Acinetobacter baumannii é um patógeno nosocomial que está envolvido em um amplo espectro de infeções hospitalares. A maior preocupação atual é devido a sua alta capacidade de adquirir mecanismos de resistência, principalmente aos carbapenêmicos, fármacos utilizados normalmente para o tratamento dessas infecções. Desta forma, as opções terapêuticas tornam-se restritas e por isso, as polimixinas (polimixina B e colistina) voltaram a serem utilizadas na prática clínica. A heterorresistência a colistina já foi descrita em estudos recentes com isolados de A. baumannii e outros estudos detectaram a presença de resistência adaptativa as polimixinas. O objetivo deste estudo foi investigar a presença do fenômeno de heterorresistência e resistência adaptativa a polimixina B, e avaliar sua estabilidade. A pesquisa foi feita em isolados pertencentes a 15 clones diferentes de A. baumannii resistentes aos carbapenênicos e sensíveis a polimixina B. A avaliação da heterorresistência foi feita através da análise do perfil da população (PAP) para 29 isolados, selecionados aleatoriamente (pelo menos um de cada clone). A indução da resistência foi avaliada para 22 isolados, selecionados aleatoriamente (pelo menos um de cada clone), submetendo os isolados ao cultivo em concentrações crescentes de polimixina B. A determinação da estabilidade das subpopulações e da indução da resistência foi feita através de passagens, em dias consecutivos, em meio livre de antibiótico. Foram consideradas subpopulações heterogêneas aquele isolado que possuía colônias com uma CIM maior do que a população original para polimixina B. A CIM foi reavaliada após 75 e 60 dias de estocagem em -80ºC para os isolados que apresentaram subpopulação heterogênea ou indução da resistência para a polimixina B, respectivamente. Dos 29 isolados, submetidos a avaliação da heterorresistência, 26 (90%) apresentaram subpopulações heterogêneas para polimixina B. Nenhum isolado apresentou subpopulação superior a 2 μg/mL para polimixina B, ou seja, não foi encontrado neste estudo subpopulações heterorresistentes. As CIMs das subpopulações heterogêneas permaneceram iguais após os subcultivos em meio livre de antibiótico, mas quando a CIM foi reavaliada depois da estocagem, os valores obtidos foram os mesmos da população original. Dos 22 isolados submetidos a indução de resistência, 12 (55%) apresentaram algum crescimento até a concentração de 64 μg/mL de polimixina B. Após as passagens em meio livre de antibiótico a CIM diminuiu, voltando a CIM original na reavaliação após a estocagem a -80ºC. Este estudo mostra pela primeira vez a avaliação da heterorresistência e indução da resistência para polimixina B em isolados de A. baumannii resistentes aos carbapenêmicos. O fenômeno de heterorresistência não foi encontrado neste estudo, no entanto, subpopulações com uma CIM maior do que a original foram identificadas em 90% dos isolados. As CIMs das subpopulações permaneceram estáveis após 4 dias de passagens em meio livre de antibiótico, mas retornaram a CIM original após estocagem, o que sugere o envolvimento de mecanismos moleculares neste fenômeno. A presença da resistência induzida a polimixina B foi detectada em 55% dos isolados, sugerindo que este fenômeno pode ser comum entre os isolados de A. baumannii resistentes aos carbapenêmicos, frente a polimixina B. Embora a presença de subpopulações heterogêneas e a indução da resistência a polimixina B tenha sido comum neste estudo, mais estudos são necessários para um melhor entendimento do significado clínico e das implicações terapêuticas destes dois fenômenos.

Dissertação (Mestrado em Engenharia Mecânica) - Centro Universitário FEI, São Bernardo do Campo, 2016.

The aim of this research is to reconstruct a metaphysical interpretation of the philosophy of history with regard to the spirit of historical thinking. The spirit of historical thinking is to emphasize the relation between what happened in the past and historical thinking about the past in the present. However, current philosophies of history, which are largely epistemologically oriented, have not adequately explored this relation. In order to investigate the relation between past and present, I refer to an Aristotelian philosophy of practice and politics, and adapt it to the domain of the philosophy of history, and argue the case for a metaphysical science of history. A metaphysical science of history contains two primary parts. They are the part on physis and the part on technê/phronēsis. With regard to physis that metaphysically investigates the natural generating progress of entities, I argue that the existence of historical events can be understood as a natural developing progress in which the events are ordered in a chronological sequence. Such chronological sequence is essentially the physis of history in the metaphysical sense (I characterize it as ‘Ordnungszeit’). For the part on technê/phronēsis, I demonstrate that Aristotelian knowing is for itself an action of knowing, which is located beyond a given temporal position in the past to both the past and the thinking present, and indicates the fundamental Beingness of history (I characterize it as ‘Geschehenszeit’). Finally I conclude that the historical eudaimonia, namely the pursuing of the completeness of historical knowledge, is the final presentation of actualizing Geschehenszeit, as it bridges the past and the present in accordance to the spirit of historical thinking.

