Relatório de estágio na Câmara Municipal de Ourém

O presente relatório enquadra-se no âmbito do trabalho final do curso Mestrado em Reabilitação Urbana, do Instituto Politécnico de Tomar. O estágio decorreu na Câmara Municipal de Ourém e teve como objeto, participar na coordenação com a Divisão Obras Municipais, Divisão da Ação Cultural e Divisão de Educação e Assuntos Sociais em intervenções a nível da Reabilitação Urbana. O estágio numa Câmara Municipal foi a opção que pareceu mais enriquecedora para conclusão do Mestrado em Reabilitação Urbana e para o futuro da minha vida profissional. Esta opção de estágio deve-se ao desejo de poder aplicar alguns dos conhecimentos obtidos ao longo do Mestrado, de conhecer a realidade do trabalho em obra e inserido numa equipa profissional, fiscalizadora, lidando com as responsabilidades inerentes à profissão. O relatório aborda quatro casos de estudo, respeitante às reabilitações, 1ª fase de intervenção na capela de São Sebastião em Atouguia, 2ª fase da reabilitação de zona de lazer no Agroal, freguesia de Formigais, 1ª fase de intervenção da capela da Perucha e reforço do pontão de Caxarias. Acompanhamento de pequenas reabilitações, reclamadas por juntas de freguesia e munícipes. O relatório procura descrever os procedimentos adotados no acompanhamento das obras de reabilitação e para fácil entendimento as descrições são acompanhadas por fotografias

Priming with a Potent HIV-1 DNA Vaccine Frames the Quality of Immune Responses prior to a Poxvirus and Protein Boost.

The use of heterologous immunization regimens and improved vector systems has led to increases in immunogenicity of HIV-1 vaccine candidates in nonhuman primates. In order to resolve interrelations between different delivery modalities, three different poxvirus boost regimens were compared. Three groups of rhesus macaques were each primed with the same DNA vaccine encoding Gag, Pol, Nef, and gp140. The groups were then boosted with either the vaccinia virus strain NYVAC or a variant with improved replication competence in human cells, termed NYVAC-KC. The latter was administered either by scarification or intramuscularly. Finally, macaques were boosted with adjuvanted gp120 protein to enhance humoral responses. The regimen elicited very potent CD4 <sup>+</sup> and CD8 <sup>+</sup> T cell responses in a well-balanced manner, peaking 2 weeks after the boost. T cells were broadly reactive and polyfunctional. All animals exhibited antigen-specific humoral responses already after the poxvirus boost, which further increased following protein administration. Polyclonal reactivity of IgG antibodies was highest against HIV-1 clade C Env proteins, with considerable cross-reactivity to other clades. Substantial effector functional activities (antibody-dependent cell-mediated cytotoxicity and antibody-dependent cell-mediated virus inhibition) were observed in serum obtained after the last protein boost. Notably, major differences between the groups were absent, indicating that the potent priming induced by the DNA vaccine initially framed the immune responses in such a way that the subsequent boosts with NYVAC and protein led only to an increase in the response magnitudes without skewing the quality. This study highlights the importance of selecting the best combination of vector systems in heterologous prime-boost vaccination regimens.IMPORTANCE The evaluation of HIV vaccine efficacy trials indicates that protection would most likely correlate with a polyfunctional immune response involving several effector functions from all arms of the immune system. Heterologous prime-boost regimens have been shown to elicit vigorous T cell and antibody responses in nonhuman primates that, however, qualitatively and quantitatively differ depending on the respective vector systems used. The present study evaluated a DNA prime and poxvirus and protein boost regimen and compared how two poxvirus vectors with various degrees of replication capacity and two different delivery modalities-conventional intramuscular delivery and percutaneous delivery by scarification-impact several immune effectors. It was found that despite the different poxvirus boosts, the overall immune responses in the three groups were similar, suggesting the potent DNA priming as the major determining factor of immune responses. These findings emphasize the importance of selecting optimal priming agents in heterologous prime-boost vaccination settings

A DREAM challenge to build prediction models for short-term discontinuation of docetaxel in metastatic castration-resistant prostate cancer.

Background: Docetaxel has a demonstrated survival benefit for metastatic castration-resistant prostate cancer (mCRPC). However, 10-20% of patients discontinue docetaxel prematurely because of toxicity-induced adverse events, and managing risk factors for toxicity remains an ongoing challenge for health care providers and patients. Prospective identification of high-risk patients for early discontinuation has the potential to assist clinical decision-making and can improve the design of more efficient clinical trials. In partnership with Project Data Sphere (PDS), a non-profit initiative facilitating clinical trial data-sharing, we designed an open-data, crowdsourced DREAM (Dialogue for Reverse Engineering Assessments and Methods) Challenge for developing models to predict early discontinuation of docetaxel. Methods: Data from the comparator arms of four phase III clinical trials in first-line mCRPC were obtained from PDS, including 476 patients treated with docetaxel and prednisone from the ASCENT2 trial, 598 patients treated with docetaxel, prednisone/prednisolone, and placebo in the VENICE trial, 526 patients treated with docetaxel, prednisone, and placebo in the MAINSAIL trial, and 528 patients treated with docetaxel and placebo in the ENTHUSE 33 trial. Early discontinuation was defined as treatment stoppage within three months due to adverse treatment effects. Over 150 clinical features including laboratory values, medical history, lesion measures, prior treatment, and demographic variables were curated and made freely available for model building for all four trials. The ASCENT2, VENICE, and MAINSAIL trial data sets formed the training set that also included patient discontinuation status. The ENTHUSE 33 trial, with patient discontinuation status hidden, was used as an independent validation set to evaluate model performance. Prediction performance was assessed using area under the precision-recall curve (AUPRC) and the Bayes factor was used to compare the performance between prediction models. Results: The frequency of early discontinuation was similar between training (ASCENT2, VENICE, and MAINSAIL) and validation (ENTHUSE 33) sets, 12.3% versus 10.4% of docetaxel-treated patients, respectively. In total, 34 independent teams submitted predictions from 61 different models. AUPRC ranged from 0.088 to 0.178 across submissions with a random model performance of 0.104. Seven models with comparable AUPRC scores (Bayes factor ≤ 3) were observed to outperform all other models. A post-challenge analysis of risk predictions generated by these seven models revealed three distinct patient subgroups: patients consistently predicted to be at high-risk or low-risk for early discontinuation and those with discordant risk predictions. Early discontinuation events were two-times higher in the high- versus low-risk subgroup and baseline clinical features such as presence/absence of metastatic liver lesions, and prior treatment with analgesics and ACE inhibitors exhibited statistically significant differences between the high- and low-risk subgroups (adjusted P < 0.05). An ensemble-based model constructed from a post-Challenge community collaboration resulted in the best overall prediction performance (AUPRC = 0.230) and represented a marked improvement over any individual Challenge submission. Findings: Our results demonstrate that routinely collected clinical features can be used to prospectively inform clinicians of mCRPC patients' risk to discontinue docetaxel treatment early due to adverse events and to the best of our knowledge is the first to establish performance benchmarks in this area. This work also underscores the "wisdom of crowds" approach by demonstrating that improved prediction of patient outcomes is obtainable by combining methods across an extended community. These findings were made possible because data from separate trials were made publicly available and centrally compiled through PDS