Quantization of Presymplectic Manifolds and Circle Actions

We prove several versions of "quantization commutes with reduction" for circle actions on manifolds that are not symplectic. Instead, these manifolds possess a weaker structure, such as a spin^c structure. Our theorems work whenever the quantization data and the reduction data are compatible; this condition always holds if we start from a presymplectic (in particular, symplectic) manifold.Comment: LaTeX 2e, 28 page

Atiya-Bott theory for orbifolds and Dedkind sums

Thesis (M.S.)--Massachusetts Institute of Technology, Dept. of Mathematics, 1994.Includes bibliographical references (leaf 17).by Ana M.L.G. Canas da Silva.M.S

The archives of the Portuguese government during the residency of the court in Brazil, 1808-1822

The need to understand what happened to the dispersed and previously unsatisfactorily described records of the archives of the central Portuguese administration during 1808-1822, in order to assign a provenance to the records, was the original motivating force behind this thesis. Several aspects of the rule of Portugal and Brazil and of the process of governmental decision-making were little and fragmentarily known and there was no study on the archives of the main offices during the same period. An extensive survey of the archives was undertaken, to locate and identify series and documents of the Secretarias de Estado and other state offices, mainly in Portugal and Brazil. Private papers and British Foreign Office and some French official records were also researched. The first four chapters present aspects of the political, institutional and administrative history of Portugal and Brazil as the context for the archives. First the structure of the central administration before the invasion of Portugal by the Napoleonic armies, including the offices in Brazil, is traced. This is followed by an account of the departure of the Portuguese Court to Rio de Janeiro. The forms of government and administration in Portugal from November 1807 till September 1820 are examined next, beginning with the occupation led by Junot, the Regency and its replacement and their impact on the creation of official records. The following subchapters trace the fighting against the French and the establishment juntas of government and examine the composition and working of the governors of the Kingdom, as well as studying the British military' presence and its influence on the government during the Peninsular War. Finally the governance and the continuity of the British presence after 1814 and till September 1820 are analysed. Chapter four studies the reconstruction and working of the central government and administration in Brazil for the period between March 1808 and September 1820. Chapter five examines how offices in Portugal and Brazil created records and how these circulated and were kept. Types of documents are featured and their usage explained. The arrangement of records, including systems of classification, is analysed. Special attention is paid to the archives of the Secretaria de Estado dos Negócios do Reino and Secretaria de Estado dos Negócios Estrangeiros and also of the Gabinete do Rei and to the records of the Conselho de Estado. The frontiers between private and public records as well as procedures of secrecy within public offices are examined. The sixth chapter traces the Liberal Revolution of 1820 in Portugal, the return of King D. Joâo VI to Lisbon and the independence of Brazil in 1822. The last chapter examines the transfers of records and archives of the Portuguese central administration from 1808 to 1822, especially between Portugal and Brazil, but also with reference to the repercussions of the French occupation and the Peninsular War. Aspects such as the impact of international conflicts on archives, seizure and informational value of records, safekeeping of official records, relationship between political changes, administrative practices and the management of records, evidential value of records and official memory are studied. The main issues analysed concern the custodial history and the current location of the archives of the Secretarias de Estado and other public offices. In addition, successive Brazilian and Portuguese initiatives in the nineteenth and twentieth century to identify, describe and access records produced by these offices before the independence of Brazil in 1822, are critically examined. The conclusions reached in this thesis suggest that the main change in the records was the creation of new series: namely the contas dos governadores do Reino, in consequence of the resettlement of the state apparatus in Rio de Janeiro and of the establishment of the governors of the Kingdom in Lisbon. As these worked as an intermediary body regarding the King and secretaries of state, the ways in which records circulated were often different to those prior to 1808. The bulk of the archives of the Secretarias de Estado which were transported to Rio de Janeiro returned, but not the records produced during 1808-1822 and those relating to Brazil. The location of these records and a list of them are provided for the first time. As a result of the research and findings of this thesis, it is hoped that the arrangement of the series of records of these offices and their connected departments will be simpler and more precise and the enrichment and production of new finding aids will be a natural consequence

Multiplicity formulas for orbifolds

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Mathematics, 1996.Includes bibliographical references (p. 46-47).by Ana M.L.G. Canas da Silva.Ph.D