No theory of social change can circumvent the task of specifying the process that transforms the existent order into a different order, and determining that which accounts for the difference between those two orders. This thesis examines whether the theories of social change found in the works of Alain Badiou and Ernesto Laclau succeed in fulfilling this task. Badiou contends that a political process transforms the situation in which it unfolds in so far as what it produces is a ‘truth’. Certain implications of the set-theoretical ontological discourse through which Badiou conceptualizes truths, however, prevents an unambiguous appraisal of their socially transformative character. Although Badiou stipulates that the transformative potential of a truth lies in its ‘generic’ universality, this universality becomes indistinguishable from particularity when its transformative effects are limited to a situation—but it is precisely the interplay between situations, in the plural, that is not adequately reflected in set-theoretical ontology. Whilst Laclau’s theory of hegemony can be interpreted as providing an account of this interplay between pluralities of situations, it has its own shortcoming: the transition between different social orders cannot be thought under hegemony theory as anything other than a transition wherein the to-come is conditioned by the present to an extent that is theoretically underdetermined, resulting in the blurring of the distinction between social transformation and social reproduction. The final part of this thesis explores the possibility of bringing together the Laclauian notion of the ‘simplification’ of the social space through hegemonic articulation and Badiou’s theorization of truth procedure, in an attempt to conceive the particular kind of situation in which a political process would potentially have far-reaching socially transformative consequences.

ABSTRACT In sub-Saharan Africa a causal relationship has been established between hepatitis B virus (HBV) infection and membranous nephropathy (MN), especially in Black children. The most common method of treatment is interferon therapy, which is however, only effective in 30-40% of patients. The reason for this is unclear. The objective of this pilot study was to determine whether mutations in the complete surface gene of HBV isolated from Black children with HBV-associated MN before, during and after treatment with interferon, had any effect on treatment response and vice versa. HBV DNA was extracted from the serum of a responder, reverter and non-responder patient before, during (4 and 16 weeks) and after (40 weeks) IFN treatment. The preS1/preS2/S region was amplified and cloned, and the clones sequenced. Sequence analyses revealed the preS2 region to be the most variable in the reverter and non-responder and HBsAg was the most variable in the non-responder. Phylogenetic analysis showed that the viral population dynamics between the responder strains and the reverter/non-responder strains differed as a result of various mutations found within the surface gene. Thus the presence of mutations in preS2 and HBsAg of the non-responding patients may carry predictive markers for nonresponse but further investigation would be needed to conclusively prove this.

This Thesis reconsiders the prospects for an approach to global justice centring on the proposal that every human being should possess a certain bundle of goods, which would include certain members of a distinctive category: the category of capabilities. My overall aim is to present a clarified and well-developed framework, within which such claims can be made. To do this, I visit a number of regions of normative and metanormative theorising. I begin by introducing the motivations for the capability approach, and clarifying some of its most distinctive features. Next, I focus on Martha Nussbaum's version of the approach, and identify several problems therein. The most important concerns epistemology, and especially the challenges that constructivist theories pose. The middle part of the Thesis presents an alternative, based on the work of John McDowell, which I argue has superior prospects. Then, I turn to two further problems: that of making sense of the universalistic aspirations of cosmopolitanism, and that of integrating the microscopic prescriptions of ethics with the macroscopic analyses of political philosophy. Using the Aristotelian interpretation of its core framework that I have developed, I conclude that the capability approach can provide compelling answers to important questions about global justice.

