Intensive Care Units (ICUs) account for over 10 percent of all US hospital beds, have over 4.4 million patient admissions yearly, approximately 360,000 deaths, and account for close to 30% of acute care hospital costs. The need for critical care services has increased due to an aging population and medical advances that extend life. The result is efforts to improve patient outcomes, optimize financial performance, and implement models of ICU care that enhance quality of care and reduce health care costs. This retrospective chart review study examined the dose effect of APN Intensivists in a surgical intensive care unit (SICU) on differences in patient outcomes, healthcare charges, SICU length of stay, charges for APN intensivist services, and frequency of APNs special initiatives when the SICU was staffed by differing levels of APN Intensivist staffing over four time periods (T1-T4) between 2009 and 2011. The sample consisted of 816 randomly selected (204 per T1-T4) patient chart data. Study findings indicated reported ventilator associated pneumonia (VAP) rates, ventilator days, catheter days and catheter associated urinary tract infection (CAUTI) rates increased at T4 (when there was the lowest number of APN Intensivists), and there was increased pressure ulcer incidence in first two quarters of T4. There was no statistically significant difference in post-surgical glycemic control (M = 142.84, SD= 40.00), t (223) = 1.40, p = .17, and no statistically significant difference in the SICU length of stay among the time-periods (M= 3.27, SD = 3.32), t (202) = 1.02, p= .31. Charges for APN services increased over the 4 time periods from $11,268 at T1 to $51,727 at T4 when a system to capture APN billing was put into place. The number of new APN initiatives declined in T4 as the number of APN Intensivists declined. Study results suggest a dose effect of APN Intensivists on important patient health outcomes and on the number of APNs initiatives to prevent health complications in the SICU.

The notion of &rdquo / Planar functions&rdquo / goes back to Dembowski and Ostrom, who introduced it in 1968 first time to describe projective planes with special properties in finite geometry. Recently, they attracted an interest from cryptography because of having an optimal resistance to differential cryptanalysis.This thesis is based on the paper &rdquo / New semifields, PN and APN functions&rdquo / by J&uuml / rgen Bierbrauer. The whole purpose of this thesis is to understand and present a detailed description of the results of the paper of Bierbrauer about planar functions. Here and throughout this thesis &rdquo / new&rdquo / means &rdquo / new&rdquo / in the paper of Bierbrauer. In particular we have no new constructions here and we only explain the results of Bierbrauer.

In the thesis a new way of checking whether a function is CCZ-equivalent to a permutation is given. The results for known families of almost perfect nonlinear (APN) functions are presented for functions defined over GF(2n ), for even n ≤ 12. The ways how to reduce the number of polynomials from each family are studied. For functions of the form x3 + a-1 tr1(a3 x9 ) it is shown, that they cannot be CCZ-equivalent to a permutation on fields GF(24n ) for n ∈ ℕ .

In this thesis, we examine a family of vectorial boolean functions on F22m inspired by Kim function, in order to find new APN permutations on F22m for m > 2. The functions of this family are defined as F(X) = X3 + bX3q + cX2q+1 + dXq+2 , where parameters b, c and d are from F2m . Necessary and sufficient conditions for this functions to be APN or equivalent to a permutation are presented in this thesis. To find conditions for being APN, Trace-0/Trace-1 decomposition method is used. A method using exponential sums is used to deduce which functions of this family is CCZ-equivalent to a certain type of permutation. These results were then used to search for APN permutations on F26 and F210 . 1

No description available.

