Determining Disparities by Income Level as Risk Factor for Low Visual Acuity Among U.S. Adults Using the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2008

INTRODUCTION: Visual loss is a serious health, social and economic problem worldwide in the United States (U.S.), being a cause of morbidity and disability in society. Subsequently, low vision is high in developing countries, where social determinants of health (SDH) play a significant role in individuals\u27 health status. Studies confirm the impact of SDH on low vision and access to visual healthcare in the U.S. Yet there is no recent research that addresses the relationship between income level, as a SDH and low vision in the U.S. at the national level. AIM: This study aims to analyze income disparities in visual acuity using data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2008 to verify the association between income level and low vision. METHODS: This study is a population-based and nationally-representative, observational, secondary data analysis using information from NHANES (1999 – 2008) with a sample=27,200 adult participants. The study measured descriptive statistics, bivariate statistics (chi-squared), and logistic regression to compute the strength of association between the household income and visual acuity. RESULTS: Lower-income subjects had significantly lower odds of normal vision (OR=0.822, p\u3c0.05) and higher odds of low visual acuity (OR=1.214, p\u3c0.05) and severe visual impairment (OR=1.44, p\u3c0.05), compared to high-income level groups. DISCUSSION: Low income is associated with lower likelihood of normal vision and higher risk of visual impairment. To improve disparities in visual health, economic inequality and its effects (for example, unequal access to health insurance and preventative visual healthcare) must be improved

Academias de ginástica : proposta para uma gestão de qualidade com ênfase nas pessoas

Orientadora : Irene Duran OteroMonografia (especialização) - Universidade Federal do Paraná, Curso de Especialização em Administração EsportivaInclui referênciasResumo: O presente trabalho consiste em uma sugestão para mudança nas academias, enfatizando seu recurso principal, que são as pessoas que as compõem. Desta forma, faz-se um estudo sobre a origem das academias, a sua evolução histórica e como a qualidade pode vir a se tomar um diferencial competitivo. Estuda-se o tema dando ênfase à qualidade pessoal, procurando demonstrar ser este um dos atributos mais procurados pelas empresas e consumidores, assim como fator de diferenciação entre os concorrentes. As pessoas estão mais exigentes em relação a preço e qualidade, e certamente as organizações que tiverem a missão de atendimento de qualidade encontrarão um amplo mercado. De um modo geral as academias ainda se preocupam em apenas convencer o cliente a se matricular, mas manter o cliente matriculado é um dos maiores desafios, que dependerá do empenho de toda a equip

Análise comparativa da dieta de peixes entre dois ambientes costeiros:Estuário(Baía de Guaratuba) e mar aberto(Plataforma entre 15 e 20 metros)

Orientador:Paulo de Tarso da Cunha ChavesMonografia(Bacharelado) - Universidade Federal do Paraná. Setor de Ciencias Biológicas. Curso de Graduaçao em Ciencias Biológica

Alimentação e reprodução do Bagre Africano Clarias gariepinus (Burchell, 1822) na bacia do rio Guaraguaçu, Paranaguá, Paraná, Brasil

