNs in leaves of Pterodon polygalaeflorus Benth. and Pterodon pubescens Benth. (Fabaceae: Papilionoideae) were detected in adult specimens, at the time of production of new buds and flowers. The goals of the present study are to register the occurrence of the EFNs in P. pubescens and P. polygalaeflorus, and provide comparative data on the anatomical structures. The EFNs occur in the rachis and are located under the insertion of each petiolule. Each nectary consists of a small elevation whose apical portion is deeply invaginated, resulting in a depression (secretory pole), a common characteristic of both species. Unicellular, nonglandular trichomes occur along the rachis, being less numerous in P. polygalaeflorus while in P. pubescens they cover the EFNs. The secretory tissue consists of parenchyma cells with dense cytoplasm compactly arranged. The nectar reaches the surface of the EFNs by rupturing the thin cuticle which covers the secretory pole, since both species lack stomata or any other interruption at the epidermis. The basic difference between the two species, in relation to the EFNs, is the density of the pubescence, which is always greater in P. pubescens. Structural and dimensional modifications may be observed, even between basal and apical nectaries in the same rachis, so it does not constitute a taxonomical tool

Recurrent Modification of a Conserved Cis-Regulatory Element Underlies Fruit Fly Pigmentation Diversity

The development of morphological traits occurs through the collective action of networks of genes connected at the level of gene expression. As any node in a network may be a target of evolutionary change, the recurrent targeting of the same node would indicate that the path of evolution is biased for the relevant trait and network. Although examples of parallel evolution have implicated recurrent modification of the same gene and cis-regulatory element (CRE), little is known about the mutational and molecular paths of parallel CRE evolution. In Drosophila melanogaster fruit flies, the Bric-à-brac (Bab) transcription factors control the development of a suite of sexually dimorphic traits on the posterior abdomen. Female-specific Bab expression is regulated by the dimorphic element, a CRE that possesses direct inputs from body plan (ABD-B) and sex-determination (DSX) transcription factors. Here, we find that the recurrent evolutionary modification of this CRE underlies both intraspecific and interspecific variation in female pigmentation in the melanogaster species group. By reconstructing the sequence and regulatory activity of the ancestral Drosophila melanogaster dimorphic element, we demonstrate that a handful of mutations were sufficient to create independent CRE alleles with differing activities. Moreover, intraspecific and interspecific dimorphic element evolution proceeded with little to no alterations to the known body plan and sex-determination regulatory linkages. Collectively, our findings represent an example where the paths of evolution appear biased to a specific CRE, and drastic changes in function were accompanied by deep conservation of key regulatory linkages. © 2013 Rogers et al