L’arthrose est la pathologie articulaire la plus fréquente, caractérisée par une destruction progressive du cartilage articulaire et impliquant une communication anormale entre l'os sous-chondral et le cartilage. Notre équipe a identifié la protéine 14-3-3ε comme un médiateur soluble secrété par l’os et capable d’altérer l'homéostasie du cartilage en stimulant l’expression de MMP-3 et MMP-13, deux métalloprotéases impliquées dans la dégradation du cartilage au cours de l’arthrose. CD13/APN, récepteur potentiel pour cette protéine, a été mis en évidence à la surface des chondrocytes murins et humains. Le but de cette étude était d’étudier son implication dans la réponse des chondrocytes à 14-3-3ε. L’invalidation de CD13/APN par des siRNA ou des anticorps bloquants, réduit significativement l’effet catabolique chondrocytaire induit par 14-3-3ε. Les chondrocytes articulaires possèdent une activité APN mais elle n’est pas modifiée en présence de 14-3-3ε. Nous avons mis en évidence la présence d’une interaction directe entre 14-3-3ε et CD13/APN grâce à la technologie SPR (Surface Plasmon Resonance) et le système Biacore. En utilisant 14-3-3ε marquée à la biotine, nous avons montré que 14-3-3ε est capable de se lier à la surface des chondrocytes via CD13/APN. Nous avons donc eu recours ensuite aux études de modélisation in silico qui ont permis d’identifier le résidu Y582 phosphorylé appartenant à la séquence E579FNYVW584 de CD13/APN, comme résidu indispensable pour sa liaison à 14-3-3ε. Ce travail de thèse permet de mieux comprendre le mécanisme d’action de 14-3-3ε et propose l’interaction entre 14-3-3ε et CD13 comme une nouvelle cible thérapeutique dans l’arthrose. / Osteoarthritis (OA) is a whole-joint disease characterized by progressive destruction of articular cartilage involving abnormal communication between subchondral bone and cartilage. Our team identified 14-3-3ε protein as a subchondral bone soluble mediator altering cartilage homeostasis. This protein acts as a potent stimulatory factor of MMP-3 and MMP-13 involved in the degradation of cartilage matrix in OA. CD13/APN, potential receptor of this protein, was identified on the surface of chondrocytes. The aim of this study was to investigate its involvement in chondrocytes response to 14-3-3ε. CD13/APN invalidation, using the siRNA strategy and blocking antibodies, reduces significantly the catabolic effect induced by 14-3-3ε in chondrocytes. APN activity was identified in chondrocytes but found unchanged following stimulation with 14-3-3ε. Then, we have revealed the presence of a direct interaction between 14-3-3ε and CD13/APN through the SPR (Surface Plasmon Resonance) and the Biacore system. Using biotin-labeled 14-3-3ε, we have shown that 14-3-3ε is able to bind to the surface of chondrocytes in a manner that is dependent on CD13/APN. It was then necessary to identify the putative motifs involved in this interaction. We therefore used in silico modelling studies which have identified the phosphorylated residue Y582, belonging to the E579FNYVW584 sequence of CD13/APN, as a critical residue for its binding to 14-3-3ε. This thesis work suggest that CD13 plays its receptor role to bind 14-3-3ε and transmit its signal in chondrocytes to induce a catabolic phenotype similar to that observed in OA. Thus, 14-3-3ε-CD13 interaction could be a novel therapeutic target in OA.

L’Aminopeptidase-N (APN ou CD13) [EC.3.4.11.2] est une ectoenzyme homodimérique de nature glycoprotéique appartenant à la famille M1 des zinc-aminopeptidases. Elle est surexprimée à la surface des cellules endothéliales angiogéniques, ainsi que sur un certain nombre de cellules tumorales. Et il existe une corrélation étroite entre l’élévation de l’expression de l’APN, une activité enzymatique accrue et le pouvoir invasif de nombreux types de cellules tumorales. Des inhibiteurs puissants et sélectifs de l’APN, appartenant à la famille des composés de type amino-benzosubérone, ont été synthétisés au laboratoire. Ces composés ont été testés in vitro et in vivo, et il est apparu qu’ils présentaient une affinité variant du nano au picomolaire. En parallèle à ces essais, un nouveau projet a débuté il y a quelques années au laboratoire, visant à déterminer la structure tridimensionnelle de l’APN humaine. La connaissance de cette structure constitue un enjeu majeur car des co-cristallisations avec ces inhibiteurs permettraient de résoudre le mode de liaison de cette nouvelle famille de composés à l’APN. La difficulté de cette étude réside dans le fait que l’APN est une glycoprotéine membranaire particulièrement difficile à purifier à partir de tissus ; de plus, cette protéine étant ancrée dans la membrane de la cellule, sa cristallisation en est d’autant plus complexe. Plusieurs stratégies de clonage et de surexpression de l’APN humaine ont été envisagées, avec pour objectif final, l’obtention d’une protéine cristallisable, glycosylée ou non. / Aminopeptidase-N (APN or CD13) [EC.3.4.11.2] is a highly glycosylated type II membrane-bound ectoenzyme that belongs to the M1 family of zinc-dependent aminopeptidases. The members of this family have a thermolysin-like catalytic domain with the consensus HEXXH-X18-E zinc-binding sequence and an exopeptidase motif, GXMEN, in the active site. APN/CD13 is a widespread enzyme, located in many tissues, organs and cells, whose multiple functions dependent on its location. It is overexpressed on the endothelial cells of angiogenic, but not normal, vasculature, as well as on numerous tumor cells. As it was demonstrated that APN plays a critical role in tumor cell angiogenesis and metastasis, this protein was identified as a potential target for cancer therapy. In this context, highly potent and selective non-peptidic APN inhibitors, with Ki values ranging from micro to nanomolar, were previously designed and synthesized in the laboratory. In vitro and in vivo efficacy of these novel amino-benzosuberone derivatives was tested. In parallel to these works, a new project was started a few years ago which consists to solve the 3D structure of mammalian APN. Co-crystallizations with amino-benzosuberone derivatives would determine the binding mode of these novel inhibitors. Nevertheless solving the structure of a membrane protein like mammalian APN still remains a challenge. Therefore several cloning and expression strategies for human APN production were developed.