That Conrad was familiar with Schopenhauer’s philosophy has been proposed by literary scholars and seconded, in passing, by philosophers. This has resulted in one-way studies of literary influence. This thesis is instead a two-way study in the philosophy of literature. It shows how Schopenhauer’s philosophy can illuminate Conrad’s fiction and how the fiction can become an analytical tool for exploring the philosophy. There are two strands in Schopenhauer’s philosophy. One is uncompromisingly concerned with salvation and will-denial. The second focuses on self-knowledge and character, which leads to self-fulfilment and accommodation with the world. It is the latter strand, with character at its core, where the interests of the philosopher and creative writer coincide. My methodology is different from previous studies in that I propose Conrad’s direct source for Schopenhauer was not The World as Will and Idea but his essays, which are directed more towards the worldly strand of his philosophy. I argue that the use by literary scholars of Schopenhauer’s magnum opus as Conrad’s direct source has diverted them from his main area of interest in the philosophy, namely its approach to self-knowledge and character, and that this misplaced focus has tended to distort interpretations of his fiction.

La adecuación al nuevo escenario educativo definido en el Espacio Europeo de Educación Superior (EEES) ha supuesto una transformación de la Universidad Española. El cambio en el proceso de enseñanza-aprendizaje implica favorecer el aprendizaje autónomo de competencias genéricas y específicas en el estudiante. La adopción de una nueva metodología centrada en el discente supone que los profesores y los estudiantes deben adoptar nuevos roles, que conllevan nuevas formas de pensar, de sentir y de actuar. El cambio en la concepción pedagógica y la renovación metodológica en el proceso de enseñanza-aprendizaje lleva consigo, a su vez, el uso de diferentes métodos educativos y medios pedagógicos en entornos virtuales de aprendizaje. Al objeto de analizar el modelo y estrategias de enseñanza-aprendizaje aplicado a la formación universitaria, en entornos virtuales, se ha realizado una exhaustiva revisión bibliográfica con el propósito de conseguir un instrumento, con garantías métricas de calidad, que evaluara adecuadamente dicha metodología. Una vez realizada esta revisión, se seleccionó el cuestionario The Distance Education Learning Environments Survey (DELES) de S.L. Walker (2005), como el instrumento más adecuado y con mayor validez aparente para nuestro objetivo de investigación. Ha participado en nuestro proyecto de investigación una muestra de 265 estudiantes matriculados en diversas asignaturas, impartidas por profesorado del Departamento de Psicología de la Salud de la Universidad de Alicante, con metodología de enseñanza-aprendizaje semipresencial y a distancia. El instrumento seleccionado, DELES, evalúa a través de 34 ítems y 5 opciones de respuesta, seis áreas de interés: (1) Apoyo del Profesorado; (2) Interacción y Colaboración entre Estudiantes; (3) Relevancia Personal; (4) Aprendizaje Real; (5) Aprendizaje Activo y (6) Autonomía. Además, este instrumento incluye una escala adicional que permite evaluar el grado de satisfacción del estudiante con la metodología de enseñanza-aprendizaje utilizada en la asignatura. La investigación realizada ha mostrado una buena viabilidad, fiabilidad y validez del instrumento de medida. La adaptación del cuestionario a nuestro medio universitario es satisfactoria. El instrumento muestra buenos criterios de calidad métrica. A través del mismo se comprueba que los estudiantes valoran de manera muy positiva el apoyo e interacción con el profesorado, manifiestan un alto grado de acuerdo en relación a la aplicabilidad de los conocimientos adquiridos en la asignaturat estiman favorablemente la utilización de casos reales en las sesiones y consideran muy provechoso el aprendizaje activo y autónomo.