Orientador : José Marcelo Rocha AranhaTese (doutorado) - Universidade Federal do Paraná, Setor de Ciências Biológicas, Programa de Pós-Graduação em Zoologia. Defesa: Curitiba, 12/02/2008Inclui bibliografiaArea de concentração: ZoologiaNa Floresta Atlântica encontram-se inúmeros corpos d’água que estão entre os primeiros ambientes a sofrer com as degradações antropogênicas. Este ecossistema é tido, atualmente, como um dos mais ricos do planeta em biodiversidade, entretanto, é também considerado um dos mais ameaçados. Um grande problema ocasionado pelas atividades antrópicas na Floresta Atlântica é a introdução de peixes exóticos que pode causar vários danos à comunidade nativa. O presente estudo foi desenvolvido na bacia do rio Guaraguaçu (25º45’W e 48º35’S) que se encontra no domínio da Floresta Atlântica. Com a finalidade de detectar a presença de espécies exóticas na bacia do rio Guaraguaçu foram desenvolvidos estudos preliminares pelo Laboratório de Ecologia de Rios da UFPR (EcoRios), nos quais foi constatada a presença do Bagre Africano Clarias gariepinus (Burchell, 1822) (Clariidae, Siluriformes), tanto por meio de entrevistas com a comunidade local, como pela captura de exemplares de vários tamanhos. Uma vez que esta é uma espécie introduzida, foram desenvolvidos estudos sobre sua biologia neste local. Foram capturados ao todo 63 (sessenta e três) indivíduos de Clarias gariepinus, 30 machos e 33 fêmeas, com comprimento e massa totais variando de 334-885 mm e 262,88-4550,00 g, respectivamente, em diferentes trechos da bacia. O conteúdo estomacal de 62 indivíduos foi analisado, apresentando um total de 54 itens. A espécie foi considerada onívora, pois os itens alimentares variaram desde restos vegetais até vertebrados, como peixes e anfíbios. A atividade alimentar da espécie foi considerada intensa. Ocorreram diferenças temporais na dieta e em relação aos tamanhos dos indivíduos. O período reprodutivo da espécie provavelmente ocorre entre setembro e janeiro, pois uma maior freqüência de fêmeas e machos reprodutivos foi encontrada nesta época, assim como as relações gonadossomática e hepatossomática para ambos os sexos apresentaram um pico neste período. O período reprodutivo da espécie possivelmente está associado ao aumento da temperatura da água e da pluviosidade no local. A presença da gramínea invasora Echinochloa polystachya nas margens do rio possivelmente é um fator facilitador de seu provável estabelecimento neste local. Características como rusticidade, tolerância a variações ambientais, grande porte, voracidade, plasticidade na dieta, presentes no bagre africano são consideradas como fundamentais para que uma espécie introduzida se estabeleça em um novo ambiente. Por fim, os estudos sobre a biologia do bagre africano são necessários para que futuras propostas de manejo sejam realizadas no rio Guaraguaçu, porém em conjunto com a pesquisa científica é fundamental a conscientização da população que está associada ao local para que sejam evitadas novas introduções, assim como a legislação e fiscalização devem ser realizadas de forma eficiente para que o problema de introduções de espécies seja amenizado e a biodiversidade dos ambientes naturais como da Floresta Atlântica seja conservada.In the Atlantic Forest there are countless water bodies which, among others, are the first sorts of environments to undergo anthropic degradations. This ecosystem is presently considered one of richest in the world concerning biodiversity, nevertheless, is extremely threatened. One serious problem induced by anthropic activities in the Atlantic Forest is the introduction of exotic fish species that possibly injures native communities. The present study was developed in Guaraguaçu River Basin (25º45’W; 48º35’S) in the Atlantic Forest domains. Preliminary investigations aiming to detect the presence of exotic species in Guaraguaçu River Basin were done by Laboratório de Ecologia de Rios, UFPR (EcoRios) through interviews with the local human community and also collecting specimens of different sizes. The African catfish Clarias gariepinus (Burchell, 1822) (Clariidae, Siluriformes) was recorded in this area and efforts were concentrated on the study of this introduced species’ biology. The amount of 63 individuals were captured (30 males and 33 females) with length and total weight ranging from 334-885 mm and 262.88- 4550.00 g, respectively, in different stretches of the basin. The stomach content of 62 specimens was analyzed and 54 items were encountered. This species was considered omnivorous, as its alimentary items varied from plant fragments to vertebrates, such as fishes and amphibians. Feeding activity of C. gariepinus was considered intense. There were temporal discrepancies in feeding habits and also in regards to the size of specimens. The breeding season probably occurs from September to January, because a higher frequency of reproductive males and females was observed along this period when the gonadosomatic and hepatosomatic indices for both genders were also higher. This species breeding period is possibly associated to the increase of water temperature and rain precipitation. The presence of the invasive grass Echinochloa polystachya on the river margins is perhaps a factor that eases its probable establishment in that place. Features like rusticity, tolerance to environmental variations, large size, voracity and plasticity in diet observed in the African catfish are taken as fundamental for an introduced species to remain in the new place. At last, the studies regarding the African catfish biology are essential for future management proposals to be undertaken in Guaraguaçu River. However, together with the scientific approach, the understanding of the local human communities is crucial to avoid new insertions of exotic species. Likewise, legislation and legal inspection must be effectively executed so that the issue of introducing species is softened and the biodiversity of natural environments, such as the Atlantic Forest, can be preserved