Cyclic-additive-difference sets are combinatorial objects defined by Claude Carlet in 2018. It is, in some sense similar to cyclic difference sets, a well-known concept. In this thesis, first we summarize the current knowledge about cyclic-additive-difference sets and their connection to differential cryptanalysis. Then we present our own results. First, we prove the existence of three infinite families of cyclic-additive-difference sets arising from powers of Singer sets which is an open problem asked by Carlet in 2019. Then we generalize the definition of cyclic-additive-difference sets to the fields of odd characteristic and study similar sets in odd characteristic case. 1

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-06-18T12:03:46Z No. of bitstreams: 1 470806 - Texto Parcial.pdf: 594844 bytes, checksum: 13a8320d85aa95f4a242505ee468acba (MD5) / Made available in DSpace on 2015-06-18T12:03:46Z (GMT). No. of bitstreams: 1 470806 - Texto Parcial.pdf: 594844 bytes, checksum: 13a8320d85aa95f4a242505ee468acba (MD5) Previous issue date: 2014-08-29 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: The use of questionnaires for the diagnosis of sleep disorders in children has increased significantly both in the scientific field and in the clinical practice. Objective: To identify the available and validated questionnaires for assessment of sleep in the pediatric population. Methodology: The potential eligible studies published up to June 2014 were identified from a search at Medline, Embase, LILACS, Scielo and Doaj. The search was conducted using a combination of the following terms: (Sleep OR Apnea) AND Questionnaires. Scientific papers that used questionnaires to assess sleep in pediatric population with unrestricted period of publication and language were included. Exclusion criteria were articles that were not related to the pediatric population and also those which did not use sleep assessment questionnaire for this population. Results: Out of the 8,266 articles identified, 8,168 were excluded for two main reasons: not working with the pediatric population or not presenting a questionnaire to assess sleep. Thus, 98 articles were fully analyzed with 105 questionnaires that assessed sleep in pediatric population. From these studies, it was possible to identify 64 different scales that assess sleep disorders in children and adolescents. All of the questionnaires evaluated (n = 105), 70 (67%) were valid. The most commonly cited instruments in the literature were CSHQ (Children's Sleep Habits Questionnaire), PSQ (Pediatric Sleep Questionnaire), SDSC (Sleep Disturbance Scale for Children), PDSS (Pediatric Daytime Sleepiness Scale), SHS (Sleep Habits Survey), MEQ (Morningness-Eveningness Questionnaire), and ISQ (Infant Sleep Questionnaire). These scales were cited in more than 50% of the papers. In the evaluation of the quality criteria of the instruments, the less presented in the studies were the responsiveness and test-retest agreement. Conclusion: There are, in the literature, validated questionnaires for all age groups to assess pediatric sleep which are of easy accessibility and applicability. However, it is still necessary to evaluate the psychometric properties of the instruments, since many scales applied in the clinical practice have no major validation criteria for their usefulness. / Introdu??o: O uso de question?rios para o diagn?stico dos dist?rbios do sono em pediatria tem aumentado expressivamente tanto no meio cient?fico, quanto na pr?tica cl?nica. Objetivo: Identificar os question?rios dispon?veis e validados para avalia??o do sono em popula??o pedi?trica. Metodologia: Os potenciais estudos eleg?veis publicados at? junho de 2014 foram identificados a partir da pesquisa nas bases de dados Medline, Embase, LILACS, Scielo e Doaj. A pesquisa foi realizada utilizando a combina??o dos seguintes termos: (Sleep OR Apnea) AND Questionnaires. Foram inclu?dos artigos cient?ficos que utilizaram question?rios para avaliar o sono na popula??o pedi?trica, sem restri??es de per?odo de publica??o e l?ngua. Os crit?rios de exclus?o foram artigos que n?o trabalhavam com popula??o pedi?trica e tamb?m aqueles que n?o apresentavam question?rios de avalia??o do sono nessa popula??o. Resultados: Do total de 8266 de artigos identificados, 8168 foram exclu?dos por dois principais motivos: n?o trabalhavam com popula??o pedi?trica ou n?o apresentavam um question?rio para avaliar sono. Desta forma, foram avaliados 98 artigos na ?ntegra com 105 question?rios que avaliavam sono em uma popula??o pedi?trica. A partir da an?lise desses estudos, foi poss?vel identificar 64 escalas distintas que avaliam dist?rbios do sono em crian?as e adolescentes. Do total de question?rios avaliados (n=105), 70 (67%) foram validados. Os instrumentos mais citados na literatura foram CSHQ (Children?s Sleep Habits Questionnaire), PSQ (Pediatric Sleep Questionnaire), SDSC (Sleep Disturbance Scale for Children), PDSS (Pediatric Daytime Sleepiness Scale), SHS (Sleep Habits Survey), MEQ (Morning-Eveningness Questionnaire) e ISQ (Infant Sleep Questionnaire). Essas escalas s?o citadas por mais de 50% dos artigos revisados. Na avalia??o dos crit?rios de qualidade dos instrumentos, os menos apresentados nos estudos foram os de responsividade e concord?ncia teste-reteste. Conclus?o: H? na literatura question?rios validados para todas as faixas et?rias para avaliar o sono pedi?trico, de f?cil acessibilidade e aplicabilidade, mas ainda ? necess?rio avaliar as qualidades psicom?tricas dos instrumentos, pois muitas escalas aplicadas na pr?tica cl?nica n?o possuem crit?rios de valida??o importantes para a sua utilidade.

