Tissue specific promoters from rice and wheat for modifying grain characteristics

Trabalho final do 6º Ano Médico com vista à atribuição do grau de mestre no âmbito do ciclo de estudos de Mestrado Integrado em Medicina, apresentada à Faculdade de Medicina da Universidade de CoimbraA tiroidite, inflamação da glândula tiroideia, é, juntamente com o bócio, a afecção endócrina mais frequente, sendo comummente encontrada em medicina ambulatória. Associada a uma função tiroideia normal, aumentada ou diminuída (frequentemente com evolução de uma condição para outra), as circunstâncias da sua descoberta podem ser variadas e a distinção dos seus vários tipos baseia-se, essencialmente, no panorama clínico, rapidez de instalação sintomática, história familiar e presença ou ausência de sintomas prodrómicos e dor no pescoço. Vários critérios podem ser utilizados para a sua classificação, nomeadamente histológicos e clínicos (acompanhada ou não de dor tiroideia), sendo, contudo, a evolução da doença o critério classicamente utilizado. Assim, de acordo com este último, os diferentes subtipos de tiroidite podem ser agrupados em: tiroidite aguda, tiroidite subaguda ou tiroidite crónica. A primeira é uma forma dolorosa de tiroidite extremamente rara causada por uma infecção bacteriana, fúngica ou parasitária da tiróide e surgindo, sobretudo, na criança/adolescente e adulto jovem. Nas tiroidites subagudas, podemos encontrar a tiroidite subaguda granulomatosa ou de De Quervain – causa mais frequente de dor tiroideia, eventualmente, de origem viral – e as tiroidites subagudas linfocíticas – tiroidites esporádica indolor, do pós-parto, iatrogénica (interferão, interleucina-2, lítio), tóxica (amiodarona), por irradiação (iodo 131, irradiação externa) ou traumática (cirurgia, punção, traumatismo externo). Finalmente, nas tiroidites crónicas, caracterizadas, portanto, por um maior tempo de evolução, podemos destacar a tiroidite de Riedel, de natureza fibrótica e fisiopatologia desconhecida, e a tiroidite de Hashimoto, a tiroidite mais frequente e causa mais comum de hipotiroidismo nas regiões com aporte suficiente de iodo e da qual as tiroidites esporádica indolor e do pós-parto se aproximam pelo seu carácter autoimune. O diagnóstico destas afecções é feito pelo contexto e achados clínicos, incluindo a presença ou ausência de dor, textura e autoanticorpos. Adicionalmente, o grau de absorção de iodo radioactivo pela iii glândula é reduzido na maioria dos pacientes com inflamação viral, induzida por radiação, traumática, autoimune ou induzida por drogas. O tratamento é, primeiramente, dirigido ao alívio sintomático da dor tiroideia e restabelecimento do eutiroidismo.Thyroiditis, inflammation of the thyroid gland, is, along with goiter, the most frequent endocrine pathology, being commonly found in ambulatory medicine. Associated with normal, elevated or depressed thyroid function (often with evolution from one condition to another), the circumstances of its discovery are varied and the distinction of its several types is based primarily on the clinical setting, rapidity of symptom onset, family history and presence or absence of prodromal symptoms and neck pain. Different criteria can be used to its classification, namely histological and clinical (with thyroid pain or not). Nevertheless, the evolution of the disease is the classically used criterion. Thus, accordingly with this one, the several subtypes of thyroiditis can be divided into: acute thyroiditis, subacute thyroiditis and chronic thyroiditis. The first one is an extremely rare painful form of thyroiditis cause by a bacterial, fungic or parasitic infection of the thyroid and it in children/adolescents and young adults. In subacute thyroiditis, we can have the subacute granulomatous or de De Quervain thyroiditis – most common cause of thyroid pain, eventually of viral original – and the subacute lymphocytic thyroiditis – sporadic painless, postpartum, iatrogenic (interferon, interleukin-2, lithium), toxic (amiodarone), by irradiation (iodine 131 and external irradiation) or traumatic (surgery, puncture or external traumatism) thyroiditis. Finally, in chronic thyroiditis, characterized, therefore, by a longer time of evolution, we can mention Riedel’s thyroiditis, of fibrotic nature and unknown physiopathology, and Hashimoto’s thyroiditis, the most frequent thyroiditis and the most common cause of hypothyroidism in the regions with an adequate iodine supply, from which the sporadic painful and postpartum thyroiditis are close by their autoimune character. Diagnosis is by clinical context and findings, including the presence or absence of pain, tenderness and autoantibodies. In addition, the degree of radioactive iodine uptake by the gland is reduced in most patients with viral, radiation-induced, traumatic, autoimmune, or drug-induced inflammation of the thyroid. Treatment primarily is directed at symptomatic relief of the thyroid pain and restoration of euthyroidism