El objetivo del presente trabajo fue determinar la seroprevalencia del virus de la hepatitis C (VHC) y de la B (VHB) en donadores militares y civiles que acudieron al Banco de Sangre del Hospital Naval así como los factores de riesgo asociados. Se trata de un estudio transversal, descriptivo y retrospectivo, cuyos datos epidemiológicos y resultados del tamizaje general se obtuvieron de los Libros de registros del Banco de Sangre e Historias Clínicas en el caso de los donantes militares, en el período comprendido de Enero de 1999 hasta Abril de 2004. El Test de MUREX HBsAg Versión 3 y Hepanostika Anti-HBc UniForm fueron empleados para Hepatis B, mientras que para el virus de la Hepatitis C se utilizó el Test de Elisa de tercera generación. Un total de 7009 donantes fueron registrados entre 1999 y 2004. Se incluyeron en el presente estudio 320, aquellos que presentaban anticuerpos contra el virus C (anti-VHC) y, para el virus de la hepatitis B: Antígeno de superficie (AgSupHBV) y/o Antígeno Core-IgG. Los datos recolectados fueron procesados y analizados en el paquete estadístico SPSS versión 10 para Windows: Prueba de Ji cuadrado o Prueba de Fisher. RESULTADOS: La prevalencia de portadores de VHC y VHB fue de 0.74% y 0.34%, respectivamente. La mayor población de infectados se encuentra entre los 18 y 30 años y corresponde al personal de la sanidad naval para la Hepatitis B y de Infantería de Marina para la Hepatitis C. No se pudo encontrar factores de riesgo relacionados en ninguna de las dos etiologias debido a una tasa de negación del 96,4% del total de donantes. CONCLUSIONES: Los resultados demuestran una baja prevalencia de infección por virus de hepatitis B, pero elevada para la hepatitis C de acuerdo a los reportes nacionales e internacionales. La pobre o nula asociación entre los factores de riesgo y la enfermedad por hepatitis B y C, que estaría en relación a la limitada efectividad y poca utilidad de la AEC. Se hace necesario que el escrutinio, a través de la encuesta de predonación, sea mas completo, diseñando un cuestionario capaz de detectar más factores de riesgo, probablemente determinanates en la transmisión de los virus de la hepatitis B y C. / The aim of the present work was to determine the seroprevalence of the virus of the hepatitis C (VHC) and of the hepatitis B (VHB) in military and civil donors who came to the Bank of Blood of the Navy Hospital as well as the associate factors of risk. It is a question of a transverse, descriptive and retrospective study realized in the Bank of Blood, which information epidemiological and proved from the general tamizaje was obtained of the Books of records of the Bank of Blood and Clinical Histories in case of the military donors, in the included period of January, 1999 until April, 2004. Murex’s Test HBsAg Version 3 and Hepanostika Anti-HBc UniForm were used for Hepatitis B, whereas for the virus of the Hepatitis C there was in use Elisa's Test of third generation. A whole of 7009 donors was registered between 1999 and 2004.Were included in the present study 320, those who were presenting antibodies against the virus C (anti-VHC) and for the virus of hepatitis B: Surface antigen (HBsAg) and/or Antigen Core-IgG. The information was gathered, percentages were obtained and the results were analyzed by means of SPSS 10 Windows version Statistics Program: chi-square or Fisher’s Tests. RESULTS: The prevalence of carriers of VHC and VHB was 0.74% and 0.34%, respectively. The principal infection people are between 18 to 30 years old, and belong to health navy personal for HBV infection and Marine Infantry for HCV infection. It couldn’t find risks factors in relation to the two etiologists, due a negative rate of 96,4%. CONCLUSIONS: The results suggest a low prevalence of infection for VHB but high for VHC infection in the studied population as it are indicate in the national and international reports. The poor or useless association between de risks factors and the illness it could be in relation to a limited effective and a poor utility of de Confidential Autoexclusion Exam. It’s necessary that this exam must be complete and have the property to identify more risks factors on the transmission of HBV and HCV. / Tesis de segunda especialidad

En las dos últimas décadas del siglo pasado, nuestro país atravesó una de las mayores crisis político-social, con una enorme cuota de violencia y muerte y cuya consecuencia socioeconómica de más impacto, fue un acelerado despoblamiento de las áreas rurales donde el fenómeno violentista era mayor, con su consiguiente masiva migración hacia los centros urbanos más importantes del país, principalmente a la capital de la república. Estos inmigrantes en su gran mayoría provenían de los valles interandinos y de la ceja de selva, precisamente las áreas hiperendémicas de hepatitis B. Este fenómeno, asumimos que podría tener un impacto importante sobre la prevalencia de la hepatitis B en la capital, especialmente en los estratos socioeconómicos bajos, como ya se insinuaba en dos reportes de finales de la década de los ’80. La influencia de estos dos fenómenos en todos los cambios sociales en el mundo, y por ello, la migración de decenas de miles de personas del interior del país hacia la capital que hacían prever un cambio en el patrón epidemiológico de la hepatitis B en Lima pasando de endemicidad baja a intermedia, nos ha llevado a pronosticar , un incremento de la prevalencia de la infección por el virus B en adolescentes, y el consiguiente riesgo de transmisión al neonato; además la población adolescente en el año 2003, es en su inmensa mayoría vulnerable a la infección por el VHB, pues las campañas de vacunación contra esta infección que inició el Ministerio de Salud en el año 1996, en los infantes de cero a un año, no alcanzó a los que ahora son adolescentes. Todos estos hechos han motivado nuestro interés en demostrar el incremento de la prevalencia de hepatitis B en este grupo poblacional, así como investigar todos los otros factores de riesgo que puedan contribuir a la transmisión de esta enfermedad. Este es el propósito de esta investigación. / Tesis