Made available in DSpace on 2015-04-14T13:30:32Z (GMT). No. of bitstreams: 1 458173.pdf: 849988 bytes, checksum: 2aaeecaae9f8e5e1eff48a4c0093b2dd (MD5) Previous issue date: 2014-01-21 / This before - and-after experimental work was carried out to evaluate the influence of a mandibular advancement device for the treatment against sleeping disorders, by comparing the results of the initial and final polysomnography and make an assessment of the improved quality of sleep through the application of polysomnography and sleep quality questionnaire before and after the use of mandibular advancement appliance. Performing correlations between variables of sleep verifying the degree of improvement with the use of mandibular advancement appliance. 19 subjects with a mean age of 39.9 years (SD 12.98) were evaluated before and after the use of mandibular advancement appliance. Was then performed diagnosis by clinical examination, polysomnography and sleep through the SAQ and ESS before using the appliance. After three months, subjects again made polysomnography and answered the SAQ and ESS to assess whether there was an improvement in sleep. To be considered OSAHS, the examination should have an AHI higher than 5 per hour of sleep. The results show there was an improvement in sleep quality, as well as a direct relationship between polysomnography, the ESS- BR and SAQ. Therefore, the mandibular advancement appliance had a positive effect on sleep and did not cause significant side effects in the stomatognathic system in a period of three months / Foi realizado um trabalho do tipo an?lise de banco de dados com objetivo de avaliar a influ?ncia do aparelho de avan?o mandibular no tratamento contra os dist?rbios do sono, atrav?s da compara??o dos resultados da polissonografia inicial e final e fazer uma avalia??o da melhora na qualidade do sono atrav?s da aplica??o da polissonografia e de question?rio de avalia??o de sono (SAQ?) antes e depois da utiliza??o da placa de avan?o mandibular. Realizando correla??es entre vari?veis de sono e verificando o grau de melhora com a utiliza??o de placas de avan?o mandibular. Foram avaliados 19 indiv?duos com idade m?dia de 39,9 anos (DP 12,98) antes e depois do uso da placa de avan?o mandibular. Foi, ent?o, realizado diagn?stico atrav?s do exame cl?nico, da polissonografia e do sono atrav?s do SAQ? e ESS antes do uso da placa. Ap?s tr?s meses, os indiv?duos novamente, fizeram polissonografia e responderam SAQ? e ESSE-BR para avaliar se houve melhora no Sono. Para ser considerado SAHOS, o exame devia apresentar IAH maior que 5 por hora de sono. Observou-se uma melhora na qualidade de sono, al?m de uma rela??o direta entre a polissonografia, o ESE-BR e o SAQ?. Portanto, a placa de avan?o mandibular teve um efeito positivo no sono e n?o provocou efeitos colaterais significantes no sistema estomatogn?tico num per?odo de tr?s meses