Investigating organic aerosol loading in the remote marine environment

Aerosol loading in the marine environment is investigated using aerosol composition measurements from several research ship campaigns (ICEALOT, MAP, RHaMBLe, VOCALS and OOMPH), observations of total AOD column from satellite (MODIS) and ship-based instruments (Maritime Aerosol Network, MAN), and a global chemical transport model (GEOS-Chem). This work represents the most comprehensive evaluation of oceanic OM emission inventories to date, by employing aerosol composition measurements obtained from campaigns with wide spatial and temporal coverage. The model underestimates AOD over the remote ocean on average by 0.02 (21 %), compared to satellite observations, but provides an unbiased simulation of ground-based Maritime Aerosol Network (MAN) observations. Comparison with cruise data demonstrates that the GEOS-Chem simulation of marine sulfate, with the mean observed values ranging between 0.22 μg m−3 and 1.34 μg m−3, is generally unbiased, however surface organic matter (OM) concentrations, with the mean observed concentrations between 0.07 μg m−3 and 0.77 μg m−3, are underestimated by a factor of 2–5 for the standard model run. Addition of a sub-micron marine OM source of approximately 9 TgC yr−1 brings the model into agreement with the ship-based measurements, however this additional OM source does not explain the model underestimate of marine AOD. The model underestimate of marine AOD is therefore likely the result of a combination of satellite retrieval bias and a missing marine aerosol source (which exhibits a different spatial pattern than existing aerosol in the model)

Gastrointestinal Bleeding in Antithrombotic Therapy in Patients with Coronary Heart Disease: Risk Factors, Pathogenesis and Treatment

Aim. Description of risk factors, pathogenesis and treatment strategies of gastrointestinal bleeding (GIB) in the course of antithrombotic therapy in patients with coronary heart disease (CHD).Key points. Risk factors of GIB during antithrombotic therapy in CHD patients include: GIB, gastric and/or duodenal ulcer in the history, reflux esophagitis, presence of H. pylori, inflammatory bowel disease, diverticula, haemorrhoids, angiodysplasia, gastrointestinal neoplasia, age above 65 years, concomitant treatment with non-steroidal anti-inflammatory drugs (NSAIDs), glomerular filtration rate <50 mL/min, high doses of direct oral anticoagulants (DOACs) ≥3 in HAS-BLED score. Pathogenesis of GIB in the course of antithrombotic therapy is associated with systemic hypocoagulation and local damaging effects of these drugs. Strategies of GIB treatment during DOAC therapy in patients with CHD are determined by severity of bleeding and threat to life. Aside to standard conservative measures, endoscopic or surgical haemostasis requires usage of antidotes to suppress effects of DOACs and other specific drugs in severe cases.Conclusion. GIB associated with antithrombotic therapy in CHD patients poses a serious medical problem of growing importance with wider application of anticoagulant drugs. Antithrombotic therapy requires accurate decision making, risk assessment, careful monitoring of the patient’s condition and timely diagnosis of gastrointestinal disorders following good rationale in GIB prevention