Osteoporosis management during the COVID-19 pandemic - Position paper

verCOVID-19 pandemic significantly increased the already large number of victims of osteoporosis in Portugal. Osteoporosis outpatient clinics were either closed or had limited presential appointments. Many hospitals reduced orthopaedic services to make space for patients with COVID-19. In addition, the volunteer or forced sedentarism, as imposed by the pandemic, increased the risk of falls and fractures drastically. It urges to intensify the current efforts to improve the management of bone health and to prioritize fragility fracture care and prevention. This paper addresses the challenges in osteoporosis management during the COVID-19 pandemic and provides guidance on osteoporosis management. This position paper is a joint initiative of several health professionals and patients dedicated to osteoporosis.publishersversionpublishe

Efficacy and safety of percutaneous left atrial appendage closure in chronic kidney disease patients with atrial fibrillation : results of a 7-year registry

© The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.INTRODUCTION AND AIMS: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, the most devastating complication being thromboembolism leading to fatal or disabling stroke. Although oral anticoagulation (OAC) is the mainstay of prevention therapy in the general population, its benefit in chronic kidney disease (CKD) patients is less well defined. End-stage renal disease patients treated with vitamin K antagonists present increased risk of bleeding, accelerated cardiovascular calcification and increased risk of calciphylaxis. Left atrial appendage closure (LAAC) is performed to prevent complications in high-risk AF patients with contraindications to OAC and in AF patients with events despite OAC.info:eu-repo/semantics/publishedVersio

Portuguese multidisciplinary recommendations for non-pharmacological and non-surgical interventions in patients with rheumatoid arthritis

BACKGROUND: Patients with rheumatoid arthritis (RA) report significant levels of disease impact, which are improved, but not fully abrogated by immunosuppressive therapy, even when remission is achieved. This imposes the need for adjuvant interventions targeting the uncontrolled domains of disease impact. Non-pharmacological interventions are widely used for this purpose, but they have not been the object of professional recommendations or guidelines. OBJECTIVE: To propose multidisciplinary recommendations to inform clinical care providers regarding the employment of non-pharmacological and non-surgical interventions in the management of patients with RA. METHODS: The EULAR standardized operating procedures for the development of recommendations were followed. First, a systematic literature review was performed. Then, a multidisciplinary Technical Expert Panel (TEP) met to develop and discuss the recommendations and research agenda. For each developed recommendation i) the level of evidence and grade of recommendation were determined, and ii) the level of agreement among TEP members was set. A recommendation was adopted if approved by ≥75% of the TEP members, and the level of agreement was considered high when ≥8. All relevant national societies were included in this construction process to attain their endorsement. RESULTS: Based on evidence and expert opinion, the TEP developed and agreed on five overarching principles and 12 recommendations for non-pharmacological and non-surgical interventions in patients with RA. The mean level of agreement between the TEP members ranged between 8.5 and 9.9. The recommendations include a broad spectrum of intervention areas, such as exercise, hydrokinesiotherapy, psychological interventions, orthoses, education, general management of comorbidities, among others; and they set the requirements for their application. CONCLUSIONS: These recommendations are based on the consensus judgment of clinical experts from a wide range of disciplines and patients' representatives from Portugal. Given the evidence for effectiveness, feasibility and safety, non-pharmacological and non-surgical interventions should be an integral part of standard care for people with RA. It is hoped that these recommendations should be widely implemented in clinical practice. The target audience for these recommendations includes all health professionals involved in the care of patients with RA. The target patient population includes adult Portuguese people with RA.publishersversionpublishe

Comparative effectiveness and predictors of response to tumour necrosis factor inhibitor therapies in rheumatoid arthritis