Gibbs Sampling with Low-Power Spiking Digital Neurons

Restricted Boltzmann Machines and Deep Belief Networks have been successfully used in a wide variety of applications including image classification and speech recognition. Inference and learning in these algorithms uses a Markov Chain Monte Carlo procedure called Gibbs sampling. A sigmoidal function forms the kernel of this sampler which can be realized from the firing statistics of noisy integrate-and-fire neurons on a neuromorphic VLSI substrate. This paper demonstrates such an implementation on an array of digital spiking neurons with stochastic leak and threshold properties for inference tasks and presents some key performance metrics for such a hardware-based sampler in both the generative and discriminative contexts.Comment: Accepted at ISCAS 201

The role of control region mitochondrial DNA mutations in cardiovascular disease : stroke and myocardial infarction

Recent studies associated certain type of cardiovascular disease (CVD) with specific mitochondrial DNA (mtDNA) defects, mainly driven by the central role of mitochondria in cellular metabolism. Considering the importance of the control region (CR) on the regulation of the mtDNA gene expression, the aim of the present study was to investigate the role of mtDNA CR mutations in two CVDs: stroke and myocardial infarction (MI). MtDNA CR mutations (both fixed and in heteroplasmy) were analysed in two demographically-matched case-control samples, using 154 stroke cases, 211 MI cases and their corresponding control individuals. Significant differences were found, reporting mutations m.16145 G > A and m.16311 T > C as potential genetic risk factors for stroke (conditional logistic regression: p = 0.038 and p = 0.018, respectively), whereas the m.72 T > C, m.73 A > G and m.16356 T > C mutations could act as possible beneficial genetic factors for MI (conditional logistic regression: p = 0.001, p = 0.009 and p = 0.016, respectively). Furthermore, our findings also showed a high percentage of point heteroplasmy in MI controls (logistic regression: p = 0.046; OR = 0.209, 95% CI [0.045-0.972]). These results demonstrate the possible role of mtDNA mutations in the CR on the pathogenesis of stroke and MI, and show the importance of including this regulatory region in genetic association studies

Registry of patients and treatments of hospital medicines in Catalonia: a tool to improve quality and efficiency of hospital drug use

Medicació hospitalària; Registre de pacients; ConsumMedicación hospitalaria; Registro de pacientes; ConsumoHospital medication; Patient registration; ConsumptionEines i polítiques de col·laboració innovadores per millorar la qualitat del servei i l'atenció al registre de pacients i tractaments de medicaments hospitalaris a Catalunya, una eina per millorar la qualitat i l'eficiència del consum de fàrmacs hospitalari

Sistema autônomo em FPGA para captura e processamento em tempo real de imagens da pupila