Security methods for a group of mobile robots according to the requirements of Russian and foreign legislation

This paper is devoted to the problem of creating security methods for mobile robotic systems. The urgency of the problem of ensuring the security of mobile robotic systems is associated with the presence of a contradiction between the growing popularity of the mobile robotic systems and the presence of many vulnerabilitie

Developing models of IoT infrastructures to identify vulnerabilities and analyse threats

This article describes the developing stands of typical IoT infrastructure Technologies, which are designed to identify vulnerabilities and analyse potential threats. Scenarios of attacks typical for such systems have been developed, and the consequences of implementing attacks have been determined. Attacker can use the developed scenarios, been motivated by different goal

АНАЛИЗ ОСНОВНЫХ НАПРАВЛЕНИЙ РАБОТЫ ГОРОДСКОГО ПСИХОСОМАТИЧЕСКОГО ЦЕНТРА СПб ГБУЗ «АЛЕКСАНДРОВСКАЯ БОЛЬНИЦА», ОРИЕНТИРОВАННЫЙ НА ВЫДЕЛЕНИЕ ПРИОРИТЕТНЫХ НАПРАВЛЕНИЙ СОВЕРШЕНСТВОВАНИЯ ЛЕЧЕБНОЙ И ПРОФИЛАКТИЧЕСКОЙ РАБОТЫ

The authors have analyzed the results of the City Psychosomatic Centre (CPSC) activity in 2009-2011 ys in order to find out the most important trends in the clinical work that may be helpful in planning of management and prophylaxis. The methods applied were statistical and clinico-statistical analyses of the results of of the Center work in 2009-2011 ys. There were changes in the structure by increasing the incidence of diseases associated with stress and organic damage brain with mental disorders, showed an increase in the flow of male patients. Found that the average length of stay in bed in the center of psychosomatic inpatient unit was 9.2-9.7 days, which creates barriers to good practice the use of antidepressants. Overcoming of these challenges can be achieved through the formation of new forms of continuity between the departments of the psychosomatic center, the health center and the offices of St. Petersburg SHCI «Alexander's Hospital,» and other medical institutions of the city.Проанализированы показатели работы городского психосоматического центра (ГЦПСМ) с целью выявления наиболее важных тенденций клинической работы, которые могут быть использованы для планирования лечебной и профилактической деятельности ГЦПСМ. Проведен статистический и клинико-статистический анализ результатов работы ГЦПСМ СПбГБУЗ «Александровская больница» за 2009-2011 гг. Выявлено изменение структуры заболеваемости за счет увеличения заболеваний, связанных со стрессом и органическим поражением головного мозга с психическими нарушениями, выявлено увеличение потока больных мужчин. Установлено, что средняя продолжительность пребывания на койке в стационарном отделении психосоматического центра составила 9,2-9,7 дня, что формирует препятствия для качественной практики применения антидепрессантов. Преодоление этих проблем может быть достигнуто за счет формирования новых форм преемственности между разными подразделениями психосоматического центра, отделениями СПбГБУЗ «Александровская больница» и другими медицинскими учреждениями города