Funding Information: positions on two Pfizer sponsored trials and has directed an educational course supported by Bristol Myers Squibb. He serves as an epidemiology consultant to CORRONA. J.A.P.S. has received honoraria as a speaker or consultant and benefited from research support from several pharmaceutical companies involved in the production of biologic agents (Abbott, Amgen, MSD, Pfizer and Roche), always at sums less than E10 000. All other authors have declared no conflicts of interest. Funding Information: Funding: This work was supported by a grant from Harvard-Portugal Program HMSP-ICS/SAU-ICT/0002/ 2010.Objectives: Adalimumab, etanercept and infliximab are effective TNF inhibitors (TNFis) in the treatment of RA, but no randomized clinical trials have compared the three agents. Prior observational data are not consistent. We compared their effectiveness over 1 year in a prospective cohort.Methods: Analyses were performed on subjects' first episode of TNFi use in the Rheumatic Diseases Portuguese Register, Reuma.pt. The primary outcome was the proportion of patients with European League Against Rheumatism good response sustained at two consecutive observations separated by 3 months during the first year of TNFi use. Comparisons were performed using conventional adjusted logistic regression, as well as matching subjects across the three agents using a propensity score. In addition, baseline predictors of treatment response to TNFi were identified.Results: The study cohort included 617 RA patients, 250 starting etanercept, 206 infliximab and 161 adalimumab. Good response was achieved by 59.6% for adalimumab, 59.2% for etanercept and 51.9% for infliximab (P = 0.21). The modelled probability of good response did not significantly differ across agents (etanercept vs adalimumab OR = 0.97, 95% CI 0.55, 1.71; etanercept vs infliximab OR = 1.25, 95% CI 0.74, 2.12; infliximab vs adalimumab OR = 0.80, 95% CI 0.47, 1.36). Matched propensity score analyses also showed no significant treatment response differences. Greater educational attainment was a predictor of better response, while smoking, presence of ACPA, glucocorticoid use and worse physician assessment of disease activity at baseline each predicted a reduced likelihood of treatment response.Conclusion: Over 1 year, we found no difference in effectiveness between adalimumab, etanercept and infliximab.publishersversionpublishe

Score CTo-aBCDE : um novo score preditor de sucesso nas CTOs

© 2020 Sociedade Portuguesa de Cardiologia. Published by Elsevier España, S.L.U. This is an open access article under the CC-BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Introduction: Patient selection for percutaneous coronary intervention (PCI) in chronic total occlusions (CTOs) is crucial to procedural success. Our aim was to identify independent predictors of success in CTO PCI in order to create an accurate score. Methods: In a single-center observational registry of CTO PCI, demographic and clinical data and anatomical characteristics of coronary lesions were recorded. Linear and logistic regression analysis were used to identify predictors of success. A score to predict success was created and its accuracy was measured by receiver operating curve analysis. Results: A total of 377 interventions were performed (334 patients, age 68±11 years, 75% male). The success rate was 65% per patient and 60% per procedure. Predictors of success in univariate analysis were absence of active smoking (OR 2.02, 95% CI 1.243-3.29; p=0.005), presence of tapered stump (OR 5.2, 95% CI 2.7-10.2; p8 with high probability (95%). Conclusion: In our sample only anatomical characteristics were predictors of success. The creation of a score to predict success, with good accuracy, may enable selection of cases that can be treated by any operator, those in which a dedicated operator will be desirable, and those with an extremely low probability of success, which should be considered individually for conservative management, surgical revascularization or PCI by a team experienced in CTO.info:eu-repo/semantics/publishedVersio

TRAF1/C5 but Not PTPRC Variants Are Potential Predictors of Rheumatoid Arthritis Response to Anti-Tumor Necrosis Factor Therapy

Background. The aim of our work was to replicate, in a Southern European population, the association reported in Northern populations between PTPRC locus and response to anti-tumor necrosis factor (anti-TNF) treatment in rheumatoid arthritis (RA). We also looked at associations between five RA risk alleles and treatment response. Methods. We evaluated associations between anti-TNF treatment responses assessed by DAS28 change and by EULAR response at six months in 383 Portuguese patients. Univariate and multivariate linear and logistic regression analyses were performed. In a second step to confirm our findings, we pooled our population with 265 Spanish patients. Results. No association was found between PTPRC rs10919563 allele and anti-TNF treatment response, neither in Portuguese modeling for several clinical variables nor in the overall population combining Portuguese and Spanish patients. The minor allele for RA susceptibility, rs3761847 SNP in TRAF1/C5 region, was associated with a poor response in linear and logistic univariate and multivariate regression analyses. No association was observed with the other allellic variants. Results were confirmed in the pooled analysis. Conclusion. This study did not replicate the association between PTPRC and the response to anti-TNF treatment in our Southern European population. We found that TRAF1/C5 risk RA variants potentially influence anti-TNF treatment response.This work was supported by a grant from Harvard-Portugal Program HMSP-ICS/SAU-ICT/0002/2010. Daniel H. Solomon received support for this work from the NIH (K24-AR-055989). Elizabeth W. Karlson received support for this work from NIH (K24-AR-AR0524). Reuma.pt received unrestricted grants from Abbott, Bristol-Myers Squibb, Merck Sharp and Dohme, Pfizer, Roche, and UCB Pharma