This dissertation proposes an algorithm and a corresponding hardware implementation capable of capturing images from the human eye and processing these images to obtain, in a portable, autonomous, secure, and non-invasive way, in real time, information regarding the pupil. More specifically, the objective is to obtain information that allows the equipment to determine the pupil's diameter, both in static form (i.e., with constant light intensity) and in dynamic form (pupil under varying light intensity). Such a system can be used in the health sector, for example, in exams such as pupillometry, a test done by ophthalmologists, or for measuring the pupil's expansion rate, a test used in the diagnosis of a series of diseases that affect the nervous system.Essa dissertação propõe um algoritmo e um equipamento (hardware) para captação de imagens da pupila do olho humano e processamento das mesmas a fim de obter, de forma portátil, autônoma, segura, não invasiva e em tempo real, informações sobre a pupila. Mais especificamente, o objetivo é obter informações que permitam determinar o diâmetro da pupila, tanto de forma estática (pupila com tamanho estável, sem a incidência intencional de luz) quanto dinâmica (pupila variando devido à aplicação de luz com intensidade variável). Tal sistema pode ser utilizado no setor da saúde, por exemplo, para realização da pupilometria, exame feito na área de oftalmologia, ou para medição da velocidade de expansão da pupila, exame auxiliar no diagnóstico de uma série de doenças que afetam o sistema nervoso