ДИДАКТИЧНІ АСПЕКТИ ОПТИМІЗАЦІЇ БЕЗПЕРЕРВНОЇ МЕДИЧНОЇ ОСВІТИ ДІЛЬНИЧНИХ ПЕДІАТРІВ

The aim of the study is to share the experience and views on improving methods of continuous medical education under health care reform.The main body. The article deals with the problem of district pediatricians continuous education and to set out own reading of educational process optimization. The educational process optimization is specified by valuable intentional aspects of doctor training, application of effective pedagogical methods, wide implementation of informational technologies. It allows doctor to use education services directly at working place or at home, to improve level of individualization and differentiation of training, to improve motivation, and also to decrease financial dependence that is just as important nowadays. Under heltcare reform it is desirable, that cycles of advanced thematic training are short-time: 5, 10, 14 days, and their amount are not restricted during the year.Subjects of the advanced thematic training of district pediatricians must be aimed at children health preventive, maintenance and strengthening and oriented to evidence-based medicine. This kind of approach is going to promote high-quality training of highly experienced specialists, forming his professional competency at all the stages of continuous professional development.Using modern computer equipment and teaching aids (right amount of computers, interactive boards, simulators, Smart-system for interactive testing), the introduction of advanced teaching techniques, methods and technologies contributes the necessary level of knowledge of pediatricians.During cycles (including on-site ones) binary lectures, which increase the effectiveness of learning material assimilation and promote students’ activeness are held; the elements of distance learning platform based on Moodle KhMAPE (moodle.med.edu.ua) with additional review sessions on Skype at the Center of Distance Education of Academy are used.Looking forward, in conditions of concurrent education environment, it will be possible «to make free choice of educational establishment, education form (courses, internship, e-Learning)». District pediatricians will choose and estimate the work of medical educational organization by themselves corresponding to given education service.Conclusions. Information technologies for medical education optimize and increase the effectiveness of continuous modern pediatrician professional development. The introduction of new advanced methods into district doctors’ medical education promotes new thinking, increases interest and satisfaction with the educational process.Мета роботи – поділитись власним досвідом та думками про вдосконалення методів безперервної медичної освіти в умовах реформування охорони здоров’я.Основна частина. У статі висвітлено проблеми безперервної медичної освіти дільничних педіатрів. Представлено власний погляд на оптимізацію навчального процесу, що полягає в підвищенні змістовних аспектів підготовки лікаря, застосуванні ефективних педагогічних прийомів і методик, а також широкому впровадженні новітніх інформаційних технологій. Це дозволяє лікарю одержати освітні послуги прямо на робочому місці чи вдома, підвищити ступінь індивідуалізації і диференціації навчання, покращити мотиваційну активність, окрім цього, знизити фінансову залежність, що є не менш важливим у наш час.В умовах реформування охорони здоров’я бажано, щоб  цикли тематичного удосконалення бути короткотривалими: 5, 10, 14 днів, а їх кількість – не обмежувалася протягом року.Тематика циклів тематичного удосконалення сучасних дільничних педіатрів обов’язково має бути спрямована на профілактику, збереження й зміцнення здоров’я дітей і орієнтована на доказову медицину. Такий підхід сприятиме якісній підготовці висококваліфікованого спеціаліста, формуванню його професійної компетенції на всіх етапах безперервного професійного розвитку.Використовуючи сучасне комп’ютерне обладнання та технічні засоби навчання (достатня кількість комп’ютерів, інтерактивна дошка, симулятори, Smart-система для інтерактивного тестування), впровадження передових педагогічних прийомів, методів і технологій сприяє формуванню необхідного рівня знань  педіатрів. На циклах (у тому числі й на виїзних) проводяться бінарні лекції, що підвищує ефективність засвоєння матеріалу заняття та сприяє активності слухачів, використовуються елементи дистанційного навчання на базі платформи Moodle ХМАПО (moodle.med.edu.ua) з додатковими консультаціями викладачів по Skype у Центрі дистанційної освіти академії.У перспективі, в умовах конкурентного освітнього середовища відбудеться “вільний вибір закладу, форми навчання (курси, стажування, e-Learning)”. Дільничні педіатри будуть самі обирати й оцінювати роботу вищого медичного навчального закладу за якістю наданої їм навчальної послуги.Висновки. Інформаційні технології в медичній освіті оптимізують та підвищують ефективність безперервного професійного розвитку сучасного лікаря-педіатра.Впровадження нових сучасних методів у медичну освіту дільничних лікарів сприяє формуванню нового мислення, підвищенню зацікавленості та задоволеності навчальним процесом