ADN mitocondrial i risc cardiovascular

En el últims anys, diversos estudis s’han enfocat cap a l’enteniment del paper dels determinants genètics nuclears i, en menor mesura, mitocondrials, en les malalties cardiovasculars per a prevenir esdeveniments clínics. Malgrat que la majoria dels estudis han intentat predir el risc cardiovascular mitjançant l’ús de puntuacions de risc genètic basades en variants nuclears, fins ara cap estudi ha dut a terme una puntuació de risc utilitzant el genoma mitocondrial. Els objectius plantejats en aquesta tesi són els següents: 1) analitzar el comportament de la mortalitat i morbiditat hospitalària de les malalties cardiovasculars de major rellevància a l’estat Espanyol; 2) determinar l’existència d’una possible associació entre la variació de la regió control del genoma mitocondrial i la susceptibilitat a desenvolupar un infart de miocardi o un accident cerebrovascular i 3) valorar si la incorporació de les variants mitocondrials a una puntuació de risc genètic, emprant marcadors nuclears, millora la capacitat de discriminació i predicció del risc cardiovascular. La metodologia així com la presentació dels resultats i la discussió s’han organitzat en 4 capítols dirigits a respondre els diversos objectius. En el capítol 1 s’ha realitzat un estudi epidemiològic descriptiu que respon a la necessitat d’actualitzar, a nivell nacional, les dades de mortalitat i morbiditat dels principals subtipus de malaltia cardiovascular, per edat i sexe, en totes les comunitats autònomes d’Espanya al llarg dels últims 15 anys. Els resultats obtinguts mostren que les malalties cardiovasculars continuen sent una de les principals causes de morbimortalitat a Espanya; no obstant, també s’observa una disminució de les taxes de mortalitat estandarditzades per edat. Tenint això en ment, s’ha plantejat analitzar l’ADN mitocondrial en individus residents a Castella i Lleó provinents d’un estudi transversal, observacional i descriptiu. Per aquest motiu, en el capítol 2 d’aquesta tesi s’ha investigat l’associació entre els haplogrups mitocondrials i dues malalties cardiovasculars, l’infart de miocardi i l’accident cerebrovascular, així com els factors de risc cardiovasculars clàssics. Les dades obtingudes van mostrar evidències suggestives de que l’haplogrup H pot actuar com un factor de risc genètic per a l’infart de miocardi. A més, en relació als factors de risc clàssics, els resultats també suggerien una funció beneficiosa de l’haplogrup J contra la hipertensió. En el capítol 3, per a la mateixa població de Castella i Lleó, es va analitzar el paper de les mutacions fixades i en heteroplasmia de la regió control de l’ADN mitocondrial que podrien actuar com a factors de risc independents als haplogrups. En aquest cas, també es van observar diferències significatives entre casos i controls, mostrant que les variants m.16.145G>A i m.16.311T>C podien comportar-se com possibles factors de risc en el desenvolupament de l’accident cerebrovascular, mentre que les variants m.72T>C, m.73A>G i m.16.356T>C podien actuar com possibles factors genètics de protecció front a l’infart de miocardi. Tenint en compte els resultats obtinguts, es va realitzar una darrera anàlisi (capítol 4) per tal d’avaluar la magnitud de la informació genètica mitocondrial en la millora de la capacitat de discriminació de les malalties cardiovasculars. Es va crear una puntuació de risc segons el model additiu que suma els al·lels de susceptibilitat de 11 SNPs nuclears i les 5 posicions mitocondrials descrites anteriorment. L'addició de les variants mitocondrials millora la capacitat de discriminació de les malalties cardiovasculars més enllà de la del conjunt dels factors de risc clàssic i els SNPs nuclears en aquesta població. En resum, els resultats presentats en aquesta tesi posen de manifest la influència de les variants mitocondrials en les malalties cardiovasculars. Aquest és el primer treball en avaluar l’ús d’una puntuació de risc que incorpora el genoma mitocondrial i que aconsegueix millorar significativament la capacitat de discriminació dels esdeveniments cardiovasculars.In recent years, several studies have focused on understanding the role of nuclear and, to a lesser extent, mitochondrial genetic determinants, in cardiovascular diseases to prevent clinical events. Although most studies have tried to predict cardiovascular risk using a genetic risk scores based on nuclear variants, so far no risk score was developed using the mitochondrial genome. The main goals of this thesis are summarized in the following three points: 1) to analyse the state of mortality and hospital morbidity from the most relevant cardiovascular diseases in Spain; 2) to determine the possible association of control region variants of the mitochondrial genome with the susceptibility to develop a myocardial infarction and stroke; and 3) to assess whether the incorporation of mitochondrial variants in a genetic risk score, based in nuclear SNPs, improves the ability to discriminate and predict cardiovascular risk. The methods as well as the presentation of the results and the discussion were organized in 4 chapters aimed to answer the defined objectives. In chapter 1, a descriptive epidemiological study that responds to the need to update the mortality and morbidity data of the main subtypes of cardiovascular disease, by age and sex, in all the Spanish autonomous communities over the last 15 years has been carried out. The results obtained show that cardiovascular diseases continue to be one of the main causes of mortality and morbidity in Spain. However, there is also a decrease in standardized mortality rates by age. Bearing this in mind, mitochondrial DNA has been considered for analysis in individuals residing in in the Spanish autonomous community of Castile and Leon who come from cross-sectional, observational and descriptive study. For this reason, in chapter 2 of this thesis the link between mitochondrial haplogroups and two cardiovascular diseases, myocardial infarction and stroke, and the classic cardiovascular risk factors, was investigated. The data obtained showed suggestive evidence that haplogroup H can act as a genetic risk factor for myocardial infarction. Additionally, in relation to classic risk factors, the results also suggested a beneficial role of haplogroup J against hypertension. In chapter 3, for the same Castile and Leon population, the role of fixed and heteroplasmy mutations of the mitochondrial DNA control region, which act as independent risk factors from haplogroups, was analysed. In this case, significant differences were also observed, reporting that the variants m.16.145G> A and m.16.311T> C could act as possible risk factors in the development of stroke, while variants m.72T>C, m.73A>G and m.16.356T>C could act as possible beneficial genetic factors for myocardial infarction. Taking into account the results obtained, a final analysis (chapter 4) was carried out in order to evaluate the magnitude of the mitochondrial genetic information in improving the ability to discriminate cardiovascular diseases. A risk score was created based on the additive model that adds the susceptibility alleles from the 11 nuclear SNPs and the 5 mitochondrial positions described above. The addition of mitochondrial variants improves, in this population, the ability to discriminate cardiovascular diseases beyond the set of classic risk factors and nuclear SNPs. In summary, the results presented in this thesis show the influence of mitochondrial variants on cardiovascular diseases. This is the first work to evaluate the use of a risk score that incorporates the mitochondrial genome and that significantly improves the ability to discriminate cardiovascular events